Dental anxiety is a common problem in young children. There are many reasons why a child may become anxious about visiting the dentist. It may be fear of the unknown, shyness, pain and tiredness, sensory and communication difficulties, a bad gag reflex, scary stories or a bad experience in hospital or with a past dental procedure. Many parents have dental anxiety themselves which children are usually very quick to pick up on. Inhalation sedation or “laughing gas” is a very safe method of helping children overcome dental anxiety; making the experience more pleasant and easier to cope with.
Inhalation sedation uses a sweet smelling mix of nitrous oxide and oxygen to help children cope with anxiety in the dental setting. It is similar to the gas used in the labour ward for women giving birth, however, the concentration of nitrous oxide used is lower. The gas is breathed in through a rubber nose piece “Mickey mouse nose”. Unlike when sedation is given as a tablet, the effects are seen quickly. The sedation stops immediately once the gas is withdrawn. This makes it extremely safe for use in children. There are very few side effects. Rarely children can become nauseous if they have had a heavy meal beforehand. There are no lasting after effects. The effects of the gas wear off once the nose piece is removed and so unlike other types of sedation there is no drowsiness or slurred speech.
Sedation in children relies a lot on psychological suggestion and it is very important that children are given the time to develop trust and confidence before treatment starts. Sedation also works well in conjunction with hypnosis. This involves using imagery and storytelling during the sedation to help reframe anxiety and difficult associations a child has. It is often best to have a trial run with this type of sedation to ensure that it suits the child’s needs before starting treatment.
Inhalation sedation feels different for different children. Some children will report they feel light; as though they are floating, others say it makes them feel heavy. Sometimes children may feel butterflies in their tummies or a tingling sensation in the fingers and toes. The most important effect of the sedation is that it creates a sense of calm and relaxation as the child has their treatment done. There are two added advantages of this type of sedation. One is that it makes children forget the procedure and the second is that it reduces sensitivity to pain.
Nitrous oxide sedation is not suitable for all children. It only works if children are willing to co-operate. Sometimes parents have the impression it can be used with restraint to “gas a child down”. This is not the case and thankfully practices like these are no longer acceptable. It works with children who are anxious but willing to co-operate. It is less effective in children who are unable to breathe effectively through their nose or who are unable to communicate such as in very young infants. Therefore it is important to understand that children need to be assessed first, it see if this type of anxiety management is suitable or not.
Kerry Paediatric Dental Practice provides a comprehensive range of solutions for pain and anxiety management in children and adolescents. You can find out more about these topics on our website; www.dentistry4children.ie