Sedation dentistry refers to the use of sedation during dental treatment. Sedation is most commonly used during extensive procedures, for patients with dental phobia or for patients who find it difficult to sit still. There are different types of sedation, including nitrous oxide ("laughing gas"), IV sedation, oral sedatives and general anesthetic.
Sedation can range from the use of nitrous oxide to calm a patient to general anesthetics used to put patients to sleep. Patients with dental phobia, low pain tolerance, major dental treatment, physical handicaps or strong gag reflexes may require sedation. Procedures like fillings, crowns, extractions and cosmetic procedures often require sedation.
Sedation is endorsed by the American Association of Pediatric Dentistry and is an effective way to make many patients comfortable during their dental visit. Before using a sedative or anesthetic, it is important to tell your dentist about any medications or medical treatments your child is receiving. Before administering any sedative or anesthetic, your dentist will talk to you about the process of sedation and pre and post-sedation instructions.
Who should be sedated?
Our dentists recommend that those children with severe anxiety and/or the inability to relax are candidates for sedation. Usually these children are young or have trouble managing their anxiety. This can prevent injury to the patient and provide a better environment for delivering quality dental care - it's hard to do dentistry on a moving child!
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What medications are used?
Conscious Sedation - There are several medications that can be used for conscious sedation, from inhalation agents (laughing gas) to medicines that are drank from a cup or possibly an injection. None of these sedatives render the child unconscious. Our dentists will base their recommendations of medications to be used based on the child's age, level of anxiety, amount of dental work that needs to be completed and length of appointment. "Laughing Gas" Nitrous oxide, more commonly known as laughing gas, is often used as a conscious sedative during a dental visit. The gas is administered with a mixture of oxygen and has a calming effect that helps phobic or anxious patients relax during their dental treatment. Because it is a mild sedative, patients are still conscious and can talk to their dentist during their visit. After treatment, the nitrous is turned off and oxygen is administered for five to 10 minutes to help flush any remaining gas. The effects wear off almost immediately. Nitrous oxide rarely has side effects, although some patients may experience minor nausea and constipation. Your doctor will provide you with pre and post-sedation instructions.
Sleep Dentistry (General Anesthesia) - Sometimes a child needs to be unconscious in order for the dentist to safely complete needed dental treatment. General anesthesia puts a child into a deep sleep. He or she is unable to feel pain or to move around. This is the same kind of sleep a child would have for removal of tonsils or placement of ear tubes. General anesthesia is done in a hospital or surgery center that is equipped to monitor your child during deep sedation. As in other forms of outpatient surgery, your child will go home the same day.
Your dentist may recommend general anesthesia if your child:
Can't relax or calm down enough for treatment to be performed safely, even with conscious sedation and other behavior management techniques.
Needs oral surgery or other dental treatment that would be difficult for the child to tolerate while awake.
Needs a lot of dental work that can best be done in one long appointment.
Has a disability that limits his or her ability to understand directions and be treated safely in the dental office
General anesthesia carries some risk.
Your dentist will discuss the risks and benefits with you and answer any questions you may have to determine if general anesthesia would be appropriate for your child.
General anesthesia for dental procedures can be provided by any of the following:
Oral and maxillofacial surgeon
CRNA (Certified Registered Nurse Anesthetist)
These professionals are trained to deliver the medicines and monitor the child during the procedure. They also know how to handle any problems that may occur.
Your child will need a physical examination before receiving general anesthesia. The CRNA and or Anesthesiologist and nursing staff will perform this exam on the day of your child's appointment. The exam will make sure he or she doesn't have any conditions that could interfere with or be affected by the anesthesia.