Sedation and General Anesthesia

In pediatric dentistry, there are some scenarios which indicate the use of sedation or general anesthesia. One goal of a pediatric dentist is to keep a child as comfortable and calm as possible throughout their visit, and these tools can help to ensure that patients receive the best possible care.

Why is Sedation Used?

Sedation can be used for a variety of reasons in pediatric dentistry. Sometimes, a dentist will use sedation to keep a child physically comfortable or emotionally calm. Other times, it can help children who are very young or those with special needs safely tolerate a procedure. Sedation can lower the risk of injury from sudden movements by a child, especially if they are anxious, as well as minimize or eliminate discomfort during dental work. While sedation is not designed to put a child to sleep, general anesthesia is another tool which does induce sleep. General anesthesia is usually indicated for longer, more complex procedures, or for children with severe anxiety, the very young, or those with special needs.

The best way to help a child comfortably navigate the sedation process is to become educated about what to expect, understanding how a child will react, and following pre and post-sedation instructions. A pediatric dentist is the best resource for understanding why sedation is needed and how to prepare.

Nitrous Oxide

Nitrous oxide is a commonly used sedative in pediatric dentistry. Pediatric dentists and their staff are expert specialists in providing children with a calm and friendly environment. However, some children may still experience anxiety at the dentist. Nitrous oxide is an effective solution to help a child stay comfortable, happy, and cooperative with their dentist. Important conversations to have with a pediatric dentist prior to the administration of nitrous oxide include whether the child has been recently ill or nasally congested, any current medications, and any applicable medical history such as a diagnosis of asthma.

Administered via a small mask over the nose, a mixture of nitrous oxide and oxygen is inhaled by the child, resulting in immediate relaxation. Also known as "laughing gas," nitrous oxide is very safe, non-allergenic, its effects last only as long as its administration, and the dentist can control the concentration. During administration, children are generally happy and calm. It is not uncommon for children to report tingling in their extremities. Fully awake, the child is responsive, can answer questions, and follow instructions. After the dentist has finished, the mask is removed, and the effects of nitrous oxide diminish within several minutes.

General Anesthesia

There are a variety of reasons a pediatric dentist may use general sedation during a procedure. Unlike nitrous oxide, general sedation induces sleep. Children who need complex, lengthy dental procedures, as well as those with severe anxiety or those with special needs, can benefit from general anesthesia, which eliminates awareness and anxiety during a procedure.

Pediatric dentists are extensively trained in administering general anesthesia, and will discuss risks, benefits, and alternatives along with pre and post-procedure instructions. In addition to following important directions such as fasting before the visit, a child must also receive a physical evaluation from their primary doctor before undergoing general anesthesia. After the procedure, children are only discharged once they are stable and ready to go home. Rest, dietary restrictions, and monitoring for after the procedure will be reviewed by the dentist and their staff.

Sedation is an important tool to allow a dentist to perform procedures safely, and for a child to have a comfortable and safe experience. The American Academy of Pediatric Dentistry publishes guidelines for pediatric dentists to follow when administering sedation. Your child's pediatric dentist will be available to answer any questions regarding