When Is Sedating a Child at the Dentist Appropriate?

Updated on November 03, 2010
A.H. asks from San Jose, CA
19 answers

My son is 4 and he has been to the dentist 3 times now. All of the visits have been awful (ear splitting screaming, struggling, kicking, grabbing at tools, refusing to open his mouth, etc…)

A bit of background: He has never liked being touched by people he does not know well. The first 3 years at the pediatrician and the first year and a half at the barber were like this too but he eventually got used to it. No amount of soothing, distracting, bribing or disciplining ever helped he just had to get used to it.

Given his history the dentist feels that sedation is not appropriate and that he will just get used to this like everything else. For all of the visits I have been expected to just hold him still. She may be right in one respect, but keeping him still enough for an exam or partial cleaning is at the upper limit of my physical strength and last visit I even got knocked on my butt and left sore for days afterward.

Last visit she nonchalantly informed me that she will be needing X-rays net time. There are deep black grooves on his lower molars. I have absolutely no idea how I will keep him still enough for X-rays. Duct tape maybe? (kidding :) Especially since this is a brand new thing he has no experience with and I know from my own experience that it is uncomfortable. This is a well thought of pediatric dentist who came highly recommended by other moms I know as well as my own dentist. Is she doing the right thing? Anyone been through this? How did you manage it?

***Edit, To clarify, when I say sedate, I mean give something, anything to help him relax. as opposed to knocking him out completely***

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J.M.

answers from Fresno on

Well he probably only goes to the dentist every 6 months. He may not even recall much of the past vists. In order to get used to the dentist you may need to take him for visits often and practice x-rays at home. Just do the things they do for x-rays. Have him bite down on some plastic thing to practice and then pretend to x-ray. You can practice having him open his mouth for the dentist at home. I think it will take a lot of practice and a lot of friendly dropin visits to the office.

Good luck

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S.W.

answers from San Francisco on

Maybe it is the dentist. My children, 4 and 5, go to Dr. Fridgen in San Jose and he is awesome. I was very worried the first time and they managed to help them understand what was going on and stay calm. I was amazed. They did have laughing gas for the fillings, but that went well also.

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C.B.

answers from San Francisco on

I suggest you find a new dentist..Any dentist who doesnt want to give at least a local anesthetic to child or even a topical first then a local injection...UGH!! I am an RDA (Registered Dental Assistant) and quite frankly if it is going to calm him down, then do it...No one will get used to it as he so called put it..Your child is going to grow up and be like alot of the adults we see and hate the dentist because some jack a... didnt want to take the time to administer an injection. Please take your child somewhere else.
I also recommend that you not be in the operatory with him. Sometimes children act differently when the parents are not in the room. But if he has issues with people touching him, then I dont know....Teach him about the sugar bugs on his teeth if he doesnt brush and floss. This works with y kids and their fanatical with their teeth. Hope I was helpful..
I would try a different dentist..

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D.B.

answers from Charlotte on

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C.G.

answers from Boca Raton on

I am going through this myself, and he won't even sit still for laughing gas, so while that is a good suggestion, I know from personal experience, that he will fight that as well and when they are that combative, laughing gas just won't help. I would not do sedation because that requires an anesthesiologist on hand to perform the procedure too and that is extremely costly!! I had to have sedation when we found that he had 4 cavities!!
A suggestion a friend of mine gave me whose husband is a dentist is to bring the child with you to your own dentist appointment so that he can see you sitting still and how it really does not hurt and that nothing bad is going to happen. I will be testing this out in about 2 weeks, so if you want I could let you know how he responded.

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L.L.

answers from Topeka on

Your talking about my son..He is now 7 he has been to the dentist since his 1st birthday for 2 yrs straight I took him to the same dentist same routine they talked to hims showed him everything time to get in the chair nada he wouldn't cooperate with them I held him tlaked to him told him what they are going to do etc.(He did well at home with brushing I helped him daily)
We ended up going to another office (pedatric dentists) they told me I could go back if I wanted to I said call me if you can't get him do what is needed they did what they needed to come to find out he had tiny cavaties on the molars they were in between his teeth so tave the others they had to do caps OMG this was horribly more crying,screaming they tried to use laugging gas he didn't want it he refused to have the nose on him so they of course used it sometimes then none of it the other times.He has bad baby teeth I feel horrible about this I tried to force his teeth to get cleaned at the dentists office but they were so laid back said he'll come around well he hasn't yet till this day if he got the proper cleanings I feelt his could of all been avoided I did what I did as a parent took him in every 6 weeks did brushing at home avoided baby bottles,juices without water,soda pop,lots of candies & this is still what happened to him..Now a few yrs haves passed we have a new dentist that is OK not sure yet there hasn't been too many visits with him yet but now i'll be calling him his crown fell out along with his spacer his tooth of course will need to be pulled before he develops an infection pain from the nerves I told him what to expect he is worried as so am I but after several talks with the dentsts all this wasn't my fault alot of genetics plays a role in how our childrens turn out..I have bad teeth I get cavaties hubby doesn't I too hate going to get them worked on the sounds,smell,& just having to lay there with my mouth opened hoping they don't mess up.
Anyway I don't look forward to this next visit I will have to go in with him & try to make him stay still if he wants to avoid the laughing gas thye haven't suggested sedation of putting him to sleep that is done in the hospital

