Nitrous Oxide | Conscious Sedation | IV Sedation | Outpatient General Anesthesia |
Options for your child’s treatment
Pediatric dentists exists for a reason, they are specialty trained to examine and treat your child. Working with the behavior of young, immature and/or sometimes frightened children as well as those who may be physically or mentally challenged is an area that is unique to pediatric dentistry and requires an understanding of child psychology, pharmacology and child development mixed with patience, love and discipline.
In our office, we look at every possible way we can best help your child before we make a plan. We do not sedate every child who needs work done on their teeth. If we feel sedation is the best option, we try to use the most minimal approach possible. Our goal is to treat the child in the safest, least invasive manner possible. Our doctors understand that the use of any medication always carries with it some risk, and should not be taken lightly. We make every attempt to use our best judgment in determining which children need some form of sedation and which do not.
Our decisions on how to treat a child are dictated by what is in the best interest of the child, NOT what is most convenient for the doctors or the parents/guardians. Please keep this in mind as you visit our office.
Our goal is to facilitate a pleasant experience that does not cause your child a lifetime of fearing the dentist. We want to make the dental experience easy for them first, and then as easy for you and us possible.
Pediatric dentists are trained in many methods to help children feel comfortable with dental treatment. For example, in the “Tell-Show-Do” technique, a pediatric dentist might name a dental instrument, demonstrate the instrument by using it to count your child’s fingers, and then use the instrument in treatment. The modeling technique pairs a timid child in dental treatment with a cooperative child of similar age. Coaching, distraction, and good old TLC are other possibilities to give your child confidence in dentistry. But by far the most preferred technique is praise. Every child does something right during a dental visit, and pediatric dentists let children know that.
Occasionally a child’s behavior during treatment does requires assertive management to protect him or her from possible injury. Voice control (speaking calmly but firmly) usually takes care of it. Some children need gentle restraint of the arms or legs as well. Usually this simply involves a parent or assistant helping the child remain calm.
Despite our best efforts, there are times when a child may need extra help relaxing for dental treatment. We try our best to use minimal if any sedative, but sometimes there is just no other choice. In these situations we have several options open to us.
Nitrous Oxide
We routinely offer Nitrous Oxide for any patient that we need to numb. Occasionally a patient is nervous or has a severe gag reflex that makes cleanings and/or x-rays difficult. In these situations, we are also happy to provide this option.
Some children are given nitrous oxide/oxygen, or what you may know as “laughing gas,” to relax them for their dental treatment. Nitrous oxide/oxygen is a blend of two gases, oxygen and nitrous oxide. Nitrous oxide/oxygen is given through a small breathing mask which is placed over the child’s nose, allowing them to relax, but without putting them to sleep.
The American Academy of Pediatric Dentistry, recognizes this technique as a very safe, effective technique to use for treating children’s dental needs. The gas is mild, easily taken, Then with normal breathing, it is quickly eliminated from the body. It is non-addictive. While inhaling nitrous oxide/oxygen, your child remains fully conscious and keeps all natural reflexes.
Prior to your appointment:
Please inform us of any change to your child’s health and/or medical condition.
Tell us about any respiratory condition that makes breathing through the nose difficult for your child. It may limit the effectiveness of the nitrous oxide/oxygen.
Let us know if your child is taking any medication on the day of the appointment. This includes prescribed, over-the-counter, or herbal medications.
Conscious Sedation
Conscious Sedation is recommended for apprehensive children, very young children, and children with special needs. It is used to calm your child and to reduce the anxiety or discomfort associated with dental treatments. Your child may be quite drowsy, and may even fall asleep, but they will not become unconscious, and our intention is not to “knock them out.” Our intention is to relax them enough for us to be able to perform the procedure needed.
There are a variety of different medications, which can be used for conscious sedation. The doctor will prescribe the medication best suited for your child’s overall health and dental treatment recommendations. We will be happy to answer any questions you might have concerning the specific drugs we plan to give to your child.
Prior to your appointment:
Please notify us of any change in your child’s health and/or medical condition. Do not bring your child for treatment with a fever, ear infection or cold. Should your child become ill, contact us to see if it is necessary to postpone the appointment.
You must tell the doctor of any drugs that your child is currently taking (prescribed, over-the-counter, or herbal medications) and any drug reactions and/or change in medical history.
Please dress your child in loose fitting, comfortable clothing.
Please make sure that your child goes to the bathroom immediately prior to arriving at the office.
Your child should not have anything to eat or drink after midnight the night before the procedure.
The child’s parent or legal guardian must remain at the office during the complete procedure.
Please watch your child closely while the medication is taking effect. Hold them in your lap or keep close to you. Do not let them “run around.”
Your child will act drowsy and may become slightly excited at first.
After the sedation appointment:
Your child will be drowsy and will need to be monitored very closely. Keep your child away from areas of potential harm.
