If your child’s dentist recommends anesthesia for a dental treatment, you probably have questions, and rightly so. Anesthesia and sedation are powerful medications and shouldn’t be used without careful consideration. Dentists may recommend general anesthesia or sedation when there are multiple dental procedures that must be completed; when the condition is severe or complicated, like an advanced abscess or root canal in the molars; or when the patient has a condition that prevents them from maintaining a relatively relaxed demeanor for a sustained period. Anesthesia and sedation for pediatric dentistry will be administered by a pediatric anesthesiologist, a doctor who specializes in providing anesthesia for children and will monitor the patient throughout the procedure and as they recover from the anesthesia medications and “wake up” after surgery.
General anesthesia completely relaxes a person’s reflexes so that their whole body is asleep. When patients wake up from general anesthesia, they have no memory of what occurred, and they feel no pain during the procedure. Preceding procedures that will use general anesthesia, it’s imperative to follow all the dentist’s instructions for drinking and eating. These directions will be based on your child’s age and weight and must be followed stringently to ensure the safety of the procedure. Generally, infants under 12 months can be fed with four to six hours before anesthesia, and children over the age of one should refrain from eating or drinking anything but clear liquids, like water or Pedialyte, after midnight on the night before the procedure. If your child takes any daily medications, be sure to discuss these with your pediatric dentist and anesthesiologist so you know whether they’re safe to take before anesthesia.
After you and your child check in for their procedure, an anesthesia nurse will take your child’s medical history, height, weight, and vital signs, and you’ll sign a consent form before anesthesia is administered. If your child is particularly anxious or upset, the anesthesiologist may give them an oral medication that relaxes them over the course of a few minutes before administering general anesthesia. You can stay in the room when the anesthesia is administered, and you may want to provide comfort items for your child to hold while the medication takes effect. The medication is administered through a mask that emits nitrous oxide and makes your child sleep. Once the nitrous oxide takes effect, an intravenous tube is inserted into a vein in the child’s arm or hand to deliver consistent medication throughout the procedure. While sedated, your child’s heart rate, vital signs, and blood pressure will be consistently and closely monitored.
Sometimes, it’s more stressful for the parents than the children when children undergo anesthesia and sedation for pediatric dentistry. Remember that children pick up on the emotions and concerns of their parents, so try to be reassuring and tranquil as you and your child prepare for the procedure. Rest assured that your child is in expert hands and that they are sleeping soundly through the entire procedure. You might soothe them, and yourself, if you touch or caress their hand while they’re beginning to enter sedation sleep, and the sound of your voice can also provide comfort. Following a procedure that uses anesthesia and sedation, your child should not return to daycare or school, and they may not feel up to returning the next day, either; they might still feel drowsy or woozy and should stay home where an adult can monitor them. Your child should also resist being active for the remainder of the day, and you’ll want to make sure to take your child back to the dentist for a follow-up visit at the recommended time.
After the procedure or procedures have been completed, your child will recover in the recovery room, which can take several hours. Your child’s mouth may remain sore for several days, and their throat may remain sore for a day or two after anesthesia; over-the-counter pain medications like children’s Tylenol can help. For the first few hours after the procedure, your child may feel nauseated or dizzy and should keep activity to a minimum, and they should eat only soft foods for the first few hours after coming out from sedation. If a fever appears within the first 24 hours following the procedure, or if there is severe pain, bleeding, or vomiting, call your dentist immediately. While complications are rare, they can occur and should be addressed promptly. In the vast majority of cases, anesthesia and sedation for pediatric dentistry can make otherwise daunting dental treatments and procedures more manageable for you and more comfortable for your child, so work with a reputable pediatric dentistry team if you’re considering a complex dental procedure for your child and you can both rest easy.