Anxiety about going to the dentist is a very common feeling, regardless of age. The American Dental Association estimates that about 22% of the adult American population avoids going to the dentist due to feelings of anxiety and fear. For all these cases, conscious sedation can be the solution, helping the patient to overcome this state of anxiety that prevents them from taking care of their oral health.
Conscious sedation in dentistry is a concept that is still in an embryonic phase in Portugal and unknown to the general population, hence some fears or myths also arise, but the truth is that it is already a technique widely applied throughout the world. A large part of the adult population, throughout their lives, has already undergone some type of examination or treatment with the same type of sedation, namely colonoscopy or endoscopy, so the novelty is only related to the association of this type of treatment with dental treatment. .
For children over 6 years of age, the procedure is exactly the same as for adults, only requiring a natural adjustment of drug doses for the child’s age, size and weight.
Oral sedation
This type of sedation is carried out through the administration of a tablet or syrup that is administered orally. In this type of sedation, the child or adult will feel calmer and sleepier before the procedure. This type of sedation is a very light sedation that helps the patient feel more relaxed and calm but does not allow the patient to fall asleep.
Nitrous Oxide
Nitrous Oxide is known as laughing gas. This gas is an inhaled sedative drug that is administered through a facial or nasal mask. A mixture of Nitrous Oxide and Oxygen is administered, which can vary between 30% and 70% and will calm the patient, keeping him well oxygenated for a few minutes. This therapeutic option can be quite effective for short-term procedures (15 – 20 minutes), and is not recommended for longer-term treatments due to its side effects such as Carbon Dioxide (CO2) retention or hysteria attacks. This means that treatments often have to be canceled due to unpredictable behavior that patients exhibit, such as the hilarious effect that gas has.
Intravenous sedation
Intravenous sedation is the third and final type of sedation possible and can also be applied to children from 6 years of age (or younger, depending on prior assessment). The biggest constraint with intravenous sedation is that, as the name suggests, this type of sedation involves the insertion of a peripheral venous catheter (PVC) into a vein. This is a fairly well tolerated procedure because, despite involving the puncture of a vein, in reality, this is the only time the patient will feel anything. After insertion of the PVC, the infusion of the sedative drug (propofol, midazolam, ketamine, or others) is immediately started and the patient falls asleep immediately, only waking up at the end of the treatment. Post-procedure amnesia is quite common in this type of sedation, so the child will most likely not even remember the moment the PVC was placed.
The best way to ensure that your child has the best experience possible with sedation is to prepare them for their trip to the dentist. There are some simple procedures that must be carried out before the consultation, to prepare the child for sedation:
Feelings of dizziness, decreased motor coordination, nausea or even outbursts of uncontrolled laughter are normal effects of sedation. The child needs some time to recover from the sedation and eliminate all the drugs from their body. Don’t forget to: