Sedation
dentistry

Dental sedation refers to medicating the patient prior to a dental procedure to help them be less anxious. They may be asleep or just in a very relaxed, sleepy state where they can still follow the dentist’s instructions.

When to use dental sedation

Young children with dental pain and/or infection require treatment at any age —sometimes that means a child will need to go under sedation, or even general anesthesia in a hospital. There are many reasons sedation may be required: some dental procedures require a child to lie completely still, there may be a lot to fix, or the noise of the drill may be scary. The goal is always to provide the safest, most pain-free treatment.

Age, maturity, the amount of needed dental work, and behavior are all considered when determining who should receive sedation dentistry. For instance, if a child would need multiple appointments to complete needed work and there was a risk of escalating anxiety, a single appointment under sedation may be the best options.

Special sedation expertise

Dr. Francis has the specialized training required for pediatric sedation dentistry and is also a certified pediatric advanced life support provider. He can administer medications by mouth, in the form of a nasal spray, intramuscular injection and/or intravenous (IV) administration.

Most of the sedation procedures in children are performed using medications that the child drinks, usually 15 – 60 minutes before the procedure. The child is monitored on a continuous basis and reversal medication is available (drugs used to reverse the effects of anesthetics) in the rare case a child has a poor reaction to the anesthesia. Generally, children must be at least three years old to undergo dental sedation.

doctor and patient

What to expect

  • Before the procedure

    • Dental sedation appointments are set in the morning. Your child should not have anything to eat or drink after dinner the night before their procedure.

    • It is very important that one of the parents or the primary caregiver accompanies the child for the procedure. If this is not possible, prior approval has to be made with the staff and Dr. Francis, otherwise the procedure will be cancelled.

    • Dress your child in loose-fitting, comfortable clothing.

    • Remember to tell the dentist about any prescriptions or over-the-counter medications that your child is taking.

    • Bring their favorite toy! A comfort item like a stuffed animal or little toy is a great way to help your child feel better.

    • Dr. Francis will do a physical exam the day of their procedure to ensure they are healthy.

    • Your child will be administered a combination of 2-3 medications, based on Dr. Francis’ assessment. The amount and type of medication used is based on the child’s weight and age and the amount of dental work that needs to be done.

    • Your child will sit with you for 30 minutes to more than an hour while we wait for the medication to take effect, making them sleepy and relaxed.

  • During the procedure

    • Once they are relaxed and sleepy, the child is taken into the procedure room. Dr. Francis with them and observing them the whole time.

    • Children receive nitrous oxide through a mask as well, to aid in keeping them sedated.

    • Throughout the procedure, the child’s heart rate, blood pressure, breathing, and oxygen levels will be monitored.

    • Parents and caregivers are asked to stay in the waiting room during the procedure. They will be updated by the staff as to how their child is doing. Some parents request that they be allowed to quickly come and check on their child, we allow that.

    • There is no guarantee that a child will cooperate fully during a sedation. If a child is not cooperative enough to complete the procedure in a safe manner, we will stop the procedure.

  • After the procedure

    • The child remains in the office after the dental work is complete, until they are good to go or back to normal — typically 20 minutes.

    • Once the procedure is completed, the child is discharged to a parent or other caregiver. We require that a parent or other caregiver be accompanied by another adult on the way home so that the child be watched by somebody other than the driver on the way home.

    • Monitor your child after the treatment. Side effects of the medication include increased crankiness or being overly emotional and sleepiness. In very rare cases, a child may have an adverse reaction to the medications which make them very angry for a period.

    • Give them soft foods like lukewarm soups, mashed vegetables, or smoothies to avoid discomfort in the mouth.

    • Encourage your child to stay hydrated by drinking water.

    • Use an ice pack to help with any swelling.

In-hospital dentistry

Performing dentistry in a hospital dentistry enables Dr. Francis to provide comprehensive dental care on patients with medical conditions, emotion or developmental limitations, special needs, high anxiety, and/or long treatment plans. Dental treatment is performed under general anesthesia in a hospital or outpatient facility. The patient will be unconscious during the procedure and will be monitored by an anesthesiologist or nurse anesthetist. Once the procedure is complete and the patient has regained consciousness and recovered, they will be released to go home.

General anesthesia

Under general anesthesia, your child will be completely asleep, unlike sedation dentistry where children are typically very sleepy and relaxed, but awake. An anesthesiologist administers the medications and monitors your child while Dr. Francis performs the dental procedure.