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.
Dental sedation or anesthesia
Children between the ages of 1 and 8, needing extensive dental treatment that involves many or most of their teeth requiring restorations and/or extractions will be best served to have that treatment rendered under in office sedation, or general anesthesia in the office or in the hospital. In hospital general anesthesia is usually reserved for children whose insurance require that the treatment be done in the hospital or if they have complicated medical history that requires additional personnel to be on hand.
Reno-Sparks Pediatric Dental Sedation Center
Dr. Francis has been offering sedation and general anesthesia dentistry for over 20 years. He has undergone additional training to acquire the privileges to offer dental care under sedation. He does not take this responsibility lightly. He periodically attends simulation courses in pediatric dental emergencies to keep his skills sharp, so that he can recognize emergencies and deal with them appropriately.
Over the course of his career, he has treated over 5000 children under sedation in a safe and effective manner. Nationwide, pediatric dental providers have been trying to stay away from in office sedations because of the risks involved. Dr. Francis believes this is a safe and viable way of rendering treatment to children. Many providers in Northern Nevada refer children to Dr. Francis for treatment under sedation. He likes to personally meet the child and assess, if it is an appropriate treatment modality for the child. He also requires that he meets the parent and or guardian, and answer all questions before the child is scheduled for treatment under sedation.
What to expect
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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.
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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.
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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.
Dentistry under General Anesthesia
In-hospital
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. Once the procedure is complete and the patient has regained consciousness and recovered, they will be released to go home.
In-office
General anesthesia can be rendered in the office by a dental anesthesiologist who is specially trained to deliver this care. This is also convenient for families because there are no preregistration and physical exam requirements that need to be met because of established hospital protocols. Dr. Francis and his staff have undergone additional training to be able to support the anesthesiologist with emergency situations if they arise.