Pediatric dental sedation
Pediatric dental sedation is a technique aimed at relaxing the child during dental sessions, without causing loss of consciousness.
We know how important it is to take care of oral health in childhood, but the fear of the chair and the white coat can make any attempt at interaction difficult.
Putting the child to sleep does not help. In many cases we need their collaboration and for this reason it is advisable for them to remain awake and aware. The way we proceed is to eliminate the fear of pain with sedatives taken by inhalation, avoiding the risk of psychological trauma related to the dentist.
This is a procedure agreed upon in advance with the parents or guardian and is very useful as a supplement to local anesthesia in dental phobic patients, suffering from epilepsy or heart disease. However, we also adopt it in situations where the gag reflex is activated, such as taking impressions, inserting the dental dam, and cleaning.
The phases of conscious sedation in the child
Although we have no difficulty in putting people at ease, sometimes it is necessary to use pharmacological methods to facilitate the execution of dental procedures. Among these we reserve the intake of drugs in oral and intravenous form for a small number of cases, while the method that is becoming increasingly popular is inhalation sedation.
Before knowing what it consists of, let's clarify the difference between this practice and anesthesia: the purpose of the latter is the temporary loss of sensitivity of the treated part by injection of an anesthetizing substance. We would like to clarify it because the non-experts consider the two terms as synonyms, but in reality they are not. Sedation, on the other hand, takes place through an electronic machine, designed for the preparation and administration of a mixture of oxygen and low concentration nitrous oxide, in percentages that vary according to the patient's needs. The aroma is sweet and well tolerated by those who are more sensitive to odors, and in addition to having a mild anesthetic effect (however insufficient to replace a local anesthetic), it induces a state of sedation in the patient.
The gaseous solution has practically immediate release and effect. Within three minutes we can proceed with the dental treatment. Unlike what happens with other molecules, there is no reduction in alertness at the end of the treatment. The introduction of only oxygen during the last minutes of the visit contributes to achieving this result.
In our study we almost always use this procedure for reasons that go beyond not creating imbalances on the waking state and the rapid elimination of the effects. The substances used are non-toxic and do not cause long term damage as they are not metabolized by the body. The nitrous oxide taken by inhalation does not have time to reach the liver and kidneys, therefore the elimination takes place with the same breaths.
Ultimately, the method has very few contraindications to be carefully evaluated during the preliminary medical history. It is essential that parents inform us about the child's health conditions in the most detailed way possible, also informing us of any allergies to medicines and treatments in progress.
It is necessary to be aware, above all, of disorders that prevent the patient to breathe independently. Viewing medical records and other types of reports helps us to study, in these very rare cases, alternative solutions.
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