Posts for tag: sedation dentistry
There are different ways to ease a child's potential nervousness with dental visits, like starting those visits around their first birthday or seeing a pediatric dentist who specializes in children. But even doing those things won't guarantee your child won't develop some form of dental anxiety, which could complicate their dental care.
To help make appointments easier for anxious children, many dentists use conscious sedation as a means of helping them relax. With this technique, the dentist administers a mild sedative to the child to take the edge off their nervousness, while allowing them to remain awake during treatment.
Sedation isn't anesthesia, the means we use to stop pain during treatment (although sedation may be used with anesthesia). Rather, sedation reduces emotional fear and anxiety. And unlike general anesthesia, a sedated child can still breathe without assistance and, depending on the depth of the sedation, respond to physical and verbal stimuli.
In most cases, children are administered sedation medications by mouth, usually as a syrup, although on occasion it might be delivered intravenously with an IV. The dose is usually given some time before their treatment session after the dentist has evaluated them. Dentists mostly use mild sedatives like Midazolam or Hydroxyzine with very little risk of side effects for children.
During the procedure, a designated staff member continually monitors the child's vital signs. Besides heart rate, pulse and respirations, they may also check the child's exhaled carbon dioxide levels to ensure they're breathing normally.
After the treatment session is over, staff will continue to monitor the child until their vital signs return to pre-sedation levels. If the child is of driving age, they'll need someone to drive them home. Children who've been sedated should remain home for the rest of the day, but they can usually return to school the next day depending on what kind of dental work they've undergone.
Dentists follow strict protocols for pediatric sedation adopted by the American Academy of Pediatrics, the American Dental Society, and the American Academy of Pediatric Dentistry. In addition, many states have also established processes for administering sedation therapy. It's a safe and effective method to ease a child's anxiety over their dental visit.
If you would like more information on making dental visits easier for kids, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Sedation Dentistry For Kids.”
Most dental procedures today only require local anesthesia to numb just the affected area. It's a safer approach than general anesthesia: the unconscious state created by putting someone "to sleep" can lead to some unpleasant complications.
But patient comfort involves more than preventing physical pain during a procedure. There's also the emotional factor—many people experience nervousness, anxiety or fear during dental visits. It's especially problematic for an estimated 15% of the population whose dental visit anxiety is so great they often try to avoid dental care altogether.
One option is to use general anesthesia for patients with acute anxiety rather than local anesthesia. This removes them consciously from their anxiety, but they must then be monitored closely for complications.
But there's a safer way to relax patients with high anxiety called intravenous or IV sedation. The method delivers a sedative medication directly into a patient's bloodstream through a small needle or catheter inserted into a vein. The sedative places the patient in a relaxed "semi-awake" state, taking the edge off their anxiety while still enabling them to respond to verbal commands.
Coupled with local anesthesia, they won't experience any pain and very little if any discomfort. And many of the sedatives used also have an amnesiac effect so that the patient won't remember the procedures being performed.
IV sedation does require monitoring of vital signs, but the patient won't need help maintaining their breathing or heart function. And although the medication can be adjusted to reduce any lingering after-effects, a patient will still need someone to accompany them to and from their visit.
For lesser anxiety or nervousness, dentists sometimes prescribe an oral sedative to take just before a visit. This can help take the edge off your nerves and help you relax. With either method, though, sedation can help you overcome fear and anxiety and have a more pleasant treatment experience.
If you would like more information on IV sedation, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “IV Sedation in Dentistry.”
Did you know 50% of people admit to some form of anxiety visiting the dentist, with roughly 1 in 6 avoiding dental care altogether because of it? To ease anxiety dentistry has developed sedation methods that help patients relax during dental treatment.
Many can achieve relaxation with an oral sedative taken about an hour before a visit. Some with acute anxiety, though, may need deeper sedation through an intravenous (IV) injection of medication. Unlike general anesthesia which achieves complete unconsciousness to block pain, IV sedation reduces consciousness to a controllable level. Patients aren’t so much “asleep” as in a “semi-awake” state that’s safe and effective for reducing anxiety.
While there are a variety of IV medications, the most popular for dental offices are the benzodiazepines, most often Midazolam (Versed). Benzodiazepines act quickly and wear off faster than similar drugs, and have a good amnesic effect (you won’t recall details while under its influence). While relatively safe, they shouldn’t be used with individuals with poor liver function because of their adverse interaction with liver enzymes.
