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SEDATION OPTIONS
Nitrous Oxide / Conscious
Sedation /
In Office General
Anesthesia
Outpatient General
Anesthesia / Early
Orthodontics

Nitrous Oxide
Some children are given nitrous oxide/oxygen, or what you may
know as laughing gas, to relax them for their dental treatment.
Nitrous oxide/oxygen is a blend of two gases, oxygen and nitrous
oxide. Nitrous oxide/oxygen is given through a small breathing
mask which is placed over the child’s nose, allowing them to
relax, but without putting them to sleep. The American Academy
of Pediatric Dentistry, recognizes this technique as a very
safe, effective technique to use for treating children’s dental
needs. The gas is mild, easily taken, then with normal
breathing, it is quickly eliminated from the body. It is
non-addictive. While inhaling nitrous oxide/oxygen, your child
remains fully conscious and keeps all natural reflexes.
Prior to your appointment:
-
Please inform us of any change to your child’s health and/or
medical condition.
-
Tell us about any respiratory condition that makes breathing
through the nose difficult for your child. It may limit the
effectiveness of the nitrous oxide/oxygen.
-
Let us know if your child is taking any medication on the
day of the appointment.
Conscious Sedation
Conscious Sedation is recommended for apprehensive children,
very young children, and children with special needs. It is used
to calm your child and to reduce the anxiety or discomfort
associated with dental treatments. Your child may be quite
drowsy, and may even fall asleep, but they will not become
unconscious.
There are a variety of different medications, which can be used
for conscious sedation. The doctor will prescribe the medication
best suited for your child’s overall health and dental treatment
recommendations. We will be happy to answer any questions you
might have concerning the specific drugs we plan to give to your
child.
Prior to your appointment:
-
Please notify us of any change in your child’s health and/or
medical condition. Do not bring your child for treatment
with a fever, ear infection or cold. Should your child
become ill, contact us to see if it is necessary to postpone
the appointment.
-
You must tell the doctor of any drugs that your child is
currently taking and any drug reactions and/or change in
medical history.
-
Please dress your child in loose fitting, comfortable
clothing.
-
Please make sure that your child goes to the bathroom
immediately prior to arriving at the office.
-
Your child should not have solid food for at least 6 hours
prior to their sedation appointment and only clear liquids
for up to 4 hours before the appointment.
-
The child’s parent or legal guardian must remain at the
office during the complete procedure.
-
Please watch your child closely while the medication is
taking effect. Hold them in your lap or keep close to you.
Do not let them "run around."
-
Your child will act drowsy and may become slightly excited
at first.
After the sedation appointment:
-
Your child will be drowsy and will need to be monitored very
closely. Keep your child away from areas of potential harm.
-
If your child wants to sleep, place them on their side with
their chin up. Wake your child every hour and encourage them
to have something to drink in order to prevent dehydration.
At first it is best to give your child sips of clear liquids
to prevent nausea. The first meal should be light and easily
digestible.
-
If your child vomits, help them bend over and turn their
head to the side to insure that they do not inhale the
vomit.
-
Because we use local anesthetic to numb your child’s mouth
during the procedure, your child may have the tendency to
bite or chew their lips, cheeks, and/or tongue and/or rub
and scratch their face after treatment. Please observe your
child carefully to prevent any injury to these areas.
-
Please call our office for any questions or concerns that
you might have.
In
Office General Anesthesia
If your child is unable to tolerate conscious
sedation, or has extensive dental treatment needs, Dr. Sharafi
may recommend In Office General Anesthesia. A Pediatric
Anesthesiologist is present to administer general anesthesia and
monitor your child in our office. These highly trained
physicians provide anesthesia to infants and children everyday
at Children's Hospital in San Diego and the offices of many
pediatric dentists. All have subspecialty (fellowship) training
in pediatric anesthesia and are board-certified by the American
Board of Anesthesiology
Prior to your appointment:
-
Please notify us of any change in your child’s health and/or
medical condition. Do not bring your child for treatment
with a fever, ear infection or cold. Should your child
become ill, contact us to see if it is necessary to postpone
the appointment.
-
You must tell the doctor of any drugs that your child is
currently taking and any drug reactions and/or change in
medical history.
-
Please dress your child in loose fitting, comfortable
clothing.
-
Please make sure that your child goes to the bathroom
immediately prior to arriving at the office.
-
Your child should not have milk or solid food after midnight
prior to the scheduled procedure and clear liquids ONLY
(water, apple juice, Gatorade) for up to 6 hours prior to
the appointment.
-
The child’s parent or legal guardian must remain at the
office during the complete procedure.
After the sedation appointment:
-
Your child will be drowsy and will need to be monitored very
closely. Keep your child away from areas of potential harm.
