Sedation and General Anesthesia for Dental Treatment
In most cases, most dental treatment can be accomplished with the use of local anesthesia only. Most adults receive dental treatment using this modality and older cooperative children are usually able to be treated in this fashion, as well. However, when treatment plans are extensive, requiring a large amount of time or when the treatments are uncomfortable, sedation benefits patients during the time of their dental treatment. This applies to children and adults with and without disabilities. The type and level of sedation is determined by your Pediatric Dentist since they are the one that knows the difficulty of the procedures that need to be performed and understand the amount of time it will require to complete the procedures. Understanding these parameters and establishing a dialogue with the young patient and the parent (s) will allow your Pediatric Dentist to recommend the most appropriate level of sedation for your child. Our goal is always to provide care in a manner that promotes patient safety and comfort.
Types of Sedation
Sedation is delineated by the level of sedation that is attempting to be accomplished, not by the medication or the route of administration of any given medication. Although all of these parameters work hand in hand, sedation is considered to be light, moderate or deep. Light and moderate sedation usually fall in the category of what is known as conscious sedation. This means that the patient is conscious and can respond to verbal commands. Deep sedation is also known as general anesthesia. It is a level of sedation where the patient usually loses consciousness and might require assistance to maintain their airway and other vital functions. In deep sedation/ general anesthesia, the patient is usually non responsive and can’t respond to verbal commands.
Light sedation is usually delivered by the use of Nitrous Oxide/ Oxygen inhalation which might be used alone or in concert with other orally administered medications such as minor tranquilizers. Nitrous Oxide/ Oxygen is a very potent analgesic which can also render some level of euphoria to the patient during administration. The euphoria sometimes leads to the patient laughing without any stimulation, hence the nickname “laughing gas”. Nitrous Oxide/ Oxygen is very useful on a cooperative patient that needs additional analgesic relief more than what can be obtained from local anesthesia alone. Minor tranquilizers are excellent at helping to decrease the fears of a patient and provide some level of amnesia. The use of Nitrous Oxide/ Oxygen and minor tranquilizers is very safe since these medications have a wide range of safety.
Moderate sedation is a deeper level of sedation than light sedation. Usually the same medications are used as with light sedation but the dosage might be increased and other medications might be added to achieve a deeper level of sedation. This level of sedation is very useful for the cooperative patient that is apprehensive, or patients needing a considerable amount of treatment or very invasive treatments, such as dental extractions.
Deep sedation/ general anesthesia is usually reserved for patients that are uncooperative due to their age, sensitivity, or need for extensive dental treatment. These services are rendered in the office or in the hospital/surgicenter operating room. For patients who receive general anesthesia in office, all general anesthesia is performed by a Board Certified Anesthesiologist. The venue is determined by the health of the patient and other factors.
The determination as to which type of sedation should be employed is dependent on the information given to your Pediatric Dentist by the parents/guardians/care givers, as well as our patient's ability to cooperate for treatment. That information in addition to the findings that your Pediatric Dentist obtains from the examination will help guide your Pediatric Dentist to issue a recommendation as to how your child can best be treated. At the core of our decision making on this important topic is the comfort and long term well-being of your child. It is important to provide an accurate medical history and description of your child’s past behavior during dental treatment, as well as any information about your child’s temperament. This will help us to assess the most appropriate modality to assist us in making your child more comfortable during dental treatment. Our doctors have been providing all levels of sedation and general anesthesia to our patients for decades. Our Pediatric Dentists are uniquely qualified to make these recommendations due to their level of training and their years of experience. Risks and benefits of the proposed care will be discussed by the doctor. Alternatives will be discussed and will be offered if appropriate for your child. Orange County Pediatric Dental Group takes pride in giving families a full range of options as to how their child's dental needs can be managed. We know that you will receive more choices in our office than most other Pediatric Dental office in Southern California.
Conscious sedation and general anesthesia are safe and effective treatment modalities for helping children and anxious patients obtain high quality dental care. Please ask our doctors about these modalities that can assist your child in having a pleasant experience in obtaining dental care.