Experts agree that children should have their first dental visit by one year of age, but for most children, their first encounter with a dentist happens much later – with serious consequences. By age five, more than 25% of American children have tooth decay – and they don’t even have their permanent teeth yet. This is a set up for a lifetime of dental difficulties. And by the time children finally see a dentist, they often need cavities filled or even teeth pulled. Because it’s an unfamiliar and unpleasant experience, some parents and dentists opt to do the procedures using sedation.
Also referred to as sleep dentistry, sedation goes beyond traditional Novocain for dental pain to induce a deep state of relaxation in patients. Some adults require sedation due to a severe dental phobia or because they are undergoing oral surgery. Children, however, are sometimes sedated for normal dental exams. Is this necessary?
If you ask parents why they seek sedation for their children during dental procedures, many will tell you that their child is afraid of the procedure or the pain involved. Before jumping right to sedation, even of the mildest sort, parents should help children manage their anxiety naturally.
Start by visiting the dentist in advance so that your child can become comfortable with the office and the staff. Many offices welcome visits from children so that they can sit in the big chair and see the instruments ahead of their appointment. It’s also important to reassure your child that you’ll be there the entire time. If you have dental anxiety of your own, be sure to keep that in check. You don’t want your child to inherit your fears.
Find A Pediatric Practice
Another way to improve your child’s experience of the dentist without having to sedate them is by locating a pediatric practice, rather than a general dentistry office. Though most dentists treat adults and children, some specialize in treating younger patients. These dentists and their assistants are trained to comfort and distract children and have many strategies that can make going to the dentist a less intimidating process.
Pediatric dental assistants can provide educational sessions for patients, teaching them about proper hygiene and how to brush their teeth properly to prevent further dental problems. They may also explain any upcoming procedures, perform mindfulness activities with patients to calm them down, or simply distract them during the procedure by asking questions or using props. A dentist would far rather pause because of a laughing and squirming patient than one that is crying and trying to get away.
The Sedation Question
Despite everyone’s best efforts, preparation and distraction aren’t enough to help every child cope with a trip to the dentist and any subsequent procedures. For these children, who may have an unusually intense fear of the dentist, need a lot of oral surgery or multiple fillings or extractions, or who have a strong gag reflex, choosing sedation can make the experience more manageable.
Most dentists offer several different kinds of sedation depending on factors like age, safety, distress level, and procedure. The lightest form of sedation is nitrous oxide, also known as laughing gas. Given nitrous oxide, children are generally awake, but they will feel relaxed and possibly lightheaded. For children who are just a little nervous, a few visits using nitrous oxide can help them build comfort with going to the dentist.
Another mild form of sedation is oral sedation, using a pill like halcion. Dentists can opt to scale the dosage so that it’s enough to make the child tired and even fall asleep or place them in a deeply relaxed state, more akin to the effects of nitrous oxide. Children who receive this form of sedation are generally less aware of any procedure than those receiving nitrous oxide.
Finally, in especially extreme cases, children can be given either IV or general anesthesia so that they are fully asleep during their dental procedure. This is generally reserved for cases in which the patient has severe anxiety, requires extensive dental work, or has a disability or condition that makes it difficult to perform the procedure while awake.
There are definite risks to sedating children for dental procedures, including dangerous reactions and even death, but for the majority of children, it can make a stressful and painful experience less upsetting. To ensure your child’s safety, general anesthesia should only be performed in an appropriate setting so that they can receive medical interventions if necessary.
Finding natural ways to cope with dental anxiety will serve your children well as they grow and help them to develop a positive relationship with oral hygiene, but it’s okay to offer them added support during their early years if it helps them receive necessary treatment. Ideally, after several visits, they will be able to tolerate a lower level of sedation or even go without as they learn what happens at the dentists and develop better coping skills.