Does My Child Really Need Sedation for a Dental Procedure?

By August 14, 2020 No Comments
child sits on dentist chair

Probably not. Follow these four “Smart Step Sedation” steps to find out.

Recently, a concerned mom came into our office for a second opinion. She showed us a treatment plan from another dentist that included mandatory sedation and was told, “It’s better for the child and the dentist for her to be sedated for this treatment.” 

This mom was highly concerned, and rightly so. We were too. We see many cases like this where well-meaning great dentists routinely sedate young children unnecessarily.

For specialized pediatric dentists, the vast majority of children can be effectively treated with little or no sedation. In the small percentage of cases when sedation may be necessary, it should always be approached as a last-resort, through a four-step process.

 Smart Step Sedation: Four Steps in Sedation as a Last Resort

Sedating your child for a dental procedure is rarely necessary, and should be undertaken only as a last resort, particularly for the more invasive forms of sedation.

Smart Step Sedation is a framework for assessing the best possible sedation scenario for your child. It starts with the most conservative sedation option, and ‘steps up’ to the next level only when necessary, based on your child’s unique needs. This can include specific dental challenges, age, medical history, temperament or special needs factors.

If you’ve been told sedation is necessary, or if you’re wondering if it’s right for your child, follow these four steps as a guide for answering your questions.

Smart Step Sedation

Step 1: Use Sedation as a Last Resort

On average, less than 5% of pediatric patients require any sedation at all. Start with the assumption that your child is in the 95% that do fine with no sedation. Utilize the least amount of sedation, and the least invasive treatments possible to still get the best dental outcomes for your child. 

Step 2: Nitrous Oxide ‘laughing gas’

For the % of children who may need some form of sedation, this is almost always the starting point, and is effective for 95% of those cases. It is an extremely mild form of sedation – highly safe with virtually no side effects.

 Your child will breathe this safe gas for a few minutes to relax them so they don’t notice the numbing or “sleepy juice” injection in their gums. This treatment is so gentle, most children don’t even notice it, and leave feeling happy and relaxed. 

Step 3: Oral Sedation

The next step up is an oral medication that your child will be given to drink to make them sleepy. This is a safe and effective step for many children.  Only about 3% of children will require this method. 

Step 4: Intravenous (IV) Sedation

The last option is intravenous sedation. This is best administered by a pediatric specialist dentist or an anesthesiologist, often in a hospital setting. This method is recommended only when all previous steps have been eliminated. Less than 2% of children will need this level of sedation.

This graph illustrates the extremely small percentage of cases that require higher degrees of sedation. 


Smart Step Sedation Guide

Last Resort

As you can see from this graph, oral or intravenous sedation should be last resorts, and only need to be considered for a tiny fraction of all pediatric dental procedures. As stated previously, start with the mindset that more aggressive sedation approaches for your child should only be considered for the most extreme circumstances.

Talk to Your Dentist. And Another Dentist. Preferably a Pediatric Specialist.

When dealing with sedation questions for your child’s dental work, it’s best to get more than one opinion. First ask your regular dentist, but always get a second opinion, particularly if the recommended sedation plan seems overly aggressive or expensive. 

In the hands of experienced pediatric specialists, your child can come away from a sedation experience smiling inside and out, and actually looking forward to the next visit.

A major concern for many parents in their child’s dental care is the amount of sedation that may be required. Unfortunately, many dentists who are not specifically trained in pediatric dentistry recommend aggressive sedation procedures designed to make the child more cooperative and easier to work on. However, pediatric dental specialists suggest that these procedures are often unnecessary and that the dental work can be completed with much less invasive sedation options – and more often than not, with no sedation at all.

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