Information on Moderate Sedation

The most common method of moderate sedation used by Dr. Koneru is a combination of oral medications (benzodiazepines, antihistamines) with nitrous oxide sedation.

This level of sedation is more suited for small children or children who are more anxious about dental treatment. The combination of medications usually produces hypnosis (sleepiness), euphoria, anxiolysis and analgesia. Although most children respond well to this level of sedation, a small number (2%) may paradoxically become excited or hyperactive. It is hard to know exactly whether your child will become happy, sleepy or grumpy. The added benefit of this method, is that about 60% of children experience anterograde amnesia which means they may not remember what happened during the dental appointment, preventing the development of fears for subsequent appointments.

Preparing my child for moderate sedation

Children scheduled for moderate sedation must not have solid food, or cow’s milk for 6 hours before the dental appointment. Breast milk is allowed up to 4 hours before the appointment. Your child may have clear fluids such as water, apple juice or ginger ale up to 2 hours before the dental appointment (not milk or orange juice). This is meant to avoid aspiration, prevent nausea and to allow the sedatives to have a better effect. Discuss with your child that he/she is going to have a fun experience fixing their teeth at the dentist. Avoid negative information such as ‘it will be ok, mommy/daddy will be with you’ or ‘don’t worry it won’t hurt’. These comments suggest to the child that something is going to be stressful. It is more constructive to say ‘this is great, we can go get your teeth fixed, count the sugar bugs and then go for ice cream!’ This suggests that it’s no big deal, that you are excited to go to the dentist and that it will be a fun experience. Positive suggestion and exposure are effective ways to reduce fears. More specific instructions will be given to you and your child by our dentists and staff.

Please note: If your child cannot breathe through their nose, has a cough and has yellow and green secretions, the appointment will need to be cancelled and rescheduled.

Please arrive 30 minutes before your scheduled appointment. This will allow us time to check your child’s vital signs and administer the oral medication. The medication takes 10-30 minutes to take effect. Your child will be allowed to play while seated under parental supervision in the recovery room. When the medication takes effect your child will appear ‘drunk’. At this point, parents will be asked to carry small children into the dental treatment room. For older children if they are unable to walk, they will be wheeled into the treatment room. Appropriate monitors will be placed on your child. The nitrous oxide mask will also be placed on your child’s nose. Once dental treatment is finished your child will be monitored closely to ensure they are stable enough to be discharged home. Additional instructions will be given to you on how to look after your child. We recommend that two adults accompany the child home. Your child will require supervision for the remainder of the day and should not be allowed to go to school or daycare. We recommend that your child stay at home under adult supervision.