Sedation Options FAQ

What are the sedation options for my anxious child, and what are the pros and cons of each?

Option 1: Traditional dental appointments with nitrous oxide ("laughing gas")
With nitrous oxide, Dr. Meggan can only treat one quarter of the mouth at a time, which means treatment may need to be done in multiple appointments.

This may not be an option for a very young child that is not able to lie still. At Growing Smiles, our goal is to use techniques that are predictable, allow for high quality dental care, and most importantly, allow for a positive dental experience. Nitrous oxide analgesia (laughing gas) may be used to help your child relax. Your child will also have a local anesthetic delivered to the area being treated and will have to be watched closely for 4 to 5 hours following the procedure to prevent chewing or biting of the lip, tongue, or cheek.

Pros:
  • Least expensive method.
  • You are able to spread out the appointments to fit your budget or to maximize your insurance benefits.
Cons:
  • Multiple appointments, children tend to get “dental fatigue” by the third appointment.
  • Your child has memory of all of the treatment.
  • Your child is numb and will need to be watched closely following procedures.
Option 2: Pediatric Oral Conscious Sedation appointments
This can reduce the number of the appointments needed, most of the time in half. Conscious sedation is a medication given to the child by mouth as a drink, or administered nasally, before the procedure. It can have an amnesia effect, but your child is awake throughout the procedure. The child will also have a local anesthetic delivered to the area being treated. Your child will have to be watched closely for 4 to 5 hours following the procedure to prevent chewing or biting of the lip, tongue, or cheek. Your child may be quite drowsy, and may even fall asleep.

There are a variety of different medications, which can be used for conscious sedation. Dr. Meggan will prescribe the medication best suited for your child's overall health and dental treatment recommendations. We will be happy to answer any questions you might have concerning the specific drugs we plan to give to your child.

Pros:
  • Can have an amnesia effect, your child may have little to no memory of the procedure.
  • Lessens the number of appointments required to complete treatment.
Cons:
  • Your child can still be combative and may yell for treatment.
  • Is generally more expensive than Option 1 and most insurance will not cover sedation.
  • Your child is numb and will need to be watched closely following procedures.
Option 3: Pediatric IV sedation appointment with Board Certified Pediatric Anesthesiologist
All treatment can be completed in one IV sedation visit. There is generally no local anesthesia required, so there is no concern regarding the child chewing their lip or cheek following the appointment. We are able to take any necessary dental radiographs if we have been unable to get them in the past due to age or cooperation. These films allow us to create a more accurate treatment plan.

All treatment is completed in one visit. Your child is given medication while sitting on your lap and once it takes effect, your child is moved to the dental operatory. After treatment is completed, the child wakes up with you in the room. They have no memory of the treatment.

Pros:
  • All treatment is completed in one visit.
  • Children will have no memory of the treatment.
  • Dental radiographs previously not taken due to cooperation can be obtained.
  • Abscessed (infected) teeth can be removed without your child feeling any discomfort from pressure.
Cons:
  • A more expensive option and the sedation portion may not be covered by insurance. In some cases, medical insurance will pick up some or all of the costs associated with the anesthesia. Parents will need to contact their medical providers to see if this is a covered expense. Once the appointments are booked, the pediatric anesthesiologist can assist in the paperwork concerning this aspect.
  • If dental radiographs are not obtained prior to the sedation appointment, the full extent of the decay may not be known. Once films are taken and new decay is found, it needs to be treated at the sedation appointment. This may result in a change in the original treatment plan given at the child’s examination visit and may result in greater costs than previously planned, but can benefit your child by reducing the need for additional future procedures.
  • Dental insurance may not cover all procedures completed in this visit, depending on your maximum benefits per calendar year.
Option 4: Outpatient General Anesthesia
Outpatient General Anesthesia is recommended for apprehensive children, very young children, and children with special needs that would not be indicated for treatment under conscious sedation or I.V. sedation. General anesthesia renders your child completely asleep. This would be the same as if he/she was having their tonsils removed, ear tubes, or hernia repaired. This is performed in a hospital or outpatient setting only.

While the assumed risks are greater than that of other treatment options, if this is suggested for your child, the benefits of treatment this way have been deemed to outweigh the risks. Most pediatric medical literature places the risk of a serious reaction in the range of 1 in 25,000 to 1 in 200,000, far better than the assumed risk of even driving a car daily. The inherent risks if this is not chosen are multiple appointments, potential for physical restraint to complete treatment and possible emotional and/or physical injury to your child in order to complete their dental treatment. The risks of NO treatment include tooth pain, infection, and swelling, the spread of new decay, damage to their developing adult teeth and possible life threatening hospitalization from a dental infection.

Pros:
  • All treatment is completed in one visit.
  • Children will have no memory of the treatment.
  • Dental radiographs previously not taken due to cooperation can be obtained.
  • Abscessed (infected) teeth can be removed without your child feeling any discomfort from pressure
Cons:
  • Most expensive option and the sedation portion may not be covered by insurance. In some cases, medical insurance will pick up some or all of the costs associated with the anesthesia. Parents will need to contact their medical providers to see if this is a covered expense.
  • If dental radiographs are not obtained prior to the sedation appointment, the full extent of the decay may not be known. Once films are taken and new decay is found, it needs to be treated at the sedation appointment. This may result in a change in the original treatment plan given at the child’s examination visit and may result in greater costs than previously planned, but can benefit your child by reducing the need for additional future procedures.
  • Dental insurance may not cover all procedures completed in this visit, depending on your maximum benefits per calendar year.