Types of Sedation and Anaesthesia

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 is not asleep. It makes you feel different. Conscious sedation is commonly achieved with laughing gas, drinks 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
- Pediatric 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 is asleep. Deep sedation is commonly achieved with incremental doses of a medication (the medication is effective for 3–5 minutes) through an intra venous (IV). Deep sedation is what adults experience to allow for colonoscopy procedures to be successful and comfortable. This same technique and medications can be used to treat children for restorative dental procedures. Deep sedation is extremely predictable. Placing an IV in an awake child can be challenging, therefore, children are initially sedated with an anaesthetic vapour while they watch a movie prior to IV placement.
Only those whom have completed a residency in anaesthesia have the training to provide this service.
What you see
- Some movement
- No vocalization
Training
- Dentist
- Anaesthesiologist
Method
- Intra venous (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 intra venous (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.
Dentist anaesthesiologists and medical anaesthesiologists have this level of training.
Types of Sedation and Anaesthesia
What you see
- No movement
- No vocalization
Training
- Dentist 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