A visit to the dentist can be a frightening proposition for lots of kids (and plenty of adults). After 5-year-old Diamond Brownridge died recently in Chicago following a dental procedure in which she was sedated, parents are rightfully jittery about putting their own children in the same position. Armed with knowledge of what to expect, though, you can ease dentist office anxieties.
According to Dr. Indru Punwani, head of pediatric dentistry at the University of Illinois at Chicago's College of Dentistry, parents should ask how long after the procedure the child should be acting normally, if the procedure is routine and how the child will be monitored.
Depending on individual circumstances, the dentist might choose one of three levels of sedation or general anesthesia to keep the child as comfortable as possible. Physical condition, age and ability to understand the procedure all factor into this decision.
Dentists use minimal sedation in the form of nitrous oxide and other drugs if the child is able and willing to wear a nose piece. She should be alert during the procedure, require minimal monitoring and be OK to leave the office five minutes after the procedure is finished.
A child that requires more extensive work or is too young to wear the nose piece required for nitrous oxide is a candidate for moderate sedation. She should be able to breathe and swallow on her own and respond to verbal and physical stimulation, but should still be monitored constantly to make sure heart rate, breathing and blood pressure are normal.
The next level is deep sedation, which is used when a lot of work is required in the child's mouth. For deep sedation, an anesthesiologist, oral surgeon or credentialed pediatric dentist must be present. The child will not be able to breathe fully on her own and will be less responsive to stimulation. The deepest level is general anesthesia, during which the child should react about the same as she would for deep sedation.
One way parents can help is by being forthcoming with all the details of the child's health, including past sedation experiences, breathing issues the child may have and allergies. Dentist's instructions should be followed carefully as well.
Although problems can occur, Punwani maintains that, when done properly, sedation is very safe. "This is a routine procedure carried out in thousands of offices every day," he says.
For more information, visit the American Academy of Pediatric Dentistry's Web site at www.aapd.org.