Sedation and dental work for toddler

[Jeannie]

My 19 month-old daughter needs dental work done. She has some developing
cavities. The dentist wants to make some fillings and says it should only take
10-20 minutes.

He has given 2 options: 1. sedation with Versed (generic name - midazolam
http://www.fpnotebook.com/PSY149.htm
http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202372.html), or 2. cry it out
for 10-20 minutes. From what info I have found on midazolam, it seems to be
relatively safe and widely used for children. The greatest risk seems to be
possible overdose, which can cause depressed (or arrested) breathing and heart
rate, but, it appears that the drug wears off quickly, and it can be countered
with assisted breathing. The info sheet that the dentist gave me said that
children may have diverse reactions after the drug begins to wear off, either
silliness/laughter or crankiness. Disorientation, dizziness are other
post-procedure side-effects.

I'm still somewhat undecided on which way to go. I'm leaning toward drug-less
cry-it-out. I found some information that showed that children might actually
have a worse time in post-surgery recovery, behaviorally, if they *don't* receive
sedation (http://www.kidsource.com/kidsource/content5/pre.op.seds.html). But,
full-blown surgery with general anesthesia seems to be quite different from taking
20 minutes to apply dental fillings.

Can anyone give any personal experiences regarding their young children and
midazolam (or any other sedative) or just allowing them to cry-it-out with regard
to dental procedures? How were your pre- and post-procedure experiences?

I do plan on asking the dentist for more information, regarding dosage and
preparedness for adverse reactions. Are there any other questions that you might
suggest?

Thanks a bunch.
--
Jeannie
E-mail: jeannie at talisweb dot see oh em
Web: http://www.moonflour.com

[Babs]

"Jeannie" > wrote in message
...
> My 19 month-old daughter needs dental work done. She has some developing
> cavities. The dentist wants to make some fillings and says it should
only take
> 10-20 minutes.
>
> He has given 2 options: 1. sedation with Versed (generic name - midazolam
> http://www.fpnotebook.com/PSY149.htm
> http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202372.html), or 2. cry
it out
> for 10-20 minutes.
<snip>

I don't have any info about the medication, but I'm wondering if 19 months
of age isn't a bit too young for the cry it out option?
DS is nearly 17 months, and will go with us to our next dental appointment,
which will be his first, so I don't have any first hand experience.
The reason I'm wondering if 19 month old isn't too young, is that it seems
difficult to me to explain what is going to happen and why it needs to be
done. I doesn't seem realistic to me to expect a child that age to sit
still in the chair while the cavities are being filled.
Another reason I'm not sure about the cry it out option is my own personal
experience as a child. In The Netherlands we have schooldentists. And
although I hear they are really good with children these days, that
certainly wasn't the case when I was a toddler. I'll spare you the
horrorstory, but suffice it to say the treatment without any sedation made
me so scared of dentists, I still need sedation just to have my teeth
checked. Agreed, I was 4 years and not 19 months when I had my first cavity
filled, and I don't have any recollection of my life when I was 19 months.
Ofcourse YMMV, and I mean in no way to criticise (sp?) anyone, but to me 19
months seems too young for the cry it out option.

Babs
proud mama to Nick (03/05/2002)

--
Got the swing, got the sway, got my straw in lemonade
http://www.babsje.nl

[Laura Faussone]

Jeannie wrote:

>
> Can anyone give any personal experiences regarding their young children and
> midazolam (or any other sedative) or just allowing them to cry-it-out with regard
> to dental procedures? How were your pre- and post-procedure experiences?

I'd recommend sedation, otherwise they'll probably have to strap her to a papoose
board or otherwise restrain her while they're drilling. My 3yo was really freaking
out at the drill when her sedation didn't "take".

Laura

[Leigh Menconi]

My daughter recently underwent a sedated echocardiogram and a sedated heart
catheterization. For the echo, she was given chloralhydrate mixed with
benadryl and it was a horrible experience. She seemed to have a contrary
reaction to the chloralhydrate which she'd had before but they wouldn't
listen when I told them that it didn't work well on her (seems to make her
hyper instead of sleepy).

For the catheterization, they gave her versed prior to going into the OR to
put her out so they could hook her up to the IV, etc, after she was already
out. The versed was a *much* better experience. My daughter's had lots of
"procedures" over the years (she's 4 now) because she has lots of health
problems and I will definitely ask for versed again if she needs light
sedation.

