Sedation’s role in children’s dentistry

Children’s dentistry has made leaps and bounds in the last two decades. Although some adults may have unpleasant childhood memories from a visit to the dentist, it doesn’t have to be that way anymore! In the 21st century, modern dentistry has helped to make a child’s visit to the dentist fun and enjoyable.

Antianxiety agents, or sedatives, can help patients relax as well as ease one’s dental fears. There are three types of sedation used in children’s dentistry today to aid in easily and safely treating dental infections and disease. The first and deepest form of sedation is general anesthesia. The second, mid-level form of sedation is conscious sedation. The last form is nitrous oxide, also know as laughing gas.

1.) Let’s begin with how general anesthesia can help make a child’s visit to the dentist easy. General Anesthesia means to place a person in a controlled unconscious state using medications that are administered either intravenously or through the lungs as inhaled gases. During the time the patient is anesthetized or sleeping, monitors are connected to record the patient’s vital signs, an intravenous line is established to administer medications, and an airway is placed through the nose to ensure adequate oxygen supply.

Benefits of general anesthesia are being able to treat patients who are very young, very afraid, or who have certain physical or medical conditions more safely than using local anesthetic alone (also known as novocaine). Helping patients fall asleep with the use of general anesthesia, relieves any anxiety or fear a patient may have. Patients will not remember anything about the treatment which will help alleviate long lasting dental fears, phobias, and emotional scars. All dental treatment is completed during this one visit.

2.) The second type of sedation is Conscious Oral Sedation which is described as a minimally depressed level of consciousness during which the patient is able to breathe independently and/or respond to verbal commands. Conscious oral sedation is given as an oral pre-medication liquid and is a means of sedation that lowers the anxiety level of patients who are extremely apprehensive or afraid. It is not a general anesthetic and does not put the patient to sleep; however, it often makes the patient so relaxed that they do sleep, sometimes even during the dental treatment. Conscious oral sedation is useful for patients who are inexperienced, afraid, or require a lot of dental work. Another benefit of utilizing oral sedation is that all dental treatment can usually be completed in one visit to the dentist. Conscious oral sedation of children for dental procedures is both common and, in many cases, necessary to provide appropriate dental treatment. Apprehensive children, very young children, and children with special needs would not be able to receive the necessary dental care in a safe and comfortable manner, in many instances, without this procedure.

Conscious oral sedation is given as a liquid that the patient must drink 1 hour prior to dental treatment. During this time they gradually become more sleepy and relaxed. This medication does not take the place of local anesthetic. Local anesthesia must still be given; however, the good news is that it can usually be given without the patient feeling too much discomfort. It must be recognized that patients will experience the usual numb feeling for 3-4 hours after their appointment. When looking into the use of any type of sedation, the patient should disclose information about any illnesses, allergies, other health conditions or concerns. In addition, any medications that a child is taking should be discussed with the doctor.

A wide range of sedative agents are both safe and effective for children in the dental setting when used appropriately by individuals who are trained in their use, who utilize patient monitoring equipment, and who have established emergency procedures in place to react to the rare occurrence of unexpected responses. Conscious oral sedation is successful in about 85% of the children treated. It works best in children five years old and older. It is usually not effective in patients under the age of four years and sometimes even older patients who are so afraid or nervous that they cannot relax.

3.) The final type of sedation for children is Nitrous Oxide, commonly known as laughing gas. The alternative to general anesthesia or oral sedation would be to use a local anesthetic, commonly know as Novocaine, along with the use of nitrous oxide. This would require dental treatment to be completed in multiple short dental appointments. Nitrous oxide is used with patients of all ages and few side effects are associated with its use. Nitrous oxide is mixed with oxygen and inhaled through a small mask that the patient wears on their nose. Its effects wear off soon after the mask is removed. Nitrous oxide helps to take the edge off of patient’s dental phobias and helps to make the patient feel very relaxed. Remember, if dental treatment (fillings, crowns, etc.) is not completed children are at risk of getting larger cavities and oral infections.

Dentistry has an excellent safety record. Dentists are committed to advancing the safety of all dental procedures and reducing risk, although no one can completely eliminate all risk associated with health care procedures. By utilizing conscious oral sedation, the doctor may expertly treat all of a child’s dental needs safely without the pain, discomfort, or sounds that are normally associated with dental treatment. Some patients may feel nervous or anxious about their dental visit. But one can rest comfortably knowing that their dentist wants to make sure their visit is as free from discomfort and anxiety as possible!
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The Seventh-day Adventist Clinic is offering FREE DENTAL EXAMS to all new patients. Children & adults are welcome! Call to schedule your FREE exam at #234-6323. Take charge of your dental and overall health! [I][B](Crystal A. Edmister D.D.S.[/B]

Dr. Crystal A. Edmister is a dentist at the Seventh-day Adventist Dental Clinic.[/I]