There are some common misconceptions when it comes to sedation for dental work, especially when sedating children. However, different forms of sedation can be used during a pediatric dental procedure and, when administered properly, are completely safe.
There are three different levels of sedation that can be used for dental services: mild, moderate and deep. The mild level is usually administered in oral form, such as a pill or syrup. It takes about 20 minutes to kick in.
This should be used for child patients who are cooperative and need very mild work done. Patients can also receive nitrous oxide, also known as “laughing gas.”
The moderate form is administered through an IV, which causes patients to become sleepy and not remember the procedure, but they’re still conscious. The moderate level should be used on someone who is cooperative, so it fits best for patients who are mildly anxious.
Deep sedation, also referred to as general anesthesia, can be used on young children who have a lot of dental work needed or special needs patients. This is the deepest level of sedation in which a higher dose of fentanyl as well as propofol and ketamine are administered through an IV, so the patient will be totally asleep. This level requires extra care from the anesthesiologist to make sure the patient is reacting to it properly.
When it comes to deciding which level of sedation to use on the patient, the dentist can make a recommendation but ultimately it’s up to the patient or guardian to decide on the level of sedation. Of course, the dentist also reserves the right to opt out of treating the patient if they strongly disagree with their choice. After all, patient safety is our No. 1 priority as dentists. We weigh all the risks and benefits when determining the safest and most effective solution for the patient.
As far as the proper age for sedating children goes, depending on the necessity of the procedure, it’s best to wait until the kid is age two or older. When a child does need to be sedated, it should be done in an outpatient surgery center and it needs to be conducted by an anesthesiologist.
When it comes time to sedate a child, the dentistry and the anesthesia should be kept separate for the safety of the kid. Each of them needs to have complete focus on what they are doing rather than the dentist trying to do both. That’s when problems occur is when the dentist is doing both and gets distracted, which can cause them to lose focus on the patient’s vital signs and over sedate.
There are many benefits to using sedation, when appropriate, on children and those with special needs. Usually all the dental work can be done in a single visit rather than the patient having to come back. In the old days before children were able to be sedated for dental work, they had to be held down or tied up in a papoose (aka straight jacket). This caused a negative experience for children and created a fear of the dentist that could last into adulthood. When people grow up with this kind of dental anxiety, it will cause them to put off going to the dentist and eventually create dental decay that will only get worse in time.
My job is to make sure my patients are as comfortable as possible and that they aren’t afraid to come to the dentist as children or adults. We make it a priority to thoroughly monitor patients during regular dental work and when using sedation.
If you have any questions regarding using sedation in pediatric dentistry, please contact one of our Children’s Dentistry locations in Southern Nevada or visit our website at ChildrenSedationDentist.com.