Sedation Dentistry

What is Sedation Dentistry?

Sedation dentistry is simply the use of medication during an oral surgery or other dental procedure to help a patient feel as comfortable as possible. It has sometimes been referred to as “sleep dentistry”, but that is not really true as patients are usually awake during the procedures except for those under general anesthesia. The sedation is most suitable for individuals with real fear or anxiety of visiting a dentist or sitting on a dental surgery chair, particularly children.

Smiling Little Girl with Hat

How is Sedation Dentistry done?

There are various ways in which sedation dentistry is administered including:

Inhaled minimal sedation– Here the dentist administers to you nitrous oxide (laughing gas) combined with oxygen through a gas mask that is placed over your nose.
Oral sedation– This can be used for minimal to moderate sedation. For minimal sedation, a pill (typically Halcion), is administered about half an hour before the procedure.
IV sedation– Here the sedative drug is given through a vein, enabling it to work more quickly and for the dentist to continually adjust the level of sedation.

Is Sedation Dentistry Safe For kids?Add Your Heading Text Here

Sedation for dental procedures on kids is safe if done right. Nitrous oxide, which is administered through inhalation, tends to be the safest for kids and almost all dentists can administer it. It helps the kid remain calm throughout the procedure. Oral sedation also works for children, but there is only a small percentage of pediatric dentists who are trained on how to administer it. A pediatric dentist has to know how to ensure that the administered dosage is right for the child’s age and weight.

Nitrous Oxide

For some children your dentist may use a sedative, which can induce minimal sedation and help the child to relax for the treatment. Some sedatives, such as nitrous oxide, can be administered before or during dental procedures. Nitrous Oxide is a safe and effective sedative agent that is mixed with oxygen and inhaled through a small mask that fits over the nose to help the patient relax. Nitrous Oxide, sometimes called “laughing gas” is one option your dentist may offer to make the patient less anxious during treatment. Some complications with Nitrous Oxide may but are limited to include nausea.

Prior to your appointment:

  • Please let us know of any change to your child’s health and/or medical condition.
  • Tell us about any colds or conditions that make 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.

Moderate Sedation

Moderate Sedation is recommended for apprehensive children, very young children, and children with special needs. Moderate sedation is a safe method in which a liquid is given to the patient to drink. The patient will still be awake for treatment but moderately sedated so that they can be comfortable and cooperative for treatment. Treatment can be completed in two appointments or less. Your child may be given a mixture of different medications along with Nitrous Oxide and local anesthesia. 

To Download our Pre-Anesthesia Instruction Sheet click here.

Prior to your appointment:

  • Eating and Drinking Instructions:  To avoid vomiting and complications during treatment.  DO NOT ALLOW YOUR CHILD TO HAVE ANY FOOD OR DRINK (even water) AFTER MIDNIGHT prior to the schedule day of treatment. This means NO BREAKFAST!  An empty stomach is MANDATORY!
  • Changes in Health: Any change in your child’s health such as the development of a cold, fever, diarrhea or vomiting within two days prior to the day of treatment, is reason for concern!  Please inform our office of any change in your child’s health as soon as possible.  For your child’s safety, a new appointment may need to be made for another day.
  • Arrival: Your child’s safety and comfort is our main concern! DO NOT BRING OTHER CHILDREN WITH YOUR TO THIS APPOINTMENT, AS YOUR CHILD WILL NEED YOUR FULL ATTENTION. ONLY PARENT/OR LEGAL GUARDIAN MAY ACCOMPANY PATIENT TO THIS APPOINTMENT.   Our doctors recommend that a second responsible adult come with you to the appointment to help take care of your child while driving home. 
  • Clothing: Dress your child in loose fitting, comfortable clothing and bring a change of clothes, if possible.
  • Medication:  DO NOT give your child any medication unless cleared by the treating provider.
  • Treatment: The doctor will go over all dental treatment with you before your child’s treatment and update you if any changes need to be made.  When the dental treatment is completed, the doctor asks that you join your child while recovering.  The doctor will discharge your child into your care, to go home, when they feel it is appropriate.  This usually is within 15 minutes of your child’s completed treatment.
  • MONITORING: Your child’s respiration and heart rate will be monitored throughout the procedure by a stethoscope that is attached to an earpiece worn by the doctor.  We also monitor oxygen saturation and heart rate using pulse oximetry. To do this, we must tape a comfortable clip to your child’s finger or toe.  At no time is your child left unattended during treatment.
  • Your child will act drowsy and may become slightly excited at first.
  • The child’s parent or legal guardian must remain at the office during the complete procedure.

Because each child’s metabolism is different and there is no 100% guarantee with any sedative medication, there is the possibly your child’s sedation will need to be aborted before treatment has started or prior to treatment being completed. 

