Anxiety can be an issue that both children and adults suffer from before going to the dentist. Sometimes the level of anxiety is so high, that it can interfere with the dental procedure. In these cases, we recommend a very safe and effective solution called sedation. Sedation is a common alternative that will help a patient relax before and during his dental treatment.
Conscious sedation can achieve a minimal, moderate, or even deep suppression of consciousness — after which the child will remember nothing about the procedure. Minimal conscious sedation is the most commonly used for the treatment of fear and anxiety with invasive dental procedures. It allows the child to retain the ability to breathe independently and respond appropriately and normally to physical tactile stimulation and verbal commands. Minimal (which can progress to moderate) conscious sedation is commonly achieved with medication taken by mouth (orally).
Because reducing fear and anxiety is not the same as preventing pain, minimal or moderate oral conscious sedation is often accompanied by a nitrous oxide/oxygen combination, which when inhaled produces some pain relief; this is used with a local anesthetic delivered by injection. If your child is to be sedated at the dental office, you will typically be instructed to feed him a low-fat dinner the night before and then have him refrain from all food or liquid from that point until after treatment.
On the day of the procedure, your child will receive a pre-sedation physical evaluation by the dentist, who will administer one or more sedative drugs in a syrup form. The two most popular drugs in use today for oral conscious sedation in pediatric dentistry are Midazolam (brand name Versed) and Hydroxyzine (brand name Vistaril or Atarax). These are both very safe drugs that are fast-acting and leave the child’s system quickly. It’s important to note that no sedative is completely risk-free. However, minimal sedation does have the lowest risk when compared to other higher levels of sedation and general anesthesia.
A sedated child must be continually monitored during dental treatment for vital signs: heart rate, respiration rate, blood pressure, temperature, and blood oxygen level — by a designated auxiliary staff member. Ventilation (air entering and leaving the lungs) may also be monitored by measuring exhaled carbon dioxide. To further ensure your child’s safety, the pediatric dentist Alexandria VA may also use special positioning and immobilizing equipment to keep movement to a minimum during the procedure thus ensuring that the airway is protected and that no injury will occur while instruments are in the mouth.
Once the treatment is completed, you and your child will wait until his vital signs return to pre-sedation levels. He will need a ride home, and to be supervised by an adult for the rest of the day. He should definitely not return to school until the next day.
The American Academy of Pediatrics, the American Academy of Pediatric Dentistry, and the American Dental Association have jointly established criteria for the use of oral conscious sedation in pediatric dentistry.
For cases in which children are very incapable of undergoing a procedure without the assistance of sedation, whether its by age or maturity level, we offer another method. SuperKids Pediatrics Dentistry offers IV sedation and is administered by our certified anesthesiologist. In cases that the patient may pose harm to his own safety during the procedure, we recommend this alternative. However, all options will be discussed with the parent(s)/guardian(s) of the patient in order to achieve the best outcome.
For more information regarding sedation services, give any one of our office locations a call at:
46175 West Lake Drive, Suite 430, Sterling, VA. 20165 • Phone: 703-774-0014
9800 Falls Road, Suite 7, Potomac, MD 20854 • Phone: 301-299-4400
5787 Winston Court, Alexandria, VA 22311 • Phone: 703-931-4400