Some children are anxious about being in a dental center and cannot sit still long enough to be properly treated. Sometimes a child may be very cooperative but will have a strong gag reflex that makes it difficult for them to tolerate things in their mouth. For each of these situations, the pediatric dentist may recommend some form of light sedation.
The pediatric dentists at Woodbridge Kids Dentistry are trained to provide several levels of light sedation. Based on an assessment of your child and your child’s treatment needs, one of the following light sedation techniques may be recommended.
- Laughing Gas (Nitrous Oxide/Oxygen)
- Oral Sedation
- Combination Therapy: This is a combination of oral and nitrous oxide sedation to allow for more extensive treatment to be completed in fewer visits or for the highly anxious child where only one sedative agent would not be sufficient to alleviate the anxiety.
Laughing Gas (Nitrous Oxide/Oxygen)
After the consultation appointment, the dentist will assess your child and may recommend Laughing Gas sedation for your child as he or she receives treatment. Laughing Gas is a mixture of two chemicals: nitrous oxide and the oxygen we are used to breathing. The specific mix of the gases can be adjusted to reach the optimal level to reduce your child’s anxiety and nervousness. The gas mixture is used to ease your child’s fears so that your child may relax and receive treatment both comfortably and safely.
Laughing Gas is inhaled with a small mask that fits over your child’s nose. Your child is awake and responsive throughout the appointment. As the gas begins to work, your child will become calm while still being able to talk with the dentist. When treatment is complete, your child will switch to breathing only oxygen, which will remove the effects of the Laughing Gas within 5 minutes.
How to prepare for Your Child’s Sedation Appointment:
- The most significant side effect of Laughing Gas is nausea, which may lead to vomiting. To reduce the risk of vomiting, your child should have nothing to eat or drink 2-hours prior to the scheduled appointment.
- The use of Laughing Gas sedation is greatly influenced by whether your child is able to breathe only through his/her nose, rather than through his/her mouth. It is necessary, therefore, that some degree of co-operation be obtained from your child.
- If your child develops a cold and cannot breathe through his or her nose, please contact our office and we will be happy to reschedule the appointment. If your child cannot breathe through his or her nose, the Laughing Gas will be ineffective.
- Different children have different experiences with Laughing Gas, but for most it is the equivalent feeling to an adult after consuming a couple of glasses of wine. The benefit of Laughing Gas is that there is no hangover effect.
- Your child should be able to walk out of the dental center on his or her own. However, some children will experience a sensation of “rubber knees” due to the child’s level of relaxation.
- Not all children will react the same way to Laughing Gas. As a result, there may not be a significant sedation effect for your child, which will result in a different form of sedation being recommended.
After the consultation appointment, the dentist will assess your child and may recommend your child have his or her dental treatment done with oral sedation. It will relax your child so that s/he can receive treatment comfortably and safely.
How to Prepare For Your Child’s Oral Sedation Appointment:
- Based on your child’s age, weight and level of anxiety, the dentist will recommend one type of oral sedative.
- Because the oral sedative medication works best on an empty stomach, your child must not have anything to eat 6 hours prior to the appointment. Because Sedation appointments are booked in the morning, we recommend that your child not have any breakfast. Your child may have water or apple juice up to 2 hours before the appointment, but no other food or drink.
- On the day of the appointment, we recommend that two adults accompany the patient home. One adult should monitor the child in the car seat, while the other drives. Most children return to their normal state within 2 to 3 hours of their appointment, but some children may require 6 to 8 hours for the effects to wear off. Because of this, please be prepared to have a responsible adult stay at home with your child, as he or she may be unable to resume his or her regular daily schedule.
- You are required to arrive at the office 30 minutes prior to your oral sedation dental appointment. The Woodbridge Kids Dentistry pediatric dentist will administer the oral sedative that is combined a choice of “flavours”. The oral sedative will produce effects in most children in 10 to 20 minutes.
- After administration, your child will be allowed to play, while supervised, in the children’s waiting room, until the effects are noticed. Please sit close to your child because they may suddenly and unexpectedly lose their coordination and as a result, accidentally hurt themselves.
- When the sedative effect begins, your child will appear dental-“drunk”. There are different types of dental-drunks: happy, silly, sleepy, and in some rare instances, angry dental-drunks. It is difficult to predict what type of dental-drunk your child will be.
- When your child appears sufficiently sedated, we will ask you to carry your child to the treatment room. The oral sedatives used do not necessarily induce sleep, but some children become very lethargic, their gait becomes erratic, and they will need support to walk.
- This effect may continue for approximately two to three hours after the appointment, and the child should be watched during this time as he may accidentally fall and hurt himself. Some children experience some mild amnesia and have a foggy recollection of the visit.
- Not all children will react the same way to Oral Sedation. As a result, there may not be a significant sedation effect for your child, which will result in a different form of sedation being recommended.
Combination of Oral Sedation and Laughing Gas
After the consultation appointment, the dentist will assess your child and may recommend your child have dental treatment done with combination sedation. Your child will be given an oral sedative along with Laughing Gas.
The procedure follows the oral sedation protocol and then, once in the dental chair, the Laughing Gas protocol. Combination sedation carries a slightly higher risk than single-type sedation. There are respiratory concerns, and nausea-and-vomiting side effects. This type of sedation is safe with advanced training and appropriate monitoring.
How to Prepare For Your Child’s Sedation Appointment:
- Your child must not have anything to eat 8 hours before their appointment. Your child can have WATER OR APPLE JUICE UP TO 2 HOURS PRIOR TO THE APPOINTMENT. That is ONLY water or apple juice. NOTHING ELSE. If your child was given something they were not supposed to have, the pediatric dentist will have to cancel the appointment.
- Your child must arrive 30 minutes prior to the appointment. The Woodbridge Kids Dentistry team will take pre-operative vital information (pulse, oxygen saturation and blood pressure).
- The dentist will administer the oral medication (in some instances as for older patients, the medication may be administered at home).
- Once your child becomes relaxed, you will need to carry or escort your child to the treatment room.
- Once your child is settled into the dental chair, we monitor your child’s pulse and oxygen saturation levels, and your child will then be introduced to the Laughing Gas mask and Laughing Gas sedation will commence. (see Laughing Gas sedation).
- Your child will be continuously monitored throughout the dental procedure. When treatment is complete, your child will receive a cleansing treatment of 100% oxygen for no more than 10 minutes in order to remove the effects of the Laughing Gas. You should be prepared for your child to still have the effects from the oral sedation and therefore he/she MUST be monitored closely. You will be the one providing the close monitoring, and so your child needs to stay home with a responsible adult and not return to daycare or school.