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Pediatric Dental Sedation Topics

Pediatric SedationBelow, we have outlined the most common forms of sedation techniques used in pediatric dentistry. All three are very effective and commonly used. We have also included tips and guidelines to help you prepare for your child's appointment.

Nitrous Oxide

Nitrous oxide/oxygen, commonly known as “laughing gas” is given to some children to relax them for their dental treatment. Nitrous oxide/oxygen is made up of two gases, oxygen and nitrous oxide. Nitrous oxide/oxygen is given through a small breathing mask which is placed over the child’s nose, allowing them to relax, but without putting him/her to sleep and is harmless to the child.

The gas itself is mild and easily taken with normal breathing; it is also quickly eliminated from the body. It is not addictive and there are no side effects. While inhaling nitrous oxide/oxygen, your child remains fully conscious and maintans all natural reflexes.

Preparing for your child's appointment:

  • Please inform the office of any change to your child’s medical condition and/or health.
  • Please inform the office of any respiratory condition(s) that makes breathing through the nose difficult for your child. Difficulty in breathing might limit the effectiveness of the nitrous oxide/oxygen.
  • Please inform the office if your child is taking any medication on the day of the appointment; including over the counter medications, prescription medicines, herbal supplements, or vitamins.  

Conscious Sedation

Conscious sedation is recommended for very young children, apprehensive children and children with special needs. Conscious sedation is used to calm your child and to reduce the anxiety or discomfort associated with dental treatments. Your child may be drowsy and might fall asleep, but he or she will not become unconscious. Our experience is that children become completely at ease using this method of sedation. This type of sedation is commonly used in very young children prior to stronger anesthesia for surgical procedures (of all types). Different medications used for conscious sedation. We will prescribe the medication best suited for your child’s overall health and dental treatment(s) being performed. Please feel free to contact us regarding the specific drugs to be used during sedation. 

Preparing for your child's appointment:

  • Do not allow your child to have solid food for at least 6 hours prior to his or her sedation appointment and only clear liquids for up to 4 hours before the appointment.
  • It is necessary that you tell the doctor of any drugs that your child is currently taking (prescription medicines, herbal supplements or vitamins) and any drug reactions and/or change(s) in medical history.
  • Please inform the office of any change in your child’s medical condition and/or health. If your child has a fever, ear infection, or cold do not bring your child. If your child becomes ill, please contact the office to see if it is necessary to postpone the appointment.
  • Please dress your child in comfortable, loose fitting clothing.
  • Prior to arriving at the office, please make sure that your child has gone to the bathroom as not to interrupt the procedure.
  • The child’s parent or legal guardian must remain at the office during the entire procedure.
  • Please watch your child while the medication is taking effect. Keep your child in your lap or close to you. Do not let him or her run around the office as they could harm themselves.
  • Your child may become excited at first and will act slightly drowsy as the medication begins to take effect.

After care for appointment utilizing conscious sedation:

  • Your child will need to be monitored very closely, and will be drowsy. Keep your child away from areas of potential harm.
  • If your child wants to sleep then place him or her on his or her side with their chin up.
  • You will need to wake your child every hour and encourage him or her to have something to drink in order to prevent dehydration. In the beginning, it is best to give your child sips of clear liquids to prevent nausea. The first meal should be easily digestible and light.
  • If your child vomits, to ensure that he or she does not inhale the vomit, help him or her bend over and turn his or her head to the side.
  • Your child may have the tendency to bite/rub his or her lips, cheeks, and/or tongue after treatment because we use local anesthetic to numb your child’s mouth during the procedure.  Monitor your child carefully to prevent any injury to these areas.
  • If you have any questions or concerns, please call our office. 

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Outpatient General Anesthesia

Outpatient general anesthesia is recommended for very young children, apprehensive children, and children with special needs that would not work well under conscious sedation or intravenous (I.V.) sedation. General anesthesia is a stronger type of sedation and will result in your child being completely asleep. General anesthesia would be the same as if he/she were having a standard surgical procedure, such as implementation of ear tubes, tonsil removal, or hernia repair.

This is only performed in a hospital or outpatient setting. Certainly, the assumed risks are greater than that of other treatment options. However, please keep in mind that if this type of sedation is suggested for your child by Dr. Riehs, the potential benefits have been deemed to outweigh the risks. Dr. Riehs' suggestions are carefully thought out, and are in the best interest of the child.

Most pediatric medical literature places the risk of a serious reaction in the range of 1 in 25,000 to 1 in 200,000, which is far better than the assumed risk of even driving a car daily. If this type of sedation is recommended, but not chosen, the inherent risks are multiple appointments, potential for physical restraint, and possible emotional and/or physical injury to your child in order to complete their dental needs. The risks of NO treatment include tooth pain, swelling, infection, the spread of new decay, damage to developing adult teeth, and possible hospitalization from dental infection.

Preparing for your child's appointment:

  • Do not allow your child to have milk or solid food after midnight prior to the scheduled procedure and clear liquids ONLY (i.e. water, apple juice, Gatorade) for up to 6 hours prior to the appointment.
  • Please inform the office of any change in your child’s medical condition and/or health. If your child has a fever, ear infection, or cold do not bring your child. If your, child becomes ill, please contact the office to see if it is necessary to postpone the appointment.
  • It is necessary that you tell the doctor of any drugs that your child is currently taking (prescription medicines or herbal supplements or vitamins) and any drug reactions and/or change(s) in medical history.
  • Please dress your child in comfortable, loose fitting clothing.
  • The child’s parent or legal guardian must remain at the hospital or surgical site waiting room during the entire procedure.
  • Please call our office with any questions or concerns.

After care for appointments utilizing general anesthesia:

  • Your child will need to be monitored very closely because he/she will be drowsy.  Your child will need to be kept away from areas of potential harm.
  • Your child may want to sleep; if so place him/her on his or her side with their chin up.
  • Wake your child every hour to have him or her drink something to prevent dehydration. In the beginning, give your child clear liquids to prevent nausea. The first meal should be easily digestible and light.
  • If your child vomits, turn his or her head to the side to prevent inhaling the vomit.
  • Written post-op instructions and an emergency contact number will be provided before leaving the hospital/outpatient center. 

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