What can we expect on the day of our child’s sedation appointment and how do we prepare them?
I generally recommend speaking to your child in words that are appropriate for their age and actually preparing them very little for the appointment. In their world they’re just coming to visit the dentist again and that’s really all that they need to know, they don’t need to stress about things that they can’t understand. So for instance, you might tell your child we’re going to back to and see Dr. Jen again in a couple weeks and she’s going to have another look at your teeth. Maybe you’ll get a prize. And it can be as simple as that, especially in an anxious child that’s quite concerned about what might be happening and why they have to go back. We certainly do not prepare them for possibly having a needle or a freezing done, anything that might scare them or that they have cavities and avoid any sort of blame that they have these cavities and what have they done, because it’s just not fair to them to put that kind of stress on them.
So the day before the sedation appointment, it’s important that you assess your child and make sure that they don’t have a runny or stuffed up nose and they can breathe fine, they haven’t been sick, they’re not taking any medications and they’re feeling generally well. They’re not to have anything to eat or drink after midnight so when they get up in the morning nothing by mouth at all; no water, its ok to not brush their teeth, so that we avoid any chance of them drinking water.
They’ll arrive at the office at 8 o’clock in the morning. We recommend that you keep them in comfy clothes; their pajamas are fine (as long as it’s not a onesie or a sleeper) loose clothing are best because we will need access to their arms and legs.
For girls we recommend you tie their hair back and make sure there is no nail polish on their fingers or toes. It can also be useful to let them bring a comfort item with them, whether it be a stuffed animal or a little toy, a car, something that just comforts them. Some parents also elect to have a surprise for them after the appointment also.
We will take you and your child in and you will be with them for the duration of taking the medication and them getting drowsy. You will wait in the waiting room for them until they’re finished their treatment. We recommend that you have a second adult who is able to drive you home so that you are able to be in the back seat with your child to monitor them closely as they will still be slightly sedated.
We will obtain your child’s weight when you arrive so we can correctly dose your child by weight for the medication. We will check your child’s blood pressure, their pulse oximetry, their heart rate, their temperature, their respiratory rate, and all the while we share this with them in child friendly language and make it as non-threatening and comfortable as possible. We will also have Netflix on so they can choose a movie or a TV show they like to watch and they’ll be in a calm environment with a couch and TV where they can relax with a blanket.
The medicine will be mixed with a fruit punch flavour and it’s pleasing to most children. The volume is approximately three to four teaspoons that they would have to drink and then they get a little treat to have while the medication is taking affect. The main thing you will notice is your child becoming drowsy, a little uncoordinated, they may want to lie down because it’s too hard to hold their head up; they may also say some things that don’t quite make sense. Some children have double vision but they generally are happy and just a more animated self, if you will.
At all times your child is monitored so if something doesn’t seem right we’re are able to look after any situation that may arise. The medications do have reversals if necessary. Every medication is a little bit different, every child is a little bit different but on average a child may take forty five minutes to an hour to achieve the desired sedated affect and then we will take them and wrap them in a blanket while we do the work so that they are safe.
In many cases, we will even take x-rays on your child while they are sedated if this was not able to be done prior to sedation, that’s perfectly normal. Once we take the x-rays and we determine a final plan for your child’s teeth we will notify you and clarify with you any concerns of what we are doing. Once your child is all completed, they will be back in the recovery room with their guardian and they’re able to sit and watch some TV as they recover from the sedation affects.
Only when your child is able to sit up, hold their own head up, have a purposeful conversation, if they are able to talk and eat something and we’re satisfied that their vital signs are within what they were when they arrived, then we will discharge you and you’re able to go home.
What to expect after sedation; generally children go home and they’re quite sleepy still and they may sleep for several hours. We recommend that you keep them on the couch in a central area of the house, maybe the living room where you can keep an eye on them and just monitor that they are breathing and they may sleep for several hours, that is fine.
The effects of the sedation can last the remainder of the day so we ask that activities are kept to very minimal, watching TV, DVDs, playing board games, but certainly no riding bikes, running around outside, jumping on trampolines and no sports participation that day if your child does play sports. The following day they are able to resume normal activities.
If your child had a tooth removed, they may experience some discomfort when the freezing and the sedation has worn off later that day. We recommend you give your child what you would normally give them for a headache and they should be fine by the next day.
As far as diet afterward, we recommend you begin using clear fluids for your child and just see what they’re ready for. Please avoid greasy foods such as McDonalds french fries, this sort of thing. The day of sedation just a bland diet with soft foods is recommended. A common side effect of the sedation medicine is some nausea and your child may vomit.
What is not a normal side effect is continuous vomiting, if your child were to run a fever or if they’re just not acting themselves; something’s not right. We ask that you either call our office or call Dr. Jen on her after hour’s number or take your child to the emergency room immediately.