Sedation for every child? No: who needs it and who does not
A lesson from a 45-minute visit: when sedation is the right choice and why force increases dental fear.
AuthorDr. Fidan HasanzadePaediatric dentist, treatment under sedation
Once in our practice we spent 45 minutes trying to calm a child down and win them over. Toys, stories, gentle words, surprises: we tried everything. The result? The child still would not let us treat them. In cases like this parents ask: “Maybe we can try a little longer? Let’s avoid sedation.” In this article I explain who we recommend sedation for, and who we do not.
Not every child needs sedation
With the right approach, most children agree to dental treatment. We show them every instrument, name it in the child’s own words and continue each step with their consent. We turn the examination into a game. These children do not need sedation, and we do not offer it.
When sedation is the right choice
- The child cannot be treated because of strong fear
- The child is very young and cannot stay in the chair for long
- Extensive treatment is needed on several teeth
- The child has special needs and treatment is not possible in ordinary conditions
Why force is harmful
It is very hard to provide good-quality, safe treatment to a child who is crying, frightened and trying to escape. On top of that, every time force is used it strengthens a negative memory of the dentist. Research shows that dental fear that starts in childhood often lasts into adulthood and keeps people from seeing a dentist. The 45 minutes we spend today trying to “avoid sedation” can turn into an even bigger fear tomorrow.
Sedation is not an easy option chosen for convenience. When it is indicated, it is a medical approach chosen to protect the child’s safety, the quality of treatment and their emotional comfort.
Our goal is not to treat a child’s teeth at any cost. Our goal is to protect both their teeth and their future attitude to the dentist.
Scientific sources
The information in this article is based on the following peer-reviewed scientific articles and international clinical guidelines.
- Ashley, P. F., Chaudhary, M., & Lourenço-Matharu, L. (2018). Sedation of children undergoing dental treatment. Cochrane Database of Systematic Reviews, 12, CD003877. [PMID: 30566228] | [DOI: 10.1002/14651858.CD003877.pub5]
- Klingberg, G., & Broberg, A. G. (2007). Dental fear/anxiety and dental behaviour management problems in children and adolescents: a review of prevalence and concomitant psychological factors. International Journal of Paediatric Dentistry, 17(6), 391-406. [PMID: 17935593] | [DOI: 10.1111/j.1365-263X.2007.00872.x]
- Coté, C. J., Wilson, S., American Academy of Pediatrics, & American Academy of Pediatric Dentistry (2019). Guidelines for Monitoring and Management of Pediatric Patients Before, During, and After Sedation for Diagnostic and Therapeutic Procedures. Pediatrics, 143(6), e20191000. [PMID: 31138666] | [DOI: 10.1542/peds.2019-1000]
