Types of Sedation and Anaesthesia
Just Kids Sedation Dentistry
Having a practice that is limited to just children is unique and unprecedented. SmileTown is comprised of a group of dental specialists whom have not only dedicated their careers to working with children, but also dentist anaesthesiologists and nurses. As a group of kids-focused dental offices that offers varying types of sedation and anaesthesia, it is important for our patients and their families to understand that we do not:
- call a dental anaesethesiologist into our facility
- travel to other general dental offices to provide paediatric dentistry or dental anaesthesia services
- provide medical sedation or anaesthesia services for adult procedures in hospitals or surgical suites
This is our dental space where everything is specifically designed for children. From the 1,500 sq. foot play area (not a kids corner … actually we have a grown up corner) to the paediatric benches for check ups and cleanings, to the equipment designed for small mouths, everything was designed with our patients in mind. Our doctors and staff understand paediatric dentistry and paediatric sedation/anaesthesia. Your child receives the appropriate care under the appropriate conditions; that’s because we do *Just Kids Dentistry.*
While anxiety, fear and pain can be modified by behaviour management techniques, in many cases medications are required. Usually these children are younger and although procedures are not particularly uncomfortable, they require the child to lie still. The types of sedation and anaesthesia we offer allow a child to cope better with dental treatment. This can lead to better clinical outcomes and help prevent injury from uncontrolled or undesirable movement.
SmileTown Sedation and Anaesthesia Options
Deep Sedation and Sleep Dentistry
There are four ways to manage behaviour so that children can undergo dental treatment:
Awake
Awake is self explanatory and can involve any of the following; tell-show-do, voice control, non-verbal communication, positive reinforcement, distraction, parental presence or absence, protective stabilization. Some general dentists are naturally gifted in dealing with children. Pediatric dentists are formally trained in the above techniques.
What you see
- Movement and vocalization expected
Training
- General Dentist
- Pediatric Dentist
Method
- Tell-show-do/voice control
- Non-verbal communication
- Positive reinforcement
- Distraction
- Parental presence/absence protective
- Stabilization
Appointment, Freezing, Predictability
- Multiple appointments if several areas need treatment
- Requires local anaesthesia (freezing)
- Unpredictable; depends on age, pre-existing level of anxiety, type and amount of dental treatment
Conscious Sedation
Conscious sedation patients are not asleep; however, it makes patients feel calm and relaxed. Conscious sedation is commonly achieved with laughing gas, a sedative drink or a combination of both. Conscious sedation can be unpredictable and results can vary from child to child.
Older children (4–6 years of age) show six times more success for overall behaviour than younger ones (2–3 years of age).
General dentists can take training after dental school to administer medications that achieve conscious sedation. Dental anaesthetists receive this training during specialty training.
What you see
- Movement and vocalization expected
Training
- General Dentist
- Paediatric Dentist
Method
- Nitrous oxide (laughing gas) inhalation
- Oral sedation (drink or pill)
- Nitrous oxide plus oral sedation
Appointment, Freezing, Predictability
- Multiple appointments if several areas need treatment
- Requires local anaesthesia (freezing)
- Can be unpredictable; depends on age, type and amount of dental treatment, pre-existing level of anxiety
- Some children may become agitated or distressed
Deep Sedation
Deep sedation or sleep dentistry patients are asleep. Deep sedation is what adults experience during colonoscopy procedures to be successful and comfortable. This same technique and medications can be used to treat children for restorative dental procedures. Placing an intravenous (IV) in an awake child can be challenging. Therefore, children are initially drifted to sleep with a gentle mask and anesthetic vapours while they watch a movie prior to IV placement. As such, many patients consider deep sedation needle-less. Deep Sedation is routinely maintained with incremental doses of medications through an IV. Deep sedation is extremely predictable and safe.
Only those whom have completed a residency in anaesthesia have the training to provide this service.
What you see
- Some movement
- No vocalization
Training
- Dental Anaesthesiologist
Method
- Gentle mask asleep
- Intravenous (IV) sedation
Appointment, Freezing, Predictability
- One treatment appointment
- No local anaesthesia (freezing) unless tooth is removed
- Predictable; treatment will be completed
General Anaesthesia
General anaesthesia is commonly used for operations in hospitals. General anaesthesia involves placing an endotracheal (breathing) tube and using anaesthetic vapors and other intravenous (IV) medications to keep a patient asleep. General anaesthesia is extremely predictable. As with deep sedation, children are initially sedated with an anaesthetic vapor while watching a movie prior to IV placement.
Dental anaesthesiologists and medical anaesthesiologists have this level of training.
What you see
- No movement
- No vocalization
Training
- Dental Anaesthesiologist
- Physician Anaesthesiologist
Method
- Anaesthetic vapour inhalation through
an endotracheal tube
- Anaesthetic vapour inhalation through
Appointment, Freezing, Predictability
- One treatment appointment
- No local anaesthesia (freezing) unless tooth is removed
- Predictable; treatment will be completed