Added later we went to the dentist due to crown & spacer fell out he cried but they had to use the noxious (the nose) on him he was hesitant at first but did better than anyother time:)I hate to see him go through this it tears me up as a mom I try to keep my kids away from harm but teeth are just 1 of those things that fail us even if we try our hardest to not let them..I must say I don't like to go either hate needles now due to some bad draws/sticks in the past but it must be done to avoid black teeth:)

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L.B.

answers from Biloxi on

My son is 14 - had a dentist visit yesterday with a new dentist as I switched us - and got gassed. He has always had dental anxiety and it is just easier - keeps him relaxed and reduces the stress on everyone.

I don't know if a 4 year old can use the gas???

So, how about a visit to the library or bookstore and check out books about going to the dentist that you can read together. Do you have a check up between now and his next visit? If so, maybe take him with you and let him watch you get your teeth cleaned and x-rayed.

Keep in mind he has only been 3 times and at 6 months between visits. It is still scary to lay in a chair with bright lights in your eyes and strange people coming at you with wicked looking tools. Hmmm, no wonder mine wants to be gassed.

Good Luck - you know this too shall pass.

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K.H.

answers from San Francisco on

You are talking about the same thing I went through with my oldest daughter. We ended up taking her to Pediatric DDS in San Jose. His
name is Dr. Ikehara. He and his whole staff are wonderful with the kids.
He does give sedative (gas) but only enough to calm them. When I go
back to check on the kids I cannot even tell they are sedated. All 4 of my children went to this dds and loved him and his whole staff. He is located on Hillsdale Ave between Meridian Avenue and Ross Ave.

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M.S.

answers from San Francisco on

I feel for you...I have a son who was just like you described. I dreaded taking him to the dentist and when I did everyone new he was there. They always had to use a papus bored to strap him down as he would not cooperate,(screaming, would not open mouth, etc.) I hated every aspect of it and understood why he hated it as well but knew I needed to have his teeth worked on. When he had alot of work done they gave him this drink that sedated him, which I hated but whoooo, the work was done and we were out of there. I don't recommend that all children take this drink, I am clearly saying that that was what it took to get the work done without him getting so worked up. My son is 20 now and has had braces and can go to the dentist just fine, however he does not like to here the gross details of dental needs or medical needs either, he was sedated when his wisdom teeth came out.
Good luck to you on whatever you decide!!!!

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R.K.

answers from Boston on

Is he hard to brush at home? My little guy is horrible to brush even at home he has some sensory issues and oral is one of them an OT was a lot of help with this. When you compare it to how he acted at the doctor and barber you have to remember that he sees the doctor and the barber more frequently then the dentist. Ours is wonderful she is a pediatric dentist but she specializes in special needs even though she sees anyone 0-21 yrs old. My son would not sit in the dentist chair he was terrified of it so we sat him in my lap on a regular chair and I sat knees to knees with the dentist we laid him down so his head was in her lap and she did a quick brush with a regular tooth brush the first visit, the second visit we did a little more, the third he sat in the dentist seat with me, and this last visit he sat in the chair all by himself. She asked if I thought he would cooperate with xrays but I reminded them that it was the first time he sat in the chair by himself so she did not want to push it and said next cleaning they would try to do 1 and just 1 not a full set and that they would slowly work up to a full set of xrays. Maybe you can ask if you can bring him inbetween visits just to visit the office it might help him get more used to the idea of going. Maybe speak with your pediatrician he/she knows your child well and see what they think they might be able to prescribe or recommend something to help your son relax while at the dentist. I have anxiety about the dentist but I have a reason I was 8 years old and had a filling and wanted my Dad to come in and hold my hand for the novicaine they wouldn't let him instead the got another assistant to help hold me down and the drilled without using it! Your son right now just doesn't like the idea of someone he does not know touching him I don't think that not sedating him for xrays will cause a permanent fear or aversion to the dentist like someone else suggested.

