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SedationCanHelpanAnxiousChildRelaxDuringDentalTreatment

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.”

SedationCanHelpCreateaMorePositiveDentalExperienceforaChild

You may not be nervous at all about visiting the dentist. But put yourself in a child’s place — a routine dental visit could be an anxious experience for them, and even more so if it involves dental work.

Dental professionals recognize this and go to great lengths to make children’s visits as pleasant as possible. It’s common among pediatric and family dentists to see child-friendly exam rooms and a well-trained staff experienced with interacting with children.

While this helps, some children still struggle with anxiety. Dentists have one other technique that can ease a child’s nervousness: conscious sedation. This technique involves the use of pills, inhaled gas or intravenous drips to help patients relax.

Sedation is different from general anesthesia, which uses drugs to render a patient unconscious so they won’t experience pain. A sedated patient remains in a conscious but relaxed state: they can still breathe independently and, with the most moderate form of oral sedation, be able to respond to touch or verbal instructions.

Oral sedation may also be accompanied by other methods like nitrous oxide gas that also aid with physical discomfort. Many drugs used often have an amnesiac effect — the patient won’t remember details about the procedure, which could contribute to less anxiety in the future.

Typically, a child receives an oral sedative just before the procedure. Most drugs are fast-acting and leave the child’s system quickly afterward. A staff member monitors their vital signs (pulse, respirations, blood pressure, etc.) during the procedure and after in recovery. They’ll remain in recovery until their vital signs return to normal levels and then be able to go home. They should stay home the rest of the day under adult supervision, but should be alert enough the next day to return to their normal activities.

Relieving anxiety is an important tool to ensure your child receives the dental care they need. It also creates a positive experience that could encourage a young patient to continue regular dental care when they reach adulthood.

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.”

ConsciousSedationEasesTreatmentAnxietyforYoungDentalPatients

While pediatric dentistry has made great strides in making young patients’ dental visit experiences more relaxing, some children and teenagers still have difficulty with anxiety. Their anxiety in turn can make necessary care much harder to provide.

For difficult cases, many dental providers for children now incorporate a technique known as conscious sedation to help ease anxiety. With this technique, they’re able to perform procedures like cavity-filling or tooth-extraction that are more difficult with an anxiety-prone patient.

While general anesthesia creates a total loss of consciousness, conscious sedation uses precise medications to suppress consciousness at different levels ranging from light to deep suppression, and create a relaxed state for the patient. A child under sedation can still breathe normally and respond to certain stimuli, including touch and verbal commands. For only a light or minimal effect, a dentist normally administers the sedation drug as a pill the child takes orally. For deeper sedation, the medication is most likely delivered through a vein (intravenously).

Sedation reduces fear and anxiety but not necessarily pain, so it’s often accompanied by some type of anesthesia, either a local anesthetic delivered by injection to the procedure site or with a nitrous oxide/oxygen gas combination that’s inhaled through a mask worn by the patient.

Even though the child isn’t completely unconscious, one of the dentist’s staff will monitor vital signs (heart and respiration rates, blood pressure and blood oxygen level) throughout the procedure. This continues even after the treatment is over until the child’s vital signs return to pre-sedation levels. Once released, they will need a ride home and should rest for the remainder of the day. They can then return to school and resume other normal activities the next day.

With the advent of newer and safer drugs, conscious sedation is becoming a more widespread technique in both medicine and dentistry. Using it to ease a child’s anxiety increases the chances they’ll receive all the dental care they need without unpleasant memories of their visit that could follow them into later life.

If you would like more information on the role of 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.”

ConsciousSedationcanMakeYourChildsDentalVisitMorePleasant

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.”

By David A.Susko DDS, PC
August 04, 2014
Category: Oral Health
HatsOfftoEtherandEvenBetterAnesthetics

The next time you’re visiting Boston, why not make time for a stroll in the city’s renowned public garden? It’s got a little something for everyone: acres of greenhouses and formal plantings, a picturesque pond where you can go for a paddle in swan-shaped boats, and the first (and perhaps the only) statue dedicated to an anesthetic gas.

Yes, the Ether Monument (also called “The Good Samaritan”) is a vaguely Moorish-looking sculpture that commemorates the first use of anesthetic in a medical procedure. This ground-breaking event took place at nearby Massachusetts General Hospital in 1846. But if it seems that perhaps the park designers were feeling a bit light-headed when they commissioned this statue* then just think of what it would have been like to have a tooth drilled without it!

Today, of course, ether is no longer used for anesthesia; that’s because medical science has developed far better ways to make sure you don’t feel pain when you’re having a procedure. However, we do still use a gas for people who need a little more help relaxing during dental treatment. It’s called nitrous oxide, but sometimes goes by the nickname “laughing gas.”

This sweet-smelling gas, mixed with oxygen, is often administered in a process called inhalation conscious sedation. It doesn’t put you to sleep — you can still follow directions and respond to verbal cues — but it makes you very comfortable, and may even induce a slightly euphoric feeling, which wears off quickly when the gas is stopped. That’s what makes it ideal for some dental procedures: It’s quite effective for people who might otherwise have a great deal of dental anxiety, yet it’s quick, easy and safe to administer — and you can usually drive yourself home afterward.

Sometimes, however, you may need even more relaxation — for example, if you’re having multiple wisdom teeth extracted. In this case, it may be best to use intravenous (IV) conscious sedation. Here, the precise amount of medication you need is delivered directly into your bloodstream via a tiny needle. As with nitrous oxide, you’ll remain conscious the whole time, but you won’t feel any pain — and afterward, you probably won’t remember a thing.

Sedation dentistry has come a long way since the days of ether… but making sure you don’t feel pain or anxiety remains a critical part of what we do. Before a procedure, we’ll talk to you about what type of anesthesia is best — and if you have any questions or concerns, we’ll work with you to make sure you have the best experience possible. If you would like more information about sedation dentistry or relieving dental anxiety, call our office for a consultation. You can learn more in the Dear Doctor magazine articles “Oral Sedation Dentistry” and “Sedation Dentistry For Kids.”



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