In our office, we offer different options for your child’s dental treatment. The decision on how dental treatment will be completed is based on the following criteria:
Child’s temperament and personality
Communicability with patient
Reaction to new environment
Experience at previous medical/dental visits
Parental anticipation of behaviour for future dental treatment
Other factors that can influence the behaviour of child
Our goal is to provide care that is safe and comfortable for your child. Please ask the paediatric dentist if you have any questions regarding these options.
Behaviour Management Techniques
If your child is willing to help and is motivated to have the procedure done, behaviour management may be the only technique that he/she will need to have the dental procedure done. There are many behaviour management techniques that can be used.
• Tell-Show-Do method: detailed verbal and visual explanation
• Ask-Tell-Ask method: inquire about how patient feels about the planned procedure
• Voice control management: Firm verbal instructions
• Non-verbal communication
• Positive reinforcement and descriptive praise
• Memory restructuring: negative memories are restructured into positive memories.
• Parental presence/absence
The advantage of using only behaviour management techniques are
•No medication other than local anesthetic is needed
•Child will remember the experience and will be able to tolerate other dental procedure in the future
Not every child will be able to tolerate dental procedures with behaviour management techniques only.
In our office, we provide a program called "desensitization" for many children who requires more time to get used to the dental office environment as well as routine check-ups.
The goal of desensitization is to have a child get used to the dental exam, cleaning and radiographs in a step-by-step fashion. Most children adapt to this protocol easily and show tremendous improvement within the first few visits, whereas some children may require more appointments to achieve a successful dental appointment.
Desensitization gives a child an opportunity to get accustomed to a dental office and the staff and can also help with at-home dental care.
Nitrous Oxide Sedation (Laughing Gas)
Nitrous oxide is also known as laughing gas. It is often used for children who are mildly or moderately anxious or nervous. It eases their fears so that they can relax during treatment. This helps them to receive treatment in a comfortable and safe manner.
Nitrous oxide is mixed with oxygen and delivered through a small mask over the nose. Your child will be asked to breathe through the nose and not through the mouth. As the gas begins to work, your child usually will become less agitated and less nervous.
The effects of nitrous oxide are mild. It is safe and quickly eliminated from the body. Your child remains awake and can continue to interact with the dentist. When the gas is turned off, the effects wear off very quickly. The dentist will give your child oxygen for a few minutes after treatment. This helps to flush the child's body of any remaining gas.
Sometimes children may reject wearing the mask. Nitrous oxide may not be the right type of sedation for them. In addition, nitrous oxide can sometimes make a child feel nauseous. Before a dental visit, it is best to feed your child only liquids or a light meal a few hours beforehand. Also, if your child is congested or has trouble breathing through the nose on the day of treatment, nitrous oxide may be less effective.
Children who are more anxious may need a stronger medicine than nitrous oxide. Several of these medicines are given by mouth (orally). When choosing a medicine, the dentist will consider your child’s:
•Ability to cooperate
With oral sedation, your child may be sleepy but can be awaken. He or she also can respond to simple commands. Minor side effects such as nausea or vomiting can occur with some medicines. Before a visit in which your child is to receive oral sedation, you should receive instructions on how to prepare for sedation.
During sedation, your child should be completely relaxed and cooperative with the procedure. However, every child reacts differently with the same dose of medication. Some children may still resist treatment. Noises from dental procedure may cause child to react. Because your child will not be able to remember the treatment, parents will have the choice to continue with restraint or to postpone treatment. Treatment will stop if it is too difficult to complete the treatment in a safe and pain free manner. In the event that this occurs, the dental procedure may have to be postponed until an alternative course of treatment can be arranged.
After the treatment is completed, your child will be moved to the recovery room. In the recovery room, your child will slowly wake up as medication wears off. Children usually wake up from sedation quietly. There is a rare side effect of the medication known as the ‘Angry Child Syndrome’. Children act very angry and there will be nothing that will help to sooth your child. Your child will slowly calm down over time and will not remember this experience.
It takes about 24 hours for the medication to completely leave the system. Postoperative instruction will be given before your child is discharged from the office.
Sometimes a child needs to be unconscious in order for the dentist to safely complete needed dental treatment. General anesthesia puts a child into a deep sleep. He or she is unable to feel pain or to move around. This is the same kind of sleep a child would have for removal of tonsils or placement of ear tubes. General anesthesia is done in a facility where anaesthetist will be doing the anesthesia while paediatric dentist will be performing the treatment. Your child will go home the same day. More information about general anesthesia will be given if general anesthesia is chosen as treatment option.