Treatment Management Options
Many children are calm, comfortable and confident in a pediatric dental office. Sometimes, however, a child feels anxious during treatment. Your child may need more support than just a gentle, caring manner to feel comfortable.
No "Shots" Here!
Of course, that's not entirely true. But our numbing process ensures that many children aren't even aware that they received a injection of local anesthetic (shot), but rather a "squirt of sleepy juice." We use child-friendly words like "sleepy juice" to avoid lying and abusing your child's trust.
Our numbing process includes:
- Topical anesthetic, which is applied to numb the cheek before an injection, and we give it plenty of time to work
- Distraction, which gets your child to think about something else instead of what is actually happening
- Slow numbing-the slower we go, the easier it is
- Nitrous oxide, or laughing gas, or sedation for more anxious children
Nitrous oxide/oxygen is a safe, effective technique to calm a child's fear of the dental visit. Nitrous oxide/oxygen is not effective for all children, especially those who have severe anxiety, nasal congestion, extensive treatment needs or experience discomfort wearing a nasal mask. For those children, other treatment options are available such as oral sedation or outpatient surgery at the hospital.
Nitrous oxide/oxygen (N2O/O2) is a blend of two gases - oxygen and nitrous oxide. When inhaled, it is absorbed by the body and has a calming effect. Normal breathing eliminates nitrous oxide/oxygen from the body.
Your child will smell a sweet, pleasant aroma and experience a sense of well-being and relaxation. If your child is worried by the sights, sounds or sensations of dental treatment, he or she may respond more positively with the use of nitrous oxide/oxygen.
Nitrous oxide/oxygen is perhaps the safest sedative in dentistry. It is non-addictive, easily taken, then quickly eliminated by the body. Your child remains fully conscious - keeps all natural reflexes - when breathing nitrous oxide/oxygen.
The day of the restorative appointment give your child little or no food before the dental visit. Occasionally, nausea or vomiting occurs when a child has a full stomach.
Please let the dentist know about any respiratory condition that makes breathing through the nose difficult for your child. It may limit the effectiveness of the nitrous oxide/oxygen. Finally, let the dentist know of any medication that your child is currently taking the day of the dental visit. Please click here for more information on nitrous oxide/ oxygen.
Oral sedation may be recommended for your child due to the extent of decay present and the apprehension level of your child. This is not “sleep dentistry”. We do not believe in this technique or in using “deep sedation” with children. The patient’s treatment is performed in our office. We use oral conscious sedation to help facilitate your child’s treatment needs. Our goal is to help your child relax; the sedation takes the edge off and lessens anxiety while the patient remains conscious. The medication that we use is Vistaril or Valium.
The medication is given according to your child's current weight and their medical history. The dentist will have your child see his/her pediatrician before the sedation appointment to listen to your child's heart and lungs.
We ask that you call our office by 1:00 pm the day before the sedation appointment so that we may know he/she has been cleared for the procedure. Please make sure that your child has nothing to eat or drink after midnight the night before the sedation appointment.
On the day of the sedation appointment, please dress your child in comfortable, non-confining clothing. When you arrive in the office, your child will be given the oral medication. Once your child has been given the medication, we will have you sit in our health education room. We have a television, VCR, and DVD for your convenience. The medication takes approximately one hour to take effect.
Once the medication has taken effect, we will bring you and your child into the operatory. If x-rays are necessary, we might ask that you hold the film in your child's mouth. If you are pregnant or think that you might be pregnant, please let our assistants know.
After the x-rays are taken, we will gently wrap your child up in the papoose blanket for his/her dental work. At this time, we would ask that you wait in the reception area during the treatment. The dentist will have a dental assistant come out during the procedure to let you know how the treatment is progressing.
Please do not be alarmed if you hear your child crying. The oral sedation is a conscious sedation. Your child will drift in and out of sleep. Your child will not be in any pain during the procedure. At all times during the oral sedation procedure, a dental assistant is monitoring your child through the use of a pulse oximeter. This enables the dentist to monitor your child's oxygen level and respirations per minute.
After the sedation, the dentist will review the treatment and any post-op instructions concerning the dental treatment. The dentist or staff member will call you later that afternoon to see how your child is doing.
Outpatient Surgery at Children's Hospital of the King's Daughter
Due to the extent of decay present, your child's age, their health history and the apprehension level of your child, outpatient surgery at Children's Hospital of the King's Daughters might be recommended for your child. Dental treatment is performed on an outpatient basis with the assistance of an anesthesiologist on staff at the hospital. All of your child's dental treatment would be performed at one time, in one visit.
Our practice administrator would meet with you to review the proposed treatment plan, discuss your insurance coverage and schedule all pre-operative appointments. Prior to the surgery appointment, your child will have a pre-operative appointment with either your pediatrician or a
pediatrician on staff at the hospital.
Unless indicated by the pediatrician or your child's health history, no lab work is required prior to the dental surgery. You and your child will also come to our office for a pre-operative appointment with the dentist. This appointment enables you to review the treatment plan and have all of your questions answered prior to the surgery.
After the dental treatment has been completed, you and your child will return to our office for a post-operative visit with the dentist. At this visit, the dentist will evaluate oral hygiene and post-operative healing.