Pediatric sedation dentistry is the use of orally administered sedative medication to minimally sedate a child for four main reasons: he or she (1) is unmanageable, (2) has a severe gag response, (3) requires extensive dental treatment, or (4) has a parent with significant time limitations.

Pediatric sedation dentistry is much different than adult sedation dentistry. When children visit the dentist, they are often fearful, anxious, and unmanageable, with no desire to have dental treatment performed. In adult sedation dentistry, the adults are also fearful and anxious but seeking to have their fears and anxiety managed to have dental treatment completed. The sedative medication and techniques used in pediatric sedation dentistry help manage behaviors, while those used in adult sedation dentistry control fear and anxiety.

Children that are fearful, unmanageable, or combative, have a severe gag reflex, require extensive dental treatment, or have a parent with significant time limitations benefit the most from pediatric sedation dentistry.

Children are rarely on systemic drugs unless they have asthma, diabetes, cardiac conditions, obesity, blood disorders, or disruptive behaviors. These children are not good candidates for pediatric sedation dentistry. A specialized anesthesiologist can better perform such dental care for patients.

A sedative with a rapid onset administered for children undergoing pediatric sedation dentistry produces an amnesic effect. This results in a shorter recovery time. Drowsiness is the most common postoperative outcome. Due to the medication’s amnesiac effects, the child will typically remember little or nothing about the sedation experience.

Children must have an empty stomach beginning after they have their evening meal to the next morning when they have their appointment.

The goal of pediatric sedation dentistry is to use medication with the widest margin of safety and reversibility. Children who receive pediatric sedation dentistry are minimally sedated and continually monitored for their responsiveness to verbal communication and physical stimulation to ensure safety. Nitrous oxide/oxygen analgesia can be used in conjunction with oral medication to allow lower doses of the medication.

Performing dental care on a sedated child is different than on a non-sedated child. The dentist and sedation team must perform quality dental treatment in a short period. They must also manage sedation procedures with the proper protective equipment, monitoring, and emergency preparedness skills to ensure optimum safety.

All dentists should check with their malpractice carrier to determine whether any additional premiums will be added to their policy for performing pediatric sedation dentistry in their state or province. Most carriers will not increase premiums for pediatric sedation dentistry if the dentist has completed appropriate training and acquired the necessary standard of care equipment.

Certain governmental programs and some private insurance carriers do cover pediatric sedation as part of their benefits. If there is ever a question about what is covered in a patients’ policy, the dental office or patients’ parent/guardian should contact the insurance provider to find out additional information.

Dentists who perform pediatric sedation dentistry require specialized equipment. This equipment includes but is not limited to protective and positioning equipment for the child during the sedation appointment, monitoring equipment, emergency preparedness supplies and equipment, DEA-approved drug storage, and administrative equipment.

Depending on the regulatory requirements for pediatric sedation dentistry in your state or province, additional training may be required for certification beyond an approved course in pediatric sedation dentistry. There may be recertification requirements as well to maintain your pediatric sedation dentistry permit. However, DOCS Education highly recommends all dentists who perform pediatric sedation dentistry also complete an approved Pediatric Advanced Life Support (PALS) course. Their sedation team staff should complete an approved Basic Life Support (BLS) course as well. After receiving certification from these courses, DOCS Education recommends that the doctor and staff continue with recertification in two-year intervals. The dentist and sedation team staff should train regularly in their office by practicing emergency drills and codes.

DOCS Education regularly offers a 3-day Pediatric Sedation Dentistry course that meets most state and province regulatory requirements. Check your Sedation Regulations here.

DOCS Education is an AGD PACE-Approved provider.