Sedation dentistry is most helpful for:
- Children who require major treatment
- A very anxious child
- Pre-cooperative children due to their young age
- Children that have had traumatic dental experiences (sound and smell aversion)
- Children with a strong gag reflex
- Children who are medically compromised or have special needs
Children who are very young or who have a high level of anxiety that interferes with the cooperation necessary for the dentist to perform treatment may require some level of sedation. Sedation is also helpful for special needs children. There are safe and effective medications available today that can help relax the child and promote a good environment for optimal and safe dental treatment.
Nitrous Oxide (Laughing Gas)
Conscious sedation is an option for children who are mildly apprehensive. This highly effective method can be administered in an inhalation method using nitrous oxide (N20-02).
Nitrous oxide (also known as laughing gas) is a clear, odorless gas that is used as a mild sedative during dental procedures. The main indication for using nitrous oxide is to reduce fear and anxiety in a patient but nitrous oxide can also reduce pain and minimize a hyperactive gag reflex. The gas is administered with a mixture of oxygen and has a calming effect that helps anxious patients relax during their dental treatment. The sedative effects of nitrous oxide have a quick onset and allow patients to remain conscious and talk to their dentist during their visit. We usually tell parents that it gives a feeling similar to floating on a raft. Nitrous oxide is very safe and the effects wear off almost immediately.
Our office uses nitrous oxide during most operative procedures (filling, crowns, extractions). We also often use nitrous oxide when placing sealants on young children in order to help minimize the gag reflex and relieve any anxiety. We explain the use of nitrous oxide to our patients by referring to it as happy air, laughing gas, space air, etc. We have our patients breath through a nasal mask and have them try to guess what the air smells like (most say they smell chocolate or strawberries but some have even said they smell pizza, hot dogs, or even burnt bacon)! After the procedure is over we have the patient’s breathe 100% oxygen for 5 minutes to make sure that all of the nitrous oxide is out of their system and they don’t have any residual dizziness. Sometimes after an appointment with nitrous oxide a patient feels tired or wants a nap… this is not due to the laughing gas but rather a child’s feeling “stressed” to get through the appointment (sitting still, opening wide, following directions for an extended period of time) or the length of the appointment. Once a child is finished with the appointment they may be relieved and ready to rest!
If your child is going to receive nitrous oxide make sure that they have no food or drink (other than water) three hours prior to the appointment. Children with full stomachs may occasionally experience nausea or vomiting (rarely) during nitrous oxide sedation. Please let us know if your child has any respiratory condition that makes breathing through the nose difficult as it can limit the effectiveness of nitrous oxide. Also, make sure you let us know if your child is taking any medications. Finally, please be aware that there are limitations to the effectiveness of nitrous oxide. Unfortunately it does not benefit all children, if a child doesn’t breathe through their nose ( and continues to breathe through their mouth) it will not be effective.
Deep sedation is sometimes necessary for children that are unable, by either age or maturity level, to cooperate during dental treatment. Our practice utilizes a certified dental anesthesiologist for cases where the patients are apprehensive, very young, or children with special needs that would not work well under conscious sedation. Dr. Commarato 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. 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 upon 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. They should not be left unattended, and should not walk unescorted.
- If your child wants to sleep, place them on their side with their chin up. 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.
- Although extremely rare, 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.