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T.H.

answers from Sacramento on

For God's sake SEDATE HIM!!! I had he same problem with dentists and I NEVER got used to it. Now I am 40 years old and haven't been to a dentist in over 10 years due to my fear of dentists and will probably end up with dentures by the time I am 45. If his dentist doesn't want to do it, find another dentist. If you decide to not sedate him, don't bother with any orthodontic work as he will be in dentures by the time he is my age after years and years of infections due to lack of dental care. T.

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B.R.

answers from Sacramento on

Is there some toy or book you could take along that would help distract him during the proceedure? Also, I would ask the dentist that if you have to hold him for these things, could she have one of the assistants help you do that. It doesn't sound like a one-person job and it would seem that someone in the office could spare the five minutes or so that it takes in order to help you with it.

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R.D.

answers from Kansas City on

Make sure you stay in the room with him. No matter what!

If he is a dentist specializing in children, then he has seen his fair share of kids terrified of those in his profession. Dentists are doctors. Would you be questioning his ped? I would go with laughing gas, in very small amounts. He needs to get those teeth taken care of! Best of luck - to you both!

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R.V.

answers from San Francisco on

We have a family dentist and he suggested we start bringing our then 3 year old to all our appointments so she could see it was fine. The dentist would come down to her level and say show me those beautiful teeth and she'd open wide and he'd compilment her for good brushing. Just making it all a positive interaction. They'd give her a toothbrush and a toy each time . We didn't do a first cleaning until after she was 4. She was very excited to have her turn to sit in the chair by then. They never forced anything (they are baby teeth) and on this Monday she went again saying she loves going to the dentist. They do full cleaning's and x -ray's now.We did this with all our children and no problems.Even my son who had issues with the doctors office because he had to be held down for stiches when he was a toddler. It took him years to get over his fear of the doctor.But he did great with this gentle approach with the dentist. This info may not help you because you can't go back. But maybe someone else. I think you have to take time and build trust. It's not worth it to force it and create a bad experience. I am dissapointed to think that your pediatric dentist would have encouraged you to forcefully hold your child down. This sounds awful and totally unnessary . At this point I don't know what you can do to change it. He'll just have to mature and grow out of it. But I'd back off as much as possible.

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B.S.

answers from Sacramento on

Given your description of how your child reacts to the visits, I would think sedation is probably a good idea. If you are not comfortable with that dentist, however, you should go somewhere else. My son went to our regular dentist until he was four. At that time, he needed a cavity filled and he would not sit still in the chair for it. After a few attempts (on different visits), we moved him to Children's Choice Dental. They try many other ways of calming children before resorting to sedation. We finally did end up using nitrous to get the cavity filled. Good luck!

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R.F.

answers from San Francisco on

CHANGE DENTISTS! This should not be a place where children are traumatized. I have a 6 y/o who wouldn't cooperate either. I changed dentists & found some who were willing to go at her pace, meaning not even touching her mouth for a visit or two.

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C.M.

answers from San Francisco on

I recommend Dr. Vernon Adams in Palo Alto (650) 321 - 6448.

My son has special needs and going to the dentist is very difficult. He's 20 now and Dr. Adams has done work on his teeth under IV-sedation twice. He is able to work on this teeth every 6 months the rest of the time without sedation. We usually put one of those x-ray aprons on my son when he's in the dental chair because the weight relaxes him.

It doens't sound like your son needs IV sedation, but Dr. Adams has the full range of tools in his box. . .

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C.B.

answers from San Francisco on

I think you should try to give him something to help him relax. If you keep holding him down and the drama with the visit continues, he will NEVER want to go to the dentist and although the outward drama with subside, inside he will be anxiety-ridden every time you mention a dentist appointment. If he can have a "good" visit, he will not become so stressed out about going because he will have a good memory. perhaps give him something to keep him calm and then let him listen to an ipod with some of his favorite songs while sitting in the dentist chair.

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M.L.

answers from San Francisco on

The first thing that comes to my mind is "Cure Tooth Decay" by Ramiel Nigel. That is my answer - treat the cause not the symptom. This has been the best book I've red since Super Baby Food by Ruth Yaron. My son started developing a small cavity at 2 1/2 and that's when I got my hands on this book at a pediatric dentist in Mill Valley (CA). Since then the cavity has been contained.

You can make a difference with what your child eats and prevent cavities up front so you don't have to face this decision ever. I would not be able to sedate my child and I hope never to have to face such decision, so my prevention has been the diet. For him and for me.

Hope this helps and good luck!

http://www.curetoothdecay.com/

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