“Smart Step” Sedation

By January 6, 2020 No Comments
Pediatric Smiles Client

What you need to know before your dentist sedates your child


A visit to the dentist can potentially go a number of different ways for a child. When not handled carefully, even a child’s routine visit can quickly be filled with fear, crying, screaming and resistance to treatment that can take years to overcome. 


Which begs the fundamental question: why sedate children at all?


To Sedate or Not Sedate?

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.


First Rule of Thumb: The less sedation, the better. 


When pediatric dentists say “a conservative approach” to sedation, they mean utilizing the least amount of sedation, and the least invasive treatments possible to still get the best dental outcomes for your child. 


On average, less than one-third of pediatric patients require any sedation at all.


For children who would benefit from sedation, always start with the most gentle options possible, and only move to the next step when necessary for the well-being of your child.


Keep in mind that we are talking about the 33% of children for whom any form of sedation should be necessary. Two-thirds do just fine with no sedation at all


“Smart Step” 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 the specific dental challenges, age, medical history, temperament or special needs of your child, among other factors.


Here’s how Smart Step works:


Step 1: Nitrous Oxide “laughing gas”

This is almost always the starting point.  You child will breath this safe gas for a few minutes to relax them so they don’t notice the numbing or “sleepy juice” injection. This treatment is so gentle, most children don’t even notice it, and leave feeling happy and relaxed. For 95 percent of children needing some form of sedation, this type is more than adequate.

Step 2: 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 3: 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. 

Talk to Your Dentist. And Another Dentist.

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.

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