Dental Drama

By Teresa Morgado on October 08, 2010
Going to the dentist can be a scary experience for many adults so imagine what it’s like for a young child to be prodded and poked with sharp metal tools.

Dr. Edward Gelfand, dentist and founder of Dawson Dental Centre in Newmarket, Ont., says most adult dental fear and anxiety is a result of a bad childhood experience. Dental sedation is one way to ensure your child has a good experience and thus a healthy adult relationship with the dentist.

Age matters

A child can be sedated for a dental procedure as early as 18 months old. The goal is to have a child completely comfortable seeing a dentist fully awake by six years of age. Dr. Gelfand recommends a child’s first visit to the dentist be at around age two. “Parents think because baby teeth are going to fall out they do not need to be checked and cleaned.” Some baby teeth do not come out until a child is 12 or 13 years old. If not properly taken care of and looked at by a dentist, these baby teeth can cause problems. Baby teeth also need to be cleaned because they can become decayed, which can be painful for your child. Sedation is an option for children who are so agitated while in the dentist’s chair that they risk hurting themselves or not having an important procedure done.

Types of sedation

The type of sedation your child will need depends on his or her comfort with seeing a dentist awake and the amount of work that needs to be done.
  • Mild sedation: Your child is awake but very relaxed due to laughing gas (nitrous oxide) or a pill similar to a sleeping pill.
  • Conscious sedation: Your child is in a daydream-like state but still awake and responsive. This is achieved with a combination of laughing gas and a sleeping pill.
  • Intravenous sedation: Your child is in a sleep-like state. The medication is given through an IV. The sleep-like state is induced at the most uncomfortable moments.
  • General anesthesia: Your child is completely asleep. The anesthesia must be given by an anesthesiologist.

“It is hard for a child to sit still with their mouth open for a long period of time,” says Dr. Gelfand. “Sedation will help the dentist get the procedure done in a timely manner and your child will not remember sitting in a chair being poked at for a long period of time.” As your child gets more and more comfortable seeing a dentist he or she can receive a lower level of sedation, and eventually, no sedation at all. Dr. Gelfand says in most cases a child will not need any sedation after only one major procedure is done with sedation. If your child has already been traumatized by a dentist they may need more time to become comfortable again.

Finding a dentist

If your child is unable to cope with having dental work done, consult a dental sedation practitioner. Make sure:
  • the dentist does a thorough review of your child’s medical history, including asking about previous sedation experiences, current medications and allergies.
  • you have a clear understanding of the procedure being recommended.
  • you and your child feel comfortable in the dental setting.
  • the clinic is experienced in offering dental sedation to young children.
  • the clinician providing the sedation has the right equipment to treat potentialemergencies quickly and appropriately.

Advantages

  • Kids don’t have any bad memories from their dental visit – the cause of anxiety and fear of the dentist.
  • The dentist gets three to five times more work done when the child is sedated.
  • The child doesn’t know there’s something being done in their mouth.

Disadvantages

  • The child is groggy and might be in a bad mood when he or she wakes up.
  • A second appointment is needed to check the child’s bite when he or she is awake.
  • Cost of sedation is between $300 and $500 an hour.
  • Serious complications of sedation are extremely rare but include oxygen desaturation, vomiting, airway obstruction, apnea, cardiac arrest or death.

Published in October 2010.


By Teresa Morgado| October 08, 2010

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