PLEASE REMEMBER:

  • Be on time for your appointment or plan to arrive early
  • Do not allow your child any food or drink (even water) after midnight before the scheduled day of treatment.
  • Supervision by a responsible adult is are required before and after the sedation
  • The behavior of your child will be altered after the procedure.
  • Do no give your child any medicines before or after the sedation appointment unless your physician has prescribed them and the doctor has been informed.
  • Notify us if there is a change in health prior to your appointment
  • Do not plan further activities for your child on the day of their dental treatment.  Allow your child to rest and plan a quiet and relaxed day.
  • Patient needs to be accompanied by a parent and/or  legal guardian who is able to sign a legal document consenting to treatment.

After the moderate sedation appointment:

Your child will be drowsy and will need to be monitored very closely. Keep your child away from areas of potential harm.

If your child wants to sleep, place them on their side with their chin up. Wake your child every hour and encourage them to have something to drink in order to prevent dehydration. At first it is best to give your child sips of clear liquids to prevent nausea. The first meal should be light and easily digestible.

If your child vomits, help them bend over and turn their head to the side to insure that they do not inhale the vomit.

Because we use local anesthetic to numb your child’s mouth during the procedure, your child may have the tendency to bite or chew their lips, cheeks, and/or tongue and/or rub and scratch their face after treatment. Please observe your child carefully to prevent any injury to these areas.

We may use different medications to sedate your child that we planned, but we anticipate that one of the following will be best for your child.  These maybe used in addition to nitrous oxide and local anesthesia. 

  • Meperidine, Midazolam, Hydroxyzine
  • Midazolam
  • Diazepam

If you have any further questions, do not hesitate to call the office at 540-785-4494

General Anesthesia

General anesthesia is commonly used to facilitate dental treatment in patients with anxiety or challenging behavior, many of whom are children or patients with special needs. When performing procedures under general anesthesia, dental surgeons must perform a thorough pre-operative assessment as well as ensure that the patients are aware of the potential risks and that informed consent has been obtained. In rare cases, for extremely anxious individuals who are unable to cooperate when sedated, general anesthesia may be the most sensible form of treatment used for patient’s when two or more quadrants of the mouth require restorative care. With general anesthesia, all treatment can be done in one appointment which helps to lessen the patient anxiety and decrease the patients fearfulness for future dental procedures. 

To Download our Pre-Anesthesia Instruction Sheet click here.

Pre-operative instructions for General Anesthesia:

Patient’s scheduled between 7:30am – 11:30am: 

  • Nothing to eat after midnight
  • Nothing to drink after midnight

Patient’s scheduled 11:30am or later:

  • Nothing to eat after midnight
  • Clear Fluids ONLY (as listed below) are allowed up to 4 hours prior to patient arrival time

Clear Fluids IncludeWater & Apple Juice are the only acceptable clear fluids allowed by anesthesiologist

Pre-Operative instructions for in-office General Anesthesia are as follows:

  • A parent and/or legal guardian must bring patient the day of treatment & they must remain in the office from the time of check-in with the front desk until their child is released by the anesthesiologist. 
  • We require 2 adults accompany each GA patient on the day of treatment.
  • No school or daycare the day of surgery
  • Please make sure your child is strictly supervised to ensure no eating or drinking except as instructed
  • Please let the office know if the patient has had a recent cough, cold or illness w/ fever in the 1-2 weeks prior to your child’s General Anesthesia appointment
  • As a courtesy to parents, we would recommend that you do not schedule other appointments the same day as your child’s treatment, as the day may not run exactly on schedule & could potentially effect the arrival time of your other appointments. 
  • Please expect to be at the office for a minimum of 4-5 hours (approximately)
  • You may want to bring a blanket or a change of clothing for the patient, in case they have an accident while under anesthesia (these things do occasionally occur).
  • If your child has Asthma and takes a daily medication, please give medication as prescribed by doctor.  If your child has a rescue inhaler, please bring it with you to the appointment.   

If you have any questions or concerns regarding the anesthesia or the above guidelines, please contact our Pediatric Dental Coordinator, or one of the other front desk staff members at ClearCare.

After the General Anesthesia appointment:

Your child will be drowsy and will need to be monitored very closely. Keep your child away from areas of potential harm.

If your child wants to sleep, place them on their side with their chin up. Wake your child every hour and encourage them to have something to drink in order to prevent dehydration. At first it is best to give your child sips of clear liquids to prevent nausea. The first meal should be light and easily digestible.

If your child vomits, help them bend over and turn their head to the side to insure that they do not inhale the vomit.

Because we use local anesthetic to numb your child’s mouth during the procedure, your child may have the tendency to bite or chew their lips, cheeks, and/or tongue and/or rub and scratch their face after treatment. Please observe your child carefully to prevent any injury to these areas.

If you have any further questions, do not hesitate to call the office at 540-785-4494