Nitrous oxide, or laughing gas, is the most frequently used method for easing mild to moderate anxiety in children. Administered through a small mask that fits over your child’s nose, it is an effective way to calm anxiety. Your child will be asked to breathe through his or her nose and not through their mouth. As the gas begins to work, your child will become calm, although he or she will still be awake and able to talk with the dentist.
At the end of your child’s appointment, he or she will resume breathing regular oxygen, and all the effects of nitrous oxide will disappear. As your child gets older and becomes more comfortable during dental visits, nitrous oxide may not be necessary.
General anesthesia may be advised for children who are very young, have extensive dental decay, or patients with special healthcare needs. This procedure is completed in a hospital operating room under the presence of an anesthesiologist or a nurse anesthetist and your dentist. All dental treatment can usually be completed in one visit. General anesthesia is administered through an oral or nasal breathing tube that will keep your child asleep during the dental procedure. A pre-op physical completed by your child’s primary care physician is required prior to dental care under general anesthesia. Our dental office will assist you in scheduling a physical with your physician and the dental treatment in the hospital. Your child MUST NOT eat or drink anything after midnight the night before treatment in the hospital. Although parents are not permitted in the hospital operating room, please plan to stay at the hospital as you will be will your child before and after surgery while your child recovers.
Please observe the following after the surgery:
- ACTIVITY: Your child should not return to school or daycare the day of surgery. Your child should be under close parental supervision and activities restricted for the rest of the day. The first two days after surgery are generally the most uncomfortable. The remainder of the post-operative course should be gradual steady improvement.
- DIET: Encourage clear liquids to avoid dehydration and advance to clear soft foods (Jell-O, popsicles, broth) following. You may move to a more routine diet as your child tolerates.
- PAIN: Mild swelling and discomfort are normal occurrences following dental treatment in the operating room. Your child may also have a sore tongue and throat from the safety throat pack used during surgery. This can be managed with Tylenol every 3-4 hours or Motrin every 4-6 hours as needed.
- NUMBNESS: Local anesthetic is generally not needed for dental treatment in patients who are under general anesthesia. Your dentist will inform you of any areas that were numbed during the surgery. Soft foods may be eaten until all the effects of the numbness have gone away. Watch to see that your child does not bite, scratch, or injure the cheek, lips, or tongue during this time.
- BLEEDING: Some procedures will cause bleeding; however, this is easily controlled by applying pressure with gauze or a damp washcloth. Bleeding should never be severe. If bleeding remains uncontrolled, please contact us.
- DENTAL FILLINGS: After placement of dental fillings (white or silver), teeth may be sensitive to hot, cold and pressure for a brief period of time.
- STAINLESS STEEL CROWNS: It is common for gum tissue surrounding a stainless steel crown to bleed and appear bruised following placement. This will subside over time. Regular oral hygiene is necessary to maintain proper gum health.
- FEVER: Your child’s temperature may elevate to 101 degrees F/38 degrees C for the first 24 hours after surgery. Tylenol every 3-4 hours or Motrin every 4-6 hours will help alleviate this condition. Encourage clear liquids to avoid dehydration. Contact your local pediatrician if your child’s temperature elevates beyond 101 degrees F/38 degrees C.
- NAUSEA: Your child may experience nausea after surgery. Sometimes pain medications given during surgery may be the cause. Allow your child to take sips of clear liquids. Please contact us if vomiting persists beyond 4 hours.
- ORAL HYGIENE: Toothbrushing and regular oral care may resume following dental surgery. Your dentist will inform you of any extraction sites and give you proper care instructions.
- SEEK ADVICE:
- If vomiting persists beyond 4 hours
- If the temperature is above 101 degrees F/38 degrees C
- If there is difficulty breathing
- If any other matter causes you concern