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Sedation Dentistry


Nitrous Oxide/Oxygen (N2O)

Many children are calm and confident in our office because everything we do revolves around our patients. Dr. Eric Downey, Dr. Carolyn Muckerheide, Dr. Ashley Schaaf, and our team emphasize comfort, reassurance, and gentleness in all we do. However, circumstances do arise when restorative treatment can only be safely accomplished with the assistance of sedation. Varying degrees of sedation are available and are selected on a case by case basis.

Nitrous Oxide/Oxygen, often called "laughing gas", can help calm a child’s fear during dental treatment. Nitrous oxide is a blend of two gases, oxygen and nitrous oxide. It is given through a small breathing mask which is placed over the child's nose. When inhaled, it is absorbed by the body allowing them to relax, but without putting them to sleep or diminishing their reflexes. 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 non-addictive, has a mild sweet smell, and is quickly eliminated from the body by normal breathing.

Learn more about nitrous oxide here (PDF) >

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.
  • Limit your child to a very light meal before this procedure, such as toast or a bagel. (Occasionally nausea occurs when a child has a full stomach.)
Not every child is alike. Therefore, nitrous oxide/oxygen is not effective for some children, especially those who have severe anxiety, nasal congestion, or extensive treatment needs. Dr. Eric Downey, Dr. Carolyn Muckerheide, Dr. Ashley Schaaf, have comprehensive specialty training and can offer other sedation methods that are right for your child.

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Moderate Sedation

For young, pre-cooperative, or special needs children we are proud to offer unique sedation opportunities. Moderate Sedation is ideal for the timid and apprehensive patients, but still willing to cooperate.

For the older child, Diazapam (Valium) can be given for management of anxiety and to provide light sedation and will act as a retro-amnesic medication (usually they will not remember the dental procedure). This medication will NOT cause your child to be asleep or diminish their reflexes. This type of medicine will make your child a little drowsy, and will keep him or her relaxed and calm during the procedure.

Diazapam (Valium) is administered orally and well-absorbed from the gastrointestinal tract, the onset of medication occurs within 60-90 minutes of administration. One tablet will be taken the night before the appointment and the second 1 hour prior to the dental appointment. This dosing is to optimize the effect of the medication for the dental appointment. The amount of valium given will be based on your child's weight.

Prior to your appointment:

  • Please inform us of any change to your child's health and/or medical condition.
  • Let us know if your child is taking any medication on the day of the appointment other than the Valium.
  • Limit your child to a very light meal before this procedure, such as toast or a bagel. (Occasionally nausea occurs when a child has a full stomach.)

The medicine usually begins to work within 20 minutes. Your dentist will have your child take the medicine once you arrive at the appointment. If your child is having sedation, he or she should have nothing to eat or drink after midnight the night before the appointment.

For younger children or trauma Midazolam can be used for management of anxiety by providing light sedation and retro-amnesia (usually they will not remember the dental procedure). Midazolam is an excellent short-acting agent that will be administered nasally. It has a rapid onset of 10-15 minutes. Midazolam will NOT cause your child to go to sleep but, it will make your child a little drowsy, and will keep him or her relaxed and calm during the procedure.

Prior to your appointment:

  • Please inform us of any change to your child's health and/or medical condition.
  • Let us know if your child is taking any medication on the day of the appointment.
  • Please be sure that your child does not eat or drink anything after midnight prior to their dental appointment! If they eat or drink anything, Dr. Eric Downey, Dr. Carolyn Muckerheide, Dr. Ashley Schaaf will reschedule your appointment.

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IV Sedation

Some children have difficulty cooperating with necessary dental care, especially if treatment is extensive and time-consuming. Intravenous (IV) sedation is recommended for the very young, pre-cooperative, and special needs child. We can accomplish in-office dental treatment in a safe and controlled setting with the assistance of an independent Anesthesiologist. IV sedation is a deep sleep that insulates your child from the stress and discomfort associated with dental procedures. It is not the same as general anesthesia used in a hospital.

Prior to your appointment:

  • The anesthesiologist will review your child’s medical history in detail with you and any pertinent medical/dental provider caring for your child.
  • The anesthesiologist will provide you with preoperative and postoperative instructions.
  • Your child's diet will be restricted on the day of the dental procedure. This will be explained to you by the anesthesiologist. If your child fails to comply with the diet instructions, their appointment will be rescheduled for their safety.

For more information please visit: http://www.pediatricsedation.com

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Hospital Dentistry

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 as an outpatient service at Legacy Emanuel Hospital.

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