Children and Sedation Dentistry

Many parents are uncomfortable at the idea of their children being sedated. It makes sense, children are less robust than adults. Chemicals introduced to their blood streams can have unexpected effects. However, sedation is usually a less severe alternative to general anesthesiology. What are the facts regarding child sedation for dentistry? What questions should a parent ask before a procedure?

Types of Sedation

Mild

The patient stays awake during mild sedation. It is a medication or medications that are usually used on older children or adults. The patient typically remains calm and awake when used. There is often memory loss after the procedure.

Moderate

Usually this leaves children sleepier, but still able to respond to simple verbal stimulus. Breathing is still independent. Waking up from it is quite easy. This is a better option for older children or young adults. Young children can become very uncomfortable when moderately sedated. Most children will have no memory of the dental procedure after this type of sedation.

Deep

This uses intravenous (IV) medication. The child will usually sleep throughout the procedure. There must always be an independent observer (usually an anesthesiologist) present throughout deep sedation to monitor the child’s vital signs. Assisted breathing is sometimes necessary. The anesthesiologist determines when the patient is ready to go home after deep sedation.

General Anesthesia

Under general anesthesia, the patient will be completely asleep. This is only performed by specially-trained anesthesia professionals. It can only be performed in specially-equipped dental offices, hospitals, and surgical centers.

Nitrous Oxide

Commonly called laughing gas, nitrous oxide is a non-invasive, minimal sedation. It produces feelings of relaxation, and can make people feel light-headed. Sometimes users have giggles or laughter. It is administered via a mask with oxygen.

When is Sedation Recommended?

Sedation is often used on very young children because they can not keep still. This is necessary when an exact procedure must be performed. This makes the visit less stressful for the child and dentist. It also reduces injury chances.
Sedation helps children manage anxiety during a dental procedure. The most obvious way is by alleviating pain. The second way is by making them feel comfortable, relaxed, and happy about the treatment.
Children with special needs often benefit from sedation. It helps reduce movement, and aids relaxation and cooperation.

When is General Anesthetic the Right Choice?

When the procedure can not be performed safely without it.
The child has a condition limiting cooperation.
A lengthy procedure is necessary.
A complex and intricate dental procedure must be performed.

General anesthetic requires more intensive care before and after treatment. There is also a longer period of recovery. It can only be performed in specially-equipped locations. Whenever possible, conscious sedation is preferred over general anesthetic.

As a Parent, What Questions Should You Ask?

Preoperative Care and Questions

Who will provide an evaluation of my child before an operation? This person will need to look at past medical operations, allergies, current medications, previous illnesses and hospitalizations. As a parent, it is good to have these records on hand if possible.

How long to go without food or drink before the operation?

An extremely important question is how long a child should go without eating or drinking before a sedative operation. Not eating or drinking is necessary before any operation. However, small children may have special medical requirements on this issue.

Will any sedation or medication be administered at home prior to the operation?

If so, what is/are the medication(s)? What dangers are there? How should they be administered? What kind of monitoring is necessary after the medication is taken?

What training does the sedation/anesthesia professional have?

Does the training comply with the American Dental Association (ADA) guidelines? Does this dental office have the proper licensing from the state/government?

Questions to Ask about the Procedure

These questions should be asked beforehand, but they regard the procedure while it is underway.

Type of sedation

What type of sedation is it (mild, moderate, or deep)? Will there be general anesthesia administered as well? These questions help you answer if your child will be awake or asleep during the procedure.

Monitoring

How will the child be monitored during the procedure? Are the right emergency medical devices available while the operation is underway? What is the written emergency response plan?

Questions for After the Sedative Procedure

Monitoring

What kind of monitoring is necessary for the child after the operation? What are the instructions and emergency contact info for after the child gets home?

Are you Considering a Dental Procedure for your Child?

If your child may need a dental procedure that requires sedation, it’s understandable to be nervous. You probably have plenty of questions that weren’t answered here. And it’s possible a search on the internet didn’t help you either. If so, don’t hesitate to contact us. If you are in the Fort Worth area we are happy to see you and answer your questions. Dr. Ku is an award-winning dentist with many years of experience. Our office can offer advice on how to get complex procedures done, with and without sedation.