One great service we provide at our office is in-office conscious oral sedation dentistry. Not all pediatric dentists in the Greater New Orleans area provide this service and instead, choose to treat these patients under general anesthesia at the hospital. Our in-office sedation allows your child to be treated in our office with you present by their side for the entire treatment. In most circumstances, we can complete your child’s dental treatment with one or two in-office visits, thus eliminating the need to put your child to sleep at a hospital. In certain circumstances, some children do need to be treated at a hospital, and we provide that service as well.
As previously mentioned, this procedure (when indicated) is performed in our office and allows you, the parent, to be by your child’s side during the entire treatment. Your child is given a medicated liquid (“sleepy juice”) to help alleviate anxiety and make the dental treatment faster and easier for them. We will also administer nitrous oxide (laughing gas, see other section on this) to better help your child relax. The combination of the liquid and the laughing gas makes most children relaxed and comfortable enough to handle the dental treatment. Your child will still need to be “numbed” by placing a topical anesthetic jelly and then an injection. Please do NOT tell your child this is going to happen and let us word all treatment in a kid-friendly manner. This in-office oral sedation procedure does typically make your child a little sleepy but does not put them to sleep. Your child will be breathing on their own and can usually respond to simple requests, such as “Open” and “Close”.
Most patients are fine to walk on their own afterwards but should not return to school that day. They can return to school and normal activities the following day. All of our dental assistants are certified in CPR and will be constantly monitoring your child with the required monitoring equipment to ensure their safety. In addition, Dr. Nathan is certified in CPR and Pediatric Advanced Life Support (PALS). He has undergone extensive specialty training in conscious sedation during his 2-year pediatric dental residency and maintains an active Conscious Sedation License, as issued by the Louisiana State Board of Dentistry. As an added safety measure, we only use sedative drugs that have a reversal agent drug if needed. Safety is our main concern and is taken very seriously at our office. Every measure will be taken to ensure the safety of all of our patients. In-office sedation is not indicated on any patient below the age of 2. If recommended for your child, Dr. Nathan will discuss this procedure thoroughly with you and will be happy to answer any questions you may have.
INSTRUCTIONS FOR IN-OFFICE SEDATION APPOINTMENTS
(same as the packet you were given at our office)
Absolutely NO Food or Drink Prior to your appointment!!
It is extremely important for your child’s safety to follow these pre-op and post-op instructions very carefully.
Pre-op Instructions (before your reserved appointment):
- Your child is to NOT have ANY food or drink after midnight prior to the day of your child’s sedation appointment. This is for your child’s safety. The sedation medication can possibly make your child vomit. If they do vomit, they could potentially choke on any food or liquid or breathe the contents into their lungs. This could be life-threatening. I am not trying to scare you. I just want and need you to know how important and serious this is. If your child eats or drinks anything, we will probably have to reschedule to another day and potentially charge you a fee for the lost appointment time. Please call us if they do accidentally eat or drink anything. Do NOT just not show up for your appointment.
- If your child becomes sick prior to the appointment (vomiting, cough, congestion, sneezing, or fever), please give us a call as we may need to reschedule the appointment until they are well. We will always re-assess your child’s health in our office the day of the appointment.
- DO NOT give your child any medications before or after an in-office conscious oral sedation without consulting with Dr. Nathan first. Some medications could interact with our sedation medicines and be unsafe for your child.
- Please also inform Dr. Nathan and/or Staff if your child is taking any medicines or is allergic to any medications or has any health problems.
- Plan on being at our office for about 2-2.5 hours on the day of your appointment. We have to re-assess your child that day, then give them the medicine, then wait about 45min to 1hour for the medicine to start working, then we have to do the actual dental treatment. Please make every effort to be at your appointment on time, as we have a lot to do that day and have reserved a large amount of time in our schedule for you and your child. DO NOT JUST NOT SHOW UP FOR YOUR APPOINTMENT. If you do not show up, we may have to charge you a fee for not showing up and/or charge you a fee to hold any future sedation appointments. We have many, many children that need these appointments, and it is not fair to anyone if you do not show up. We understand things happen, so if you have a problem, please call us to reschedule.
Post-op Instructions (after your reserved appointment):
- After any in-office conscious oral sedation, it is best for your child to go home and rest. The “sleepy juice” stays in their system for about 6 hours, so please closely monitor their activity for the remainder of the day. No real physical activity until the following day. They will not be able to go to school that day, but can return to school and all normal activities the following day.
- Make sure your child is safely secured in a car seat or seat belt on the ride home, as they may be “wobbly” or sleepy.
- Your child’s breathing pattern should be normal, but please watch this. If they have any problems breathing, take them to the emergency room.
- Wait one hour after treatment is complete before giving your child anything to eat, as their mouth will be numb during that hour. We don’t want them to bite their lip, cheek, or tongue. Please watch this, as some children will chew on their mouth anyway. Call us if you have a problem. It is okay to give them something to drink.
- If you notice your child is running fever after treatment, Children’s Tylenol and plenty of liquids with help alleviate it.
- Sometimes the “sleepy juice” can cause the patient to become nauseous or vomit due to not having any food or drink in their system. If they do happen to vomit and it persists beyond 4 hours, please call us.
- Children’s Motrin, Advil, Tylenol, and Aleve can be given for pain or discomfort.
- If you have any concerns, please feel free to give us a call at any time. Dr. Nathan is on call all the time. We will be calling the same evening to check on your child.
Helpful Tips for your Child’s Behavior:
- Always be positive.
- Be careful not to let your anxiety show – This has the most negative influence on the child’s behavior. Be strong for your child.
- Avoid using words like “pain, hurt, needle, shot, drill”. For example, if you tell your child “This will not hurt”, they will focus on “hurt”.
- Please be sure to always use “kid-friendly” words. We will be doing this as well.
- When preparing your child, DO NOT go into excessive detail about the procedure because you may show anxiety or say things that may trigger anxiety. It is best to let the dentist and assistants explain the details. We are all highly trained in this area.
- It is fine to offer a reward for good behavior but be careful not to offer bribes.
- Sometimes, children will cry when they are afraid or want to escape a situation. Some situations cannot be avoided. It is best to be reassuring and encouraging by saying things like “Good job” or “Be brave”. Crying is not bad and sometimes cannot be avoided. Remember – Be POSITIVE.
- Some children are better behaved when the parent waits in the waiting area. When the parent is present, these children will be disruptive in an attempt to have the parent remove them. Most of these children cooperate and are not disruptive when the child can deal directly with the dentist and/or assistant. In most cases, we like to try with the parent present first, but may need you to leave the room in certain cases. Dr. Nathan will discuss this with you, if he feels this would be best for your child.