Your Options If You Cannot Face the Chair

If the thought of the dentist is what keeps you out of the chair, sedation is an ordinary part of dental care rather than a last resort. Most general practices offer at least one form of it, and the differences come down to how deep the effect goes, who is allowed to give it, and what you can do for the rest of the day afterwards.

Here is what each level actually feels like, who tends to suit it, and roughly what it adds to the cost. Every figure below varies by city, by practice and by how long your appointment runs, so treat them as a starting point for a conversation rather than a price.

Sedation is a range, from mildly relaxed to barely aware

Dental sedation is usually described in levels. Minimal sedation leaves you awake and able to answer questions, just far less bothered by what is happening. Moderate sedation leaves you drowsy, slightly slurred and remembering very little. Deep sedation and general anesthesia go further again, and in most of the country those are done in a hospital or a specialist surgical office rather than a family practice.

Which level you are offered is not decided by how nervous you feel alone. It also depends on your medical history, the medicines you already take, how long the treatment will take, and what training and licensing the practice holds. A dentist who cannot provide the level you need should be able to refer you to somebody who can.

Nitrous oxide has usually worn off before you reach the parking lot

Nitrous oxide, often called laughing gas, is breathed through a small nose piece mixed with oxygen. It takes effect within a few minutes and the dentist can turn it up or down while you are in the chair. Most people describe a warm, light, slightly floaty feeling and a sense that the appointment went faster than it should have. You stay awake and you can talk.

The reason it is so widely used is the recovery. Once the gas is switched off and you breathe pure oxygen for a few minutes, the effect clears, and most people are cleared to drive themselves home. It suits ordinary anxiety, a strong gag reflex, and children who need a filling done calmly.

• You stay conscious and can respond throughout
• The level can be adjusted during the appointment
• It clears within minutes, so a driver is usually not needed
• It does little for severe phobia on its own

Oral sedation means a tablet, a driver and most of your day

Oral sedation is a tablet taken an hour or so before the appointment, sometimes with another the night before to help you sleep. You remain conscious and can respond, but you are drowsy, and many people afterwards remember only fragments of the visit. For a lot of anxious patients that gap in the memory is exactly the point.

The trade offs are practical rather than medical. The dose cannot be adjusted once it has been swallowed, it takes time to build, and it can linger into the evening. You will need somebody to bring you and take you home, and you should not drive, work or sign anything that matters for the rest of the day.

IV sedation is deeper, and not every dentist is licensed to give it

With intravenous sedation the medicine goes into a vein in your arm or hand, so it works within minutes and can be adjusted as the appointment goes on. Most people are barely aware of the treatment and remember almost none of it, while still breathing on their own and responding if they are spoken to.

This is the usual route for long surgical appointments, several extractions in one sitting, implant placement, or dental phobia that has kept somebody away for years. Sedation permits are issued state by state, and a practice offering it has to be trained and equipped for monitoring. It is entirely reasonable to ask who administers it, what qualification they hold, and who is watching the monitors while the dentist works.

Sedation is billed on top of the treatment, usually by the clock

Sedation appears as its own line on the estimate. Nitrous oxide commonly runs from around 50 to 150 dollars for an appointment. Oral sedation often falls between 150 and 500 dollars. IV sedation is normally billed in fifteen minute blocks and often works out somewhere between 400 and 1,000 dollars an hour, with the first block priced higher than the ones after it.

Those ranges shift a great deal by city, by practice and by how complicated your case is, so ask for a written estimate that shows sedation separately from the dental work. Dental plans often cover sedation only where it is medically necessary, for example with surgical extractions or for a patient with a disability or a medical condition, and rarely cover it for anxiety alone. Medical insurance sometimes covers what dental will not, which is worth asking about before you assume the answer.

• Nitrous oxide: roughly 50 to 150 dollars per appointment
• Oral sedation: roughly 150 to 500 dollars, plus arranging a driver
• IV sedation: often 400 to 1,000 dollars an hour, billed in blocks
• All of these vary widely by city and by case, so get the estimate in writing

Saying out loud that you are frightened changes the appointment

You do not have to earn sedation by having a complicated case. Telling a practice before you book that you struggle with dental treatment lets them book longer, agree a stop signal with you, start with something small, and tell you honestly which options they are licensed for. Some offices will see you for a visit where nothing happens except talking, and that is a normal request to make.

If your current dentist cannot offer what you need, it is worth looking for one who can. Our directory searches every dental practice in the United States by town or ZIP code and shows the closest first, free and without an account, so you can call a few and ask what sedation they provide before committing to anything.

• Which types of sedation do you offer in this office?
• Who administers it, and who monitors me during treatment?
• Will I need somebody to drive me home?
• How is the sedation billed, and will you check my coverage first?

Frequently asked

This is general information to help you ask better questions, not a diagnosis. Anything happening in your own mouth needs a dentist who can look at it.