Oral sedation
What is oral sedation?
Most commonly, oral (intraoral) sedation is performed on children. During a single session of oral sedation, it is possible to treat 1 to 2 teeth, sometimes three, because the effective work time is 30 to 40 minutes. If there are more teeth to be treated, treatment may be carried out in several sedation or in a single general anesthesia (narcosis). Oral sedation means that the medicine is taken through the mouth (patients drink it). Medication is mixed with syrup and is drunk from a cup or a syringe. The sedation onset it 10 to 20 minutes. During sedation, medicines are used to help patients tolerate the tooth treatment procedures. It is not general anesthesia (narcosis). The patient is not asleep, but relaxed, drowsy, dizzy, is not afraid, and sleep is easily interrupted. Patient does not pay attention to his surroundings, does not remember parts or all the procedure. During oral sedation, depending on the dose and individual characteristics of your child, a minimal to medium level, rarely deep sedation is achieved.
What should I know before oral sedation?
No eating is allowed 6 hours before the procedure and drinking 2 hours before. If the patient is taking any medication, you must inform the anesthetist. Clothes should be comfortable. It the patient caught a cold, has a sore throat, cough, fever, stomach ache or has any other acute illness, please call the reception, and inform us at 8 644 77447. We recommend not brushing teeth before the procedure so as not to swallow any water.
What should I know after sedation?
It is allowed to drink after the procedure. It is better to drink more often in small amounts and look for nausea. Eating is allowed after roughly two hours, after the effects of sedation go away. It is better to begin with soft, easily digested foods – porridge, yoghurt, bananas. Take medication the doctor has prescribed. If your child is in pain, take suspension of ibuprofen or paracetamol. If you encounter unusual problems, call clinic reception immediately at 8 644 77447. After work hours, go to the emergency room. Cycling, climbing, running is not allowed 24 hours after sedation. Do not take the child to kindergarten or school that day, let them rest. The children will not remember the procedure, so only tell them positive things after the procedure, don't mention that something was not great (they cried, felt pain, etc.).
Who can undergo sedation?
Children who are afraid to go to the dentist, do not tolerate treatment or are uncooperative during treatment.
Who cannot undergo sedation?
Those sensitive (allergic) to benzodiazepines or patients with certain central nervous system illnesses. Patients with an acute infection (cold), fever.
What are the drawbacks of sedation?
It cannot be increased or prolonged. Sedation does not end with the treatment procedure. Patients must stay in the clinic for a while (usually up to 1 hour). In approx. 20 % of cases in children oral sedation is ineffective – the child still cannot be treated. Also, in 20 % of cases a paradoxical (inverse) reaction may occur. It can be from slight to severe, when your child becomes irritable, angry, aggressive, cries. It lasts until the effect of medication wears off.
Is sedation safe?
It is safe if your child's age and weight are observed, but there is always some risk. If sedation is performed by an experienced doctor in a licensed clinic, risk associated with sedation is minimal, and any problems may be solved in a professional manner.
Intravenous sedation – what is it?
For adults, intravenous sedation is performed the most commonly It is suitable for both short and long, simple and complex procedures General anesthesia is used rarely, often in difficult surgical cases. Sedation may be used for all procedures, both surgical, such as implantation, and simple, like tooth treatment, bleaching and professional cleaning. Due to great results of intravenous sedation, other anesthetic procedures (oral sedation, mask anesthesia, general anesthesia) are rarely performed on adults, but, if necessary, they may also be performed in our clinic. During sedation, medicines are used to help patients relax during tooth treatment. It is not general anesthesia (narcosis). The patient may not sleep, but is relaxed, feels no fear, and sleeps, but is easily woken up. Patient does not pay attention to his surroundings, does not remember parts or all the procedure. Intravenous sedation is more efficient than oral sedation. A thin, short plastic catheter is introduced into a vein, through which the medication is injected to produce sedation. Its level may be controlled, sedation may be increased or prolonged, if needed. Intravenous sedation begins immediately, there is no waiting time. Heart and breathing activity are monitored - a sensor is placed on the finger to monitor the blood oxygen level and pulse, a blood pressure cuff is placed on the arm to monitor blood pressure, and an electrocardiogram is done, if necessary. During intravenous sedation, depending on the dose, a medium to deep sedation is achieved.
