One of the main goals we have as pediatric dentists is to provide comprehensive and safe dental care in a way that is comfortable to children and prevents feelings of anxiety and stress. Sedation is a technique used to complete dental treatment safely and effectively to children who are too anxious, too young, or require extensive treatment. In addition to the patient’s comfort and safety, sedation is also helpful for us to provide successful dental care.
Nitrous oxide or "Laughing Gas" is an odorless gas that is administered with oxygen and, when inhaled, can decrease a patient’s anxiety, discomfort, and gag reflex. After a patient has been breathing nitrous oxide and oxygen for a few minutes, they generally feel less concerned with dental treatment and more focused on the movie that they are watching. The patient remains awake and responsive during treatment. Because nitrous oxide is effective only when it is inhaled, it is important that the patient is not congested nasally, they can cooperate with laying in the chair and they can have the “nitrous nose” placed over their nose. For some patients, nitrous oxide is not quite enough to make them comfortable for treatment and we can stop the appointment at a safe time to discuss other treatment options.
Moderate sedation is the use of oral medications that are specifically chosen based on each child’s age, weight, and treatment needs. After choosing a flavor, the patient will be asked to drink the small amount of liquid medication (the medication can be syringed with the help of a parent but this is not preferred). The patient and parent will watch a movie for about 30-45 minutes in one of our quiet rooms while the medications take effect. Sedative medications cause most children to become relaxed and drowsy, but the goal of moderate sedation is not that the patient becomes unconscious. Although many children will appear alert after treatment, it is important that the patient have constant adult supervision for the remainder of the day.
In-office IV sedation is provided by a dental anesthesiologist whose entire role is to closely monitor and keep the patient comfortably anesthetized throughout the visit. During IV sedation, the patient is completely asleep and unaware of dental treatment being performed. The last thing many children remember is walking into the operatory with their parents. IV sedation is indicated for children who are not able to tolerate treatment with nitrous oxide and/or moderate sedation. It allows the dentist to complete all treatment in one visit.
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