I think the biggest misconception of sedation dentistry is that it an easy and relaxing experience. I don’t want to discourage sedation but I just want parents to know the real deal when their kids are sedated and what to expect. Not all levels of sedation are the same! Not all kids will be sleeping peacefully through their appointment, but there are great benefits to every level of sedation. If sedation is recommended for your child just be aware that there is more than 1 level of sedation and know what to expect so you are not thrown off guard. Haas Dental Associates we are fortunate to have Dr. Jim and Dr. Trontz, who are pediatric sedation, dental specialists. So we are able to provide 4 different sedation options for children.
- LEVEL 1 - MILD SEDATION - NITROUS OXIDE
- Benefit - Cost-Effective, Anti-anxiety effect, The effect wears off in 5 minutes, no known effects
- Disadvantages - Patients can sometimes feel nauseous and vomit. If patient is unable to breathe through their nose, they can lose the effect quickly
- LEVEL 2 - MODERATE SEDATION - ORAL MEDICATION
- Benefit - Cost-Effective, Amnesia effect, Anti-anxiety effect, Medication wears off quickly
- Disadvantage - Patient is sedation but awake. Risk of not being 100% effective. Patient can be upset during the procedure, cry and act out due to medication. Can be traumatizing for some parents. Taste of medication: if patient is unwilling to drink the medication, it can be delivered via intranasal.
- LEVEL 3 - DEEP SEDATION - I.V. MEDICATION
- Benefits - Child is asleep and all treatment can be completed at one time
- Disadvantages - Expensive, patient can be groggy, risks increase with deeper level of sedation but is still a very safe option
- LEVEL 4 - DEEP SEDATION - INTUBATED AT HOSPITAL
- Benefits - Child is asleep and all treatment can be completed at one time
- Disadvantages - Expensive. Patient can awake from anesthesia and be upset and uncomfortable. Risks increase with deeper level of sedation but is still a very safe option.
The lowest level of sedation is using nitrous oxide. Nitrous oxide is a mild, anti-anxiety gas that is breathed in through a nasal cannula. It is also effective in pain control and provides a nice distraction for kids. Kids are awake and completely coherent. They may experience a floating or tingling feeling, sometimes this may make them laugh and that’s how this type of sedation earned the nickname “laughing gas”. This type of sedation is only effective in the chair, there are no known side effects, and this is a very safe and comfortable option for many children.
The next level of sedation is using oral medication. This type of sedation is considered a moderate level and it can be a great in-between option for certain kids. The benefit of this medication is the anti-anxiety and amnesia effect, so kids will not remember the appointment at all. The downside to this type of sedation is it may not be 100% effective and kids can be visibly upset and cry. So when I say sedation isn’t pretty, this is a perfect example. It can be tough for a parent to watch and hear their child be upset, so it’s more traumatic for the parent and not the child.
The third level of in-office sedation that we offer is I.V. sedation. With I.V. sedation, an anesthesiologist puts the child into deep sedation. The child is not awake but is NOT intubated. The benefit of this type of sedation is that all work can be completed. The downside to this type of sedation is the expense.
The final option for sedation is General Anesthesia. This type of sedation is the deepest level of sedation and takes place in a hospital setting. Patients who have this type of sedation are intubated. The benefit of this type of sedation is that all work can be completed all at once.
