13 Aug 2018 Sedation Dentistry—Is It Right for Kids?
It’s a tough situation—you have a young child that needs a root canal or another involved procedure. You and your dentist are worried that your child cannot sit still long enough to finish the procedure. What will happen if my child moves? Will their mouth be damaged? Will my child feel pain and be scared to return to the dentist again? Will this fear become a lifelong problem? Will we have to make several appointments to get a procedure done? What if the local anesthesia (numbing shot) isn’t enough pain relief?
All of these concerns are legitimate for any parent with a young child. What options do parents have? What are the risks to sedation dentistry? What is the cause of this tooth pain in the first place? This article explores the answers to these questions.
What are my options for sedation?
Local anesthesia shot and no sedation. This is when the dentist rubs your gum with a numbing cream and then shoots some anesthesia into your mouth’s tissue. A certain section of your mouth becomes numb within a few minutes. Usually, this local anesthesia wears off within a few hours. This is the most common anesthesia in general dentistry and can be used on children.
Nitrous Oxide is also called laughing gas. It is delivered through a mask that fits over your nose. It starts to work in about 5 minutes. Laughing gas can calm nerves and give you a feeling of euphoria. It is used for both children and adults. Its effects can be minimized at the end of the visit by administering oxygen through the mask.
Oral sedation is when your child is given a pill that they take to relax or help them not care about the procedure. Usually, oral sedation (pills) are prescription drugs that you fill and take with you to your dental appointment. Some drugs take longer than others, but generally, your child takes the pill at the dental office and waits 20-30 minutes for the drug to take effect. These types of drugs can be taken safely by children but do have side effects and may take several hours to wear off.
Conscious sedation is when an anesthesiologist meets you at your dentist office and administers sedating drugs through an IV. This type of sedation is the most expensive since you are paying for your anesthesiologist’s time. The anesthesiologist will monitor how the drug is affecting your child. Your child is intended to remain groggy but awake during the procedure. This type of drugs has to be carefully monitored. If too much drug is administered, your child could become unconscious, which can be dangerous.
What are the risks to using anesthesia or sedation?
With a local anesthesia, the risks are minimal. With nitrous oxide, there is minimal risk of a child’s oxygen level dropping too low but will careful monitoring, this risk can be managed.
With oral sedation, every medication has side effects but since the medication is taken only once, with careful monitoring, this risk can be managed.
Conscious sedation is more risky. But again, monitoring keeps your child safe. Your child must be monitored for oxygen level and airway obstruction, the most common risks.
A Good Rule of Thumb
As a parent, you know your child the best. You know his or her temperament and what is possible to endure. Children younger than 6 can be difficult at a dentist but are at the greatest risk for complications. One parent brought a young child to a dentist with a cavity and conscious sedation was recommended. The same parent went to another dentist who gave the child a prize and did a filling using only laughing gas. The tooth wasn’t even numbed.
Always administer the least possible sedation/anesthesia needed to get through a procedure. Remember, sedation should not be a first line treatment.