dental-informatics

[dental-informatics]

DENTAL SEDATION FOR CHILDREN: YAY OR NAY?

Have you been sitting on a dental chair, waiting for the dentist and praying that something - ANYTHING would happen that can whisk you away from the impending doom that you'll feel? As adults, surely we've all felt anxious, distressed, and edgy before but the unsettling sensation during dental appointments truly left impacts on us like no other. Now imagine how children go through with it.

Children don't possess proper coping skills regarding their dental experiences, making dental care to children quite challenging. This is a crucial aspect to acknowledge because once the children develop dental anxiety, dental fear and avoidance will start in which generally result in bad oral health. Sedation began to be practiced by dentists in the 1900's, it is not only to reduce pain but also to help with fear and anxiety that people feel before a dental procedure or even during a basic cleaning. According to Nelson (2022), it is estimated that 100,000–250,000 pediatric dental sedations are performed each year in the USA, and practitioners anticipate a need for more pharmacological  behavior management in the future. High levels of pediatric dental disease, increasingly difficult child behavior, and parent expectations support a need for sedation services.

Sedation also may be used when several procedures need to be done at the same time, when the safety of a child may be compromised, or if your child has a strong “gag” reflex. Your child’s dentist will give the sedation. Once your child has received sedation, the dentist will give him or her an injection (shot) or injections in the treatment area to keep it pain-free during and after the procedure. The sedation medicine may last up to 6 hours after the treatment is done.

Types of Sedation:

Nitrous oxide 

Often called “laughing gas,” nitrous oxide is a very safe, mild sedative that will help your child remain relaxed during dental procedures. Your child’s dentist will give the sedation with the use of a “space mask,” which carries air (oxygen) mixed with the medication. 

Oral Sedatives

If your child is nervous, oral sedation may be used. It is taken by mouth or through the nose. This type of medicine will make your child a little drowsy, and will keep him or her relaxed and calm during the procedure. The medicine usually begins to work within 20 minutes.

IV Sedation

Intravenous (IV) sedation requires a needle to be inserted into your child’s vein, usually in the arm or hand. The biggest advantage to IV sedation is that the dentist can give your child more medicine during a longer procedure to keep him or her relaxed. Home preparation is required for this type of sedation.

Benefits or advantage of dental sedation to children

Dental procedures can be incredibly exhausting especially for the kids that had traumatizing experiences with a dentist and are also afraid just by looking at the dental instruments. Well, under the calming effects of sedation, children are more likely to sit still so our dentists and hygienists can work efficiently and effectively. According to dentiland.net there are seven possible benefits the patient can gain after receiving the dental sedative.

It Offers Choice - There are three kinds of sedation as mentioned above. These choices would help you to find the right fit for your child.

It Helps Manage Dental Anxiety -  Any signs of anxiety in children is worth addressing early on to manage and reduce it. Sedation is a fantastic tool for dental anxiety relief as it helps to get the patient into a physiologically relaxed state, including deep breathing and a reduced heart rate. It will help prevent your child from panicking before or during the treatment.

Quicker Dental Procedures - if the patient is being relaxed it may lead to less extended procedure. But if a patient is anxious, they might move around in the chair or show discomfort, making the dentist pause his or her next phase of the treatment. That’s why it’s a win-win situation in which the patient settles quickly allowing the dentist to finish the procedure less time consuming.

Manage The Gag Reflex - this is a typical response in patients when a dentist examines the back of the mouth, that often happens with young children. Receiving sedatives before the treatment lowers the risk of damage and minor injuries inside a patient's mouth from gagging while a dentist is conducting an examination.

It Reduces Pain - Managing pain is one of the most important tasks of a dental practitioner when handling children. Sedation is one way of making your child comfortable throughout the treatment and avoiding distress for it can help reduce pain before, during, and after your child’s dental treatment.

It Aids Complex Procedures - Sedation will help ensure the dentist has the best chance of completing a procedure accurately, minimizing the risk of follow-up surgery or complications.

It Helps Relieve Parent Anxiety - No parent likes to see their kid struggling to have their dental treatment accomplished. Unfortunately children can sense when their parents feel anxious, and that can make your child more anxious and nervous. By choosing sedation, you have added reassurance that your child will be just fine.

Effects of Sedative Drugs/IV or Gas. 

Children react to these sedatives differently depending on their tolerance level. It is important that the dentist determine the right amount of sedation needed by the patient so that the patient will not suffer any unexpected side effects. The most common side effects associated with intravenous sedation are headaches, dizziness and nausea.

In conclusion, dental fear and anxiety is a common problem in pediatric patients. Children are not little adults; they differ physically, psychologically, and emotionally. Thus, the effect of dental procedures may cause trauma and discomfort to the children in which it could lead to more serious psychological and emotional issues. Dental sedation can allow dentists to provide treatment with minimal said trauma and discomfort and also preserving their trust. On the other hand, it also has countless risks - even permanent damages and is seen with much apprehension. Nonetheless, dental sedation to children continues to grow and is seen more with opportunity than adversity. "Therefore, practitioners should strive to reduce patient risk by carefully selecting patients who are medically optimized for sedation and instilling a culture of safety into clinical practice", Nelson and Xu (2022).

References:

Nelson, T. M., & Xu, Z. (2015). Pediatric dental sedation: challenges and opportunities. Clinical, cosmetic and investigational dentistry, 97-106 

https://www.dentiland.net/benefits-of-sedation-dentistry-for-children-in-tijuana .