-
If your child wants to sleep, place them on their side with
their chin up. Wake your child every hour and encourage them
to have something to drink in order to prevent dehydration.
At first it is best to give your child sips of clear liquids
to prevent nausea. The first meal should be light and easily
digestible.
-
If your child vomits, help them bend over and turn their
head to the side to insure that they do not inhale the
vomit.
-
Please call our office for any questions or concerns that
you might have.
Outpatient General Anesthesia
Outpatient General Anesthesia is recommended for apprehensive
children, very young children, and children with special needs
that would not work well under conscious sedation or I.V.
sedation. General anesthesia renders your child completely
asleep. This would be the same as if he/she was having their
tonsils removed, ear tubes, or hernia repaired. This is
performed in a hospital or outpatient setting only. While the
assumed risks are greater than that of other treatment options,
if this is suggested for your child, the benefits of treatment
this way have been deemed to outweigh the risks. 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 even driving a car daily. The inherent risks if
this is not chosen are multiple appointments, potential for
physical restraint to complete treatment and possible emotional
and/or physical injury to your child in order to complete their
dental treatment. The risks of NO treatment include tooth pain,
infection, swelling, the spread of new decay, damage to their
developing adult teeth and possible life threatening
hospitalization from a dental infection.
Prior to your appointment:
-
Please notify us of any change in your child’s health. Do
not bring your child for treatment with a fever, ear
infection or cold. Should your child become ill, contact us
to see if it is necessary to postpone the appointment.
-
You must tell the doctor of any drugs that your child is
currently taking and any drug reactions and/or change in
medical history.
-
Please dress your child in loose fitting, comfortable
clothing.
-
Your child should not have milk or solid food after midnight
prior to the scheduled procedure and clear liquids ONLY
(water, apple juice, Gatorade) for up to 6 hours prior to
the appointment.
-
The child’s parent or legal guardian must remain at the
hospital or surgical site waiting room during the complete
procedure.
After the appointment:
-
Your child will be drowsy and will need to be monitored very
closely. Keep your child away from areas of potential harm.
-
If your child wants to sleep, place them on their side with
their chin up. Wake your child every hour and encourage them
to have something to drink in order to prevent dehydration.
At first it is best to give your child sips of clear liquids
to prevent nausea. The first meal should be light and easily
digestible.
-
If your child vomits, help them bend over and turn their
head to the side to insure that they do not inhale the
vomit.
-
Prior to leaving the hospital/outpatient center, you will be
given a detailed list of "Post-Op Instructions" and an
emergency contact number if needed.
Early Orthodontics
The American Association for Orthodontists recommends that every
child have an orthodontic evaluation by the age of 7. Early
detection and treatment gives your child the edge: a much better
chance for natural and normal development. By working with the
natural growth instead of against it, we can prevent problems
from becoming worse, and give your child a lifetime of healthy
smiles!
Early
treatment should be initiated for:
-
Habits such as tongue thrusting and thumb sucking
-
A
constricted airway due to swollen adenoids or tonsils
-
Mouth breathing or snoring problems
-
A
bad bite
-
Bone
problems (i.e. narrow or underdeveloped jaws)
-
Space maintenance (for missing teeth)
Phase One
- Functional
(Growth) Appliances and/or Limited Braces - Ages 5 to 12
In the
first phase, the doctor is interested in the position and
symmetry of the jaws, future growth, spacing of the teeth,
breathing and other oral habits which may, over a period of
time, result in abnormal dentofacial development.
Treatment initiated in this phase of development is often very
successful and some times, though not always, can eliminate the
need for future orthodontic treatment.
Phase
Two - Braces - Ages 12 to 14
In the
second phase, the doctor will be looking at how your child’s
teeth and jaws fit, and more specifically work, together. Your
child’s teeth will be straightened and their occlusion (bite) is
properly aligned. Attention will be given to the jaw joint, (TMJ),
the facial profile and periodontal (gum) tissues. By undergoing
the first phase, we can usually reduce the amount of time needed
for braces.
Facts: Early Treatment is Important to Consider!
Facial
Development -
Seventy-five percent of 12-year-olds need orthodontic treatment.
Yet 90% of a child's face has already developed! By guiding
facial development earlier, through the use of functional
appliances, 80% of the treatment can be corrected before the
adult teeth are present!
Cooperation
- Younger children between the ages of 8 and 11 are often much
more cooperative than children of ages 12 to 14.
Shorter Treatment Time
- Another advantage of early Phase One treatment is that
children will need to wear fixed braces on their adult teeth for
less time.
To Correct Underdeveloped or
Overdeveloped Jaws -
Almost 55% of children who need orthodontic treatment due to a
bad bite have underdeveloped or overdeveloped upper or lower
jaws. Functional appliances and/or limited braces can reposition
the jaws, improving the child's profile and correcting the bite
problem - within 7 to 9 months!
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