Children who are very young or who have a high level of anxiety that interferes with the cooperation necessary for the dentist to perform treatment may require some level of sedation. Sedation is also helpful for special needs children. There are many safe and effective drugs available today that can help relax the child and promote a good environment for optimal and safe dental treatment.
Conscious sedation is an option for children who are older (two years and above) and are mildly apprehensive. This highly effective method can be administered as an oral form or in an inhalation method using nitrous oxide (N20-02) (Laughing gas).
General anesthesia is sometimes necessary for children that are unable, by either age or maturity level, to cooperate during dental treatment. Our practice utilizes a certified anesthesiologist for cases where the patient may pose a threat to their own safety during treatment. This will be discussed with the parent(s)/guardian(s) of the patient before treatment to ensure the optimum beneficial outcome.
We do not use any form of physical restraint unless needed under urgent situations (extractions, or injuries sustained secondary to facial trauma). Our main goal is to always keep our patients comfortable in order to reinforce a positive experience.
Sedation dentistry is most helpful for:
- Children who require major treatment.
- A very anxious child.
- Children that have had traumatic dental experiences (sound and smell aversion).
- Children with a strong gag reflex.
- Children who are medically compromised or have special needs.
Nitrous Oxide (laughing gas)
It is important that children remain calm and still during dental treatment to prevent injury to the child and dental staff and to receive a high quality of professional dental care. For children who are afraid, uncooperative, or too young to understand dental treatment, nitrous oxide/oxygen for analgesia may be very beneficial in the helping the child relax.
The following information will help parents understand sedation with the use of a combination of nitrous oxide and oxygen gases for safe analgesia.
- It is very safe because the child remains awake, responsive, and breathes on his/her own without assistance.
- Much more oxygen is given than what we breathe in normal room air. This provides a wide margin for safety.
- Nitrous oxide/oxygen is usually breathed through a small mask placed over the nose.
- Dental treatment is more comfortable and time seems to pass faster for a relaxed child.
- It is sometimes known as “laughing gas” because some patients become so comfortable and relaxed they laugh.
- Often the pediatric dentist will request that no food or drink be given to the child before treatment.
- A local anesthetic is usually still given to numb the areas that are to be treated so that there is very little discomfort.
- Oxygen is usually given at the end of treatment to remove the effects of nitrous oxide gas and end the treatment.
- The child is awake and sometimes remains relaxed after dental treatment but will continue to feel the numbness in the treated area. Once the nitrous oxide is turned off, it only takes seconds for the gas to completely leave the body.
Please feel comfortable in discussing with us any other questions you may have about the procedures.
The patient, who may be anxious, fearful, or not able to cooperate for necessary dental treatment, may need some help to relax. At times, Nitrous Oxide sedation may not be sufficient to offset the level of anxiety of the patient, as sedation with oral medication is an alternative to help a child to be more relaxed.
The following information will help parents to understand sedation with oral medication:
- Sedative medications usually are either tablets or liquid and are taken orally.
- The sedative may be a single medication or a combination of two or more medications.
- The sedative medication is usually given before treatment begins, as directed. There is usually a waiting period before the dental treatment starts. (approximately 45 min)
- The pulse and breathing of the child are monitored and recorded regularly.
- The oral medication usually causes drowsiness which may last for several hours.
- Often Nitrous oxide/oxygen is used in conjunction with oral sedatives.
- Often the pediatric dentist will request that no food or drink be given the child before treatment.
Please feel comfortable in discussing with us any other questions you may have about oral sedation.
The patient, who may be anxious, fearful, or not able to cooperate for necessary dental treatment, may require treatment under general anesthesia. When nitrous oxide or conscious oral sedation are not adequate to place the child in a comfortable state for the completion of dental work, general anesthesia can be utilized safely in order to prevent any psychological or emotional trauma to the young pediatric patient. Depending on the age of the patient, and the level of anxiety they feel in a dental office setting, the dentist may recommend using this form of sedation.
The following information will help parents to understand General Anesthesia:
- It is very safe as a qualified dental anesthesiologist sedates your child during the dental procedure.
- All dental work is completed during this single visit
- If radiographs (X-rays) were not obtained at the initial exam due to fear or uncooperative behavior, they will be obtained while your child is sleeping, possibly revealing new cavities which will be restored at the immediate time as well.
- As a side effect of the medications the anesthesiologist uses, the pediatric patient will have little to no memory of the dental work completed, preventing psychological and emotional trauma which may last for years.
- Unlike nitrous oxide or conscious oral sedation where the dentist both monitors the patient’s vital signs and completes the dental work, during general anesthesia those jobs are now divided by two doctors. The anesthesiologist’s sole job is to monitor the vital signs of the patient, whereas the dentist can focus entirely on the dental work which needs to be completed.
All questions should be answered prior to the surgery, and we encourage parents to call the office if new questions arise as well.