In cases where patients, primarily children, are extremely apprehensive or have extensive dental treatment, the treating dentist may recommend I.V. (Intravenous) Sedation, also referred to as conscious sedation. During treatment, the child will be in a depressed state of consciousness, arousable by voice and physical stimulation, and monitored by an on-site anesthesiologist.
Tebo Dental does not perform Oral Sedation, and we refuse to restrain children with papoose boards or by any other means.
The following outlines what to expect, step-by-step, when parents have a child that qualifies for I.V. Sedation.
First, it is important to note that children undergoing I.V. Sedation are going into surgery, and should be viewed as such. Sedation is not a primary method of performing operative treatment, but it is an effective one if a child’s anxiety is such that rendering treatment becomes difficult during their operative appointment. At Tebo, we perform sedation in-house and were the first in the state of Georgia to offer I.V. Sedation in a dental office (whereas before, it had only been performed in hospitals).
For treatment to be performed, an anesthesiologist and a registered nurse are present in our office to administer anesthesia and monitor any child throughout the duration of their appointment.
The anesthesiologist will require complete quiet and an adequate environment to properly anesthetize the child, so for this reason, we will not be able to let parents in the treatment room while treatment is being rendered.
A Step-By-Step Walkthrough of The I.V. Sedation Process
- The parent/guardian must bring the patient one hour prior to the appointment to fill out paperwork, take vital signs, weigh the patient, and perform other preparative measures to ready the child to be sedated.
- The patient will be brought to the back and given a Ketamine shot in the leg or backside. This medication relaxes the patient. The patient may stop blinking, stare at the ceiling and/or stop moving. This is completely normal. Parents are in the room for this injection, and it takes about 5 minutes for the medicine to take effect.
- Once the medicine takes effect, the parent/guardian will be escorted back to the waiting room.
- The anesthesiologist will apply the monitors and start the I.V.
- The anesthesiologist will sit next to the patient throughout the duration of the entire appointment to monitor him/her. He will make sure that the vital signs are normal at all times.
- Once the I.V. is started, the patient will be given a medicine called Propofol. This medicine keeps the patient asleep during the procedure.
- The treating dentist and his or her dental assistant will complete the treatment while the patient is sleeping.
- Once the procedures are finished, the patient will be moved to the recovery room where he/she will be with a registered nurse until they respond to such verbal commands as “open your eyes.” This process typically lasts about 30-45 minutes.
- The dental assistant will escort the parent to the conference room and provide instructions on how to care for their child after treatment.
- The doctor will go over the treatment completed, post-operative and oral hygiene instructions, and will let them know that our sedation coordinator will get them when the patient is starting to wake up.
- The parent or guardian will then be escorted back to our waiting area.
- As soon as the patient starts to wake up and responds to verbal commands, the parent/guardian will be called to the recovery room. This is when the nurse will explain post-operative instructions and the patient will be released to go home.
Medicaid Patients in Sedation
Medicaid requires an approved prior authorization before patients are seen for I.V. Sedation. Patients can be seen in sedation once per year with some Medicaid plans and once per lifetime with other plans. There are out of pocket expenses if sedation is needed a second time and it is not covered by the insurance.
General Anesthesia at the Hospital
Our hospital doctor, Dr. Terry Holder, sees patients at Children’s Healthcare of Atlanta in Duluth, Northeast Georgia Medical Center in Gainesville, and Scottish Rite in Atlanta, GA. General anesthesia is administered at the hospital by a licensed anesthesiologist. During general anesthesia, the patient’s will be in an unconscious state and you will be unable to feel pain during the dental procedures. While you're unconscious, the anesthesiologist monitors your body's vital functions and manages your breathing.
There are strict requirements that must be met in order for patients to qualify for I.V. Sedation under Medicaid. This will be determined during a comprehensive exam after radiographs are taken. Please note that not every case qualifies under Medicaid.
Call our office today to schedule a free consultation if you think Sedation Dentistry may be right for you!