ABChildren's Dentistry (972) 910-0003

Sedation

Sedation dentistry provides a safe, comfortable dental treatment for children with special needs. Children who have a level of anxiety that prevents good coping skills or are very young and do not understand how to cope in a cooperative fashion for the delivery of dental care should be sedated. Sedation is safe when performed by a trained pediatric dentist who follows the sedation guideline from the American Academy of Pediatric Dentistry.
 
  • Nitrous Oxide
  • Conscious Sedation
  • I.V. Sedation
  • General Anesthesia

Oral Sedation Instructions for Your Child

Medication Instructions
If your child will be pre-medicated to treat his or her dental condition, please follow the instructions below prior to the appointment to ensure safe, successful, and comfortable dental treatment.

Specific Instructions
  • Allow your child to have a good dinner the evening before the appointment and a snack before bedtime.
  • Ensure that his or her normal routine is followed the evening prior to the dental appointment (e.g., no overnights at relative's house).
  • Medication will be given by mouth (orally). Therefore, your child must have an empty stomach in order for the medication to be effective for dental treatment. The rule is NOTHING TO EAT OR DRINK AFTER MIDNIGHT EXCEPT PRESCRIBED MEDICATIONS. Occasionally our staff will recommend clear fluids (such as water or apple juice) up to four hours before the appointment, but you should check with our office if fluids will be administered. Unless instructed by our office, your child must have an empty stomach.
  • Your child will not receive a general anesthetic. The medication is a pediatric hypnotic or sedative medicine. Local anesthetic will also be administered for pain control. Nitrous oxide, also called "happy air" or "laughing gas," will be used for further comfort.
  • After ingestion of the medication, we wait approximately one hour before beginning the treatment. During this hour prior to treatment, some children experience the following:
  • Crankiness or excitable behavior, especially in the first 30 minutes.
  • Disorientation, loss of balance, and coordination.
  • Accordingly, special care and guidance must be given during the first hour so your child will be safe. If at all possible, we request that on treatment day no friends or siblings accompany the child receiving treatment. Dental treatment usually requires the entire morning.
  • Parents must remain in our reception area during treatment.
  • Please be PROMPT for your appointment because it takes approximately an hour for the medication to take effect.

An important point to remember is that if your child develops a fever, productive cough, and/or heavy nasal drainage within 24 hours of the appointment, please notify our office. We may need to reschedule.
 
1.  Nitrous Oxide
Some children are given nitrous oxide/oxygen, or what you may know as laughing gas, to relax them for their dental treatment. Nitrous oxide/oxygen is a blend 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 them to sleep. The American Academy of Pediatric Dentistry recognizes this technique as a very safe, effective technique to use for treating children’s dental needs. The gas is mild, easily taken and with normal breathing, it is quickly eliminated from the body. It is non-addictive. While inhaling nitrous oxide/oxygen, your child remains fully conscious and keeps all natural reflexes.

Prior to your appointment:
  • Please inform us of any change to your child’s health and/or medical condition.
  • Tell us about any respiratory condition that makes 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.
  • Please do not feed your child within one hour of dental procedure.
 
2.  Conscious Sedation
Conscious Sedation is recommended for apprehensive children, very young children, and children with special needs. It is used to calm your child and to reduce the anxiety or discomfort associated with dental treatments. Your child may be quite drowsy and may even fall asleep, but they will not become unconscious.
 
There are a variety of different medications which can be used for conscious sedation. The doctor will prescribe the medication best suited for your child’s based on his/her overall health and dental treatment recommendations. We will be happy to answer any questions you might have concerning the specific drugs we plan to give to your child.
 
