Sometimes, treating children in the typical office setting is not possible. This can be due to several reasons. There may be an extensive amount of work that needs to be done, the inability of a child to stay completely still for a lengthy period of time, poor behavior or severe anxiety. In situations where in-office treatment is likely to be unsuccessful or there is a behavioral issue, your dentist may recommend treatment under general anesthesia. The goal is always to provide your child with the safest, highest quality treatment, in the best environment.
Patients being seen for treatment under general anesthesia, either in-office or at the hospital, receive specialized care and are continuously monitored by a licensed anesthesiologist, as well as their pediatric dentist, who has received special training in sedation dentistry through their pediatric dental residency.
The advantages of treating patients under anesthesia include: being able to complete all treatment at one time versus several lengthy sessions in the office, reduced fear and anxiety for the child, as they will not feel or remember any of the procedure, and a safer environment if the child is combative or unable to remain still for the full treatment.
There are several methods of sedation that are common in the pediatric dental office.
- Nitrous oxide/Mild Sedation: This is a mild sedative and the least invasive. It's commonly known as 'laughing gas.' Children breathe this with a little oxygen. Most children will not fall asleep, but will get more relaxed and maybe a bit silly. Most children like the feeling.
- Moderate sedation: Under moderate sedation will typically drink a medicine dosed according to their body weight. Children are sleepier, but will remain awake and can often still follow the dentist’s directions while completing the work. They breathe on their own and they may not remember much about the dental appointment. Pediatric dentists are able to safely administer these medications in the office.
- Deep sedation/ IV sedation: This involves intravenous (IV) medications to help your child sleep through the procedure. We typically offer this service in the office one day a month, as we bring in a licensed anesthesiologist and work closely with them to provide the safest experience and least stress possible. Children under deep sedation will be breathing on their own and are not intubated. A licensed anesthesiologist is always present at our office when providing IV sedations and remains for the entire procedure, monitoring the child’s heart rate, heart rhythm, blood pressure and oxygen saturation (breathing) during the procedure and until he or she wakes up. The anesthesiologist also determines when your child is ready to go home.
- General anesthesia: We treat our patients under general anesthesia in the operating room at the hospital in the safest environment possible, under constant medical supervision. Under general anesthesia, your child will be completely asleep. This means that they will be completely pain-free and won’t remember any of the dental procedure. Children seen at the hospital are intubated. Specially-trained anesthesia professionals (physicians or certified nurse anesthetists) will administer medications and monitor your child while the pediatric dentist performs the dental procedure. The anesthesiologist professional remains for the entire procedure, monitoring the child’s heart rate, heart rhythm, blood pressure and oxygen saturation (breathing) during the procedure and until he or she wakes up. Treatment in the hospital OR is often the best option when children have extensive work to be done, cannot cooperate for a lengthy procedure or have very high anxiety levels. In some cases, it may be the only option for providing your child’s treatment in a safe environment.
We treat each child individually and will discuss the benefits of in-office or hospital anesthesia with you if it becomes a treatment option that meets your child’s needs. As always, we welcome any questions and are happy to discuss your concerns. We want our patients and their providers to always feel comfortable with their dental treatment plan.