Information on Minimal Sedation
Minimal Sedation with Nitrous Oxide (laughing gas)
Laughing gas is a combination of nitrous oxide and oxygen gases. It is administered to your child through a nose mask. Your child is required to breathe through his/her nose for the sedation effect to take place. Your child may feel a sense of euphoria, tingling in his/her fingers and toes or feel like he/she is floating. Most children enjoy this feeling and are able to relax and interact in a positive manner with dental treatment. Nitrous oxide sedation also provides the added benefit of analgesia, making the injection of local anesthetic painless.
Nitrous oxide sedation alone is more suited for children with a mild level of anxiety, but who want to cooperate. It is more successful in children aged 3 years and older. A few children may not like the feeling of losing control.
Nitrous oxide sedation is extremely safe. The effects are reversible within five minutes of breathing in 100% oxygen. Children are able to go back to school or daycare. Although nitrous oxide sedation can be used in patients with a variety of medical conditions, children who have had abdominal surgery, mutation of the MTFR gene, ear or eye surgery may not be candidates for nitrous oxide sedation. As well if your child is a mouthbreather, has a cold and cannot breathe through his/her nose, nitrous oxide sedation will be ineffective and we will need to reschedule the appointment.
This level of sedation is more suited for small children or children who are more anxious about dental treatment. The combination of medications usually produces hypnosis (sleepiness), euphoria, anxiolysis and analgesia. Although most children respond well to this level of sedation, a small number (2%) may paradoxically become excited or hyperactive. It is hard to know exactly whether your child will become happy, sleepy or grumpy. The added benefit of this method, is that about 60% of children experience anterograde amnesia which means they may not remember what happened during the dental appointment, preventing the development of fears for subsequent appointments.
Preparing my child for nitrous oxide sedation
Children scheduled for nitrous oxide sedation must not have anything to eat 4 hours before the dental appointment. Clear fluids such as apple juice, water or ginger ale are acceptable up to 2 hours before the dental appointment. This is meant to reduce the chance of nausea and vomiting.
Your child will be shown the nitrous oxide mask at the consultation appointment. For small children, this mask may be called the ‘bubble-nose’, ‘elephant-nose’, ‘beep-beep nose’ or ‘air-plane nose’. Please have a discussion with your young child, informing him/her that he/she will get to wear the special nose, sing songs, and fix their teeth for their next dental appointment. Avoid providing negative information such as ‘it will be ok, mommy/daddy will be with you’ or ‘don’t worry it won’t hurt’. These comments suggest to the child that something is going to be stressful. It is more constructive to say ‘this is great, we can go get your teeth fixed, count the sugar bugs and then go for ice cream!’ This suggests that it’s no big deal, that you are excited to go to the dentist and that it will be a fun experience. Positive suggestion and exposure are effective ways to reduce fears and will ultimately make the sedation more successful. More specific instructions will be given to you and your child by Dr. Koneru and her staff.