Local Anesthesia
Yes, this an area where we will discuss the dreaded “shot.” Local anesthetic is what we use to get your child “numb”. It is historically known as Novocain but we now use a different, more effective anesthetic. We try to never use the “S” word to our patients. The doctors or staff usually will answer a child’s question of “am I getting a shot?” with “we are going to put your tooth to sleep”. The dental chairs in our facilities are call “pedo benches” which not only allow the patients to just hop on but, they also have a special opening where their head fits. This opening naturally tips the chin so when a syringe is passed from assistant to Doctor for an injection, the child does not see the syringe.
The application of a topical anesthetic, a pleasant tasting gel is applied with a q-tip helps to minimize discomfort of a needle penetration. The local anesthetic is then injected to block any uncomfortable sensations your child may feel during an appointment.
Though many parents are apprehensive about how their child will react to an injection, we ask that you not to talk about it prior to your child’s visit as most parents are pleasantly surprised when their child finishes the appointment and never realized they received a “shot”.
Care of the mouth after local anesthesia:
- If the procedure was in the lower jaw, the lower teeth, tongue and lip will have the numbing sensation
- If the procedure was in the upper jaw, the teeth, surrounding tissue and possibly the lip will have the numbing sensation
- Often, children do not understand these feelings and can bite, chew or scratch at the numb area. Sometimes these actions can cause irritations to the mouth all the way up to swelling.
- Self induced soft tissue trauma such as lip and cheek biting are usually self limiting and heal without complication
- It is important for a parent to monitor your child closely for approximately 2 hours following the appointment. During that time, your child should have a liquid or soft diet until the anesthetic has worn off.
Nitrous Oxide
Nitrous oxide or “laughing gas” is used to help relax patients for dental procedures. We place a small mask on your child’s nose and administer a mixture of nitrous oxide and oxygen gasses. It has a faint, sweet smelling odor and is quickly absorbed into the system, and takes only minutes to leave the body. This is best used for short appointments with patients who only need a little help staying still.
While nitrous oxide is not right for every patient, the American Academy of Pediatric Dentistry (AAPD) recognizes laughing gas as safe and effective in helping reduce a patients anxiety.
Conscious Sedation
Conscious sedation is used with young children, apprehensive patients, and when large amount of treatment is to be done. It is given as a little drink and takes about an hour to take effect. While it does not put the patient completely “to sleep” (see our General Anesthesia section on this page), it may make them drowsy or even fall asleep.
Before your appointment
- Make sure your child has not had anything to eat or drink at midnight the night before.
- Let us know of any changes to your child’s medical history including but not limited to:
- New medical diagnosis from his/her physician
- Newly developed illness that can affect breathing (cough, runny nose, etc New medications, including over the counter medications/supplements
- Wear something comfortable such as PJs
- One adult per child is required, so please plan to bring a second adult if coming to the office with a second child. A parent or legal guardian must stay at the office throughout the procedure
- Please monitor your child while the medication is taking effect. Make sure they are not running around the office.
After sedation
- Your child will likely be drowsy well after the appointment. This is normal but you will need to continue to monitor him/her.
- Sleeping is okay, but make sure your child’s neck is straight so there is a good airway for breathing. Wake them up every hour and give them something to drink (water is best) to keep them hydrated.
- Treat the day as if it were a sick day– limit physical activity, make sure they get plenty of fluids and lots of rest.
- If your child vomits, turn their head to the side so they do not inhale the vomit.
- Since we used local anesthesia to numb your child’s mouth, please review our section on care of the mouth after local anesthesia
- Please call our office for any questions or concerns that you might have.
Outpatient General Anesthesia
General Anesthesia is recommended for apprehensive children, very young children, and children with special needs that cannot tolerate work with conscious sedation General anesthesia means your child is completely asleep– the same as if he/she was having ear tubes placed or their tonsils removed.
We only perform under GA at an outpatient surgical center with an anesthesiologist. Due to surgery center policies, parents are NOT allowed in the treatment room, but you will be able to rejoin their child in the recovery room.
While there are risks with taking your child to the OR, 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 driving a car daily).
The risks if general anesthesia is not chosen are:
- Multiple appointments
- The possibility of physical restraint required to complete treatment
- Possible emotional and/or physical injury to your child in order to complete their dental treatment.
The risks of NO treatment include:
- Tooth pain and/or infection and swelling
- Facial swelling
- Spread of decay to other teeth
- Damage to developing permanent teeth
- Possible life threatening hospitalization from a dental infection.
Prior to your appointment:
- Notify the dentist of any changes in your child’s health.
- Tell the doctor of any medications that your child is currently taking and any drug allergies or adverse reactions your child has had previously.
- Please dress your child in comfortable, loose fitting clothes that area easy to get in and out of.
- Your child cannot eat or drink anything at midnight the night before the procedure. They need a completely empty stomach.
- The child’s parent or legal guardian must remain at the OR for the entire procedure.
After the appointment:
- Your child will likely be drowsy well after the appointment. This is normal but you will need to continue to monitor him/her.
- Sleeping is okay, but make sure your child’s neck is straight so there is a good airway for breathing. Wake them up every hour and give them something to drink (water is best) to keep them hydrated.
- Treat the day as if it were a sick day– limit physical activity, make sure they get plenty of fluids and lots of rest.
- If your child vomits, turn their head to the side so they do not inhale the vomit.
- Before leaving the surgical center, you will be given a detailed list of “Post-Op Instructions” and an emergency contact number if needed.