Nitrous Oxide / Conscious Sedation 
Outpatient General Anesthesia

Some children are given nitrous oxide/oxygen, or what you may know as laughing gas, to relax them for their dental treatment. Nitrous oxide/oxygen is a blend of two gases, oxygen and nitrous oxide. Nitrous oxide/oxygen is given through a small breathing mask which is placed over the child’s nose, allowing them to relax, but without putting them to sleep. The American Academy of Pediatric Dentistry, recognizes this technique as a very safe, effective technique to use for treating children’s dental needs. The gas is mild, easily taken, then with normal breathing, it is quickly eliminated from the body. It is non-addictive. While inhaling nitrous oxide/oxygen, your child remains fully conscious and keeps all natural reflexes.

Prior to your appointment:

• Please inform us of any change to your child’s health and/or medical condition.

• Tell us about any respiratory condition that makes breathing through the nose difficult for your child. It may limit the effectiveness of the nitrous oxide/oxygen.

• Let us know if your child is taking any medication on the day of the appointment.

Conscious Sedation is recommended for apprehensive children, very young children, and children with special needs. It is used to calm your child and to reduce the anxiety or discomfort associated with dental treatments. Your child may be quite drowsy, and may even fall asleep, but they will not become unconscious.

There are a variety of different medications, which can be used for conscious sedation. The doctor will prescribe the medication best suited for your child’s overall health and dental treatment recommendations. We will be happy to answer any questions you might have concerning the specific drugs we plan to give to your child.

• Please notify us of any change in your child’s health and/or medical condition. Do not bring your child for treatment with a fever, ear infection or cold. Should your child become ill, contact us to see if it is necessary to postpone the appointment.

• You must tell the doctor of any drugs that your child is currently taking and any drug reactions and/or change in medical history.

• Please dress your child in loose fitting, comfortable clothing.

• Please make sure that your child goes to the bathroom immediately prior to arriving at the office.

• Your child should not have solid food for at least 6 hours prior to their sedation appointment and only clear liquids for up to 4 hours before the appointment.

• The child’s parent or legal guardian must remain at the office during the complete procedure.

• Please watch your child closely while the medication is taking effect. Hold them in your lap or keep close to you. Do not let them "run around."

• Your child will act drowsy and may become slightly excited at first.

• Your child will be drowsy and will need to be monitored very closely. Keep your child away from areas of potential harm.

• If your child wants to sleep, place them on their side with their chin up. Wake your child every hour and encourage them to have something to drink in order to prevent dehydration. At first it is best to give your child sips of clear liquids to prevent nausea. The first meal should be light and easily digestible.

• Although uncommon, if your child vomits, help them bend over and turn their head to the side to insure that they do not inhale the vomit.

• Because we use local anesthetic to numb your child’s mouth during the procedure, your child may have the tendency to bite or chew their lips, cheeks, and/or tongue and/or rub and scratch their face after treatment. Please observe your child carefully to prevent any injury to these areas.

• Please call our office for any questions or concerns that you might have.

Outpatient General Anesthesia is recommended for apprehensive children, very young children, and children with special needs that would not work well under nitrous oxide, or conscious sedation. General anesthesia renders your child completely asleep. This would be the same as if he/she was having their tonsils removed, ear tubes, or hernia repaired. 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 your child, 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 your child 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.

• Please notify us of any change in your child’s health. Do not bring your child for treatment with a fever, ear infection or cold. Should your child become ill, contact us to see if it is necessary to postpone the appointment.

• You must tell the doctor of any drugs that your child is currently taking and any drug reactions and/or change in medical history.

• Please dress your child in loose fitting, comfortable clothing.

• Your child 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.

• The child’s parent or legal guardian must remain at the hospital or surgical site waiting room during the complete procedure.

If your child has had dental treatment under general anesthesia, it is very important that you follow these instructions carefully.

• Bleeding from the mouth if teeth have been removed.

• Feeling sick to their stomach.  Vomiting may occur up to 4 hours after surgery.

• Pain in the mouth, jaw, or neck.

• Slight rise in temperature for 24 hours (99-100 F).

• Your child may be sleepy for several hours after returning home.

Activity and Care:

• Rest and quiet activities are important after surgery.  Your child's balance may be poor due to the medication given.  Closely supervise any activity for the remainder of the day.

• If your child had teeth removed, avoid the use of a straw for 48 hours.  You may want to place a towel over their pillow because of minor bleeding.

Diet:

• Begin your child's diet with clear liquids such as apple juice, water, koolaide, Jell-O or Gatorade.  You may increase their diet slowly to include milk and soft foods when tolerated.

Medications:

• An acetaminophen product (Tylenol, etc.) may be given every four to six hours to help relieve pain and elevated temperature.

• Avoid the use of Aspirin.

Seek Advice:

1. If vomiting persists beyond four (4) hours.

2. If the temperature remains elevated beyond 24 hours above 101 F.

3. If there is difficult breathing.

4. If any other matter causes you concern.