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Sedation in the Dental Office: An Overview

Course Number: 464

History

The contributions of dentistry to the management of pain and anxiety have been well-documented.19,20 In 1844, Dr. Horace Wells, a dentist from New England, in public demonstration to the staff of the Massachusetts General Hospital, used nitrous oxide to sedate a patient undergoing tooth extraction. The demonstration was deemed a disaster when the patient cried or moaned during the procedure. Two years later, in 1846, Dr. William T.G. Morton, on the same stage, successfully demonstrated the use of ether during tooth extraction.

Dr. Wells and Dr. Norton are considered the fathers of anesthesia (although official recognition is given to Dr. Wells) for the introduction of nitrous oxide and for the successful use of ether, respectively.21 It is of note, that twenty years after Dr. Wells’ ill-fated demonstration, the use of 100% nitrous oxide was popularized by Dr. William T.G Morton in 1863.22 The current practice of using a mixture of nitrous oxide and oxygen was introduced by Andrews in 1869.22

Over the past decades, the efforts and contributions of many great practitioners led to the modern practice of intravenous sedation in ambulatory settings. The technique of administering multiple drugs to induce sedation by titration was introduced be Niels Bjorn Jorgensen (1945) who is recognized as the father of intravenous sedation in dentistry. This technique deservedly bears his name as the Jorgensen technique.22