Pros and Cons of Laughing Gas: Sedation Dentistry at Its Finest
From all I have read on HubPages and other internet sites, I feel I should start this article with a warning that I am not a dental expert, nor am I offering dental or medical advice, and this article should not be construed as such. This article is about MY personal experience with pediatric dentistry. If you are considering using a new dentist, sedation dentistry, or any other dental or medical procedure, you should seek the advice of a qualified dental physician, and I am NOT one, nor do I play one on HubPages.
This is Part Two Of What Started as a Dental Horror Story
We live in metropolitan Phoenix, Arizona and my daughter is morbidly afraid of the dentist. And it's a fear that defies reason. She isn't merely anxious about going to the dentist, she is terrified. Poor thing, she tries to be brave. Our last attempt to take her to the dentist is detailed in my hub entitled Laughing Gas and the Dentist: a Horror Story.
Last time she went to the dentist, we took her to a reputable dentist certified in the latest and greatest cosmetic dentistry techniques. The office was clean, inviting, and full of many of the same distractions as at the Pediatric Dentist we visited later. But we were all unprepared for what happened there. I'll let you read about it by following the link to my other hub. But to hurry the story along, we were referred to a pediatric dentist.
Our visit to the pediatric dentist was a lot more successful than I expected, I'm glad to report. We first made an appointment to meet the dentist, have my daughter's needs assessed, and decide what to do next.
Our First Visit to the Pediatric Dentist was Reassuring
A pediatric dentist is a dental specialist who is trained to deal with children who have moderate to severe anxieties about going to the dentist. Though it is arguable that most children have at least moderate anxieties about dental treatment, I'm referring to anxiety that causes stressed behavior such as alterations in breathing and heart rate in the dental patient. My daughter experienced a higher level of anxiety than normal, and because she is slow to react to numbing agents like Novocaine, she always worries that the dentist will inflict unintentional pain during dental work.
I noticed that the dentist was positive, reassuring, and careful to keep my daughter in the dental chair for a minimum amount of time. The dentist's recommendations were minimally invasive. Although she spoke with us for quite some time assessing her situation, the dentist actually didn't spend too much time probing into her mouth at the first visit.
My daughter's adult teeth were erupting without the baby teeth coming loose, and she had a mouth full of double-decker teeth. The dentist assured my daughter that she could help her "wiggle out" those baby teeth and take care of an enormous cavity that she had in one of her adult teeth, although the dentist never once scolded my daughter's dental hygiene, something that sometimes happens in dentist-patient interviews. Although these dental issues were on the serious side, while the dentist didn't minimize the need for care, she explained her treatment plan in way that wasn't frightening or threatening. She focused on being able to provide a solution to my daughter, and explained the details to me. The dentist left it up to me to decide how much information to share with my daughter about the treatment plan.
Though the dental office was clean, it did not have an overly-sanitized hospital-like quality. Instead it felt more like a pediatrician's office, with brightly painted walls and soft chairs. The examination rooms were in an open, public setting that didn't make my child feel like a patient in an operating room, with bench seating for parents so they could be fully in the child's view without getting in the way.
Although she was still anxious, after this initial visit, my daughter was willing to go back. I have to add that the dental problems she had were becoming urgent, so this was a good thing.
Oral Sedation Was the Recommended Treatment Plan
The dentist recommended that we try oral sedation. Oral sedation is a mild form of sedation dentistry that using oral medications to ease the feeling of fear and anxiety, and to to produce a mild form of temporary memory loss surrounding the dental experience.
We went home armed with about 12 pages of instructions telling us how to prepare for the day, what to expect, what her treatment would entail, and how to go about preparing her.
Several other HubPages writers have written excellent descriptions about the pros and cons of sedation dentistry, and types of dental sedation. The type of sedation our dentist's office used was a drug cocktail (Halcyon) used with laughing gas mixed with oxygen. If you are going to use this form of dental treatment for yourself or a child, I strongly recommend that you do your research. You will want a well-qualified dentist who has specialized training in emergency techniques associated with negative drug reactions, including allergic reactions to the medication. Ask if the dentist has emergency equipment on site and find out if they have ever revived a patient in a dental emergency. I am not a doctor and I don't play one on HubPages. This is serious stuff and there are some real risks.
On the day of treatment, my daughter came into the office fasting. She was given the dose of oral sedative, and she was led into a dark room with her dad. They sat in the room and waited for an hour for the sedative to take effect. After an hour she still showed some anxiety, and my husband said that when they strapped her into the papoose restraint, she looked worried.
Note the dentist's written instructions said that the sedative will sometimes make a child sleep, but one should not expect this to happen with every child. It didn't happen in our case.
At this point my husband was required to wait with the other anxious parents in the waiting room, and she was worked on by the dental staff. It is difficult to know exactly what took place in the dental chair. My daughter remembered most of her treatment as when she came home, and I could tell that the medicine had not alleviated all of her anxieties. The only way to do this, I believe, is to fully sedate a child, but that carries risks that should be discussed with a doctor. And in most cases, this extreme step is unnecessary.
Recovering from Sedation Dentistry at Home
Our daughter returned from the dentist out of sorts. She complained that she had been anxious and that she had felt out of control. Because the sedation medication she ingested was powerful stuff, we kept her home from school during the rest of the day.
She was unable to stand for about an hour after the procedure, so she rested quietly. Though she was awake when she arrived home, I could tell by the tone of her voice that she was still under the effects of the sedation. She was also extremely suggestible to what we told her. After napping for an hour or two, she began to ask us questions about what had happened at the dentist. I could tell that she no longer remembered much of what happened. As instructed by the dental office, we told her that her visit had been overwhelmingly positive. She agreed very easily with our reassurances at this stage.
I felt a bit guilty being so overwhelmingly positive because when she came home she made several comments about having a high level of anxiety while she was in the dentist's chair. But within four hours of her dental treatment, she remembered very little of it. She had five teeth removed and a cavity filled, and she said she had a good experience and would go back.
Now that she has had the dental work she so desparately needed, we can proceed with working on her dental hygiene and taking her to regular visits to the dental office for cleanings.
Costs of Pediatric Dentistry
Because we have dental insurance through my husband's employer, we were able to afford the costs of this dental procedure. Even with our out-of-pocket costs, this procedure cost about as much as a middle-of-the-road big screen television. Going into this, we were concerned that it would be much more expensive than at the "regular" dental practice we had visited first.
Comparing our Pediatric Dental Visit to the "Regular" Dentist
Instead, the cost was a little less, because philosophically, the pediatric dentist was focused on treating the problem of the child, knowing that some of the treatment they offered would be temporary. Their philosophy of dental treatment was to do the least invasive dental procedure because the child's mouth would be growing and changing significantly over time, so they warned us that additional cosmetic treatments like putting a crown on the tooth with the big cavity could wait until she had her "adult mouth."
In contrast, the other dentist had recommended a new cosmetic treatment called an on-lay which would create a crown that would bond to her adult tooth. I now feel that this recommended treatment was based on that dental office's use of cosmetic dentistry as a significant source of income, and just the fact that the dentist was used to dealing with adult patients. I don't feel that the first dentist was dishonest, but I also think that that pediatric dentist offered a more appropriate treatment plan for a growing child.