Pain and anxiety in the dental setting prevent many patients from seeking needed treatment. As a result, various techniques of anesthesia or sedation have been developed over the last 150 years to overcome this problem. Both the historic evolution of sedation and the use of several currently popular techniques are described in this article. Also discussed is the balance between individual patient responses to drugs, dosages, and rate of administration. Currently used definitions of pharmacologic depression of consciousness are detailed, as are contemporaneous training requirements. Finally, unexpected, rare, and catastrophic events that can occur with sedation are briefly discussed.