WWYD? (sedative or not?)

[zannster]

So we're back in the dentist's chair, round 2...

This time, DS (2.5 yrs old) has four small cavities. We've seen two dentists. The first didn't give me much specific info about the cavities; the second said they are most likely very shallow and can even be done without any novacaine. His policy is not to use any sedatives. He thinks that bad dental experiences are created by the way the staff treats (talks to) the child, and that working while they are alert (even if scared/crying) will not have any longlasting effects.

We already had GA for a much bigger job a year ago. We don't think that's appropriate now. The dentist there suggested oral or IV sedation. We don't think we want to use IV sedation. So that leaves us with two options: Mr. Happy I-don't-use-sedation Dentist, or going back to the children's hospital dental clinic and trying oral sedatives.

DS definitely doesn't like people messing in his mouth. But he's getting used to it (poor kid). His last visit to Mr. Happy dentist was the first time he actually sat in the chair. He protested a bit but was surprisingly good about letting the dentist look at his teeth. There wasn't any drilling though. I'm sure he would be afraid and cry. The dentist said he wouldn't do more than about 10 minutes of work at a time (~1 min drilling) unless DS was doing really well - and then he would try to do more. Of course, we could try it once, and if he totally doesn't do well, we could go for the sedative.

What would you do? (Or what have you done and how did it go?)

[bobandjess99]

Well..I'm very biased....*I* won't go to the dentist without sedation. Since I personally couldn't bear to have drilling done without sedation, I certainly wouldn't expect my child to. BUT, if your child seems to be okay with this doctor and his approach, I *might* give it a try. Sorry, not much help. If these are very small cavities, does anything actually *have* to be done right now?

[angelpie545]

If you ds can tolerate it, I would give it a try without the sedative. I personally think it's best to not sedate whenever possible. Sedatives can be dangerous, and although in most cases all goes as planned, it's best not to take the risk unless it's absolutely necessary. I'm surprised to hear that so many kids are being sedated nowadays for procedures that were considered fine to do with just novicaine when I was a kid. I remember having tons of fillings and the only thing I ever got beyond novicaine was nitrus.

[Kailey's mom]

what about that laughing gas stuff, I have no clue what it is, but when I was a kid they gave me that...and I cooperated

good luck!!

[lindberg99]

My dentist never used anything (no novocaine even) and it was awful. I was terrified to go to the dentist. I still remember having a cavity drilled when I was probably 8. I was grabbing the hand of the assistant so hard I'm surprised I didn't break some bones! I think after that I convinced my mom to switch dentists.

My kids' dentist uses laughing gas, is that sedation?

[zannster]

The guy who doesn't use sedation won't even use nitrous (laughing gas). I remember having it for my first filling, but I was older - in elementary school. Now I think the stuff is nasty. I wouldn't feel comfortable making DS take it when he doesn't know what's going on. We'd have to force him to keep it on his face. No thanks.

As for the cavities...I know the going idea here is to postpone filling them as long as possible, but that just makes me nervous. My experience is that cavities only get worse. These have appeared within six months - he had a clean bill of health at the previous checkup. So I think they're aggressive.

[rumi]

Having seen four dentists for dd I can certainly attest that a LOT depends on how the dentist treats the patient. Our little girl who has been catered to by a whole extended attached family (you get my drift) was too much for two of the dentists to handle and they said she needed GA. I am glad to know that GA is safe, but still I wanted to avoid it and kept searching.

Of the other two who were willing to work on her without sedatives, one was holistic, etc and not covered by our insurance. The other was mainstream but practiced in working with children. SO we got to see how respectful talking makes a HUGE difference. Of course she did get numbed up (numbing gel + novocaine) and also used nitrous oxide (dentist called it a funny nose and she put it on w/o fuss). But she was fully awake and aware of everything and co-operated.

At the same time my friend's 3 yo had fillings done without even novocaine or anything. So I guess it really depends on how deep they are.

[Nan'sMom]

Ughhh...I just had a bad dentist experience where the dentist likes the children awake and uses intimidation to obtain compliance (needless to say, we left mid-appointment). So the moral of that story is to question a LOT how they talk to the child during the procedure (i.e., do they use intimidation, harsh voices, etc.), EXACTLY what will happen (include the questions do they use a dam, do they use topical anesthetic if a shot is necessary, do they "allow" the child to stop the procedure at any time just like they would with an adult, how do they know if the child is in pain).

Can you ask DS which he prefers? I think this should be a key element in your decision-making process if at all possible.

Best of luck!!!!

[zannster]

He's too young and wouldn't understand that question. He doesn't like going to the dentist at all, so he wouldn't tell me that he likes one over the other.

[PGTlatte]

Our now 4-yo had had two fillings and a crown by age two. Those were done by a ped dentist who used in-office oral sedation (versed). Since then, I have switched dentists due to problems we had with the practice, and in searching for a new dentist, learned more about the risks of oral sedation and decided I would not be comfortable having it used on my child again.

Our 2-yo DS has unfortunately also needed dental work - he has had fillings twice already, three teeth once and two teeth the second time. The new ped dentist we go to does not use in-office sedation beyond nitrous due to the risks...if the procedure is going to be long enough to need sedation, it is done in a hospital with an anesthesiologist. DS2's dental work has not required that. The first set of fillings were all very shallow and they did not even use novacaine. They tried the nitrous scented nose mask but he wouldn't breathe it. They worked very quickly and he was done in a few minutes. He was very upset but they never tried to intimidate him, just told him they were almost done and talked in very soothing voices. The second fillings were deeper and he did have novacaine injections and the whole process took longer. He was upset but I do not believe he was in physical pain. He had some nitrous before the novocaine and they made sure he was not flinching from being poked before they started drilling. They spoke soothingliy to him and I was at his feet rubbing his legs while they worked. It wasn't any fun but we got through it safely.

[newbymom05]

We had a filling done w/ (I think) a polymer glass deal and nothing was needed for sedation--we just held him. It totally sucked and DS hated it of course but it was being restrained that was the problem IMO. It was a shallow cavity in the front, and he just scraped it (no drilling), filled it, done and very quickly, too. We next had an extraction done w/ versed. That. Was. Horrible. DS was only 18 months and DH was afraid of the GA and the dentist himself said he didn't feel it was 100% safe. However, if we need to do work like that again, I'm getting GA in a hospital. Versed isn't a painkiller, it cause amnesia. (DS did have novocaine.)

Personally, I would use sedatives. Our dentist and staff are always unfailingly gentle, quiet and kind and DS hates it, and has since the first time since he had to be restrained (in our arms) so they could examine him. He's actually gotten better--we just went to the dentist today--but still hates it.

[lovebug]

i use to work in a dental office as a hyg'est. i would think he is NUTS!!!! if a child gets bitten by a dog and cries and is really upset (even if the bite is not that bad) it *could* have long term effects such as: the child may not like dogs or my have issues when seeing a dog. the same would be said for the dentist KWIM???

i really think a child is better off with a little *help* in the dental chair. just like *alot* of adults are better off with a little *help* in the dental chair.

NOW with that said.... if your/a child does not *mind* the chair (i.e. will sit there, stops crying when talk to about what is going on, or is OK with what is going on) then IMO sedatives are not necessary.

hope this helps

just so you know you have to follow your gut on this EVERY child is different