What should I know before intravenous sedation?
It is not allowed to eat 6 hours before the procedure and to drink 2 hours before the procedure. If you are taking any medication, you must inform the anesthetist. An entourage is needed. Driving and complex work (operating machines) is not allowed 24 hours after the sedation. Wear comfortable clothes with easily tuckable sleeves (catheter is usually placed at elbow level). During the procedure, contact lenses, removable dentures and jewelry must be taken off. On the day of the procedure and especially during the procedure, do not wear lipstick or a lot of make-up, nail polish, do not wear high heels. It you have a cold, a sore throat, cough, fever, stomach ache or any other acute illness, please call the reception at 8 644 77447 and inform us.
What should I know after intravenous sedation?
After the procedure, you must be escorted home, rest for the remaining day. You must be accompanied until the effect of sedation wears off. Do not plan and participate in any physical activities, do not drive for the rest of the day. Do not eat immediately after the procedure, and only easily digested food afterwards. If you are nauseous, lay down for a while. Do not consume alcohol and do not take any medications not prescribed by the doctor. Take medication the doctor has prescribed. If you encounter unusual problems, call clinic reception immediately at 8 644 77447. After work hours, go to the emergency room.
Who can undergo intravenous sedation?
Sedation is performed for anyone who is afraid of going to the dentist. Sedation is also suitable for those who:
Do not want to know what is happening during a procedure
Will be undergoing a long or complex procedure
Cannot sit still in a dental chair
Have a low pain threshold
Have a pronounced gag reflex
Who cannot undergo intravenous sedation?
Pregnant women, those sensitive (allergic) to benzodiazepines, patients under the influence of alcohol (drunk people), or patients with certain central nervous system illnesses. Cardiovascular disease is not an absolute contraindication. Patients with severe sleep apnea, obesity, airway obstruction are recommended oral sedation.
What are the drawbacks of intravenous sedation?
An intravenous catheter is needed for intravenous sedation, even though it is very thin. For anxious people, a special anesthetic cream is applied on the skin before puncturing the skin. Sedation does not end with the treatment procedure. Patients must stay in the clinic for a while (usually around 1 hour). The patient needs to be escorted home. The patient must willingly wish for sedation. If, for some reason, the patient does not want to be sedated (e.g., they do not like situations where they are not in control), an effective and predictable sedation is difficult to achieve.
Is intravenous sedation safe?
There is always some risk. However, if sedation is performed by an experienced doctor in a licensed clinic, risk associated with sedation is minimal, and any problems may be solved in a professional manner. Patients with preexisting conditions or health conditions, e.g., obesity, cardiovascular, pulmonary diseases, or obstructive sleep apnea; also, older patients.
Mask anesthesia
What is mask anesthesia?
Mask anesthesia is usually performed on children when extracting teeth or performing frenuloplasty procedures. It lasts 10 to 15 minutes. Afterwards children wake up quickly and can go home. In order to fall asleep, children need to breath in the anesthetic (“to blow the balloon”) 6 to 8 times. A catheter is not placed into a vein. At the beginning of the procedure, before the child goes asleep, one of the parents stays with the child. When the child is sleeping, parents are asked to wait in the waiting room. After the procedure, when the child is beginning to wake up, parents are invited back.
What should I know before mask anesthesia?
It is not allowed to eat 6 hours before the procedure and to drink 2 hours before the procedure. If the patient is taking any medication, you must inform the anesthetist. Clothes should be comfortable. It the patient caught a cold, has a sore throat, cough, fever, stomach ache or has any other acute illness, please call the reception at 8 644 77447 and inform us. We recommend not brushing teeth before the procedure so as not to swallow any water.
