Anesthesia and Sedation for Pediatric Dentistry
General anesthesia can be used on pediatric patients to keep them safe and comfortable during a dental procedure; your child’s dentist might decide to use general anesthesia in the operating room. General anesthesia also may be used if your child needs extensive or complicated procedures that will take a long time to complete, or needs several procedures done all at the same time.
A Pediatric Anesthesiologist is a doctor who specializes in anesthesia for children and will give your child the medications that will make them sleep soundly during their dental procedure. General anesthesia makes your child go to sleep and is needed for certain dental procedures and treatments so that their reflexes are completely relaxed. Your child will feel no pain during the procedure, nor have any memory of it.
Before General Anesthesia
When general anesthesia is needed, there are important rules for eating and drinking that must be followed in the hours before the procedure. The day before your child’s procedure, you will receive a phone call from a scheduling nurse who will give you specific eating and drinking instructions for your child based on your child’s age which will include:
For infants under 12 months:
- Formula fed babies may be given a bottle up to 6 hours before the scheduled arrival time
- Breast fed babies may nurse up to 4 hours before the scheduled arrival time
For all children:
- After midnight the night before the procedure, do not give any solid food or non-clear liquids including milk, formula, juices with pulp, coffee, and chewing gum or candy.
- Up to 2 hours before the scheduled arrival time, give only clear liquids such as water, Pedialyte, Kool-Aid, and juices you can see through, such as apple or white grape juice, NOT milk
- If your child takes daily medication, they should take it unless specifically told not to do so by the doctor or scheduling nurse.
Going to Sleep
The anesthesiologist will meet with you and your child to review your child’s medical information and determine which kind of sleep medication your child should receive. If your child is scared or upset, the doctor may give a special medication to help him or her relax. If you wish, you may stay with your child as the sleep medication is given.
As a parent, watching your child undergo anesthesia may be an uncomfortable experience for you. Children can sense a parent’s concern so for your presence to be helpful to your child, you must try to be as calm and encouraging as possible.
- Bring along a comfort item for them to hold, such as a stuffed animal or blankie
- Touch your child to remind them that you are there; whisper, talk, or sing to your child to provide reassurance
Even with a parent present, the operating room can be a scary place for a child so do not feel bad if your child gets upset. The main purpose of your presence at the induction of anesthesia is to help your child therefore, your child’s safety is the primary concern. If you are asked to leave the room for any reason, you must do so quickly and quietly so the medical staff can focus their full attention on your child.
Once in the operating room, a small mask will be placed over your child’s nose and mouth through which they will inhale nitrous oxide to help them relax and fall asleep. Once your child is asleep, intravenous (IV) sedation will be started to keep them sleeping throughout the procedure. IV sedation requires a needle to be inserted into your child’s vein, usually in the arm or hand. During the procedure, your child’s heart rate, blood pressure, and other vital functions will be closely monitored. When your child has fallen asleep, you will be taken to the waiting room.
After General Anesthesia
Once the procedure(s) have been completed, your child will be taken to a recovery room where nurses will carefully monitor their vital signs as the effects of general anesthesia can last for many hours.
- Their nose, mouth, and throat may remain numb for 30 to 45 minutes after the procedure
- Their throat may remain sore for a day or two
- Their mouth and gums may be sore for several days afterward
For about 30 to 40 minutes after the procedure, use caution when your child eats and drinks because they may feel dizzy or nauseated. They should only have soft foods for the first few hours following general anesthesia, unless otherwise directed by their doctor.
Your child will need to go home after their procedure, not to school or daycare. They may also need to stay home the next day, depending on how they feel. Their gums and mouth may be sensitive but children’s tylenol or motrin will help ease any discomfort.
Call their dentist immediately if they experience any of the following symptoms for more than 24 hours after their surgery:
- severe bleeding of the gums
- severe pain
- severe vomiting or dizziness
If you are calling during the evening or on a weekend, please call the hospital and ask for the dental resident on call.