Has your child’s dentist informed you that your child’s extensive dental needs will require some sort of sedation or anesthesia? If a child suffers from severe anxiety or has special health care needs, this is something that might be necessary for safe and successful dentistry.
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Dr. Tamara K. Robison is a board-certified pediatric dentist at Cosmic Smiles for Kids and Adult Dentistry in Naples and Marco Island.
Medications given in the dental office for mild conscious sedation enable your child to relax and become a bit sleepy, allowing them to have an anxious-free dental visit. The child will be able to respond to those around them and will maintain all of their protective airway reflexes.
Children with severe anxiety might need to use stronger medicines to achieve a deeper level of sedation to allow for their dental work to be completed. In this case, deep sedation or general anesthesia may be provided in the dentist’s office. A dentist is likely to recommend deep sedation or general anesthesia when the child:
- Has such severe anxiety that even with conscious sedation they cannot calm down enough to have work completed safely.
- Requires oral surgery or other treatment that would be difficult for them to tolerate while awake.
- Requires extensive work that will take a long time but would be best to accomplish in one appointment.
- Has a disability that prevents them from clearly understanding directions or from being treated safely.
When deep sedation is necessary, a pediatric dentist will provide the dentistry and work with a medical anesthesiologist or a dentist who has completed an advanced anesthesiology program beyond their pediatric residency. The pediatric dentist who provides these services in the dental office setting is responsible for the evaluation of the professional and educational qualifications of the general anesthesia or deep sedation provider. The office in which these services are provided also has to meet local, state and federal rules and regulations. A permit must be supplied by the state authorities confirming that the facility has passed a physical inspection. The inspection confirms that all necessary emergency supplies are available and that the guidelines for monitoring and management of patients during and after the sedation are followed. The protection and safety of the patient are paramount. The regulations, inspections and permits help ensure the safe delivery of these services.
Deep sedation and general anesthesia do have some risks, and your providers need to carefully explain the risks and benefits. Parents also have responsibility to follow all instructions regarding not eating before the procedure and careful observation of the patient after the appointment.
The American Dental Association has a list of questions parents should ask their dental care provider prior to their child receiving sedation or anesthesia:
- Who will complete the evaluation prior to the procedure that will include past medical history?
- How long should my child be without food or drink prior to the procedure?
- Will sedation be administered at home prior to the appointment? If so, what type of monitoring is required?
- What is the training and experience of the person giving the sedation or anesthesia to my child?
- Is the entire staff up to date on emergency resuscitation procedures?
- What level of sedation will be given to my child and what side effects can we expect from it?
- How will my child be monitored before, during and after the procedure?
- What are my instructions for caring for my child once we are released to home?
Anesthesia and conscious sedation are valuable tools for pediatric dentists to safely perform needed procedures on children who are nervous or who require extensive work. As with anything else, parents should be well-researched and prepared for their child’s visit. By working together with the dentist, they can ensure their child has a safe and successful dental appointment.
Dr. Tamara K. Robison is a board-certified pediatric dentist at Cosmic Smiles for Kids and Adult Dentistry in Naples and Marco Island.
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