SEDATION.

The use of sedation in Paediatric dentistry is a common way of delivering dental care in a compassionate and appropriate manner for young children.

There are many reasons why these services are provided and the use of oral sedatives, medications and/or the use of nitrous oxide sedation (happy gas) are the two most common forms of sedation in paediatric dentistry.

However, there are other parts of sedation which include conscious sedation, deep sedation as well as general anaesthesia.

GENERAL ANAESTHESIA

A general anaesthetic is carried out in hospital and puts a child into a deep sleep where they are unable to feel pain or move around. This is the same kind of sleep a child would have for operations such as grommet placement or removal of tonsils.

A general anaesthetic may be recommended if your child:

• Is very young or isn’t able to allow treatment to be performed safely in the dental chair.
• Needs dental treatment that would be difficult to tolerate whilst awake.
• Needs a lot of dental work that is best carried out in one long appointment rather than many separate visits.
• Has a medical, physical or emotional condition that limits our capacity to carry out treatment in the dental chair.

The general anaesthetic is a short day-stay procedure completed in a hospital with excellent paediatric and dental facilities. A Specialist Anaesthetist with the support of highly trained nursing staff will administer the anaesthetic and monitor your child throughout the entire procedure.

LOCAL ANAESTHESIA

Many procedures in the dental chair require local anaesthetic. The use of techniques such as numbing gel and distraction, will ensure that the process is as comfortable as possible for your child. Most of the time, your child won’t realise they have had local anaesthetic administered until after the procedure when they notice their numb lip and cheek!

The sensation of having a numb lip and cheek generally takes 2-4 hours to wear off. During this time it is important to ensure your child avoids disturbing the area (eg. pinching and poking), and eating or drinking anything hot is best avoided until the effects have reversed.

NITROUS OXIDE SEDATION (HAPPY GAS / LAUGHING GAS)

Children who have not had dental treatment or are anxious about dental treatment may benefit from nitrous oxide sedation. It is used to help alleviate anxiety and discomfort, and promote a positive experience during dental treatment.

A child will typically wear a nose mask and breathe in a mixture of nitrous oxide and oxygen gases. During this form of sedation a child remains awake and is able to communicate with the dentist. Once dental treatment is complete the gas is turned off and the effects of nitrous oxide will wear off within minutes. Nitrous oxide is one of the most commonly used forms of sedation in paediatric dentistry and has no known adverse effects on a child’s growth and development.

PROTOCOL TO FOLLOW WHEN BRINGING THE PATIENTS IN FOR SEDATION

• Please ensure that you do not bring any other siblings to the sedation appointment as your child will require your full attention.
• Children easily perceive anxiety on others (especially from anxious parents). Please assist us by reassuring your child pre and post-operatively. Do not mention words such as needle, pain, injection, etc. The dentist will explain your child step by step on the day of appointment.
• Our reception should provide you with a treatment plan and proposed cost for this appointment. Although this fee is accurate in most cases, this is only an estimate and this is dictated by the length of the appointment or the demands of treatment. Changes may apply on the day.
• Ensure that your mobile phone is set to silent or switched off as noises distract patients under sedation.
• Your child may have a light breakfast or meal before the appointment. All nitrous oxide sedation appointments are carried out in the mornings as children are more receptive, which makes them more compliant.
• Parents/Guardians are allowed in the room during treatment. However, we ask you to remain quiet and not to participate in the procedure. The voice of a parent is very familiar to a child and therefore children divert their attention away from instructions by the dentist. From time to time the dentist may invite you to ‘help’ but if this is not done, please assist us by adopting a passive role during the appointment.
• If your child is not complying with treatment you may be asked to take a seat in the reception area. This approach often helps children regain compliance. Although every effort is made to provide treatment under relative analgesia (RA), this technique is not successful 100% of the time. Your child may require a different approach should he/she be unable to cooperate throughout the appointment.
• If your child has received local anaesthesia (dental injections), please note that the mouth will remain numb for approximately 2-3 hours. Our nursing staff will provide post-operative instructions and explain your child the effect of numbness. Numbness is more pronounced with lower teeth. Please ensure that your child does not bite or pinch the lip while the soft tissue is anaesthetised. Drinking a cold drink through a straw can have a soothing effect on a numb mouth.
• Side effects of nitrous oxide may include, nausea, feeling unwell, not being able to cope with the nasal mask (claustrophobic), tingling of the hands/limbs and in some rare cases vomiting (hence the need to only have a light meal).
• Should you have any questions about the procedure or when you get home please do not hesitate to contact the surgery. Our staff should call you the day after to check on the recovery of your child.