Children can benefit from sedation dentistry if they experience one or more of the following:
- Young age
- First time for dental treatment
- Fear/anxiety of the dentist and dental treatment
- Need for extensive dental treatment
- Past traumatic dental experience
- Fear of being numbed
- Trouble getting numb
- Sensitive teeth
The two most common types of sedation dentistry are:
- Inhalation Sedation
- Oral Mild/Moderate Sedation
If a child has treatment with sedation, in order to make sure the child is comfortable, local anesthesia is used. This means that a child will be numbed inside of their mouth even if they are sedated.
We understand the thought of injections can be scary to our patients, so Dr. Clark or her pediatric dental associate will administer your child's oral medication. The Compudent is a computerized machine that distributes the local anesthesia at a slow rate, decreasing the discomfort to the patient. Some patients become very apprehensive even at the sight of needles or a syringe. The Wand, which is the actual handpiece, has a very non-threatening appearance and does not look like a traditional syringe.
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. Your child will also have injections (sleepy juice) to numb their teeth for treatment.
Prior to your child's appointment with nitrous oxide:
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. If your child uses an inhaler for asthma (either daily or as needed) please bring it to the dental appointment. Our office is equipped with an up-to-date emergency drug kit that has an inhaler but some children do better with one they are familiar with if it is needed.
Please do not allow your child to eat or drink two hours prior to their appointment because the nitrous oxide/oxygen may upset their stomach and result in vomiting.
Oral Conscious Sedation
Oral Conscious Sedation is mild sedation taken orally that is recommended for apprehensive children, very young children, as well as some children with special needs. It is used to calm your child and to reduce the anxiety or discomfort associated with dental treatments. Your child's pre-operative vital signs are taken before they are given the sedation medication. They are administered the oral liquid sedation medication in the office by Dr. Clark or her associate. A pulse oximeter and blood pressure monitor is on them throughout the dental treatment, along with a pre-trachial stethascope. The effect of the sedation is to produce a profound relaxation to facilitate a more pleasant dental experience. Your child may be drowsy, and may even fall asleep (similar to taking a nap), but they will not become unconscious. Your child will keep all of their natural reflexes. Even with conscious sedation, your child may still fuss during treatment. It is difficult to accurately predict how your child may react to this light sedation. Nitrous oxide/oxygen is normally used in conjunction with Oral Mild Sedation. Even though your child may be sedated, they will still receive anesthetic injections (sleepy juice) to numb their teeth for various procedures including extractions, crowns, and/or pulpotomies. If your child's treatment is limited to fillings alone, they may benefit from the use of the hard tissue laser and would not require an injection to numb the treatment area.
It is important for your child's safety that you follow these instructions carefully. Failure to follow these instructions could result in serious injury.
Pre-operative Conscious Sedation Instructions:
- Do not give your child ANY medications before the appointment which may combine with the sedative without checking with one of the doctors first. Please be sure to inform the doctors of any medications your child is taking BEFORE the appoinment day.
- If the child is on a regular medication, please inform the office when we confirm your child's appointment. If your child has an inhaler for asthma or asthma-like symptoms, please bring it with you to the appointment. Our office is equipped with a current emergency drug kit, but if the inhaler is needed, your child may do better with the one they are familiar with.
- No milk or solid food after midnight for all children. Water is allowable for:
- Children under the age of three years, up to four hours before treatment.
- Children between ages three to six years, up to six hours before treatment.
- Children ages six and older, up to eight hours before treatment.
- Please dress your child in light, loose, comfortable clothing (preferably not white) for the appointment. If your child is recently toilet trained, dress him/her in a diaper (or Pull-Up) in case of an accident.
- If prior to your appointment your child becomes ill (i.e. fever, upper respiratory infection, bronchitis, pneumonia, etc), please contact our office to possibly reschedule your appointment. Your child needs to be healthy for 4-6 weeks prior to the sedation appoinment depending on the illness.
- If your child has a favorite stuffed animal, blanket, or toy, they are welcome to bring it to the appointment. There is also a television on the ceiling so if your child has a favorite movie on DVD, we would be happy to play it for them (we have many movies at the office).
- A parent or guardian must bring your child to the office and must be present in the reception room for the entire appointment. For your child's safety, we may need to watch him/her for several minutes following the treatment to make sure he/she is alert and stable before dismissal from the office. It is recommended that you have a friend or family member accompany you to the office to assist you and your child following the completion of the appointment.
- A parent or guardian must be home with your child for the remainder of the day. Do not plan activities for your child because they will feel the effects of the medication for six to eight hours following the appointment. Your child should not go to school or daycare for the remainder of the day.
- Please plan ahead and have soft food and lots of liquid for your child following the appointment. Examples of soft foods are yogurt, Jell-o, pasta, soup, scrambled eggs, and cottage cheese.
Post-Operative Oral Mild/Moderate Sedation Instructions
- Your child needs to be watched for several hours (4+) following the sedation appointment. The effects of the medication may continue after discharge from the office and your child may be drowsy. If he/she would like to sleep after you are home, please place them on their side. It is important that you keep your child awake in the car on the way home (and have them properly restrained).
- Do not allow your child to participate in activities where physical coordination or skill is involved since his/her reactions may be slowed. Basically, no outside play following treatment. Your child may be disoriented or fussy from the medication and must be watched to avoid injury.
- Following the dental appointment, offer your child liquids, starting with a small amount of water. Once they are able to keep water down, then you may give them other clear liquids (ie apple juice, white grape juice). It is important after the dental visit that your child be hydrated. Once the numbness wears off, then your child may have soft foods (please refer to "pre-operative instructions").
- Please make sure your child does not bite their tongue, lip, or cheek due to numbness.
- Occasionally a child can have a postoperative complication such as nausea, dizziness, and vomiting. If prolonged vomiting occurs, please contact our office.
- It is recommended for your child to be given an over-the-counter anti-inflammatory following the appointment. Since your child has an empty stomach, Tylenol is better to give at first. Please follow the directions according to the manufacturer and time it to give your child medication right before bedtime.
- Please be aware that your child may be fussy following the treatment; this is one possible side effect of the medication.
- If your child seems to be having problems, please contact our office at 713-436-4080.