Sedation

Sedation is most helpful for:

• Infants
• Children who require major treatment
• A very anxious child
• Children that have had traumatic dental experiences (sound and smell aversion)
• Children with a strong gag reflex

• Children who are medically compromised or have special needs

Reducing Fears

Dr. Birsch understands parents’ concerns about the fears their children possess concerning dental care treatment. Many fear going to the dentist themselves and want things to be different for their own children.Our team employs a variety of methods to accomplish this goal.

The office environment a child enters into plays a big part in either contributing to or reducing anxiety. When children are at ease with their surroundings they tend to adopt a more relaxed attitude. The office is designed especially for children. They feel right at home with the open atmosphere, cheerful colors and underwater theme.

Communicating with children on their level is one of the most important ways to reduce their fears. Dr. Birsch and her team are excellent communicators with children. They have a great deal of experience at it because it is what they do all day long. They constantly apply a technique known as Tell Show Do. They first “tell” the child what they are going to do in terms that the child can easily understand. Then they demonstrate or “show”it to the child. Then they” do” it together. The technique is very effective. It takes a little extra time but the children are not rushed.

If cavities develop and Dr. Birsch has to provide dental treatment, nitrous oxide, or “laughing gas”,can be used to relax the child. This mild, odorless gas is breathed through a small nosepiece while the child remains awake and able to communicate throughout the dental treatment. It is a very safe and effective technique.

Conscious sedation is an excellent way to provide dental treatment to very young children, fearful children and children with numerous dental needs. The child takes a combination of liquid medications or tablets about an hour before beginning dental treatment. The medications reduce fear and anxiety and may cause drowsiness or sleep but the child will remain conscious throughout the appointment. When used in combination with nitrous oxide, a much more effective result is reached in providing relaxation.

In certain situations general anesthesia offers the best method to deliver dental care in a relaxing atmosphere. It is most often recommended for young children with extensive dental needs that would otherwise require lengthy multiple conscious sedation appointments. It is also recommended for very young children with extreme fearfulness, anxiety, and apprehension,for children that are unable, by either age or maturity level, to cooperate during dental treatment, and for children with medical conditions or special needs. With the aid of general anesthesia the child is put to sleep by an anesthesiologist in a hospital or outpatient surgery center. Dr. Birsch then provides all the necessary dental treatment while the child is asleep. After a short recovery period, the child returns home the same day.

While all of these methods usually reduce fear and anxiety, some children may still exhibit apprehension regardless of the efforts made to put them at ease. Our team has lots of patience with children. When other options are ineffective, demonstrating patience to a child eventually wins out.We get enormous satisfaction when frightened children replace their fears with confidence and their frowns with smiles.

• Please inform us of any change to your child’s health and/or medical condition.
• Tell us about any respiratory condition that makes breathing through the nose difficult for your child. It may limit the effectiveness of the nitrous oxide/oxygen.
• Let us know if your child is taking any medication on the day of the appointment

• Please notify us of any change in your child’s health and/or medical condition: any new and/or current medications, and any drug reactions and/or change in medical history.
• We must know if your child has taken any medications for 2 days prior to the sedation visit. If your child is sick (cough, cold, ear ache, congestion, fever, nausea, rash, etc.) the day before the appointment, please call our office since we may need to postpone and reschedule the appointment.
• Your child must have NOTHING TO EAT OR DRINK AFTER MIDNIGHT.We will check with your pediatrician if your child must take daily medications.
• Please dress your child in loose fitting, comfortable clothing. Two-piece pajamas without a bootie attached to the leg are excellent. Please bring an extra set of clothing with you to the appointment.
• Please make sure that your child goes to the bathroom immediately prior to arriving atour office.
• Be prepared to remain in the office up to 3 hours. Do not plan to leave the office during that time.

• Keep your child under observation; if you are unable to do so, have another responsible adult supervise your child. Do NOT leave your child unattended!
• If your child wants to sleep, place them on their side with their chin up. Do not allow your child to obstruct his/her breathing with a pillow, clothing, etc.

• Nausea and Vomiting: Any nausea and/or vomiting that may occur will last a short time. If your child does vomit, wait about 30 minutes before attempting clear liquids such as water or Ginger Ale. If nausea does not occur, progress slowly to a regular diet, beginning with easily digestibles (soup, crackers) first then solid foods.
• Bleeding and Pain: Children will respond to pain or discomfort differently, therefore their mouth may or may not feel sore after surgery. You may give Children’s Tylenol or Motrin* to help make them comfortable, if necessary. There may be also a small amount of bleeding around the gums. The gums are pushed on and cleaned around during surgery therefore a little bleeding is normal after dental surgery and should stop within a few days. If teeth were extracted there may be some discomfort and bleeding. If your child’s mouth starts bleeding excessively, please call our office immediately and/or proceed to the emergency room.
• Fever: After any surgical procedure a low-grade fever (99-100 F) is normal. You may give your child Children’s tylenol or Motrin*. If the fever continues over 101.5 F for 24 hours, please call us immediately.
• Activity: Your child may feel sleepy for the next 24 hours. This is due to the medicine your child received. Please doNOT leave your child alone. Children should rest at home but may be up and about. Please have your child refrain from exercise that requires quick reflexes for 24 hours. regular activity is encouraged the day after surgery. Keep children propped up with a pillow while sleeping. Check your child every 20-30 minutes to make sure they respond.
• Sore Throat: Your child may have a sore throat due to the drying effects of the anesthetic gases and the breathing tube placed during surgery for up to 48 hours.
• Post Operative: Your child will need to come back to see Dr. Birsch 1-2 weeks after the surgery. Please schedule a post-operative visit at the time of surgery.