Leigh in raLeigh

"Jeannie" > wrote in message
...
> My 19 month-old daughter needs dental work done. She has some developing
> cavities. The dentist wants to make some fillings and says it should only
take
> 10-20 minutes.
>
> He has given 2 options: 1. sedation with Versed (generic name - midazolam
> http://www.fpnotebook.com/PSY149.htm
> http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202372.html), or 2. cry
it out
> for 10-20 minutes. From what info I have found on midazolam, it seems to
be
> relatively safe and widely used for children. The greatest risk seems to
be
> possible overdose, which can cause depressed (or arrested) breathing and
heart
> rate, but, it appears that the drug wears off quickly, and it can be
countered
> with assisted breathing. The info sheet that the dentist gave me said
that
> children may have diverse reactions after the drug begins to wear off,
either
> silliness/laughter or crankiness. Disorientation, dizziness are other
> post-procedure side-effects.
>
> I'm still somewhat undecided on which way to go. I'm leaning toward
drug-less
> cry-it-out. I found some information that showed that children might
actually
> have a worse time in post-surgery recovery, behaviorally, if they *don't*
receive
> sedation (http://www.kidsource.com/kidsource/content5/pre.op.seds.html).
But,
> full-blown surgery with general anesthesia seems to be quite different
from taking
> 20 minutes to apply dental fillings.
>
> Can anyone give any personal experiences regarding their young children
and
> midazolam (or any other sedative) or just allowing them to cry-it-out with
regard
> to dental procedures? How were your pre- and post-procedure experiences?
>
> I do plan on asking the dentist for more information, regarding dosage and
> preparedness for adverse reactions. Are there any other questions that
you might
> suggest?
>
> Thanks a bunch.
> --
> Jeannie
> E-mail: jeannie at talisweb dot see oh em
> Web: http://www.moonflour.com
>
>
>

[Sue]

My daughter has had Versed so many times I can't even count anymore. No
problems whatsoever. I happen to like the drug because it makes them forget
what is happening to them. I personally would never put a child, especially
one that young through a procedure like that without sedation. I know it is
just fillings, but for one thing, she won't sit still long enough for the
dentist to do what he needs to do and if she is crying so bad, then he
really won't be able to do the work quickly. Have you never had a cavity
filled? They have to use the drill, which could be extremely scary for a
child that age. I'm sorry, but letting her cry it out just sounds horrible
to me.
--
Sue
mom to three girls

Jeannie > wrote in message
...
> My 19 month-old daughter needs dental work done. She has some developing
> cavities. The dentist wants to make some fillings and says it should only
take
> 10-20 minutes.
>
> He has given 2 options: 1. sedation with Versed (generic name - midazolam
> http://www.fpnotebook.com/PSY149.htm
> http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202372.html), or 2. cry
it out
> for 10-20 minutes. From what info I have found on midazolam, it seems to
be
> relatively safe and widely used for children. The greatest risk seems to
be
> possible overdose, which can cause depressed (or arrested) breathing and
heart
> rate, but, it appears that the drug wears off quickly, and it can be
countered
> with assisted breathing. The info sheet that the dentist gave me said
that
> children may have diverse reactions after the drug begins to wear off,
either
> silliness/laughter or crankiness. Disorientation, dizziness are other
> post-procedure side-effects.
>
> I'm still somewhat undecided on which way to go. I'm leaning toward
drug-less
> cry-it-out. I found some information that showed that children might
actually
> have a worse time in post-surgery recovery, behaviorally, if they *don't*
receive
> sedation (http://www.kidsource.com/kidsource/content5/pre.op.seds.html).
But,
> full-blown surgery with general anesthesia seems to be quite different
from taking
> 20 minutes to apply dental fillings.
>
> Can anyone give any personal experiences regarding their young children
and
> midazolam (or any other sedative) or just allowing them to cry-it-out with
regard
> to dental procedures? How were your pre- and post-procedure experiences?
>
> I do plan on asking the dentist for more information, regarding dosage and
> preparedness for adverse reactions. Are there any other questions that
you might
> suggest?
>
> Thanks a bunch.
> --
> Jeannie
> E-mail: jeannie at talisweb dot see oh em
> Web: http://www.moonflour.com
>
>
>

[iphigenia]

Jeannie wrote:
> My 19 month-old daughter needs dental work done. She has some
> developing cavities. The dentist wants to make some fillings and
> says it should only take 10-20 minutes.
>

Hm. My son had dental work done in June, when he was 23 months. He had 2
fillings, a root canal, and three crowns. His was done under general
anesthesia (the pediodontist will not use chloral hydrate until they're
close to 3 years; DS has actually had chloral hydrate for a sedated echo,
but that was done at a children's hospital).

