Behavior
Management Techniques and Sedation
Tell Show Do
We use this technique on virtually all young
patients. We explain to our patients what we’re
going to do. We show them what we’re going
to do. And then we do it.
Voice Control
This technique is used to intercept
inappropriate behavior as it begins. The dentist
alters voice tone and volume to interject more
authority.
Restraints
Very young children and some special needs patients
are not able to understand why they need dental
treatment. This technique is used to protect
them from harming themselves. We only use restraints
when absolutely necessary and with parents permission.
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 a management technique
that uses medications to assist the child to
cope with fear and anxiety and cooperate with
dental treatment. Conscious sedation is a good
option for children who have a level of anxiety
that prevents good coping skills or are very
young and do not understand how to cope in a
cooperative fashion for the delivery of dental
care.
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.
Things to remember
• 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 them 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.
General Anesthesia
Outpatient General Anesthesia is recommended
for apprehensive children, very young children,
and children with special needs that would not
do 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.
