Oral Conscious Sedation

Your child will become drowsy and may phase in and out of sleep with the help of laughing gas, but the medicines don’t put them completely to sleep. They will not be unconscious but rather an altered state of consciousness.

We typically use a combination of hydroxyzine (Vistaril) and Midazolam (Versed).

They’ll be at the peak of their sedation approximately 30 minutes after receiving the medicines. They’ll be loopy and drowsy for approximately 3 hours after taking the medicines. At home, they’ll most likely take a nap, which is perfectly fine, but always under the supervision of an adult and not to sleep on their back.

Yes, returning to school the next day is perfectly fine and encouraged. We recommend a low activity, relaxing day immediately following the sedation, always under the supervision of an adult.

Our office has established emergency protocols in place along with an emergency kit and equipment. In the case of an emergency, our practitioners would activate the emergency protocol appropriate for the specific scenario. Both pediatric dentists in our office are trained and required to maintain current certification in Pediatric Advanced Life Support (PALS) and Cardiopulmonary Resuscitation (CPR). The pediatric dentist would provide care for your child during an emergency until EMS arrives to transport your child to the hospital for additional care and support.

No, your child will never be left alone throughout their care in our office during oral conscious sedation. The pediatric dentist and dental assistant will always be with your child until they are returned to you after the procedure.

The oral medicines alone don’t completely put your child to sleep. The child is usually awake while being hooked up to the monitors due to the stimulation. The addition of laughing gas plays a key role in your child maintaining the proper level of sedation to safely complete the procedure.

Each child reacts differently to the medicines, but typically they’ll be loopy and drowsy for approximately 3 hours after taking the medicines. At home, they’ll most likely take a long nap, which is perfectly fine and expected. The child requires close supervision by a responsible adult, and we recommend not to let the child sleep on their back. The child is numbed with local anesthesia in the area the procedure was completed, which typically lasts between 2-3 hours as well. Specific dietary restrictions are based on the treatment the child received.

The oral medications have a specific “working time” or time frame the child is appropriately sedated, which dictates a specific amount of treatment we can accomplish during this timeframe. If the child has more treatment needs than can be accomplished in the oral sedation time frame, we may recommend 2 oral sedation visits.

The decision on whether to complete treatment with multiple oral sedation visits vs. one general anesthesia appointment has many contributing factors, all of which are taken into account by our pediatric dentists. Some factors that influence these decisions can be the urgent need for treatment, the amount of dental work required, the overall cooperation of the patient during the exam appointment, and age.

If your child doesn’t independently take the medicine because of age, the pediatric dentist can administer the medicine through a syringe. However, if the patient's behavior prevents the proper administration of medication, oral sedation likely is not the best option for the child. Please be sure to communicate to the pediatric dentist whether your child can easily take liquid medication.

Yes, nitrous oxide/laughing gas will be placed after the patient is laid back and attached to all the sedation monitors. Laughing gas provides additional anxiolysis (reduction of anxiety) and helps maintain the target level of sedation to safely complete the procedure.

Yes, your child will be numbed with local anesthesia in the areas in which treatment is completed. The numbness usually lasts between 2-3 hours. Your child may have the tendency to bite or chew their cheeks, lips, and/or tongue and scratch their face after treatment. It’s very important to observe your child carefully to prevent any injury to these areas.

Yes, both of our pediatric dentists spent two additional years after dental school to receive extensive training in the comprehensive dental care of children, which included the use of mild, moderate, and deep sedation to safely deliver treatment. Both pediatric dentists additionally have several years of clinical experience in providing oral sedation in an office setting.

Yes, we highly recommend there be 2 adults present, essentially for the drive home so that one parent can sit next to your child. Your child will likely sleep on the way home and will require close supervision for the first few hours following the sedation. If there are any additional siblings or children brought to the appointment, then there MUST BE an additional adult.

Hydration is very important, so we recommend starting with clear liquids following the oral sedation procedure. If your child is able to drink clear liquids and keep them down without getting nauseous, they can begin to eat soft foods such as applesauce, yogurt, or ice cream. We recommend waiting to eat food that requires chewing for approximately 3 hours until the numbing medication wears off. Any additional dietary restrictions will be based on your child’s treatment and will be reviewed before and after the sedation appointment.

Yes, your child is being monitored throughout the entire sedation appointment until they reach their baseline vitals and are ready to be released from the office. Your child will be monitored by several methods, including the use of a standard anesthesia monitor (aka a patient monitor) and continuous observation. The patient monitor assesses your child’s heart rate, breathing rate (respiratory rate), blood pressure, oxygen saturation, and carbon dioxide levels (capnography). Along with the patient monitor, the pediatric dentist visually monitors your child’s status throughout their care, looking for movement, breathing, and any other potential issues.

Our pediatric dentists have extensive training in identifying proper treatment modalities for each individual patient based on their own specific needs. Oral sedation is typically recommended for the following:

• Pre Cooperative/younger patients

• Patients with dental anxiety or fear

• Patients worried about shots

• A moderate amount or invasive dental treatment

• A patient’s inability to cooperate for typical dental treatment due to special needs or delayed development.

We’re happy to discuss your child’s treatment recommendations and options with you in detail.