Frankly, I cannot even imagine allowing a toddler to be strapped down to a
board and terrified by the restraints and the noise and smell of the
drilling being done by a stranger without parents present, without SOME
sedation.

--
iphigenia
www.tristyn.net
"i have heard the mermaids singing, each to each.
i do not think that they will sing to me."

[E]

"E" > wrote in message
...
> "Jeannie" > wrote in message
> ...
> > My 19 month-old daughter needs dental work done. She has some
developing
> > cavities. The dentist wants to make some fillings and says it should
only
> take
> > 10-20 minutes.
> >
> > He has given 2 options: 1. sedation with Versed (generic name -
midazolam
> > http://www.fpnotebook.com/PSY149.htm
> > http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202372.html), or 2.
cry
> it out
> > for 10-20 minutes. From what info I have found on midazolam, it seems
to
> be
> > relatively safe and widely used for children. The greatest risk seems
to
> be
> > possible overdose, which can cause depressed (or arrested) breathing and
> heart
> > rate, but, it appears that the drug wears off quickly, and it can be
> countered
> > with assisted breathing. The info sheet that the dentist gave me said
> that
> > children may have diverse reactions after the drug begins to wear off,
> either
> > silliness/laughter or crankiness. Disorientation, dizziness are other
> > post-procedure side-effects.
> >
> > I'm still somewhat undecided on which way to go. I'm leaning toward
> drug-less
> > cry-it-out. I found some information that showed that children might
> actually
> > have a worse time in post-surgery recovery, behaviorally, if they
*don't*
> receive
> > sedation (http://www.kidsource.com/kidsource/content5/pre.op.seds.html).
> But,
> > full-blown surgery with general anesthesia seems to be quite different
> from taking
> > 20 minutes to apply dental fillings.
> >
> > Can anyone give any personal experiences regarding their young children
> and
> > midazolam (or any other sedative) or just allowing them to cry-it-out
with
> regard
> > to dental procedures? How were your pre- and post-procedure
experiences?
> >
> > I do plan on asking the dentist for more information, regarding dosage
and
> > preparedness for adverse reactions. Are there any other questions that
> you might
> > suggest?
> >
> > Thanks a bunch.
> > --
> > Jeannie
> > E-mail: jeannie at talisweb dot see oh em
> > Web: http://www.moonflour.com
> >
> >
> >
> as a child, it seemed like I had quite a few cavities. they were usually
> small, so I had the work done without any Novocain. it was only once I
> became a teenager and they got BIG that I had any. I still (42 yo) prefer
> to do it without numbing. I think of it as more of a "zing" than actual
> pain. my lip and tongue aren't numb when I leave, so I can eat and drink
> and talk just fine.
> of course, I think most of this was as a child, not a toddler. I could be
> reasoned with much better. I vaguely remember getting a lolli-pop after
it
> was over, too :)
>
> Edith
> one experience I had as an adult a few years ago - dentist was drilling to
> replace a filling, went just a little too far OUCH!! he hit the nerve.
it
> only REALLY HURT when the drill went through. he dripped the Novocain
into
> the hole and he continued on to do a root canal. that was the best one
I've
> EVER had! numbness in the only place that needed it.
>
> good luck with whatever you do!
>
>

after reading other posts, I have to add on to mine. I think that that age
is too young to do it without some sedation. however, it was the needle
that still bothers me more than the drill. make sure the place the needle
goes in is somewhat numb from a local before he is "shot"
Edith

[Welches]

