Sedating child dental work

Frequent or recent upper respiratory infections may delay treatment with sedation.

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Sedation is used to increase the cooperation of children during treatment.When behaviour management techniques such as tell-show-do, voice control, non-verbal communication, positive reinforcement, distraction and parental presence are insufficient for dental treatment, sedation or general anesthesia may become necessary.1 Conscious sedation or minimal sedation is part of various techniques that are used by dentists, especially pediatric dentists, alongside behaviour management techniques.The goal is to provide quality dental treatment in both cooperative and uncooperative children.Patients may require assistance in maintaining a patent airway, and spontaneous ventilation may be inadequate. General Anesthesia is a drug-induced loss of consciousness during which patients are not arousable, even by painful stimulation.The ability to independently maintain ventilatory function is often impaired.Until recently, sedation dentistry was limited to third molar removal and other types of oral surgery.However, a growing number of general dentists and dental specialists are completing the educational and regulatory requirements for incorporating sedation into their practices.Most dentists, however, rely solely on nitrous oxide, an anxiety reducer (anxiolytic). The simple answer is that medical schools teach the use of oral and parenteral sedation, whereas dental schools teach the use of nitrous oxide.Unless a dental student continues with postdoctoral education in an advanced general dentistry program or a specialty program that teaches sedation, he or she learns only about nitrous oxide.Any evidence of this should be investigated before any sedation is used. A review of the child’s chin, oropharyngeal and tonsillar size, as well as their Mallampati classification, does help to determine the risk of obstruction during sedation.Patients who are obese and/or have anatomic airway abnormalities, especially related to certain syndromes (such as Pierre Robin) may have difficulty maintaining an airway during sedation for the procedure and during recovery.

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