Sedation and anesthesia, which are used to relax patients and alleviate pain, carry risks for both adults and children. So, it is important for parents to understand the benefits and drawbacks, be knowledgeable on the various options, and learn what information your dentists needs to know about your child prior to any dental procedure involving sedation or anesthesia.

Dental sedation and anesthesia are most often used to help children remain calm and relaxed during lengthy and complex or painful dental procedures.

They are also frequently used if a child is unable to remain unmoving during a dental procedure. However, no dental procedure using sedation or anesthesia is risk free. It is rare, but children can fall into a much deeper level of sedation than was administered and can stop breathing or even die if their physical distress is not acted upon promptly and efficiently by experienced professionals with access to life-saving equipment. Always seek an experienced dentist that will explain all procedures with what to expect for your child as well as what options you have to choose from.

There are several types and levels of sedation, as well as anesthesia itself, which are used to relax children and make dental procedures more pain-free and efficient. These include nitrous oxide, mild sedation, moderate sedation, deep sedation and general anesthesia.3 The least invasive is nitrous oxide, a mild sedative commonly called laughing gas. It relaxes a child but does not put the child to sleep. Your child will be awake and calm with both mild and moderate sedation, so dentists and oral surgeons are able to safely administer these medications. Your child may even be able to follow the dentist’s instructions, but will generally not remember what happened during the dental visit. Deep sedation involves intravenous (IV) medications which put your child to sleep during the dental procedure.

In addition to the dentist doing the procedure, deep sedation requires at least one additional qualified professional, who will monitor your child’s heart rate, heart rhythm, blood pressure, and oxygen saturation (breathing) during and after the procedure.4 The same is true for general anesthesia. Your child will be temporarily asleep and thus will require monitoring by a qualified professional in addition to the dentist or surgeon performing the procedure. General anesthesia is usually administered only in a dental office that is specially equipped, or in a hospital or ambulatory surgical center.

In 2019, the American Academy of Pediatrics and the American Academy of Pediatric Dentistry updated their guidelines on administering deep sedation or general anesthesia to children. The guidelines require at least two people be present during deep sedation or general anesthesia in order to provide advanced life support measures in the event they are needed. According to the guidelines, in addition to the dentist or oral surgeon performing the procedure, the independent observer must be a physician anesthesiologist, a certified registered nurse anesthetist, a second oral surgeon or a dentist anesthesiologist.5

Once you and your dentist have discussed the benefits and drawbacks of sedation or anesthesia and you have determined that the proper personnel and equipment are available during the procedure, make sure to provide your dentist with your child’s complete medical history. This includes allergies, medications, breathing issues, recent illnesses, medical issues and surgeries, issues with previous anesthesia administration, bleeding issues, etc.6

It is a good idea to also have another adult accompany you home once your child is awake from sedation or anesthesia. While you drive home this adult can continue to monitor your child for any difficulty breathing or swallowing, allowing you to focus on your driving. Keep a close eye on your child for several days post-anesthesia or sedation and report any concerns to your dentist or physician.

Rest assured, that when you are under the care of Dr. Hechtman at his Walled Lake Dental Office, your child will be receiving the safest most effective treatment available. With over 40 years’ experience in children’s dentistry and continuing education you can feel good about visiting the dentist. Building the foundation of a healthy smile for life begins with early dental visits and education on proper oral hygiene practices.

Our dental office in Walled Lake offers the latest technology in modern dentistry, including a comprehensive list of general, restorative and cosmetic dental care services to meet the needs of your entire family. Call today for a Free dental consult!

3,4,5 Anesthesia or Sedation for Your Child’s Dental Work?, Rita Agarwal, MD, FAAP &^ James Tom, DDS, MS, American Academy of Pediatrics

6 Anesthesia and Children: Information for Parents, American Academy of Pediatrics