Behavior Management for Dental Procedures

Sometimes, a child who needs dental treatment may not be able to cooperate enough to allow the dentist to provide the treatment in the dental office. The dentist may decide that the treatment is best provided by giving the child an oral sedative or taking the child to the operating room and using general anesthetic to complete the treatment in a single session.

Children who require these advanced behavior management techniques may be very young and unable to understand instructions or they may have a medical condition that prohibits them from being able to cooperate.

Our primary goal when using conscious sedation or general anesthesia is to keep your child comfortable while we provide the specific dental care they need. Our dentists are trained in the use of sedative agents according to the sedation guidelines set forth by the American Academy of Pediatric Dentistry. If a child requires general anesthesia, those medications are administered in the operating room by a physician trained to do so.

Conscious Sedation for Pediatric Dental Procedures

Conscious sedation is the use of medication to calm the child and reduce the anxiety associated with the dental appointment. Your child may become quite drowsy, and may even fall asleep during the treatment, but will not become unconscious and will be able to respond to simple commands such as “open your eyes.”

Sedation medications may be given in several ways, including:

• Breathing laughing gas through their nose
• Drinking a small amount of medicine from a cup, or
• Swallowing a pill if they are able

If your child requires sedation, all of the information related to the risks and benefits will be discussed with you at the time the decision is made. A series of instructions will also be discussed. One of the most important instruction points is that your child should not eat or drink anything after midnight the evening before the appointment. This is very important as medications may cause nausea. Nausea may cause children to vomit which may interfere with breathing. The appointment will be in the morning so that your child does not have to go all day without eating or drinking.

Once the medication is given, it will take about 30 to 60 minutes for the sedative effect to take place. When your child is taken in for the actual treatment, you will be able to accompany them and observe while the treatment is being completed. After the procedures are completed, you may take your child home but must remain with them. As the medication wears off they may be drowsy, so allow them to sleep but be sure they lie on their side to keep their airway open.

Because we use local anesthetic to numb your child’s mouth during the procedure, it is important that you watch your child carefully to prevent any injury to the lips or face. Because the sensation will be unusual, your child may have the tendency to bite or chew their lips, cheeks, and/or tongue and/or rub and scratch their face after treatment.

General Anesthesia for Pediatric Dental Procedures

If it is decided that conscious sedation would not be adequate to accomplish your child’s treatment, the option of treatment under general anesthesia will be discussed. When general anesthetic is used, your child will be completely asleep while the dental treatment is being done. This is the same kind of medication your child would receive if they needed to have tonsils removed or ear tubes placed.

General anesthesia is administered in the operating room (OR) in the hospital, and you will need to remain at the hospital in the waiting room throughout the procedure. When the procedure is complete, your child will be taken to the recovery room where nurses will carefully check breathing and heart rate. The effects of general anesthesia can last for many hours, so when your child is released to go home that same day, he or she may still be sleepy. Allow them to sleep but be sure they lie on their side to keep their airway open.

Your child’s mouth and throat may be sore for a day or two after the procedure. Ice packs and over-the-counter pain medication like children’s ibuprofen will help.