Other drugs or substances are often used in conjunction with IV sedation. Nitrous oxide (“laughing gas”) may be introduced initially to help with anxiety over the IV needle stick. Sometimes pain-reducing drugs like Fentanyl may be added to the IV solution to boost the sedative effect and to reduce the amount of the main drug.
If we recommend IV sedation for your dental treatment, there are some things you should do to help the procedure go smoothly and safely. Because the after effects of sedation may impair your driving ability, be sure you have someone with you to take you home. Don’t eat or drink anything after midnight the day before your appointment, and consult with both your physician and dentist about taking any prescription medication beforehand. Wear loose, comfortable clothing and don’t wear contact lenses, oral appliances like dentures or retainers, watches or other jewelry.
Our top priority is safety — we follow strict standards and protocols regarding IV sedation and you’ll be carefully monitored before, during and after your procedure. Performed with the utmost care, IV sedation could make your next dental procedure pleasant and uneventful, and impact your oral health for the better.
Making sure children are comfortable when visiting the dentist is an essential part of creating a lifetime habit of dental care. We recommend children start dental visits around their first birthday.
But for some children this may not be enough — despite parents’ and dentists’ best efforts they may still develop an inordinate fear of dental visits and even routine procedures. This kind of anxiety could inhibit them now and later in life from receiving needed dental care.
To relieve this anxiety, dentists have developed sedation therapy for children. Not to be confused with anesthesia, which numbs pain, sedation uses drugs to place a patient in a relaxed state. Depending on the drugs and dosage used, we’re able to achieve anywhere from a light state of relaxation to a deep suppression of consciousness. The approach is similar to one used with adults, although drug dosages and applications will differ with children.
Â If we’re planning to use sedation with your child we recommend you feed them a low-fat dinner the night before and then refrain from any other foods or liquids until after treatment the next day.Â Just before the procedure (and after we’ve evaluated them physically to be sure they’re healthy enough for the sedation medication), we’ll administer the sedative, usually Midazolam and Hydroxyzine. Taken by mouth in a syrup form, this places them in a mildly relaxed state.
During the procedure a designated staff member will continually monitor their pulse, breathing, blood pressure and other vital signs. We may also take other protective measures like special chair positioning or immobilization to keep movement to a minimum.
After the procedure, your child will remain in the office until their vital signs return to pre-sedation levels. Once at home, you should keep an eye on them for the rest of the day. They should not return to school or regular activities until the next day.
As sedation medication and techniques continue to advance, they’re becoming a routine part of dental care. If your child experiences anxiety, this can help make dental visits more pleasant and more likely to become part of their life from now on.
If you would like more information on taking the anxiety out of children’s dental care, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Sedation Dentistry for Kids.”
Anxiety in a child during dental procedures could interfere with the care they need. But recent advances in sedation drug therapy can calm pediatric patients safely and allow us to perform more invasive procedures without general anesthesia.
In contrast to general anesthesia, conscious sedation allows a patient to relax and feel calm while still breathing normally on their own and able to respond to certain stimuli. Conscious sedation can be deep, moderate or minimal. Deep sedation is akin to sleep and will also cause the child not to remember details of the procedure when they awaken. At the other end of the spectrum is minimal sedation, the most common type used in pediatric dentistry, which allows patients to respond to touching or verbal commands. Deep sedation drugs are usually administered intravenously, while those used for minimal sedation are administered orally with syrup. Conscious sedation doesn’t prevent pain, so it must also be accompanied by local anesthesia or other pain-relieving methods.
After you arrive for your child’s procedure, we’ll normally conduct a pre-sedation evaluation to be sure there are no medical problems that might interfere with the sedation. We typically use Midazolam (under the brand name Versed) or Hydroxyzine (also known as Vistaril or Atarax) to achieve sedation. Both are very safe, fast-acting and exit the body quickly after treatment.
During the procedure, a designated member of our staff continuously monitors your child’s vital signs, including pulse and respiration rates, blood pressure, temperature, and blood oxygen level. After the procedure your child will remain in recovery until vital signs return to pre-sedation levels. You should then take your child home and monitor them for the remainder of the day — definitely no return to school until at least the next day.
Safety is a top priority when using any sedation therapy — dental professionals follow strict procedures and protocols, as well as adhere to certification requirements enforced by many states. Performed in this manner, conscious sedation can help ensure your child’s experiences in our office are pleasant, and will hopefully result in a greater willingness when they grow up to continue professional dental care.
If you would like more information on conscious sedation for children, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Sedation Dentistry for Kids.”