If your child wants to sleep, place them on their side with their chin up. Wake your child every hour and encourage them to have something to drink in order to prevent dehydration. At first it is best to give your child sips of clear liquids to prevent nausea. The first meal should be light and easily digestible.
If your child vomits, help them bend over and turn their head to the side to insure that they do not inhale the vomit.
Because we use local anesthetic to numb your child’s mouth during the procedure, your child may have the tendency to bite or chew their lips, cheeks, and/or tongue and/or rub and scratch their face after treatment. Please observe your child carefully to prevent any injury to these areas.
Please call our office for any questions or concerns that you might have.
IV Sedation (in office)
IV Sedation is recommended for apprehensive children that would not work well under conscious sedation. IV Sedation renders your child completely asleep, but breathing under their own influence. These are meant for shorter procedures, and are only offered on completely healthy children. IV sedation patients are carefully selected by the dentist for this type of sedation appointment.
At our office, a medical anesthesiologist (physician from local hospital), joins the dentist at the office to perform the sedation on your child. Usually this is one of the same anesthesiologist that would perform general anesthesia on your patient at the local hospital. The dentists DOES NOT administer the sedative to your child in the situation, as he would do in an oral conscious sedation appointment.
We choose this option very cautiously, and take great care to make sure your child is being monitored with appropriate equipment and personnel. Your child will be accompanied by the pediatric dentist, the medical anesthesiologist as well as a dental assistant in the treatment room.
Please make sure all of your questions are answered if this is an options for your child.
Prior to your appointment:
Please notify us of any change in your child’s health. Do not bring your child for treatment with a fever, ear infection or cold. Should your child become ill, contact us to see if it is necessary to postpone the appointment.
You must tell the doctor of any drugs that your child is currently taking (prescribed, over-the-counter, or herbal medications) and any drug reactions and/or change in medical history.
Please dress your child in loose fitting, comfortable clothing.
Your child should not have anything to eat or drink after midnight the night before the procedure.
The child’s parent or legal guardian must remain at the hospital or surgical site waiting room during the complete procedure.
After the appointment:
Your child will be drowsy and will need to be monitored very closely. Keep your child away from areas of potential harm.
If your child wants to sleep, place them on their side with their chin up. Wake your child every hour and encourage them to have something to drink in order to prevent dehydration. At first it is best to give your child sips of clear liquids to prevent nausea. The first meal should be light and easily digestible.
If your child vomits, help them bend over and turn their head to the side to insure that they do not inhale the vomit.
Prior to leaving the hospital/outpatient center, you will be given a detailed list of “Post-Op Instructions” and an emergency contact number if needed.
Outpatient General Anesthesia
Outpatient General Anesthesia is recommended for apprehensive children, very young children, and children with special needs that would not work well under conscious sedation or I.V. sedation. Our dentists have thousands of case experience with treating children under general anesthesia.
What does general anesthesia care mean? General anesthesia renders your child completely asleep. This would be the same as if he/she was having their tonsils removed, ear tubes, or other outpatient procedure. This is performed in a hospital or outpatient setting only. While the assumed risks are greater than that of other treatment options, if this is suggested for your child, the benefits of treatment this way have been deemed to outweigh the risks. Most pediatric medical literature places the risk of a serious reaction in the range of 1 in 25,000 to 1 in 200,000, far better than the assumed risk of even driving a car daily. The inherent risks if this is not chosen are multiple appointments, potential for physical restraint to complete treatment and possible emotional and/or physical injury to your child in order to complete their dental treatment. The risks of NO treatment include tooth pain, infection, swelling, the spread of new decay, damage to their developing adult teeth and possible life threatening hospitalization from a dental infection.
Prior to your appointment:
Please notify us of any change in your child’s health. Do not bring your child for treatment with a fever, ear infection or cold. Should your child become ill, contact us to see if it is necessary to postpone the appointment.
You must tell the doctor of any drugs that your child is currently taking (prescribed, over-the-counter, or herbal medications) and any drug reactions and/or change in medical history.
Please dress your child in loose fitting, comfortable clothing.
Your child should not have anything to eat or drink after midnight the night before the procedure.
The child’s parent or legal guardian must remain at the hospital or surgical site waiting room during the complete procedure.
After the appointment:
Your child will be drowsy and will need to be monitored very closely. Keep your child away from areas of potential harm.
If your child wants to sleep, place them on their side with their chin up. Wake your child every hour and encourage them to have something to drink in order to prevent dehydration. At first it is best to give your child sips of clear liquids to prevent nausea. The first meal should be light and easily digestible.
If your child vomits, help them bend over and turn their head to the side to insure that they do not inhale the vomit.
Prior to leaving the hospital/outpatient center, you will be given a detailed list of “Post-Op Instructions” and an emergency contact number if needed.