What should I know after mask anesthesia?
After waking up when the procedure is over, your child may be confused and cry for a short while. Sometimes (especially after a tooth extraction) there may be the taste of blood in the mouth, which may not be pleasant for your child. If local anesthesia was performed, your child may not like the numbness in the mouth. Also, your child may be in some pain. In that case, some additional painkillers are administered. All these things may affect your child's mood, they may be irritable, upset. Your child may be dizzy, sleepy for a while. Sometimes nausea or vomiting may occur, especially if some blood was swallowed. It is allowed to drink after the procedure. It is better to drink more often in small amounts and look for nausea. Eating is allowed after roughly one to two hours, after the effects of anesthesia go away. It is better to begin with soft, easily digested foods – porridge, yoghurt, bananas. Take medication the doctor has prescribed. If your child is in pain, take suspension of ibuprofen or paracetamol. If you encounter unusual problems, call clinic reception immediately at 8 644 77447. After work hours, go to the emergency room. Cycling, climbing, running is not allowed 24 hours after anesthesia. Do not take your child to kindergarten or school that day. Let them rest at home. The child will not remember the procedure, so only tell them positive things after the procedure, don't mention that something was not great (they cried, felt pain, etc.).
Who can undergo mask anesthesia?
Children who are afraid to go to the dentist, do not tolerate treatment or are uncooperative during treatment.
Who cannot undergo mask anesthesia?
Those sensitive (allergic) to benzodiazepines or patients with certain central nervous system illnesses. Patients with an acute infection (cold), fever.
What are the disadvantages of mask anesthesia?
The main disadvantages are these: limited duration (10 to 15 minutes) and unprotected airways.
Is mask anesthesia a safe procedure?
It is safe if your child's age and weight are observed, but there is always some risk. If anesthesia is performed by an experienced doctor in a licensed clinic, risk associated with anesthesia is minimal, and any problems may be solved in a professional manner
General anesthesia (narcosis with intubation)
What is general anesthesia?
Usually for children, teeth are treated or extracted using local anesthesia (numbing the tooth). Procedures may also be done under sedation, by giving to take some medicines orally. Then children are more relaxed, less anxious. However, for some children, especially younger than 6 years and with many cavities, the only solution is general anesthesia (narcosis with intubation). General anesthesia (narcosis) is a controlled state, induced using anesthetics. The patient is asleep and feels no pain. During the procedure, the airways are protected using a special intubation tubing. After tooth treatment, anesthetics are stopped and your child wakes up.
Before the anesthesia
No eating is allowed 6 hours before the procedure and drinking 2 hours before. If the patient is taking any medication, you must inform the physician performing the anesthesia. Clothes should be comfortable. It the patient caught a cold, has a sore throat, cough, fever, stomach ache or has any other acute illness, please call the reception, and inform us at 8 644 77447. We recommend not brushing teeth before the procedure so as not to swallow any water. If you have any doubts about your child's health, call the clinic before your visit.
What parents should tell their child before anesthesia
That depends on your child's age and your opinion on what your child will understand. A five-year-old might be afraid to “sleep” during the procedure or be anxious about the pain after the procedure.
You should tell your child that some of his teeth are bad and need to be taken out or fixed. Tell your child the doctor will give him some medicine and when they sleep, their teeth will be fixed. The doctor will be by their side all the time, during the procedure and afterwards. Also, the doctor will give some medicine for the pain. Older children will want to know more. Encourage them to talk about it. Books, games, stories can help describe the procedure. The children will not remember the procedure, so only tell them positive things after the procedure, don't mention that something was not great (they cried, felt pain, etc.).
