Sedation

Pediatric dentists are trained in a wide range of methods to help children feel comfortable during dental treatment. These methods range from the “Tell-Show-Do” technique, to general anesthesia.

With Tell-Show-Do a pediatric dentist might name a dental instrument, show how it works by using it to count your child’s fingers, and then use the instrument in treatment.

We also use coaching, distraction, and basic TLC to help your child feel more comfortable in the dentist’s chair. But by far the most preferred technique is praise. Every child does something right during a dental visit, and pediatric dentists use praise to encourage good behavior.

However, sometimes a child’s behavior requires assertive management to protect him or her from possible injury. Voice control – speaking calmly yet firmly – usually takes care of it, although there are other instances that require some more direct hand-holding. As each child is individual and different, we discuss these techniques with parents in relationship to their child.

Most of the time when these methods are not successful, all that is needed is some laughing gas, also known as Nitrous Oxide. This involves simply resting a nosepiece lightly on a child’s face. The child is not “put to sleep,” however they do usually feel somewhat “tingly,” or “ticklish.”

Beyond the use of nitrous oxide, there are several other methods of sedation that can be used, depending on the age, temperament, medical history and the treatment needed. Again, because each child is different and requires individualized care, we will discuss these options with parents before making any decisions.

Pediatric Dental Group works with a team of Certified Registered Nurse Anesthetists who hold advanced certificates in this specialized procedure. This allows a child to undergo deep sedation or general anesthesia to safely complete their necessary treatment.

Safety

Depending upon the level of sedation, your child’s heart rate, breathing rate and blood oxygen will be monitored throughout his or her appointment, along with the depth and quality of breathing. We will also use a stethoscope, blood pressure cuff and clinical observation to assure the safety of your child

A complete array of emergency medications are always in the room with any sedated child and both the doctors and their staff are fully trained in their use. While we cannot make sedation risk-free, we do all that we can in order to facilitate safety.

General Anesthesia

Procedures carried out in a hospital under general anesthesia can be helpful for children requiring significant surgical procedures or patients with special health care needs. General anesthesia also may be indicated for children with extensive needs who are extremely uncooperative, fearful or anxious, or for the very young who do not understand how to cope in a cooperative fashion.

For more information visit,

AAPD Sedation Information http://www.aapd.org/media/policies_guidelines/g_sedation.pdf

AAPD Patient Management Guidelines http://www.aapd.org/media/policies_guidelines/g_behavguide.pdf

Pre-Sedation Instructions

If your doctor has requested pretreatment evaluation by your child’s pediatrician, please bring a copy of the medical evaluation to our office on the day of treatment. Also, please ask your child’s pediatrician to fax over the form when it is completed after your evaluation so our doctors can review the medical findings prior to your appointment. 

If your child is being treated in the morning, do not give him or her anything to eat or drink after midnight. Those patients scheduled for treatment in the afternoon should ask the anesthesiologist if clear fluids are permitted the morning of treatment. If clear fluids are permitted the following are allowed: water, apple juice, tea. Do not add milk to any drinks. Patients not following these instructions may have their treatment session cancelled.

Medications can be taken normally unless otherwise instructed by the doctors in this office and may be taken only with a sip of water.

Please have your child wear a shirt with short sleeves or no sleeves. No shirts with buttons. Comfortable pants or sweat pants should also be worn as well as comfortable flat shoes. No flip-flops. Please bring an extra set of clothes for the child being treated. Please bring their favorite blanket and/or stuffed toy. Remove all rings and contact lenses. Leave all valuables at home.

A change in your child’s health, especially the development of a cold or fever is very important. For your child’s safety, if your child has symptoms of a cold within fourteen (14) days of treatment you may be reappointed for another day. Please inform the office of any change in health as soon as you are aware of it. 

A responsible adult must drive your child to the office. A parent and another adult must accompany all children receiving sedation or general anesthesia.

Any child receiving sedation must be taken home by the parent and a second adult. All patients should be in a car seat or, if old enough, wear a seat belt and should be sitting in an upright position on their way home. Do not take a bus or taxi home. Go directly home.

A parent or responsible adult should be with the patient until the next day. If your child is sleepy, they should be placed on a blanket on the floor in a room where the parent or responsible adult is staying.

Please arrive for your appointment at the requested time. Depending on the planned method of sedation for your child, it can take up to 45 minutes for the medication to work. In order to keep our schedule running on-time and smoothly, if you are late for your appointment, you may need to be rescheduled. 

Post-Sedation Instructions

We will give you a comprehensive sheet of post-operative instructions on the day of your child’s appointment.

Following the appointment, your child will be returned to you and you will be asked to remain in our office for a period of time as we make sure it is safe to send your child home. Your child may remain sleepy until later in the day or early evening. For this reason, you must bring along another responsible person to help watch them in the car on the way home. Your child will also need supervision at home to help prevent any accidental falls. If your child should fall asleep, make sure they are lying on their side, with their chin away from their chest. If they should vomit, be sure they are awake or lying on their side.

Your child will receive local anesthesia. This allows us to perform dentistry with minimal discomfort. Please remind them to avoid biting or playing with their lips and cheeks. While numb or still under the influence of sedation, they can cause serious trauma to themselves without knowing. 

Please encourage your child to drink fluids as soon as they express the desire to do so. Avoid solid foods until your child completely recovers.

Your child should not experience any significant pain after he/she awakens. You may give them Children’s Motrin or Tylenol if needed for any discomfort. If the Tylenol or Motrin is not effective, please call our office. If your child should become ill, or any other problem should arise, please notify our office. If we are not in the office at that time, an emergency number is available on our voicemail system and a doctor will be contacted immediately.