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(610) 337-2325

Upper Merion Dental Associates

357 South Gulph Rd

King of Prussia, PA  19406

Tel:  (610) 337-2325                

Fax: (610) 337-3863

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PAIN FREE DENTISTRY In-Office and Out-Patient Sedation Options     

LIGHT NITROUS OXIDE & ORAL SEDATION

Conscious Sedation
Some children & adults become anxious in the dental office and can't relax or sit still long enough for the dentist to treat them. For these children & adults, your dentist may suggest forms of medication that allow the patient to relax and/or become sleepy. This is called conscious sedation, since the patient is still responsive to conversation or stimulation and all his or her protective reflexes are working. It may involve inhaling a gas or taking an oral medication.  Conscious sedation also may be used when a child or adult requires extensive dental treatment or has special needs. Your dentist will recommend which type of conscious sedation is best for your family member.

Nitrous Oxide
Nitrous oxide, also known as laughing gas, is most often used for children & adults who are mildly or moderately anxious or nervous. It eases their fears so that they can relax and receive treatment comfortably and safely. Nitrous oxide is administered by placing a small mask over the nose. The patient will be asked to breathe through his or her nose and not through the mouth. As the gas begins to work, the patient becomes calm, although he or she is still awake and can talk with the dentist. When the gas is turned off, the effects of sedation wear off almost immediately. As the patient becomes more comfortable with the dentist, nitrous oxide may not be needed.

Nitrous oxide is always delivered mixed with oxygen. To prevent overdose, nitrous oxide machines are designed to stop the flow of nitrous oxide if the oxygen concentration drops below 30 percent.  When the treatment has been completed, the nitrous oxide is turned off and pure oxygen is delivered for five to 10 minutes to help flush the patient's body of the gas. The effects of nitrous oxide should disappear as oxygen is breathed.

Oral Sedation
Children & adults who are more anxious may need an oral medication that is stronger than nitrous oxide. Several medications have a significant calming effect. When choosing a medication, your dentist will consider the patient's anxiety level, his or her ability to cooperate and the treatment required.  With oral sedation, the patient may be sleepy but can be aroused if necessary and can respond to simple commands. Minor side effects such as nausea or vomiting can occur with some medications.

Before a visit in which the patient is to receive oral sedation, you should receive instructions about eating and drinking, what to expect and what to watch for after treatment. You may need to carry a young patient home after sedation. Your dentist should also discuss how the patient will be monitored while he or she is sedated. You will need to stay for a short time after dental treatment has been completed so the patient can be observed for full recovery and possible complications.

Outpatient General Anesthesia

Outpatient General Anesthesia is recommended for apprehensive children & adults, very young children, and patients with special needs who would not work well under conscious sedation. General anesthesia renders the patient completely asleep. This is performed in a hospital or outpatient setting only.

While the assumed risks are greater than that of other treatment options, if this is suggested for the patient, the benefits of treatment this way have been deemed to outweigh the risks. Most pediatric medical literature places the risk of a serious reaction in the range of 1 in 25,000 to 1 in 200,000, far better than the assumed risk of even driving a car daily. The inherent risks if this is not chosen are multiple appointments, potential for physical restraint to complete treatment and possible emotional and/or physical injury to the patient in order to complete their dental treatment. The risks of NO treatment include tooth pain, infection, swelling, the spread of new decay, damage to their developing adult teeth and possible life threatening hospitalization from a dental infection.

Prior to your general anesthesia appointment:

Please notify us of any change in the patient’s health. Do not bring the patient for treatment with a fever, ear infection or cold. Should the patient become ill, contact us to see if it is necessary to postpone the appointment.  You must tell the doctor of any drugs that the patient is currently taking and any drug reactions and/or change in medical history.

The patient should not have milk or solid food after midnight prior to the scheduled procedure and clear liquids ONLY (water, apple juice, Gatorade) for up to 6 hours prior to the appointment.  Please dress the patient in loose fitting, comfortable clothing.  The child’s parent or legal guardian must remain at the hospital or surgical site waiting room during the complete procedure.

After the anesthesia appointment:

The patient will be drowsy and will need to be monitored very closely. Keep the patient away from areas of potential harm.  If the patient wants to sleep, place them on their side with their chin up. Wake the patient every hour and encourage them to have something to drink in order to prevent dehydration. At first it is best to give the patient sips of clear liquids to prevent nausea. The first meal should be light and easily digestible.   If the patient vomits, help them bend over and turn their head to the side to insure that they do not inhale the vomit.  Prior to leaving the hospital/outpatient center, you will be given a detailed list of "Post-Op Instructions" and an emergency contact number if needed.