Minimal Conscious Sedation

Due to anxiety and fear of dental care, many children need a special procedure to allow their treatment to be done safely and efficiently. Oral conscious sedation is the use of a sedative drug administered orally in the dental office prior to dental treatment. Sedation can help increase cooperation and reduce anxiety and/or discomfort associated with dental treatment. These sedative drugs minimally depress the level of consciousness, while allowing the child to independently and fully maintain their breathing and circulatory functions. The child can respond to verbal commands and physical stimulation. Your child is monitored throughout the procedure and additional protection is available through positioning and protective stabilization equipment to ensure the utmost safety of your child.

You, as parent/legal guardian, play a key role in your child’s dental care. Children often perceive a parent’s anxiety which makes them more fearful. They tolerate procedures best when their parents understand what to expect and refrain from dramatizing the experience. Please do not hesitate to approach our team with any questions or concerns. Our goal at Tiny Tooth Dental is for you to understand and be comfortable with the procedures. As you become more confident, so will your child.

Frequently Asked Questions 

Will my child sleep during treatment?

Conscious sedation has the benefit of making children drowsy and less reactive during dental treatment. It will not put your child to sleep. Conscious sedation can make the experience more comfortable for your child and enables the dentist to safely complete the required treatment.

Will my child cry?

Every child responds differently to treatment. Crying is a very normal response from children. It is the most natural way in which they can communicate their emotions and needs. If your child cries it does not mean they are experiencing pain.

May I accompany my child to the treatment room?

During a sedation appointment, it is imperative that the focus be solely on your child. For this reason, it can be beneficial for parents to remain in the reception area during treatment. For some parents, it is difficult to separate from their child. The doctor will allow a parent to enter the treatment room if they remain unobtrusive and follow the operative visit guidelines. Please remember that it is the safety and welfare of your child we want to ensure.

Why can’t my child eat before the sedation?

It is very important for your child to have an empty stomach when using oral conscious sedation. If your child eats within 6 hours of the sedation appointment this could cause nausea and puts the child at risk for aspiration during treatment.

Will my child be cooperative during treatment?

We have a positioning and protective stabilization wrap to use for your child. Your child will be swaddled in this wrap for the duration of the procedure. This helps ensure the safety of your child and efficiency of dental treatment being performed.

Should I talk to my child about the procedure afterwards?

We always encourage positive reinforcement with your child. Please refrain from asking your child questions about the procedure. Most sedatives have an amnesiac effect which allows the child to forget the procedure and your child will continue to want to come to visit the dentist on a regular basis.

What if the sedative makes my child restless?

Some children do become restless once the sedative begins to take effect. This is a normal reaction. This just means that the sedative is working and that your child is beginning to feel very drowsy. Some children do not like that they can’t control the way they feel so they become cranky and restless. Please do not be alarmed or embarrassed if your child has this reaction. It is very common and we are still able to treat the child safely and efficiently. If your child does become restless, always feel free to notify the front desk and someone will escort your child to the treatment area in the back if you desire.

How is the sedative administered?

The sedative is administered orally based on age and weight. We provide the sedative in the office, so there is no need to pick up a prescription.

Instructions to Follow Before Your Child’s Sedation

Your child will be administered the sedative Midazolam – trade name Versed. To provide a safe and effective sedation experience, you must carefully follow every instruction listed below:

Be calm, confident and knowledgeable

You, as parent/legal guardian, play a key role in your child’s dental care. Children often perceive a parent’s anxiety which makes them more fearful. They tolerate procedures best when their parents understand what to expect and are calm and confident. If you have any questions about the sedation process, please ask; we are happy to answer any questions that you may have.

Notify us of health changes

Please notify our office of any change in your child’s health and/or medical condition. Fever, ear infection, nasal or chest congestion, or recent head trauma could place your child at increased risk for complications. Should your child become ill just prior to a sedation appointment, contact our office to reschedule. We will try to move a patient with a future appt date to the cancelled time and reschedule you a few weeks out.

Notify us of medications

Tell us about any prescribed, over-the-counter, or herbal medications your child is taking and report any allergies or reactions to medications that your child has experienced. Check with us to see if routine medications should be taken the day of the sedation.

