Pediatric dental sedation has a unique set of challenges: child demeanor, delivery of surgical intervention in a highly innervated area and oropharyngeal and environmental considerations. Children are initially evaluated by the pediatric dentist and those determined to have anxiety or fears are often scheduled for sedation.
Procedures in the orofacial area may include dental restorations and extractions, biopsies, or trauma care and are highly stimulating to anxious patients. Retraction devices occluding the oral airway and manipulating oral soft tissues are often not accepted by fearful children. Noise from suction devices, monitors and drills lead to further undesirable stimulation.
Delivery of nitrous oxide by way of a nasal hood is routine medication to provide analgesia and augment dental sedation but requires the child to wear the hood in the optimal position. The nasal hood is an open airway device that will allow leakage of gas if not positioned correctly.
The dental office is usually not physically or organizationally connected to a medical facility or institution. In this setting moderate sedation is usually undertaken when dentists are delivering the sedation and performing the procedures without an additional sedationist.