Jeannie > wrote in message
...
> My 19 month-old daughter needs dental work done. She has some developing
> cavities. The dentist wants to make some fillings and says it should only
take
> 10-20 minutes.
Until I was adult I'd only had dental work done under general (extractions).
I never had a problem with going to the dentist. About 4 years ago I had to
have a couple of fillings and only had a local. Since then I've dreaded
going to the dentist, although I've had little treatment. Personally I'd
think 19 months was was to old to let them cry it out, and I'd suspect you
could give them a fear of dentists for life. If it's their choice it's
different, and you can't even explain totally to them at that age. DD (2
3/4) has just had an injection. The next 2 or 3 times we went past the drs.
she said "don't want another ouch", and she didn't seem to mind it at the
time-she didn't cry or object. All I'd say is make sure you're there when
they put her under and when she comes out.
Debbie

[Wendy Marsden]

My three year old son needed quite a lot of dental work done: an abscessed
tooth pulled and five caviities filled. We gave him versed before the
oral surgery and it worked well, but freaked me out. He got slack-faced,
his words started to mumble and he was clearly drugged. My Mommy-alarms
were going off even though I knew that was the intended result.

As for the cavities, though, we started going to a pediatric dentist who
distracts the kids and keeps themn calm. Sammy still hasn't had any of
those cavities filled though so I'm not sure yet how it will turn
out. (The dentist saw us for the initial exam, a cleaning and scheduled
us for October.)

My big question is how come this kid's teeth are so bad. He was 100%
breastfed until six months (and not fully weaned until 18 months). We
brush his teeth every day, give him flouride pills and he doesn't eat much
candy and never drinks soda and rarely drinks juice. (His dental problems
are all back teeth, this isn't baby bottle mouth.)

He's a third kid and the other two have 22 years of kid-dom and one cavity
between them. Yet the dentist just acts like I'm some sort of
abusive/neglectful mom because (okay, I admit it) I haven't flossed the
kids teeth. (Note that his teeth are not close-set together - floss
doesn't catch anything.) Furthermore, he has had regular dental care
since the age of 2. The cavities all came at the same time.

Wendy, who flosses his teeth NOW.

[Fern5827]

Wendy, I do not wish to alarm you, but note that DSS, CPS has dentists as a
class of mandated reporters.

You may find yourself visited by an inquiring cw from DSS.

Apparently, such instances have happened. For example, children born with OI
(osteogenesis imperfecta) have been spirited away from families for months, and
have broken bones additionally within foster care.

Hope not to yours.

>Yet the dentist just acts like I'm some sort of
>abusive/neglectful mom because (okay, I admit it) I haven't flossed the
>kids teeth. (Note that his teeth are not close-set together - floss
>doesn't catch anything.) Furthermore, he has had regular dental care
>since the age of 2. The cavities all came at the same time.

http://www.syc.org NH Website for good parents harassed by DCYF, DHS, etc.

Newsgroup alt support child protective services.


Wendy related:


>Subject: Re: Sedation and dental work for toddler
>From: Wendy Marsden
>Date: 8/4/2003 2:11 PM Eastern Daylight Time
>Message-id: >
>
>My three year old son needed quite a lot of dental work done: an abscessed
>tooth pulled and five caviities filled. We gave him versed before the
>oral surgery and it worked well, but freaked me out. He got slack-faced,
>his words started to mumble and he was clearly drugged. My Mommy-alarms
>were going off even though I knew that was the intended result.
>
>As for the cavities, though, we started going to a pediatric dentist who
>distracts the kids and keeps themn calm. Sammy still hasn't had any of
>those cavities filled though so I'm not sure yet how it will turn
>out. (The dentist saw us for the initial exam, a cleaning and scheduled
>us for October.)
>
>My big question is how come this kid's teeth are so bad. He was 100%
>breastfed until six months (and not fully weaned until 18 months). We
>brush his teeth every day, give him flouride pills and he doesn't eat much
>candy and never drinks soda and rarely drinks juice. (His dental problems
>are all back teeth, this isn't baby bottle mouth.)
>
>He's a third kid and the other two have 22 years of kid-dom and one cavity
>between them. Yet the dentist just acts like I'm some sort of
>abusive/neglectful mom because (okay, I admit it) I haven't flossed the
>kids teeth. (Note that his teeth are not close-set together - floss
>doesn't catch anything.) Furthermore, he has had regular dental care
>since the age of 2. The cavities all came at the same time.
>
>Wendy, who flosses his teeth NOW.
>
>
>
>
>
>
>
>

Fat kids--next target of DCF's inquiries.