Prior to your appointment:
  • Please notify us of any change in your child’s health and/or medical condition. Do not bring your child for treatment with a fever, ear infection or cold. Should your child become ill, contact us to see if it is necessary to postpone the appointment.
  • You must tell the doctor of any drugs that your child is currently taking and any drug reactions and/or change in medical history.
  • Please dress your child in loose fitting, comfortable clothing.
  • Please make sure that your child goes to the bathroom immediately prior to arriving at the office.
  • Your child should not have milk or solid food after midnight the day of the appointment. They may have clear liquids (water or Gatorade) only up to six hours before the appointment. It is best to not allow your child to eat or drink at all before the appointment to avoid confusion as to the time of eating. Sedation appointments are early in the morning to reduce the discomfort your child may have from being hungry.
  • The child's parent or legal guardian must remain at the office during the complete procedure.
  • Please watch your child closely while the medication is taking effect. Hold them in your lap or keep close to you. Do not let them "run around."
  • Your child will act drowsy and may become slightly excited at first.
 
After the 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. Do not allow them to sleep unattended by an adult. 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.
  • Please call our office for any questions or concerns that you might have.
 
I.V. Sedation
I.V. Sedation is recommended for apprehensive children, very young children, and children with special needs that would not work well under conscious sedation. The dentist performs the dental treatment in our office with the child anesthetized under I.V. sedation, which is administered and monitored by an anesthesiologist.

Prior to your appointment:
  • Please notify us of any change in your child’s health and/or medical condition. Do not bring your child for treatment with a fever, ear infection or cold. Should your child become ill, contact us to see if it is necessary to postpone the appointment.
  • You must tell the doctor of any drugs that your child is currently taking and any drug reactions and/or change in medical history.
  • Please dress your child in loose fitting, comfortable clothing.
  • Please make sure that your child goes to the bathroom immediately prior to arriving at the office.
  • Your child should not have milk or solid food after midnight prior to the scheduled procedure and clear liquids ONLY (water, apple juice, Gatorade) for up to 6 hours prior to the appointment.
  • The child’s parent or legal guardian must remain at the office during the complete procedure.
 
After the 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. Do not allow your child to sleep unattended by an adult. 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.
  • Please call our office for any questions or concerns that you might have.
 
General Anesthesia
General Anesthesia is recommended for apprehensive children, very young children, and children with special needs that would not do well under conscious sedation or I.V. sedation. General anesthesia renders your child completely asleep. This would be the same as if he/she was having their tonsils removed, ear tubes, or a hernia repaired. This is performed in a hospital or an outpatient setting only. While the assumed risks are greater than that of other treatment options, if this is suggested for your child, the benefits of treatment this way have been deemed to outweigh the risks. Most pediatric medical literature places the risk of a serious reaction in the range of 1 in 25,000 to 1 in 200,000, far better than the assumed risk of even driving a car daily. The inherent risks if this is not chosen are multiple appointments, potential for physical restraint to complete treatment and possible emotional and/or physical injury to your child in order to complete their dental treatment. The risks of NO treatment include tooth pain, infection, swelling, the spread of new decay, damage to their developing adult teeth and possible life threatening hospitalization from a dental infection.
 
The surgery center or hospital has specific requirements concerning paperwork, authorization and a pre-procedure health physical for your child prior to treatment in their facility. We will help you with the steps required to care for your child.
 
Prior to your appointment:
  • Please notify us of any change in your child’s health. Do not bring your child for treatment with a fever, ear infection or cold. Should your child become ill, contact us to see if it is necessary to postpone the appointment.
  • You must tell the doctor of any drugs that your child is currently taking and any drug reactions and/or change in medical history.
  • Please dress your child in loose fitting, comfortable clothing.
  • Your child should not have milk or solid food after midnight prior to the scheduled procedure and clear liquids ONLY (water, apple juice, Gatorade) for up to 6 hours prior to the appointment.
  • The child’s parent or legal guardian must remain at the hospital or surgical site waiting room during the complete procedure.
 
After the 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. Do not allow your child to sleep unattended by an adult. 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.
  • Prior to leaving the hospital/outpatient center, you will be given a detailed list of "Post-Op Instructions" and an emergency contact number if needed.
ABChildren's Dentistry (972) 910-0003