Fear of the dentist has a long history and originally, way back, there was some physical cause for it. But dentistry has come a long way, and we're fortunate to live in a time when dentists can and do address this fear. Perhaps you feel afraid of needles, maybe you have an extra-sensitive gag reflex, maybe just lying back in the dentist chair already instills anxiety in you. Maybe even just the idea of sitting in a dental chair brings on the fear. The fear can be on the level of anxiety, or it can be so severe as to be a phobia. A phobia would put you into a state of panic or terror, prevent you from sleeping the night before your appointment, (or several nights), and perhaps cause vomiting.

Sedation dentistry and sleep dentistry are often used interchangeably, but there is a difference:
In sedation dentistry (also called conscious sedation dentistry), you're in a drowsy, relaxed state, and conscious of where you are and what's happening
In sleep dentistry, you're asleep and not aware of what's happening

Ways of Administering Sedatives
Before beginning on any dental work, your dentist will discuss the options with you and listen to your concerns. There are several ways the relaxing medication can be administered, and your dentist will explain the pros and cons of each method:
Orally - about an hour before your appointment time. You will have already seen your dentist, been given the prescription, and had it filled.
o Have someone drive you to the dentist's office, and home again afterwards, because this medication will last for about 6 hours. By the time you arrive, you'll be feeling drowsy and quite free of anxiety. The dentist will use a local anesthetic to eliminate pain.
Inhalation - a mask is placed over your face while the dentist works, and you breathe in the gas, usually nitrous oxide (laughing gas), which relaxes you. A local anesthetic is also used.
Intravenously - this is done after you arrive at the dentist's office. It's less frequently done, but is completely safe and in fact the drug is more effective when given this way, as opposed to orally
With this option, you'll also be monitored for blood pressure, heart rate, and breathing. This keeps you safe. A local anesthetic will be used to block pain.
Intra-muscular - the medication is injected into muscle of the upper arm or thigh. This is less commonly used for adults, but is frequent in pediatric dentistry. Again, a local anesthetic is also used.
o You'll feel drowsy and calm.

Whichever way the sedating medication is administered, the dentist's chair will feel comfortable and you'll feel calm and safe in the reclining position. You'll be so relaxed that your cosmetic dentist can perform several dental procedures in one visit, thus reducing the number of visits required to complete all the work.

Sleep Dentistry
This is a term for dentistry done while you're under general anesthesia. It's not often done, as the sedation options take care of most people's anxiety. When it's done, a trained and certified professional will monitor you while the dentist works on your teeth. To do this type of dentistry, the dentist must have completed at least 2 years of specialized training and be certified by a dental board

Four Levels of Sedation
The above methods of eliminating anxiety provide a choice of 4 levels of unconsciousness:
Anxiolysis - this is the lightest sedation. Nitrous Oxide is the most popular way of inducing this state. Conscious sedation - this is a moderate level, created either by Nitrous Oxide or IV sedation, where you're awake and able to respond to requests from the dentist or his nurse.
Deep sedation - in this level you're halfway between consciousness and unconsciousness, and may or may not be able to respond to requests. At this level, you're being monitored, as described under intravenously above.
General anesthesia - this is total unconsciousness, where you'll be given breathing assistance and closely monitored.

Who is a Candidate for Sedation Dentistry?
Anyone could be a candidate for it, if they find that their fear is preventing them from obtaining dental care. Besides fear, there are some other scenarios that call for sedation dentistry:
For young children, who have trouble sitting still for very long.
For someone who has trouble controlling their movements, such as with cerebral palsy or Parkinson's disease.

So there's no need any more to allow fear or anxiety to deteriorate our teeth. We can now choose to have sedation dentistry, or even outright sleep dentistry. We can call a sedation dentist to schedule all the appointments we need, and can finally have all the dental work done that we've been postponing.