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The AAPD (American Academy of Pediatric Dentistry) updated their guidelines on sedation in 2019. The guidelines state that there will always be at least two people in the room who are trained to provide advanced life support measures in case there are any problems. One of the people in the room will be the dentist performing the procedure. The other will be an independent observer who must be a trained anesthesiologist or a trained pediatric dentist.
There are four different types of sedation that a dentist can offer:
- Oral sedation: This is a pill that your child will take before the procedure. It won’t put them to sleep, but it will relax them enough for the dentist to be able to work. They’ll feel very relaxed or drowsy during the procedure and for a couple hours afterward.
- Nitrous Oxide: This is more commonly known as “laughing gas” or “giggle gas.” The gas is inhaled through a mask covering both the nose and mouth. It works within minutes, and it will keep your child calm and relaxed. They will usually feel a little silly and lightheaded. Once the procedure is done, the dentist will remove the mask and let your child breathe oxygen to eliminate any remaining nitrous oxide. This tends to wear off quickly.
- Intravenous sedation: This is an IV usually inserted in the vein behind the hand. Your child will be less aware of the dental work around them and may not remember much of the procedure. There must be at least one more qualified professional, such as an anesthesiologist, to monitor your child’s heart rate, heart rhythm, blood pressure, and oxygen saturation during the procedure and until your child wakes up.
- General anesthesia: This is reserved only for when absolutely necessary or for very complex procedures that can’t be performed safely when your child is moving. This is also used if a child is too young (under three years old). Your child will stay in deep sleep throughout the procedure, but it is intensive and requires a longer period of recovery.
Dentists use sedation for kids who need complicated procedures done, who have special needs, who have high levels of anxiety, or for the kids who simply can’t keep still. It’s good to talk to your dentist beforehand to let them know what needs to be done, so your child will not be scared and for things to go smoothly. You should also tell your dentist about any medication your child is taking.
Before your child’s procedure, try avoiding giving your child solid foods and dress them in something loose-fitting and comfortable. You can also bring their favorite toy or stuffed animal to make them feel comfortable and safe. Afterward, make sure to monitor your child. Give them soft foods like soup, mashed vegetables, or smoothies. Encourage your child to drink water, and use an ice pack for any swelling.