Anesthetics
Anesthetics are medicines (solutions for injection and gases) used to induce and maintain anesthesia. Medicines used may include:
•Medical gas breathed through a mask covering mouth and nose. When the child is asleep, an intravenous catheter is placed and an infusion system (“a drip”) is connected.
•Injection through an intravenous catheter. Catheter is introduced into a vein before your child is asleep. Anesthetic cream may be applied onto the injection site beforehand.
•A special tube is used to protect the airways.
If your child had any unpleasant experience with anesthesia before, tell your anesthetist.
Who can undergo general anesthesia?
Children who are afraid to go to the dentist, do not tolerate treatment or are uncooperative.
Who cannot undergo general anesthesia?
Those sensitive (allergic) to anesthetics or patients with certain central nervous system illnesses or other severe illnesses. Patients with an acute infection (cold), fever.
Is general anesthesia safe?
Using modern general anesthesia, risk of severe problems is minimal.
Risk cannot be excluded completely, but when the patient is healthy, is feeling well, and the procedure is not extensive (most dental procedures are not), risk of life-threatening complications is 1:400,000. The risk is lower than probability of being severely injured during a car accident.
Are children with concurrent disease in higher risk?
Yes, risk is higher, therefore the benefit of tooth treatment must outweigh the risk. Every child is evaluated individually; therefore it is possible to accommodate to their needs.
Who can perform general anesthesia?
General anesthesia can only be performed by an anesthetist in a licensed practice. The anesthetist performs the anesthesia, monitors the patient during and after the procedure. It is best for the anesthetist to have experience working with children during dental procedures.
Will painkillers be used?
Usually, children receive painkillers using one or several of these methods:
•Take painkillers orally before the procedure
•Painkiller suppositories are introduced under anesthesia
•Painkillers are injected though the catheter
•Local anesthetic is injected by the tooth to be treated or extracted It is performed when your child is asleep during general anesthesia. If the child is in pain after the procedure, additional painkillers are prescribed.
Can I be along with my child?
At the beginning of the procedure, before the child goes asleep, one of the parents stays with the child. When the child is sleeping, parents are asked to wait in the waiting room. After the procedure, when the child is beginning to wake up, parents are invited back.
How long will my child be asleep?
It depends on the procedure. Waking up takes longer after a long procedure, as more anesthetic is used. 15 to 20 minutes is usually enough.
How do children feel after general anesthesia?
After waking up from general anesthesia, your child may be confused and cry for a short while.
Sometimes (especially after a tooth extraction) there may be the taste of blood in the mouth, which may not be pleasant for your child. If local anesthesia was performed, children may not like the numbness in the mouth. Also, they may be in some pain. In that case, some additional painkillers are administered. All these things may affect your child's mood, they may be irritable, upset. Your child may be dizzy, sleepy for a while. Sometimes there may be some nausea/vomiting, especially is blood is swallowed. During anesthesia, a catheter is placed into a vein, which is covered in dressing after the procedure, but left in place in case nausea or pain medication is needed. Before discharging the patient, the catheter is removed. Most children wake up quickly and may have something to drink.
After general anesthesia
Monitoring in the wake-up room may take up to 2 hours, afterwards the patient may go home.
You may give your child regular food at home. Easily digested foods are recommended (yoghurt, porridge, bananas). If the doctor prescribed painkillers at regular intervals, you should give your child the medication before any pain emerges.
If you have any questions, call the clinic at 8 644 77447. After clinic's working hours, contact an emergency healthcare provider.
Can I take my child to kindergarten/school the same day?
Usually, children should rest at home. Although after the effect of anesthetics children may seem fine, it is recommended to monitor them, not let them ride a bicycle, run, etc., so they do not get hurt.
Questions to the anesthetist
• Who will perform the general anesthesia (narcosis with intubation) for my child?
• Are there alternatives to general anesthesia?
• How often is this method used?
• What is the risk of general anesthesia?
• Is my child at higher risk?
• How will my child feel after general anesthesia?
