The goal of sedation dentistry is to create an environment in which the dentist can complete routine dental treatment in a safe and more relaxed setting for the child. There are many levels of sedation, and many options. It is important for the parent to understand the differences between the levels of sedation and to choose the best option for them and their child. When used properly, sedation dentistry helps the dentist to achieve safe and complete dental treatment, while causing minimal stress and anxiety to the patient in the process.
If your child has never been sedated before, you may not know what to expect. We want you to know that your child’s safety and comfort are always our top priorities, and the recommendation for sedation will not be made unless it is in everyone’s best interest. Our office offers four levels of dental sedation: nitrous oxide sedation, conscious (oral) sedation, IV sedation and general (hospital) sedation.
Nitrous oxide, also known as laughing gas, is safe, wears off quickly, and is very reversible. The purpose of using it is to create distraction and to reduce dental anxiety. It has been described as causing a “floaty” feeling and makes the patient’s extremities (hands, feet) tingle a little. It reduces the impact of any bothersome sensations and, when the visit is over, is flushed out of the patient’s lungs with 100% oxygen. This oxygen flush completely removes the effect of the nitrous oxide. Older patients that drove themselves to the dental visit may drive home afterwards. It is the mildest and safest form of sedation employed by pediatric dentists. For most patients and procedures, this level of sedation is all that is recommended.
Oral (Conscious) Sedation
The next level of sedation is conscious (oral) sedation. This is often prescribed for younger patients that may have a short attention span and a reduced tolerance for uncomfortable stimuli. The use of oral sedation can often shorten treatment times as well. Sometimes 4 appointments of dental work can be reduced to 2 because the sedated child is able to sit for longer periods of time in the dental chair. With oral sedation, the child must pass a medical history check, and if healthy, will come to the dental office (with an empty stomach) for a morning appointment. They will receive one or two oral medications by mouth and wait in the reception area under observation for 30-45 minutes. They are then brought back to the operatory, nitrous oxide is often administered along with the oral sedation, and the dentistry is then performed. Our office allows parents to accompany their children throughout the whole appointment. It is another safe way to complete dental treatment for children that need a little more than just nitrous oxide. They are awake the whole visit but are more relaxed than they would have been without the medication(s). Once the dental work is done, they are fine to go home without an extended recovery period in the office. Children often need a few hours after the appointment for the effects of the medicine(s) to fully wear off, but they may go back to their normal routines (including school) the following day. However, we do ask that they stay home with a responsible adult for the rest of the treatment day.
IV & General Sedation
Doctors and dentists are trained in weighing risks and benefits—in fact, it’s one of the cornerstones of what we do as healthcare professionals. With every decision we make, we think about whether any potential risks involved outweigh the potential benefits. When it comes to sedation dentistry for children, we ask, “Is the risk of sedating this patient higher than the risk of treating them without sedation?”
When parents have concerns about the safety of sedation dentistry, they’re usually talking about IV sedation. In recent years, there have been stories of children suffering serious complications due to IV sedation at the dentist. To prevent such complications, we have a separate, certified dental anesthesiologist (that has been with our office for 30+ years) administering our IV sedation and monitoring our patients so our dentists can fully focus on the dental treatment. Our office is in full compliance with current AAPD (American Academy of Pediatric Dentistry) and Texas State Board of Dental Examiners guidelines for the sedation of pediatric dental patients.
For children where conscious (oral) sedation isn’t enough, IV sedation becomes the best option. Children that are too young to cooperate, those who have special needs, and those with extensive dental needs that also travel from long distances away often benefit from IV sedation the most. Performing dental treatments on children who are fighting, squirming, screaming, or crying is dangerous for the child and for our team members. Furthermore, a traumatizing experience at the dentist as a child often plants the seeds for a lifetime of dental anxiety, making future visits difficult. Outside of a serious emergency with parental consent, we will never push through dental treatments at our office, it is always best to stop and reappoint with a new plan.
Having the option to perform a safe IV sedation in our office setting gives parents a comfortable, one-appointment option to take care of their child’s dental needs. All candidates for this type of sedation will receive a full medical exam prior to their sedation and a full consult with our experienced anesthesiologist prior to setting their dental appointment.
In most situations that require the child to be fully sedated for dental treatment, we will recommend IV as it is a milder form of sedation than general. The only time our office will recommend general sedation (full sedation with intubation) in a hospital setting is if the patient’s medical situation dictates it for safety reasons or if the family prefers that option to IV sedation. We always discuss all sedation options on a patient by patient basis. Our dentists are on staff at Children’s Medical Center in Dallas, TX and are equipped to see patients in the outpatient surgery center there if it becomes the best option.
Is Sedation Dentistry Right for Your Child?
Even though we feel sedation is safe and effective, it’s not a decision we take lightly. Again, we only perform procedures under sedation after a consultation and complete medical history examination. We’re also happy to discuss the pros and cons of all forms of sedation with you, as well as any concerns you might have. Ultimately, you know your child better than we do and likely have insight into how they might respond to their dental procedure.
Learn More About Dental Sedation
If you’d like to discuss sedation dentistry with one of our doctors over the phone before your child’s procedure, contact us today to schedule an appointment for a consultation.