Sedation Dentistry
| Sedation dentistry refers to the use of sedation during dental treatment. There are different types of sedation, including Laughing Gas (Nitrous), Oral Conscious Sedation and IV Sedation that are used in our office. You may want to contact your dental insurance carrier to verify if any of the sedation options are a covered benefit. Sedation can range from the use of nitrous oxide to calm a patient to general anesthetics used to put patients to sleep. Patients with dental phobia, low pain tolerance, major dental treatment, physical handicaps or strong gag reflexes may require sedation. Procedures like fillings, crowns, root canals, and extractions often require sedation. Sedation is endorsed by the American Dental Association and is an effective way to make many patients comfortable during their dental visit. Before using a sedative or anesthetic, it is important to tell your pediatric dentist about any medications or medical treatments your child is receiving. Before administering any sedative or anesthetic, your pediatric dentist will talk to you about the process of sedation and pre- and post-sedation instructions. "Laughing Gas" (Nitrous) Nitrous oxide, more commonly known as laughing gas, is often used as a conscious sedative during a dental visit. The gas is administered with a mixture of oxygen and has a calming effect that helps phobic or anxious patients relax during their dental treatment. Because it is a mild sedative, patients are still conscious and can talk to their pediatric dentist during their visit. After treatment, the nitrous is turned off and oxygen is administered for five to 10 minutes to help flush any remaining gas. The effects wear off almost immediately. Nitrous oxide rarely has side effects, although some patients may experience minor nausea and constipation. Your pediatric dentist will provide you with pre- and post-sedation instructions. Oral Conscious Sedation Oral Sedation allows your child’s dental procedures to be accomplished in an office setting, safely and comfortably. Your child will be given a liquid medication in our office called Midazolam (Versesd) to drink prior to beginning his/her dental procedure. This medication is given to decrease your child’s anxiety about dental treatment. It begins to work in approximately fifteen minutes. Midazolam may make your child sleepy, but he/she will not sleep through their dental procedure. Sometimes nitrous oxide (laughing gas) may also be used to help your child relax. Each child may react differently to the medication. Some children become tired; and some children become giggly. In some instances, the child may have an unwanted reaction which causes them to become hyper or upset after the medication begins to work. Usually the Midazolam will start to wear off in approximately thirty minutes, but your child will continue to feel groggy for several hours. Your child will be monitored at all times. Vital signs, such as heart rate, blood pressure, and respiratory rate will be obtained prior to giving your child the medication. These vitals will be monitored throughout the sedation appointment. In addition, a pulse oximeter will be placed on your child’s finger or toe to monitor the level of oxygen in the blood. Close observation is always used. Your child will be ready to leave the office within thirty minutes of the completion of their dental procedure. Your child will require adult supervisioin for the first few hours after their sedation visit. You may want to check with your dental insurance company to see if Oral Conscious Sedation is a covered benefit. IV Sedation IV Sedation with Special Anesthesia Services is offered in our office and administered by Special Anesthesia Services (http://www.sleepinsafety.com), a group of Nurse Anesthetists (CRNA’s) who specialize in caring for patients needing sedation in the dental office setting. In cooperative children this is accomplished utilizing a local anesthetic on the skin, which is administered just under the surface of the skin. Your child will experience only a slight sting. In children who are unable to cooperate we may give them an Intramuscular injection without them knowing it. We will ask the child to give their parent a “big bear hug”; the parent should hug the child tightly, keeping their arms clear of the upper part of their child’s buttocks. The injection will be administered quickly right through the clothing, and we will try to convince the child that a “mosquito” has bitten them; the reaction of children can vary greatly. Many children don’t cry, some cry slightly and some respond vigorously. Within several minutes the child will be unaware of their surroundings, and then an IV can safely be placed. Occasionally a parent will prefer to tell their child that they will be getting a shot. We will be happy to do this, but our experience leads us to favor the surprise approach, as the child doesn’t become apprehensive, and doesn’t tighten their muscles prior to the injection. After the IV is placed, it will be used to administer sedative drugs, and any additional medications that may be necessary. IV medication is typically composed of an amnestic/hypnotic called Diprivan (propofol). This is administered according to the child’s weight. An EKG monitors the heart rhythm. A pulse oximeter monitors blood oxygen levels. An automatic blood pressure monitor is also used. Close observation is employed. Patients are usually ready to leave the office within one hour of the conclusion of the procedure. They will be able to sit without any undesirable symptoms, their vital signs will be stable, they will be responding in an appropriate fashion and will display appropriate, but diminished, physical coordination. Children are discharged when somewhat drowsy, and will usually require carrying. They must have adult supervision for the remainder of the day and not be allowed to participate in any activities in which lack of coordination or alertness would endanger them. Special Anesthesia Services Charges Some charges will be covered by insurance. Many times, medical insurances will pay the anesthesia charges for children under the age of six, patients with a mental or physical handicap, or patients with a medical necessity. We participate in Blue Cross / Blue Shield, and Preferred Health Systems / Preferred Plus of Kansas insurances only. We can do a predetermination with these insurances to find out if there is coverage for our services. Other insurances will do predeterminations, but we don’t do these through our office. Our staff will be glad to assist you with the information you’ll need when contacting your insurance company to determine if you’re covered. You can usually accomplish the predetermination over the phone, but we suggest you have your insurance company send you a letter of confirmation. We do expect payment on the day of service. This would be all BCBS or PPK /PHS deductibles and co-payments, as well as payment in full for all other insurances or those without insurance coverage. Special Anesthesia Accepted Payments We accept cash, personal checks, cashier’s checks, money orders, traveler’s checks, Visa, Mastercard, Discover, American Express, and band debit cards. Additionally, we offer a payment plan from Care Credit. They offer interest-free financing for up to 18 months. See www.carecredit.com or call our office for details. For more information please contact our office at (316) 788-5939 or visit the website at www.sleepinsafety.com. |
