Benzodiazepines come in two flavours:

  1. Sedative-Hypnotics: drugs which induce a calming effect, including drowsiness ("sedation"). In higher doses, they induce a state resembling physiological sleep ("hypnosis").

  2. Anti-Anxiety Drugs: drugs which act primarily to relieve anxiety and make you feel calm.
While all benzodiazepines act as sedatives AND anti-anxiety drugs, some are more targeted at brain areas which control sleep and wakefulness, while others are more specifically targeted at brain areas which control emotions such as fear. The classification of whether a benzodiazepine is sedative-hypnotic or anti-anxiety is to some extent an arbitrary one, as the boundaries are quite fluid. As a rule of thumb, in higher doses benzos act like sedatives and may promote sleep, while in lower doses, they simply reduce anxiety without sedation. Benzodiazepines are Central Nervous System (CNS) depressants (for example, there can be a decline in blood pressure and breathing - which is good, because if your heart isn't racing, you'll feel calmer). They should NOT be mixed with other CNS depressants such as alcohol. Don't self-medicate and stick to the dose your dentist or doctor recommends (which may be a higher dose than specified on the drug package insert. Reason being that the package inserts recommend a dose to induce sedation or sleep in a nonstress situation such as the home environment). It is possible to overdose on these things, and overdoses could lower your breathing to dangerously low levels, which could result in coma or even death.

In case this sounds scary - unless you make a deliberate attempt to overdose, it's extremely unlikely for any dangerous symptoms to develop. The reason why benzos are so widely used is precisely because they're safe. People for whom benzos have worked well describe them as "working wonders", as having a calming and relaxing effect, or as making you feel "out of it". Giddiness, confusion and saying silly things are also common. Benzos may make you forget large parts of what happened while you were under their influence, which can be handy if you don't want to remember very much! However, this effect is not reliable.

Instructions before your Appointment

Out-in-the-sticks tip:

For the management of mild to moderate anxiety before the appointment, take 15 mg medazolam (for most average sized people) 30 minutes to 45 minutes before treatment. Advantage: relatively rapid onset, decent sedation time, and relatively rapid recovery.

To induce sleep the night before the appointment, medazolam 7.5 mg 1 hour before bed- for a good night’s rest.

Travel warning!

You shouldn't travel on your own after you've taken any of those pills - make sure you have an escort, even if you're walking there! It's easy to become disorientated and miss your stop if going by bus or train, or walk straight in front of a car - or you might even forget that you're on your way to your dentist's ("hey cool" I hear you say!!)... So find someone to accompany you. And please don't pop pills and drive!

When not to take benzodiazepines:

This varies from drug to drug. For example, some benzos are safe to take if you have liver problems, while others are not, and some are safe to take if you have heart problems, while others are not. You should be sure to inform your doctor or dentist if any of the following apply: known allergy to the drug, narrow-angle glaucoma, pregnancy, severe respiratory disease (COPD), congestive heart failure (CHF), impaired kidney or liver function, depression/bipolar disorder/psychoses, chronic bronchitis and some other conditions. Also if you're taking other medications be sure to mention this.