Wednesday, September 16, 2015

Conscious Sedation

Every day we have patients come into our office for their normal cleaning and exam and we find decay. This is when we bring up the two words that parents are always concerned about “Conscious Sedation.”
In today’s blog we are going to go over the most common questions we receive from parents in regards to a conscious sedation. We have heard every question under the sun and we are sure parents will have plenty more questions. Hopefully this post will help you guys better understand!!

What is Conscious Sedation?
                Unlike general anesthesia, oral sedations do not make a patient unconscious. Conscious Sedation reduces a child’s anxiety about treatment and helps them cooperate during treatment. In our office, we use two different conscious sedation medications; Demerol and Versed. While they are both used for in office sedations, they do have different effects on children. Both medications are in liquid form and are given orally. The dosage is based on your child’s weight. Every child that we sedate is weighed before we dose out the medication. 
Demerol sedation takes a full hour for it to go into effect, during this time you will be with the child to monitor them. You may or may not notice a difference in your child and this is completely normal. Once the patient is in the restorative rooms for treatment, we do place a nitrous oxide mask on them, which is when they usually begin to relax. For those patients that do not fall asleep, we have TV’s on the ceiling to keep them occupied.
Versed sedation has an amnestic effect, meaning it helps with the child not remembering the procedure. It takes only 15 minutes for it to go into effect.  You will notice a change in your child almost immediately. They will be dizzy, unable to stand on their own, and very emotional.  A small percentage of our patients may get irritable, happy, or sad depending on how their body responds to the medicine.  

Who is a good candidate for oral sedation?
                Children who have a heightened apprehension to dental treatment, injections, etc. are prime candidates for sedation.  Sedation also helps with children who also are too young to understand how to behave/cooperate during treatment.
                A lot of times we have children who do perfectly fine during a regular dental check-up, but as soon as they hear the word “treatment” they become afraid. They may be afraid of the situation, because it is unknown territory to them, or they have had a bad experience elsewhere. The sedation will help with this anxiety.
                Sedations are very beneficial for children with special needs.  These patients may not understand that we need them to sit still for 10 minutes to an hour depending on the amount of treatment needed. They also have to have their mouths open for extended periods of time, and this is something that may feel unpleasant, or simply something that they are not typically used to. Sedations allow them to become more relaxed, and less worried about the procedure.  We find these patients are, all around, leaving with a more pleasant experience.

Why Sedation?
                Sedation is for the comfort and safety of your child during a dental procedure. There are different tools that are used during treatment that could potentially harm your child if they are constantly moving around, and trying to grab our hands or instruments. Sedation allows your child to relax and be comfortable in an otherwise unfamiliar environment.

Is it safe?
                Dr. Johnnie Hunt and Dr. Brooke Wood both follow the guidelines of the American Academy of Pediatric Dentistry for sedation. They are Board Certified Pediatric Dentists, meaning they went to school an extra two years, and continue to go to lectures in order to stay up to date with the latest technology.  Your child’s pulse and oxygen levels are noted using a monitor before we dose out any medications in order to establish a baseline.  We also measure these vitals throughout the procedure.  If there were any drastic changes, the necessary steps would be taken. There are also reversals for both of these medications that are always within arm’s reach of the doctors and assistants at all times in the case of an emergency.
                We thoroughly review the child’s medical history before administering the sedative to ensure that there are no medical problems that we should be aware of. For any medical conditions that a child has that are not conducive to sedation, we would then present alternative options to the parent for completing the treatment.  The parent ultimately will decide which route they would feel most comfortable taking.

Pre Op Instructions
                We ask that your child not have anything to eat or drink 4 hours before the appointment. If the patient does not have an empty stomach, he/she could become extremely nauseous to the point of vomiting during the procedure.
                Even though most of our sedated patients are fairly young, they may be aware of their parent’s anxiety. If a parent is afraid or anxious, the child may start to become afraid or anxious. You are more than welcome to call our office with any questions in order to make you feel more comfortable about the sedation process. Dr. Hunt and Dr. Wood will also talk to you, and will answer any questions you may have regarding the procedure.

Post Op Instructions
                Each child reacts to sedations differently, so do not judge your child’s recovery process based on their sibling or other family members who have also been sedated. Each and every experience is specific to each child.  Both medications may stay in their system for up to 8 hours after initial dosing, so they will need adult supervision for the rest of the day. They are not to go back to school, participate in any after school activities, etc. after a sedation.

We hope that this post was helpful and informative. As always we are more than happy to answer any other questions you may have about your children’s dental care!