We do our best to give your child the best quality dental care in a safe and caring environment. Every effort is made to work with your child to gain cooperation through understanding, gentle guidance, humor and charm. When these fail, there are other management techniques that can be used to eliminate or minimize disruptive behavior. Our dentists and staff have received training in the following techniques accepted by the American Academy of Pediatric Dentistry.
BEHAVIOR MANAGEMENT: The treatment of uncooperative children, adolescents and individuals with special needs with uncontrollable body movement can be unsafe. There are several options available to help manage your child during dental treatment. You must be aware that each option has risks and benefits. The following information will be helpful to you in understanding the advantages and disadvantages of the options we offer in our practice. There is substantial variation in the cost of different treatment methods. Cost will vary depending on your child’s treatment needs and will be discussed with you.
POSTPONE TREATMENT: In the absence of pain or abscesses, postponing treatment can be a reasonable alternative. However, oral infections or diseases can lead to hospitalization and can be life threatening.
NITROUS OXIDE: Nitrous oxide (“laughing gas”) is considered one of the safest “drugs” used in dentistry and may help your child relax and cope with the stress of a dental visit. Some of the benefits of nitrous oxide include: alleviate anxiety and tension, help reduce a child’s gag reflex and make it easier for a child to receive an injection prior to dental work. Nitrous oxide is also used in combination with oral sedation and other management techniques due to the added safety benefit of delivering more oxygen to your child than is found in ordinary room air. Nitrous oxide does not usually replace the need for local anesthetic (an injection in the mouth prior to treatment).
IN OFFICE TREATMENT WITH RESTRAINT: Occasionally, the use of a pediatric wrap is required to help secure a patient during treatment. Situations under which a pediatric wrap may be considered include 1) Providing emergency treatment on a young child, 2) If a patient suddenly becomes combative in the middle of a procedure that needs to be completed. Physical restraints help to control body movement and to prevent injury to your child and the health care personnel. The pediatric wrap is NEVER used without your permission and we prefer a parent to be in the room if it is used.
TREATMENT WITH ORAL SEDATION: Sedation is a safe and important management technique that uses medication taken orally. It is meant to assist your child in coping with fear and anxiety and be able to cooperate with dental treatment. Sedation is also helpful to ensure that children without anxiety receive care in a positive way. Nitrous oxide is also administered as it accentuates the effects of the medications taken by mouth. It works best for children weighing between 35-60 pounds requiring one or two areas of the mouth to be treated. Children will sleep through the treatment about 60% of the time. In remaining cases, the children will be awake or partially awake and may cry and/or become resistant during the treatment procedure. Sometimes the sedation will not be effective and treatment under general anesthesia may be required. The American Academy of Pediatric Dentistry (AAPD) has guidelines on use of sedation in children undergoing dental procedures. Sedation is safe when administered by a trained pediatric dentist who follows the sedation guidelines.
TREATMENT WITH GENERAL ANESTHESIA: Unfortunately, some children are simply unable to cooperate for a dental visit. This would include young children or children where sedation and/or laughing gas have failed. When treatment is required on a child who is unable to tolerate treatment in a traditional dental office setting, general anesthesia may be recommended to make delivery of that required treatment possible in a safe and comfortable way. The use of general anesthesia requires the presence of an anesthesiologist in addition to the dentist. Treatment is completed in the hospital operating room or at an outpatient surgery center. An anesthetic gas is given to your child through a nasal breathing tube that will keep them asleep during the procedure. All of your child’s dental needs can be completed in one visit. Children treated with general anesthesia must have a physical examination by his/her pediatrician or primary care provider prior to their treatment. Isn’t there a safer, less risky way to treat a child’s teeth? When a child (or person of any age with a disability) needs extensive dental treatment, general anesthesia is an acceptable standard of care. This standard is supported by the American Academy of Pediatric Dentistry, the American Dental Association, the American Medical Association and the US Department of Health and Human Services. General anesthesia is also an accepted standard of care with situations involving children who have limited comprehension or children who are extremely uncooperative and require dental care that is technically difficult.