Why Sedation Dentistry or Anaesthesia Dentistry?
While anxiety, fear and pain can be modified by behaviour management techniques, in many cases medications are required. Although procedures are not particularly uncomfortable, they require the patients to lie still. Sedation and anaesthesia allow a person to cope better with dental treatment. This can lead to better clinical outcomes and help prevent injury from uncontrolled or undesirable movement.
How well prescribed medications work on any given person depends on that person’s response to that medication. The type and amount of medication and how it is given depends on the patient’s level of anxiety along with the invasiveness and extensiveness of the treatment requirements.
Medications used in our clinic for sedation can be administered by one or more of the following:
- Breathing them in (inhalation)
- Drinking a liquid or swallowing a pill (orally)
- Sprayed into the nose (intranasal)
How a medication is given (inhalation, oral, IV etc.) does not lead to more or less sedation/anaesthesia. How much medication is given does lead to more or less sedation/anaesthesia.
The Sedation Experience
Sedative medications cause most people to become relaxed and drowsy. Sedation may be recommended to help increase cooperation and reduce anxiety associated with dental treatment. Sedation can lead to better clinical outcomes, ease pain and make patients more comfortable. Some sedatives give patients temporary amnesia, so that the patient may remember very little about the dental treatment.
Typical medications and how they are given are:
- nitrous oxide or laughing gas through a nasal hood
- midazolam (sometimes with ketamine) liquid drink
- midazolam spray in the nose
Sedation Dentistry for Kids – Nitrous Oxide N2O
Nitrous oxide (N2O), also known as laughing gas, is used to help some children who are unable to accept dental treatment in the usual manner due to their young age, fear, or large amount of work required. N2O is not a general anaesthetic and your child will not be asleep. As with any form of anaesthetic, there are risks, side effects, and complications. For N2O the most common complications are nausea and vomiting. Otherwise N2O is considered extremely safe for healthy children.
Important steps to follow while using N2O to complete your child’s dental treatment:
- Nothing by the mouth, except small amounts of clear liquids (eg. water or apple juice), for at least three (3) hours prior to appointment.
- Please ensure that your child is not wearing any nail polish as this interferes with our equipment used to monitor your child’s vitals.
- Prior to treatment inform us of any prescription/non-prescription/vitamins/naturopathic drugs your child has taken.
Please note: it is impossible to predict whether the sedation with N2O will be sufficient to allow the planned dental treatment to be completed as scheduled. In some cases it may be necessary to lessen the amount of treatment or to reschedule the appointment depending on the situation. If N2O does not provide adequate sedation then the following alternatives are as follows:
- Delay the treatment until your child is able to cooperate.
- Add another sedative in combination with N2O on a subsequent visit.
- Arrange for a referral to a paediatric specialist with or without general anaesthetic in a hospital.
All of these alternatives have some advantages and disadvantages which we will be happy to discuss with you if they become necessary.
As each individual case is unique, please contact our office for specific directions regarding pre- and post- operative instructions. For common procedures, please see our page on post-operative instructions.