881 Bay Street, Plaza Suite

Toronto, ON M5S 3K6

Monday – Friday: 9:30 AM – 7:00 PM

Please note that we are open on alternating Fridays. Call ahead to book an appointment and confirm our hours.

How Our Office Helps You Deal With Dental Anxiety

Our goal is to provide you dental care without pain, fear or anxiety. If you are very apprehensive or have any fear of dental procedures, we can alleviate your fears and anxiety by using nitrous oxide sedation (laughing gas) alone or with moderate conscious sedation (nitrous and an oral sedative like Ativan/Lorazepam). Nitrous or moderate conscious sedation can be used to reduce or virtually eliminate anxiety towards dental procedures from fillings and cleanings to extractions and placement of dental implants.

Is Nitrous or Moderate Conscious Sedation for Me?

These therapies are especially suited to those who experience:

Fear and Anxiety

Experience moderate to severe anxiety in anticipation of pain or discomfort (may be the result of a traumatic dental experience in childhood).

Very Sensitive Teeth or Low Threshold for Pain

Some patients experience the inability to get numb. With general moderate sedation, the perception of pain will be altered and the patient will be virtually pain-free during the treatment.

Have Difficulty with Local Anaethetics

Have had difficulty in the past with local anaesthetics “not working” for them (medium to extreme anxiety can sometimes heighten sensitivity).

TMJ Problems

Find it difficult or uncomfortable to keep their mouth open for prolonged periods of time (usually caused by TMJ problems or other medical conditions).

Gag Reflex

For some patients, even simple procedures like taking an x-ray film or dental impression can cause gagging. Anaesthesia services can eliminate the problems caused by gagging.

Frequently Asked Questions about Nitrous Oxide (Laughing Gas)

What are the Advantages of Nitrous Oxide Sedation?

• Nitrous oxide works well for mild to moderate anxiety

• It has rapid onset

• Very few side effects

• Flexible duration can be used for any appointment length

• Patients recover quickly. There’s no “hangover” effect – the gas is eliminated from the body within 3 to 5 minutes after the gas supply is stopped. You can safely drive home and return to normal activities immediately and don’t require an escort

What are the Disadvantages of Nitrous Oxide Sedation?

• Severe anxiety may require a deeper level of sedation (like moderate conscious sedation)

• Not indicated for people who have respiratory problems (Asthma and Emphysema)

• Claustrophobic patients that do not like anything covering their nose may not be candidates

Frequently asked Questions about Moderate Conscious Sedation

What is Moderate Conscious Sedation and How Does it Work?

Will I Be Totally Relaxed?

How Safe is Moderate Sedation, Are There Any Side Effects?

Is it Covered Under My Dental Plan?

Will I Have to Miss Work Afterwards?

How Long Will the Effects of Moderate Conscious Last?

What Should I do in Advance of Moderate Sedation?

What is Moderate Conscious Sedation and How Does it Work?

Moderate conscious sedation is a very safe, effective and predictable sedative modality. It combines the use of a sedative agent like a benzodiazepine (Ativan) in combination with an inhalation gas (Nitrous Oxide and Oxygen).

When you arrive at the office for your appointment, you will be given an oral sedative like Ativan (Lorazepam) to take prior to your procedure. This will make you feel relaxed and a bit drowsy. In addition, you will be receiving Nitrous Oxide mixed with Oxygen to provide a further sedative effect. You will be connected to a monitor in order to observe your vital signs throughout the procedure. Although you won’t feel any pain, you will be able to respond to your dentist’s questions and instructions.

Dr. Tuvel has advanced training in the delivery of moderate conscious sedation. He has received his training and accreditation with Dr. Nkansah of the University of Western Ontario. In our office, patients are continually monitored for blood pressure, pulse rate and oxygen levels during treatment under moderate conscious sedation.

Will I Be Totally Relaxed?

Yes. You will receive just enough sedation so that you will be relaxed and unconcerned about the dental treatment.

How Safe is Moderate Sedation, Are There Any Side Effects?

Any medications may involve a certain amount of risk. The drugs used in moderate sedation rarely cause side effects. We will thoroughly review your medical history prior to proceeding with treatment and if necessary, consult with your medical doctor. You will be constantly monitored while under sedation. Dr. Tuvel is committed to ensuring your safety. The training and continuing education to qualify for the delivery of this modality is extensive, and to maintain this authorization requires specialized courses and equipment.

Is it Covered Under My Dental Plan?

It’s best to check with your dental plan provider. At our office, we will prepare a predetermination prior to your appointment. We will review your coverage and if necessary, make financial arrangements so that you can get the care you require. We have an insurance specialist in our office that will be glad to answer any of your questions and assist you in interpreting your plan.

Will I Have to Miss Work Afterwards?

Each patient reacts differently, so this can be a difficult question to answer. However, we find that patients need only take the same day off after moderate conscious sedation. Most are able to return to work or their normal routine the following day.

How Long Will the Effects of Moderate Conscious Last?

The length of your appointment will depend upon the procedure being done. There will also be a recovery period of 10-15 minutes after the procedure is finished. Due to the drowsiness, arrangements must be made for a responsible adult to drive you home after receiving the sedation. You must not drive or operate any machinery until the day after your appointment.

What Should I do in Advance of Moderate Sedation?

If you have been scheduled for a dental procedure using moderate conscious sedation, please follow these instructions:

• 24 hours before surgery: No alcoholic beverages.

• 8 hours before surgery: DO NOT have anything to eat or drink.

• Make sure you are not pregnant before undergoing sedation.

• No nursing a baby for 24 hours after the appointment.

• No walking stairs, exercising, or heavy lifting for 24 hours after the appointment.

• Continue to take only prescribed medication unless previously instructed otherwise by your dentist

• No driving a car or operating hazardous devices for 24 hours after the appointment. Bring a responsible person with you to drive or escort you home after the procedure. They can run errands while waiting, such as picking up your prescription, and return in time to pick you up. No eating or drinking after midnight the night before your appointment.


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Dentistry On Bay

881 Bay Street

Toronto, ON M5S 3K6


Monday – Friday: 9:30 AM – 7:00 PM

Please note that we are open on alternating Fridays. Call ahead to book an appointment and confirm our hours.

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