Sedation

Jump to:   Safety | Pre-sedation Instructions | Post-sedation Instructions

Pediatric dentists are trained in a wide range of methods to help children feel comfortable during dental treatment. These methods range from the "Tell-Show-Do" technique, to general anesthesia. Tell-Show-Do is a technique during which a pediatric dentist might name a dental instrument, demonstrate the instrument by using it to count your child's fingers, and then use the instrument in treatment.

We also use the modeling technique which pairs a timid child in dental treatment with a cooperative child of similar age. Coaching, distraction, and good old TLC are other techniques to give your child confidence in dentistry. But by far the most preferred technique is praise. Every child does something right during a dental visit, and pediatric dentists use praise to encourage good behavior.

Occasionally a child's behavior requires assertive management to protect him or her from possible injury. Voice control (speaking calmly yet firmly) usually takes care of it, although there are other instances that require some more direct hand-holding.  As each child is individual and different, we discuss these techniques with parents as they pertain to their child.

The majority of the time when non-pharmacological methods are not successful, all that is needed is some laughing gas (Nitrous Oxide). This involves simply resting the nosepiece lightly on the child's face. The child is not “put to sleep,” however they do usually feel somewhat “tingly,” or “ticklish.”

Beyond the use of nitrous oxide/laughing gas, there are several other methods of sedation that can be used.  As with non-pharmacological techniques, there are several different options that we have at our disposal depending on the age, temperament, medical history and amount of necessary treatment.   Once again, as each child is different and requires individualized care, we discuss these options with parents prior to any decision being made.  Our doctors and the parents work together to decide which is the appropriate method for each child.

Pediatric Dental Care also works closely with a dentist anesthesiologist, specifically trained in working with children, and patients with special needs to offer safe and comprehensive dental care.  This allows a child to undergo deep sedation or general anesthesia in order to safely complete their necessary treatment.  Click here to learn more about in-office anesthesia, and Dr Kevin Dincher. 

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Safety

Depending upon the level of sedation that is required, your child will be monitored throughout his/her appointment with some combination of a pulse oxymeter (heart rate, breathing rate and oxygen level of the blood), a capnographer (the depth and quality of breathing), a stethoscope, a blood pressure cuff and clinical observation. All of these monitors are used to better assure the safety of your child. A complete array of emergency medications are always in the room with any sedated child and both the doctors and their staff are fully trained in their use.  While we cannot make sedation risk-free, we do all that we can in order to facilitate safety.

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Pre-Sedation Instructions

If your doctor has requested pretreatment evaluation by your physician (pediatrician) please make sure you bring a copy of the medical evaluation to our office on the day of treatment.  It is also extremely helpful if you ask your physician or child’s pediatrician to fax over the form when it is completed after your evaluation. This allows our doctors to review the medical findings prior to your appointment.

For those patients being treated in the morning do not eat or drink anything after midnight. Those patients scheduled for treatment in the afternoon should ask the anesthesiologist if clear fluids are permitted the morning of treatment. If clear fluids are permitted the following are allowed: water, apple juice, tea. Do not­ add milk to any drinks. Patients not following these instructions may have their treatment session cancelled.

Medications normally taken, should be taken unless otherwise instructed by the doctors in this office, and may be taken only with a sip of water.

Please have the child wear shirts with short sleeves or no sleeves.  No shirts with buttons. Comfortable pants or sweat pants should also be worn as well as comfortable flat shoes. Do not wear flip-flops. Please bring an extra set of clothes for the child being treated. Please bring their favorite blanket and/or stuffed toy. Remove all rings and contact lenses. Leave all valuables at home.

A change in your health, especially the development of a cold or fever is very important.  For your safety, if you have symptoms of a cold within fourteen (14) days of treatment you may be reappointed for another day.  Please inform the office of any change in health as soon as you are aware of it.

A responsible adult must drive you to the office.  A parent and another adult must accompany all children receiving sedation or general anesthesia.

A responsible adult must drive the adult patient home.  Any child receiving sedative management must be taken home by the parent and a second adult.  Allpatients should be in a car seat or if old enough wear a seat belt and should be sitting in an upright position on their way home.  Do not take a bus or taxi home.

A parent or responsible adult should be with the patient until the next day. The child, if sleepy, should be placed on a blanket on the floor in a room where the parent or responsible adult is staying.

Please arrive for your appointment at the requested time. Depending on the planned method of sedation for your child, it can take up to 45 minutes for the medication to work. In order to keep our schedule running on-time and smoothly, if you are late for your appointment, you may need to be rescheduled.

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Post-Sedation Instructions

We will give you a comprehensive sheet of post-operative instructions on the day of your child’s appointment.

Following the appointment, your child will be returned to you and you will be asked to remain in our office for a period of time as we make sure it is safe to send your child home. They may remain sleepy until later in the day or early evening, for this reason, you must bring along another responsible person to help watch them in the car on the way home. Your child will also need supervision at home to help prevent any accidental falls. If your child should fall asleep, make sure they are lying on their side, with their chin away from their chest. If they should vomit, be sure they are awake or lying on their side.

Your child will receive local anesthesia. This allows us to perform dentistry with minimal discomfort. Please remind them to avoid biting or playing with their lips and cheeks. While numb or still under the influence of sedation, they can cause serious trauma to themselves without knowing.

Please encourage your child to drink fluids as soon as they express the desire to do so. Avoid solid foods until your child completely recovers.

Your child should not experience any significant pain after he/she awakens. You may give them Children’s Motrin or Tylenol if needed for any discomfort. If the Tylenol or Motrin is not effective, please call our office. If your child should become ill, or any other problem should arise, please notify our office. If we are not in the office at that time, an emergency number is available on our answering machine and a doctor will be contacted immediately.

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For more information visit,

AAPD Sedation Information

AAPD Patient Management Guidelines