What You Need to Know About Sedation-Based Pediatric Dentistry

Fostering a positive dental outlook for your child is important. After all, early experiences at the dentist can shape how he views dental appointments for the rest of his life. For a child who has severe dental anxiety or another condition that prevents her from being treated in a traditional setting, sedation-based pediatric dentistry may be suggested by your child’s dentist. If sedation-based dentistry is suggested for your child, you may be wondering what it is exactly.

Abra DiLisio, D.D.S., board-certified anesthesiologist and co-owner of the Tooth Pillow Dentistry in Huntington, shares what you need to know about sedation-based pediatric dentistry and how to choose the best provider for your child.
   

What Is Sedation-Based Pediatric Dentistry?

A pediatric dentist will recommend sedation-based procedures for children that need it. There is always a risk associated with going under anesthesia, so “we don’t ever want to sedate a child that doesn’t absolutely need to be sedated,” adds Dr. DiLisio, who has been practicing dental anesthesiology for nearly 8 years.

During sedation-based pediatric dentistry, an anesthesiologist will use IV sedation on a child so a dentist can perform the necessary procedures while the child is asleep. This allows dentists to treat children who are unable to sit in a traditional dental chair setting, including:

• children who have anxiety about going to the dentist
• those with severe gag reflexes
• kids with complex medical histories
• patients with special needs, especially children with autism spectrum disorder
     

“We treat a significant number of patients on the autism spectrum,” Dr. DiLisio says. “The child goes to their referring dentist for all of their cleanings, exams, and checkups, which are most often done when the child is awake, so the familiarity regarding the regular routine care remains intact. The treatment under anesthesia gets done in our office and essentially the child has no memory of the treatment that we do, so we keep all the good memories at the regular dental office.”
   

Choosing a Sedation-Based Dental Practice

Parents are often hesitant to have their children put under general anesthesia for their dental treatment, as they should be, Dr. DiLisio says. However, choosing the right team of dental anesthesiologists, pediatric dentists, and other dental professionals is paramount in assuring your child’s well-being. Here are some key things to consider when choosing a practice for sedation-based dentistry.
   

Does the provider regularly practice sedation?

Oftentimes, dental offices may not have a dedicated anesthesiologist on staff, so one will visit as needed to do sedation-based procedures. The visiting anesthesiologist typically brings their own equipment, Dr. DiLisio says. Other offices, such as the Tooth Pillow Dentistry, have an anesthesiologist on staff and only practice sedation-based dentistry. Dr. DiLisio suggests looking for an office that regularly practices sedation-based dentistry with experienced providers to ensure you child is receiving proper care.
   

Is there a separate anesthesiologist present?

Confirming there is a separate anesthesiologist present for the procedure, not the dentist monitoring the sedation during the dental procedure, is of utmost importance for the safety of the patient. Doctors who specialize in anesthesiology have completed extensive training in hospital based anesthesiology residency programs, Dr. DiLisio explains. The Tooth Pillow Dentistry is unique in that it has two anesthesiologists in the office during sedation procedures.
     

Does the practice have safety precautions in place?

Dr. DiLisio suggest parents look for a provider that takes precautions to prevent problems from occurring. The Tooth Pillow Dentistry, for example, uses a closed airway system (the patient is intubated), American Society of Anesthesiology monitoring equipment, and medications that have almost no risk of allergic reaction, according to Dr. DiLisio.
   

Is there a proper treatment plan in place for your child?

Since sedation is used only when necessary, it’s important that the child’s dentist prepare a treatment plan that will prevent future sedation-based treatment from occurring. For example, a lot of times white fillings don’t last on children’s teeth, according to Dr. DiLisio. The Tooth Pillow Dentistry will recommend treatment plans, such as crowns, that reduce the risk of additional exposure to anesthesia for the child, she says.

“You have to treat somewhat aggressively when you’re under sedation,” she says. “That doesn’t mean treating teeth that are healthy, but when there are cavities and when there’s extensive decay in the mouth, you have to treat that appropriately and you have to consider that this child is under anesthesia. The appropriate treatment plan needs to be administered to this child to prevent a sedation from happening again.”

   
Above all, as with any dental procedure, if you have any questions along the way, don’t hesitate to ask.