The special needs population is very diverse.  The reasons for sedation and anesthesia are just as varied.  How they are pre-medicated (to get into the dental chair and have an intravenous started), induced (put to sleep), maintained (stay asleep) and emerge (wake up) depends on their needs and dental treatment requirements. 

The special needs patient can be very challenging to treat in the general dental office environment.  How we treat this patient population depends on their physical (wheelchair bound, contractures, uncontrolled movements, etc.) and mental ability to cope with entering the dental office or treatment room, and allowing an intravenous to be started. 

Many special needs patients are pre-medicated to facilitate their arrival for treatment.  Pre-medication usually consists of taking a pill form of an antianxiety medication prior to treatment.  The uncooperative or violent special needs patient may also receive an injection in the shoulder or a mask to help with intravenous access.

Up to sixty percent of adults who are treated are 'mentally normal' adults who require sedation or anesthesia for a variety of reasons. They either do no freeze (get numb), are gaggers, do not like someone working in their mouth, needle phobic or anxious. Some prefer to have a large amount of dental treatment completed in one appointment.

Difficulty getting Numb
Some people perceive pain differently than others or at a much lower stimulus.  Sometimes obtaining adequate tooth numbness to perform painless treatment is impossible.  With general anesthesia and sedation this experience can be eliminated.

Extensive Treatment
For procedures such as implant dentistry or full mouth rehabilitation, and extended procedures such as periodontal surgery, root canal therapy and surgery, anesthesia services provide increased patient comfort.

Many busy adults may also benefit greatly from the use of anesthetics because it saves them from having to go to the dentist several times.  With the use of anesthetics, most dental work can be done in one visit. 

Gagging Difficulty
Some fear of dental procedures stems from one’s hyperactive gag reflex when objects are placed within the mouth.  Also, fear of choking on or swallowing dental instruments and material evoke a severe gag reflex.  Anesthesia will eliminate this reflex and fear of this happening. 

Children are not born with fear of the dentist.  A ‘learning process’ has to take place to create this negative emotion.  Psychologists tell us that a traumatic experience during childhood may affect the way we feel and behave later in life.  Nowhere is this truer than with visits to the dentist.  The mouth is a very personal area and highly innervated.  Many fearful children have had painful dental experiences.  These experiences often lead them to have dental anxiety and to avoid the dentist.  Many of these children will carry these fears well into their adult lives. 

We also know that parents who have had a traumatic experience at the dentist may, knowingly or unknowingly, transmit their anxiety to their children.