Sedation and Pediatric Dentistry

Published on November 10, 2021, Updated on February 1, 2022

Dental sedation is used to reduce your child’s anxiety and discomfort when completing the necessary dental treatment. There are a few things we would like you to know about this process to help you make an informed decision.

How Safe is Sedation Dentistry for Children

One of the biggest concerns for parents is whether sedation dentistry will be safe for kids. As with all medical procedures, there will always have inherent risks.

For most patients, sedation dentistry is completely safe. But patients with special health conditions may have higher risks. As each child is different, your dentist will review your child’s oral health history and any other concerns before the dental procedure.

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Types of Sedation Dentistry and Anesthesia Used in Children

There are different types of sedation options that dental professionals can use on children and each comes with its own risks and benefits.

Nitrous Oxide – Also known as laughing gas, nitrous oxide sedation is used if children are exceptionally nervous. Nitrous oxide is delivered via a mask placed on your child’s nose combined with oxygen. Children can comfortably breathe through the nose and out through the mouth. Nitrous oxide does not put children to sleep. They are fully awake and fully conscious (conscious sedation) for the entire appointment.

Nitrous oxide is painless to deliver and the sedative effects wear off in a matter of minutes. This is one of the benefits of nitrous oxide as the child will not have any lingering sedative effects after the appointment. Before removing the mask off completely, the pediatric staff delivers pure oxygen at the end of the appointment to ensure the nitrous oxide is gone on the child’s body.

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IV Sedation – For children who are highly anxious, uncooperative, or have extensive dental treatment needs, pediatric dentists will advise IV sedation. When this form of sedation is recommended, the pediatric dentist will ask parents to prepare the child before the appointment. Common preparatory measures include the child’s current history and physical exam results from the child’s physician or pediatrician, limiting food and drinks before the dental visit,  brushing their teeth using soft-bristled toothbrush and preparing to stay with the child after the appointment for office hours.

There are some medical conditions that may not work for in-office IV sedation and are better performed in a surgical center or hospital – dental experts will inform you if that is the case.

Oral Sedation – The patient can take a pill or liquid sedative before the procedure to help them feel relaxed. There are several types of medications used for this purpose and the one that will be prescribed will depend on the patient’s health history. An oral sedative may make the patient feel sleepy, but they will remain still remain awake for the procedure. Oral sedation may take some time to wear off after the procedure so the patient will need to take a rest at home for the remainder of the day.

General Anesthesia– This type of deep sedation is administered mainly in a hospital because the patient will be rendered completely unconscious. Patients under general anesthesia should be closely monitored and they’ll likely stay in the hospital for at least one night.

What to Do Before and After Sedation

To make sure that your child has the best possible experience is to prepare them for their dental appointment. Here are some things you can do before the procedure:

• Do not give them solid foods before sedation.

• Dress them with only loose-fitting and comfortable clothing.

• Tell their dentist about any prescriptions or over-the-counter medications that your child is taking.

• Bring their favorite toy. It is a great way to help them feel better.

Aftercare Instructions

Loss of physical coordination, grogginess, nausea or even uncontrollable giggles is normal due to the sedation effects. Your child will need to rest and special dental care procedures after their treatment. Here’s what you can do:

• Monitor your child after the treatment.

• Encourage them to stay hydrated by drinking water.

• Use ice-pack to help with the swelling.

• Give them only soft foods such as mashed vegetables, lukewarm soup or smoothies to avoid discomfort in the mouth.
• Clean their teeth by brushing them using fluoride toothpaste to make sure it is rid of any bacteria that may damage their teeth in the future.

Sources:

• Ashley PF, Chaudhary M, Lourenço-Matharu L. Sedation of children undergoing dental treatment. Cochrane Database Syst Rev. 2018;12(12):CD003877. Published 2018 Dec 17. doi:10.1002/14651858.CD003877.pub5
• Primosch RE, Buzzi IM, Jerrell G. Effect of nitrous oxide‐oxygen inhalation with scavenging on behavioral and physiological parameters during routine pediatric dental treatment. Pediatric Dentistry 1999;21(7):417‐20.

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