As you can imagine, dental treatment in very young patients is very challenging. The extent of treatment depends on each patient and is as varied as children themselves. For either very young patients, patients with special healthcare needs, or patients who are too anxious to cooperate in the traditional dental setting, there are several options: Nitrous Oxide sedation, Oral/IV sedation or treatment under general anesthesia.
Nitrous oxide, more commonly known as laughing gas, is often used as a conscious sedative during a dental visit. The gas is administered with a mixture of oxygen and has a calming effect that helps phobic or anxious patients relax during their dental treatment. It is also analgesic, making the injection and procedures in general less sensitive. Because it is a mild sedative, patients are still conscious and can talk to their dentist during their visit. After treatment, the nitrous is turned off and oxygen is administered for five to 10 minutes to help flush any remaining gas. The effects wear off almost immediately. Nitrous oxide rarely has side effects, although some patients may experience minor nausea and constipation. Nitrous Oxide sedation works best in patients who are apprehensive. It tends not to work as well in the very young or a patient who is uncooperative or defiant.
Sedation dentistry refers to the use of sedation during dental treatment. Sedation is most commonly used during extensive procedures, for patients with dental phobia or for patients who find it difficult to sit still. There are different types of sedation including oral and IV sedation.
Oral sedation involves the use of a sedative medicine or combination of medications in liquid form. The depth of sedation depends largely on the patient and is extremely variable. For this reason, patients who are sedated in office should be carefully monitored for an extended period of time. All pediatric dentists receive training in Oral Sedation. Although Oral Sedation is usually successfully accomplished, because of the variability in results and the risks involved, we do not currently offer this procedure. In the state of Nebraska, IV sedation is allowed only by people with certain credentials and very specific methods of monitoring. This form of sedation is not allowed for the traditional dental office and therefore is not available at Children's Dentistry of South Omaha. We are investigating the possibility of providing this form of treatment in the future.
Treatment under general anesthesia is performed in the hospital setting. Dr. Rothe and Dr. Skar have hospital privileges at Fremont Area Medical Center, Fremont Surgical Center, and Boys Town Hospital. Treatment under general anesthesia is very safe and allows for an entire treatment plan to be finished in one appointment. The anesthesia is performed by a Medical Doctor specialist (an anesthesiologist) who monitors the child constantly, while Dr. Rothe and Dr. Skar accomplish the dental treatment. Although every medical procedure carries risks, the safety involved with this option makes it a highly recommended procedure for young patients who require an extensive amount of work, or patients who for whatever reason are unable to cooperate in the dental office. Please feel free to ask us any questions regarding treatment in the hospital setting.