If my child needs sedation, what options do I have?

It’s never easy making the decision to have your child sedated for a procedure. It’s important that parents do their homework in advance and develop a comfort level with their child’s provider. I’ve seen it time and time again when a parent has “decided not to decide” and typically caries continue to progress, requiring more invasive procedures. If developing that comfort level means getting a second opinion, then more power to you. Parents frequently approach our office asking “what are my options with sedation?” Here are the more common routes of anxiolytics and sedation.
1- Nitrous Oxide:
Also called laughing gas. This method is mostly useful for the older child who has some minimal anxiety and will be able to be coached through the procedure. The child MUST be calm enough to breathe through her/his nose. If not, the dentist will get more of the gas than your child. This procedure is known for its safety (only commonly reported issue is possible nausea).
2- Conscious Sedation:
This is also referred to as Oral Sedation. Here, the child is given an oral dose (or in rare occasions may be given as a nasal spray) of one or more sedative drugs. There are many different medications and combinations of medications that your doctor may use based on the degree of sedation required and the child’s weight. This is done in the dental office and the procedure generally requires a healthy child. The child’s tonsil size (and airway) are amongst many factor that need to be evaluated to ensure a safe procedure. Some medications used have amnesic effects. This method requires rigid NPO (nothing by mouth) guidelines to be followed and insufficient and or paradoxical reactions (opposite of expected sedation) could occur in a minority (but significant) percent of children.
3- IV sedation:
Here, an anesthesiologist is brought along to start an IV that allows quick and direct access of medications to your child’s blood stream. This is the common choice for children that are youngest, most anxious, and or have extensive treatment needs. While with increased depth of sedation, the chances of something bad occurring increases, many consider this option the “gentlest and most predictable’ option. The cost tends of be mores as an anesthesiologist bill will accompany the dental cost. However, since all treatment is done is one sitting (in oppose to as many as 4 visit with Conscious Sedation), once the cost of missing work is calculated into the picture, IV sedation may be more cost effective. Some dentists schedule children who need this treatment in a hospital operating room (the terminology used often is General Anesthesia). This will commonly increase the costs drastically, unless the medical benefits can be used to cover the hospital bill.

In short, there are several options and each have pros and cons that require careful consideration. Please advise your dental professional for more information and consult a licensed practitioner before proceeding with any of the options discussed.

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