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Sedation and Dental Comfort

Anesthesia for the Dental Visit

Local Anesthesia / Conscious SedationNitrous Oxide / I.V. Sedation / General Anesthesia

 

Local Anesthesia

Local anesthesia numbs the teeth and gums to prevent you from feeling discomfort during dental treatment.  There are two types of local anesthesia: topical and injectable.

-A topical anesthetic helps numb the surface of the gums.  It may be used to help eliminate the slight discomfort that some patients feel from injections.  The topical anesthetic is applied with a swab.

-Injectable anesthetics work to prevent pain in the area of the mouth where treatment will take place.  They are used for procedures such as restoring teeth and preparing crowns, for example.

 

Conscious Sedation

Antianxiety agents, or sedatives, can help your child cope with dental treatment.  They may be given at the dental appointment and can be administered as liquids or injections.  These medications provide what is called “conscious sedation,” which means that your child will be awake during the procedure, but may be relaxed.   Your child may become relaxed and eventually fall asleep, but they do not become unconscious.  Sedatives may be used with local anesthetics during dental procedures. 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 48 hours prior to see if it is necessary to postpone the appointment.
  • Your child should not have solid food or drink (not even water) after midnight the night before the morning sedation appointment.  Be cautious that your little one does not wake up and eat/drink anything on the morning of the appointment.
  • You MUST remain at the office during the complete procedure.
  • Please monitor your child closely while the medication is taking effect. They should sit and watch the television, but are not to walk around without your aid.
  • Your child will act drowsy and may become slightly excited at first.

After the sedation appointment

  • Your child will need to be monitored very closely for up to 6 hours after the procedure.
  • If your child wants to sleep, place them on their side with their chin up. Wake your child every thirty minutes to one 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. Avoid milk/dairy products the day of procedure. If your child vomits, help them bend over and turn their head to the side to insure that they do not inhale the vomit.  You will start with clear liquids again, and slowly progress their diet.
  • Because we use local anesthetic to numb your child’s mouth during the procedure, please observe your child carefully to prevent any injury to the lips, tongue, or cheeks.
  • Please call our office for any questions or concerns that you might have.

 

Nitrous Oxide

Most pediatric dentists use nitrous oxide, also known as “laughing gas.”  The use of nitrous oxide has been endorsed by the American Academy of Pediatric Dentistry as a safe way to help complete dental treatment.  Nitrous oxide/oxygen is a blend of two gases, oxygen and nitrous oxide. It 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. Nitrous is easily taken, and the effects are reversed quickly once it is no longer administered.  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. Nitrous only works if your child can breath it in.
  • Let us know if your child is taking any medication on the day of the appointment.
  • If it is a morning appointment, do not feed breakfast to your child.  If it is an afternoon appointment, your child should have a light lunch before 11 am the same day.

 

I.V. Sedation

Intravenous sedation involves introducing the sedative medication intravenously.  Intravenous 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. Your child will be awake and breathing and swallowing on their own.

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 48 hours prior to see if it is necessary to postpone the appointment.
  • Your child should not have solid food or drink (not even water) after midnight the night before the morning sedation appointment. Be cautious that your little one does not wake and have anything to eat/drink the morning of the appointment.
  • You MUST remain at the office during the complete procedure.
  • Please monitor your child closely while the medication is taking effect. They should sit and watch the television, but are not to walk around without your aid.
  • Your child will act drowsy and may become slightly excited at first.

After the sedation appointment:

  • Your child will need to be monitored very closely for up to 6 hours after the procedure.
  • If your child wants to sleep, place them on their side with their chin up. Wake your child every thirty minutes to one 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. Avoid milk/dairy products the day of procedure. If your child vomits, help them bend over and turn their head to the side to insure that they do not inhale the vomit.  You will start with clear liquids again, and slowly progress their diet.
  • Because we use local anesthetic to numb your child’s mouth during the procedure, please observe your child carefully to prevent any injury to the lips, tongue, or cheeks.
  • Please call our office for any questions or concerns that you might have.

 

General Anesthesia

General anesthesia, unlike conscious sedation, causes a loss of consciousness and produces deep sleep. The natural reflexes are not present in this state of sleep, so it is necessary that a machine maintain breathing. This is usually done in the hospital, in the operation room, with an anesthesiologist. General anesthesia may be used for patients with uncontrollable anxiety or patients who are unable to control their movements (such as young children or children with disabilities). It may also be used for long or complicated procedures, when a patient may not be able to tolerate the length of treatment in a chair.

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