Sedation Dentistry in Helena MT

Sedation Dentistry

Many people have fear and anxiety when it comes to dental treatment.  Perhaps it’s the sound of the drill, or the inability to get completely numb despite the dentists best efforts.  Other people have a bad gag reflex that prevents them from having instruments in their mouth.  These barriers can be overcome through the use of sedation dentistry.

What is Sedation dentistry?

Sedation dentistry is a subdiscipline of dental medicine focusing on relaxing patients during dental procedures through the use of sedative medications.  These medications are primarily taken orally (by mouth) or administered intravenously (IV.)  Dr. Mitchell has been using sedation dentistry to help his patients overcome their dental fears since 2009.

Are there different levels of sedation?

Yes, there are four levels of sedation.

  1. Minimal Sedation– You remain awake and responsive in a relaxed state, you often remember all of what happens during a procedure.
    1. Medications used: Nitrous Oxide (laughing gas) or low levels of oral sedatives like valium and halcion.
  2. Moderate Sedation– You are in a “semi sleep state”, you respond to verbal commands but you often remember little to none of the procedure as amnesia is a common side effect of these medications. You will also experience a diminished awareness of pain, sounds and smells. Typical recovery can take hours.
    1. Medications used: IV sedation medications like versed and fentanyl
  3. Deep Sedation– You are often not awake and do not respond to verbal commands, you may need assistance to breath, and you lose some of your protective reflexes. Recovery can take longer due to the additional amounts and types of medications.
    1. Medications used: those associated with moderate sedation along with additional medications such as ketamine and propofol
  4. General Anesthesia– You are in a medically induced coma and have lost your protective reflexes, you often need to have a machine breathe for you, this is almost always done in a hospital setting and recovery can take days.
    1. Medications used: There is a wide variety used including barbituates and inhalation anesthetics eg. Desflurane


What types of Sedation Dentistry does Dr. Mitchell offer?

Nitrous Oxide (laughing gas): Minimal sedation can be achieved by the used of nitrous oxide combined with oxygen delivered through a mask that sits over your nose.  Your response can be minimal to no perceived affect to comfortable relaxation.

Oral: You can take an oral sedative about an hour prior to your dental appointment and depending on the amount taken a minimal to moderate sedation level can occur.  It can be difficult to achieve moderate sedation due to the slow absorption of these medications through your gastrointestinal system.  These medications can take over an hour to reach their peak effectiveness and thus are difficult to customize to individuals.

Intravenous (IV): Moderate sedation is achieved after an IV is started in your arm and medication is delivered directly into your bloodstream.  These medications reach peak effectiveness almost immediately and the amount given can be customized to individual patients, getting you more comfortable faster.

Combination of IV and Oral Sedation: You take an oral sedative about an hour prior to your appointment.  When you arrive you are minimally sedated and relaxed.  The IV is then started and moderate sedation is achieved more comfortably.  The combination of these two modalities benefits the extremely nervous patient as well as longer appointments as oral sedatives stay in your system longer.


Not all dentists can perform sedation dentistry.  Most can administer minimal sedation with nitrous oxide, but additional training is required to perform the higher levels of sedation.

According to a leading sedation dental organization 18-25 hours of education are required to provide oral moderate sedation.

Dr. Mitchell received almost 90 hours of hands on training in his residency and has completed over 150 hours of didactic training.  Dr. Mitchell has safely and effectively sedated hundreds of patients since 2009 and is a member of the American Dental Society of Dental Anesthesiology.