Oral sedation: Parents/Guardians of young people aged under 16 years

What is oral sedation?

The child in your care may require oral sedation for dental treatment. The use of a sedative drug (medicine) makes the child drowsy, less aware of what is happening and with few memories of what has happened during the treatment. Oral sedation does not make your child unconscious.

Oral sedation is usually given as a single drug called midazolam. A dose, chosen for your child individually, will be given as a drink or as a syrup. The sedation usually takes 20 minutes to take effect.

Once the child is sedated (drowsy), a needle is used to place a cannula (small plastic tube) into a vein in the back of the hand or in the arm. This allows a drug to be given that reverses the effect of the sedation, if necessary. A cream containing local anaesthetic will be used on the back of the hand to numb the area, before this cannula is placed. You may be asked to apply this cream to the child before coming to the dental surgery.

Benefits and risks of oral sedation Oral sedation is used to reduce anxiety and fear of dental treatment. This usually makes children more co-operative when having treatment. It is particularly helpful if children are having a long, uncomfortable or more complicated procedure.

The dentist and members of the dental team are trained to give sedation. They watch the child closely and treat any problems that may develop. They are required to use appropriate monitoring equipment during sedation. The child will go to a recovery area after the treatment where he or she will be observed until a full recovery from the sedation has been made.

It is a widely used technique but, as with the administration of any medicines, there are risks associated with oral sedation. Risks include:

  • A reduction of oxygen in the blood stream due to poor breathing during sedation. The child may be asked by the dentist/sedationist to take deep breaths to correct this. The dentist/sedationist will continually monitor the child’s breathing and oxygen levels throughout the procedure.
  • Bruising at the site of the cannula. This may take several days to fade completely.

Very rare risks are allergic reactions to the sedative drugs that your child has been given or vomiting during the procedure. Your dentist/ sedationist will discuss any concerns that you may have about the child prior to the procedure taking place.

An oxygen supply will be available and oxygen will be given if necessary. There is also a risk that the child may not like the feeling of sedation and become tearful, in which case the sedation may be stopped.

What to expect The various methods of dental treatment planned for the child will be discussed with you at a separate assessment appointment following a full dental examination. In exceptional circumstances, treatment may be carried out on the same day as assessment.

Before the sedation can be given, the dentist will confirm:

  • The child’s height and weight
  • The child’s blood pressure – taken with a cuff on the child’s arm. This may not happen for young children.
  • The level of oxygen in the blood – taken with a simple clip on the child’s finger
  • The child’s medical history. If further information is required at this stage, the child’s general medical practitioner or specialist will be contacted.

If you have any questions or are unclear about the sedation planned for the child, do not hesitate to ask your dentist.

How to prepare your child The dentist will discuss with you and explain what the patient is able to eat and drink prior to the appointment. You will also be given this information in writing. It is important that these instructions are followed carefully.

Written consent will be required from the person with parental responsibility/carer before any treatment can be given to the child. If you have agreed and signed the consent form at the assessment appointment and you are then unable to attend with the child on the day of treatment, the child must be accompanied by a responsible adult (over 18 years of age).

Please give routine medicines as normal. Any medicines or inhalers that the child may need should be brought with you to the appointment.

Dress your child in loose, comfortable clothing. No valuables should be brought to the appointment.

If the child is unwell on the day with cold/flu symptoms or any contagious illness, please contact the dentist for advice.

The appointment may need to be rearranged.

Please avoid bringing other children with you on the day of treatment

What will happen?

The child will be monitored during the procedure. This will include measurements of blood pressure, heart rate and oxygen levels at regular intervals.

Once the child is sedated, and feels drowsy and relaxed, the dentist can use local analgesia (pain relief that numbs the site of the dental treatment). Local anaesthetic as a paste is sometimes used to numb the site of the treatment. Any injections that the child may need can then be given through this numbed area to reduce the chance of any discomfort.

After the treatment has finished, the child will spend some time in the recovery area until alert and responsive. He or she will be checked by the dentist before being allowed to go home.

The child may not return to school and should not participate in active sports for the rest of the day. You may wish to make plans about how best to travel home with the child following the treatment.

The child must be supervised by a responsible adult for the rest of the day. Arrangements may need to be made for the care of other children or elderly dependent relatives during this time.

Children can be sleepy, upset or agitated for up to 3 hours after treatment. They will, however, have little memory of the procedure. Occasionally, they get hiccups. There may be some bruising on the hand or arm where the cannula was inserted.

You will be given information relating to any local analgesia and the treatment the child has received. The dental team will advise you about any medicines the child may need while recovering from the treatment.

You will be given a telephone number of who to contact in case of any concerns.

Click on the image above to see St Faith’s sedation booklet