Sedation in the Pediatric Dental Practice

Abstract

A contemporary dental practice offers a variety of sedation medications and routes of administration. Most dental sedation is delivered to children by inhalational and oral routes, although the nasal route is gaining acceptance. Minimal and moderate sedation are the levels that the dentist, acting as both the sedationist and the proceduralist, will wish to achieve in the dental office. Combinations of medications offer the ability to achieve ideal moderate sedation. Nitrous oxide, benzodiazepines, antihistamines, and other agents are discussed. Dental procedures are invasive and unique in that they occur in the oral airway. To achieve a successful outcome, sedationists and proceduralists must take into account instrumentation, loud noises, treatment duration, delivery of local anesthetics, and oropharyngeal protective barriers. Local anesthetic administration can be painful when delivered in the oral cavity. As this is the initial invasive step the child will encounter during the dental experience, providing sedation care may be of value in addition to topical anesthetic.