Sedation for Your Child’s Dental Work
Young children with dental pain, caries (a.k.a. cavities) and/or infection require treatment at any age—sometimes that means your child may require sedation. Of course, there are many reasons for this. Some dental procedures require your child to lie completely still, there may be a lot to fix, or the noise of the drill may be scary. The goal is always to provide the safest, most pain-free treatment for your child with the best experience possible.
HOW SAFE IS ANESTHESIA OR SEDATION IN DENTAL PROCEDURES FOR CHILDREN?
In 2019, the American Academy of Pediatrics (AAP) and the American Academy of Pediatric Dentistry (AAPD) updated the current guidelines for dentists and oral surgeons to follow when providing deep sedation or general anesthesia to children.
It requires that there are always at least 2 people in the office who are trained to provide advanced life support measures in case there are any problems. One of these people will be the dentist or oral surgeon performing the procedure and the other will be an independent observer. This independent observer must be “a physician anesthesiologist, a certified registered nurse anesthetist, a second oral surgeon, or a dentist anesthesiologist.”
TYPES OF SEDATION AND ANESTHESIA WE USE
Pediatric dentist: This is us! Dr. Dai & Dr. Matthews have completed all the training and licensure as a general dentist, as well as a pediatric dental residency (usually 2-3 years). Pediatric sedation training is included in the residency training. We are also board certified pediatric dentists through the American Board of Pediatric Dentistry.
Anesthesiologist: A physician or dentist who completes a 3-5-year anesthesiology residency after medical or dental school and passes all required exams. Anesthesiologists can administer anesthesia for dental procedures and oral surgery, and they may have a permit from a State Dental Board to deliver anesthesia in a dental office. Physician and dentist anesthesiologists may have specialized training to treat children, and they may have board certification by taking and passing a national exam.
This is a mild sedative and the least invasive. It’s commonly known as ‘silly air’ or ‘laughing gas.’ Children breathe this together with oxygen. They don’t usually go to sleep, but most will get more relaxed. Most will get a little silly and lightheaded, but a few don’t like the feeling.
This medication (or a combination of medications) are commonly used on older children and adults. Your child would be calm and awake—and sometimes able to do what the dentist or surgeon asks him or her to do. After the procedure, your child may not even remember things about the dental visit depending on the type of medication given.
Under moderate sedation children are sleepier, but they are usually able to do what the dentist or oral surgeon asks them to do. Older children and young adults do better with moderate sedation than younger or more fearful children. They breathe on their own and will usually wake up easily. Most children will not remember anything about the procedure.
This involves intravenous (IV) medications to help your child sleep through the procedure. While your child may still move a little and sometimes make noises. For this type of sedation, we have an anesthesiologist who comes in to the office. He will monitor your child’s heart rate, heart rhythm, blood pressure, and oxygen saturation (breathing) during the procedure and until he or she wakes up. He can also determine when your child is ready to go home. If the patient cannot be put under IV in a dental setting, then we have to refer them out to TX Childrens hospital, but we would not be the doctors/assistants going to do treatment.