Would My Child Benefit From Sedation Dentistry?

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2020

Would My Child Benefit from Sedation Dentistry? ( Part I )

By Dr. Maria Grosman

Like the answer to most medical questions, the answer is not so straightforward. There are many factors which go into the decision-making process. These factors include maturity/anxiety of the child, type of sedation available and financial resources available to the family. In our experience, the consideration of each of these variables is of utmost importance in consistently making the right decision for the pediatric dental patient.

The first step in the process is to gather all of the available information. This is accomplished by performing a complete assessment of the patient. The information gathered includes the obvious dental needs, diet, home care, age, emotional maturity, and dental anxiety. Most decisions regarding the treatment plan can be made at this stage.

For example, a two-year-old who suffers from carious lesions (cavities) on all primary (baby) teeth would likely require a more comprehensive sedation in order to complete the entire dental treatment in a non-traumatic manner. A child at this age does not have the cognitive and emotional ability to complete the treatment without potential long-term negative effects. In other words, without the right approach this child may become an adult with a long -term phobia of dentistry. On the other hand, a 16-year-old who has been consistent with regular checkups and has already had dental treatment in the past, would unlikely require sedation. Most other scenarios fall somewhere in between.

Once the needs are established, the type of sedation would be considered. Types of sedation range from simple anxiolysis with nitrous oxide (“laughing gas”) administered in the dental office setting to general anesthesia done in a hospital setting. This is where the experience and intuition of the pediatric dentist is of most importance. Ideally, we would like to use the medication facilitating the completion of the treatment with the least sedative effect.

Next month’s editorial will review the various types of dental sedations in more detail. It is at this point, that the parent/guardian must be informed and educated as to the process. For example, inhalation agents like nitrous oxide (laughing gas) completely exit the body prior to the end of a procedure. Other medications, depending on their route of administration, exit the body more slowly and prior arrangements should be made for an adult to sit with the child on the drive back home from the dental visit.

Lastly, financials should be considered when making final decisions. Insurance breakdowns provided by the major insurance carriers are usually very specific as to what will be covered in most situations. However, if there is any ambiguity an estimation of benefits (“EOB”) may be requested from the insurance company prior to the start of treatment. Finances may also direct treatment. For example, in a situation where there is a lot of dental work to be completed, doing so under a “deeper sedation” may seem more expensive because of the higher cost of administration. However, if there is a large amount of dental work needed, doing so under a “lighter” form of sedation may result in the need for multiple visits. Possibly costing more in both time and money.

Our advice is to focus on prevention. The sooner healthy habits are established, the less likely extensive treatment will be needed. Additionally, early exposure to the dental office (when dental work is not yet needed) decreases anxiety levels once dental treatment is necessary. There are also many benefits to the development of a relationship. The child is more comfortable and is more easily read by the doctor. Difficult conversations between parent and doctor are easily handled once there is trust.

▸The office of Dr. Maria Maranzini-Grosman (Board Certified Pediatric Dentist) and Dr. Alon Grosman (Specialist in Orthodontics) is located at

South Flamingo Road on the NW corner of Griffin and Flamingo Road.

For more info or to schedule an appointment, call 954-236-3434.