Sedation Options at Dunes Dental for Kids:

Introduction

Dealing with the behavior of young, immature, and sometimes frightened children, as well as those who may be physically or mentally challenged is an area that is unique to pediatric dentistry. It requires an understanding of child psychology, pharmacology, and development mixed with patience, love, and discipline. In our office, we do not sedate every child who needs work done on their teeth. Our goal is to keep the children safe, perform optimal dental work, and provide the child with the best possible dental experience. That being said, some children need a little extra help to be able to cooperate for their necessary dental treatment.  Below are the sedation options offered at Dunes Dental 4 Kids.

Nitrous Oxide

Nitrous Oxide is often called “laughing gas.” Nitrous oxide is a very safe, mild sedative that can help your child remain relaxed during dental procedures. Your child will receive this sedation with the use of a “Scooby Doo Nose,” which carries oxygen and nitrous. Your child will be asked to breathe through the nose, not the mouth, and will sense a faint, sweet smell. The sedation will take effect in a short time. The nose will remain in place until the procedure is done. Your child will be awake during the entire procedure and may have a “happy” feeling. When the procedure is complete, the nitrous oxide will be turned off and your child will breathe in pure oxygen for about 5 minutes to clear out any remaining gas.

You should limit your child to a very light meal before this procedure, such as toast or a bagel.  Nitrous oxide is the mildest form of sedation, and is not effective for all children.  One way to put it is that it keeps a calm child calm. It does not normally turn a very anxious or uncooperative child into a perfect dental patient.  Because nitrous is very safe, it is often attempted as a first line of treatment in order to assess its effect on the children.  An occasional adverse reaction to nitrous oxide is perioperative or postoperative nausea, which is very short lasting.

Oral/Conscious Sedation 

Oral Sedation dentistry is one of the techniques used at Dunes Dental 4 Kids by Dr. Howenstein.  Oral sedation is used to help patients who experience anxiety and dental fears, in order to receive the proper dental health care. Oral sedation is also referred as conscious sedation because the patient remains conscious throughout the dental treatment but in a more relaxed state.

Oral Sedation involves the administration of sedative drugs taken from the mouth in the form of liquid or nasal spray, to achieve an ideal state of relaxation. At Dunes Dental 4 Kids, we use Versed, which is a prescription liquid medication approved for use as a sedative, anxiety or anesthesia medication.  This is often combined with nitrous oxide in order to achieve the sedation possible for your child.  It is considered “moderate sedation.”  Your child will still be awake, alert, and be able to respond and feel what is going on, but will be in a more relaxed state than with just nitrous alone.  Extra monitors are used for oral sedation in order to make sure your child is as safe as possible.

Oral sedation dentistry is a great tool to relax anxious patients and increases the level of cooperation for patients with dental fears. Conscious sedation is more sedative than nitrous oxide, but is still not always 100% effective.  Each child presents a unique situation, and the parents will discuss each option with Drs. Howenstein and Hemmingsen in order to assess what is the best option for your child.

The objective of Conscious/Oral Sedation:

1) Recommended for use on apprehensive children, young children, and/or children with special care needs.

2) It is used to calm children and to reduce the anxiety or discomfort associated with dental treatments

3) Reduce movement and reaction to dental treatment

4) Enhance patient cooperation

5) Increase tolerance for longer appointments

6) Aid in treatment of the mentally/physically disabled or medically compromised patient

7) Reduce gagging

Potential adverse reactions to sedation are nausea, allergy, and over-sedation.  Dr. Howenstein follows the AAPD Guidelines for Sedation in Pediatric Patients, and has received extensive training to ensure your child receives safe and effective care while under oral sedation.

Oral sedation is not always effective. Some children do not calm down to the desired state of relaxation. Our goal is to provide safe, quality care, while giving your child the best experience possible. If oral sedation is not effective, general anesthesia could be a potential option to perform the necessary dental treatment. 

Outpatient General Anesthesia

Based on your child’s age, amount of cavities, level of cooperation, or special health care needs, nitrous oxide and conscious sedation may not be effective to provide them with a safe and comfortable visit.  Young children or toddlers are often very frightened of the dentist. The sounds they hear from the dental drill, and/or the feeling of pressure can make them go into hysterics, even if they do not actually feel pain. Moreover, some children need to have a lot of dental work completed on multiple teeth. Thus, it is sometimes best to put the child completely to sleep and finish all of the treatment in one visit.

General anesthesia is the state of pharmacologically induced “sleep”. When you are told that someone will need to be “asleep” for a procedure, often surgical, this is a reference to being placed under general anesthesia.  The aim of general anesthesia administration is to provide a lack of sensation and to ensure amnesia (no memory) and analgesia (no pain). It is our goal to provide safe, excellent care (in that order) and to provide a non-traumatic experience for our patients.  Sometimes, this is only possible through the use of general anesthesia.

Outpatient general anesthesia is considered very safe and has an excellent safety record when administered by qualified and experienced providers.  There are risks inherent in every type of procedure including anesthesia, but these risks are minimal with appropriate patients and highly trained providers. We understand and support parents’ great concern for their child when general anesthesia is recommended as the best option for success.  Our goal is always to provide a safe visit in which the best quality care can be provided in the least traumatic fashion possible.