Fasting - no food or liquids

Food and liquids must be restricted in the hours prior to sedation. Fasting decreases the risk of vomiting and aspirating stomach contents into the lungs, a potentially life-threatening problem. We will not proceed with the sedation if you do not comply with the following requirements. Let everyone in the home know about the fasting requirements, because siblings and others often unknowingly feed the child.

  • PLEASE ENSURE YOUR CHILD HAS NOTHING TO EAT OR DRINK AFTER MIDNIGHT THE NIGHT BEFORE

  • The last meal before the appointment should be light

  • Fried foods, fatty foods, and meat should be avoided

Loose clothing

Dress your child in loose fitting, comfortable clothing. Please bring a change of clothing should your child’s outfit become soiled during the procedure. During winter months, dress your child in layers we can remove to ensure your child’s comfort.

Use of diaper/pull-up

All children 3 and under, and all children potty-training must wear a diaper or pull-up. All other children must use the restroom prior to beginning treatment. We will encourage one more attempt at the office after you arrive.

Arrive on time

It is VERY important that you arrive on time for your appointment. Your scheduled time includes the time required for the sedation medication to take effect. We will reschedule or suggest proceeding without medication if you arrive late for the appointment.

Instructions to Follow after Your Child’s Sedation

Breathing

Your child cannot go to school or daycare and should be transported home immediately after treatment. Use a properly fitted car seat, booster seat or other car restraint device that includes the seatbelt. Ensure the correct upright posture of your child on the trip home. Watch child to make sure of no self-inflicted injury. If possible, you should be accompanied by an additional adult to ensure that your child is monitored closely, as he/she will be very drowsy. Once home, your child will still be drowsy and must remain under adult supervision until fully recovered from the effects of the sedation. If your child wants to sleep, position your child on his/her side with the head supported and the chin up.

Limit activities

Your child may be drowsy for some time after the sedative appointment. Restrict activities for the remainder of the day. Prohibit potentially harmful activities such as bike riding, swimming, using playground equipment, or any activity where balance is important.

Numbness – CAUTION!

In addition to the sedative medications, we use local anesthetic to numb the mouth during dental treatment. The numbness usually lasts 2-4 hours. Watch to see that your child does not bite, scratch, or injure the cheek, lips, or tongue during this time.  If your child does it is normal within 48 hours for swelling to occur inside the mouth as well as the lips. This can be treated with popsicles or a cold compress.

Irritability/discomfort

Children may be irritable after treatment. If this occurs, stay with your child and provide a calm environment. If you believe the irritability is caused by discomfort, you may give your child acetaminophen (Tylenol®) or ibuprofen (Motrin®, Advil®). Follow the instructions on the bottle for dosing based upon your child’s age/weight.

When/what to eat

Once your child is alert, you may give him/her sips of clear liquids to prevent nausea and dehydration. Small drinks taken repeatedly are preferable to large amounts. The first meal should be something light and easily digestible (ex: soup, Jell-O®, apple sauce). Do not give fatty or spicy foods (ex: French fries, tacos, salsa, milk, cheese or yogurt).

Hygiene

You must brush your child’s teeth 2-3 times daily including the day of treatment. Your child’s mouth may be sensitive, and bleeding will most likely occur, but this is normal and will subside with time and regular cleaning.  NOT BRUSHING WILL SIGNIFICANTLY INCREASE THE AMOUNT OF DISCOMFORT AND INFLAMMATION.

Nausea/vomiting

Nausea and vomiting are occasional side effects of sedation. If vomiting occurs, immediately clear the material from your child’s mouth. If vomiting persists for more than four hours, please call our office at (248)680-1680.

Fever

A slight fever (temperature to 100.5°F) is not uncommon after sedation. You may give your child acetaminophen (Tylenol®) or ibuprofen (Motrin®, Advil®). Follow the instructions on the bottle for dosing based upon your child’s age/weight. Because dehydration may cause a slight increase in temperature, clear fluids may help correct this condition. If a higher fever develops or the fever persists, call our office at (248)-680-1680.

Please keep in mind that your child has been through a dental procedure, and your child can be irritable, cranky, tired, groggy, and uncoordinated. Your child may also complain of an itchy mouth and nose. This is all normal. Try to keep your child’s mind off the dental treatment and on positive things. The less your child talks about the procedure, the less your child will remember.