Most oral surgical interventions can be successfully performed under local anesthesia. However, in cases of extreme fear and a very low pain threshold, sedation may be applied.

Sedation is the procedure of administering one or more drugs to achieve a certain degree of central nervous system depression during which verbal contact with the patient is possible because consciousness is preserved, along with their defensive reflexes.


The primary goals of sedation are to:

  1. Change the patient’s attitude towards the upcoming intervention
  2. Ensure preserved consciousness, allowing patient cooperation
  3. Raise the threshold for pain response
  4. Preserve defensive reflexes
  5. Avoid impact on vital functions
  6. Achieve anterograde amnesia

For pharmacosedation, benzodiazepines are most commonly used, as they only affect the elimination of fear and tension. Therefore, local anesthesia must be applied during the intervention.

Patient cooperation with the dentist is easily established because consciousness is preserved, and the pain threshold is raised. Considering the elimination of fear, the vital signs of the cardiovascular and respiratory systems not only remain unchanged but can also partially normalize previous disturbances. Benzodiazepines induce a certain degree of anterograde amnesia, meaning amnesia for events after the drug is administered. The degree of amnesia depends on the dose of the drug received.

The benefits of sedation for the patient lie in the reduction or complete elimination of uncontrolled fear. Reducing stress is particularly important for patients with conditions where cardiovascular system parameters are disrupted, as stress would further exacerbate these parameters.

The benefits of sedation for the dentist include the ability to establish cooperation with the patient during the dental intervention, making the work easier, with some muscle relaxation and the absence of undesirable reflexes (gagging and vomiting).


Indications for the use of sedation are:

  • Enabling the performance of dental intervention in extremely nervous and fearful patients
  • Pronounced gag and vomiting reflex
  • When a long and unpleasant intervention is expected


Contraindications for the use of sedation are:

  • Allergy to the drugs used for sedation
  • Patients with psychiatric disorders, liver, and kidney diseases
  • Pregnant women
  • Patients with severe deformities in the oropharyngeal area, where potential endotracheal intubation would be unfeasible
  • When the patient arrives without an escort

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Most oral surgical interventions can be successfully performed under local anesthesia. However, in cases of extreme fear and a very low pain threshold, sedation may be applied.

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