Sedation Techniques
In contrast to general anesthesia (which renders the child unconscious), oral conscious sedation is only intended to reduce the child’s anxiety and discomfort during dental visits. In some cases, the child may become drowsy or less active while sedated, but this will gradually dissipate after the procedure is completed.
When is sedation used?
Sedation is used in several circumstances. First, very young children are often unable to keep still for long enough for the pediatric dentist to perform high-precision procedures safely. Sedation makes the visit less stressful for both children and adults and vastly reduces the risk of injury. Secondly, some children struggle to manage anxiety during dental appointments. Sedation helps them to relax, cope, and feel happier about treatment. Third, sedation is particularly useful for children with special needs. It prevents spontaneous movement, and guides cooperative behavior.
What are the most common types of sedation?
Dr. Geshay has several sedation options available, and each one comes with its own particular benefits. He will assess the medical history of the child, the expected duration of the procedure, and the child’s comfort level before recommending a method of sedation.
Light Conscious Sedation – allows children to continually communicate, follow instructions, and cooperate during the entire procedure. The major methods of conscious sedation are described below:
Nitrous oxide – Dr. Geshay may recommend nitrous oxide (more commonly known as “laughing gas”) for children who exhibit particular signs of nervousness or anxiety. Nitrous oxide is delivered via a mask, which is placed over the child’s nose. Nitrous oxide is always combined with oxygen – meaning that the child can comfortably breathe in through the nose and out through the mouth.
Laughing gas relaxes children extremely quickly, and can produce happy, euphoric behavior. It is also quick acting, painless to deliver, and wears off within a matter of minutes. Before removing the mask completely, Dr. Geshay will deliver regular oxygen for several minutes, to ensure the nitrous oxide is eliminated from the child’s body. On rare occasions, nitrous oxide may cause nausea. For this reason, Dr. Geshay suggests that your child be NPO ( no food or liquids after midnight before the visit).
IV Sedation – IV sedation is sometimes necessary for children that are unable, by either age or maturity level to cooperate during dental treatment. A board-certified Anesthesiologist provides IV Sedation in our office and monitors your child throughout the procedure and during recovery. IV sedation can be particularly useful for children with special needs, who may face extra difficulty in tolerating the experience of dental treatment. Additionally, in cases of lengthy, complex treatments, IV sedation can be useful for children who will have a hard time sitting still for long periods of time, weigh less than 25lbs, and have a strong gag reflex.
If your child is being considered a candidate for IV sedation, a member of our staff team will review in detail all aspects of this important service with the parent or guardian. No treatment will proceed without your complete understanding and authorization.
Dr. Wach or Dr. Borandi will also talk with you prior to the visit to provide instructions and answer any questions that you may have. To assure your child’s utmost safety, Dr. Geshay requires that your child undergo a medical physical by his or her pediatrician 2-3 weeks before the IV sedation visit.
Moderate to Deep Oral Conscious Sedation – Children who are uncooperative, especially anxious, or unable to control their muscles for prolonged periods, may be offered an oral sedative. Oral sedatives come in many different forms (usually liquids, but tablets, pills can also be used), and may make the child feel drowsy. If oral sedatives are to be used, Dr. Geshay may require parents to prepare the child before the appointment. Some common preparatory measures may include: limiting food and fluid intake prior to the appointment, having the child wear comfortable clothing to the appointment, and preparing to stay with the child for several hours after the appointment. Oral sedatives rarely produce serious side effects – nausea is among the most common.
If your child is being considered a candidate for oral conscious sedation, a member of our staff team will review in detail all aspects of this important service with the parent or guardian. No treatment will proceed without your complete understanding and authorization .
To assure your child’s utmost safety, Dr. Geshay requires that your child undergo a medical physical by his or her pediatrician 2–3 weeks before the oral conscious sedation visit.
Sedation dentistry is most helpful for:
- Infants over the age of 2 years and over 25 pounds in weight.
- Children who require major treatment.
- A very anxious child .
- Children that have had traumatic dental experiences.
- Children with a strong gag reflex.
- Children who are medically compromised .
- ADHD, ADD or children with other behavioral challenges.
- Children with genetic disorders.
- Children with special needs.