Treatment of children under medication-induced sleep (conscious sedation)

Treatment of children under medication-induced sleep – this is a comfortable way to go through all necessary procedures without stress and discomfort. This method suits both adults and children, allowing a significant amount of work to be done in one visit to the doctor. The patient falls asleep in the chair and wakes up after the treatment is finished, without feeling pain or anxiety. At Gallant Clinic, medication-induced sleep is used for children as a safe alternative to general anaesthesia. The procedure is done using light sedative drugs, which bring the patient into a calm, superficial sleep without affecting the cardiovascular and respiratory systems.

During treatment, a team of experienced specialists works near the patient: a dentist, a nurse, and an anaesthesiologist. The anaesthesiologist individually selects the drug dosage, monitors the patient’s condition during the procedure, and ensures a comfortable awakening.

Indications for sedation in paediatric dentistry

Treatment of baby teeth with medication-induced sleep is recommended in such cases:

• Need for complex dental intervention, including treatment or extraction of several teeth, when the child cannot sit still for long.
• Painful procedures, especially those involving gum incision.
• Allergic reaction to local anaesthetics.
• Fear of dental treatment.
• Strong gag reflex, which complicates manipulations.
• Presence of medical conditions that prevent the child from staying in the chair for a long time.

As for contraindications, among the relative limitations are active diseases of the cardiovascular and respiratory systems, anaemia, epilepsy. The final decision on the possibility of sedation is made by the anaesthesiologist after medical history is collected and after consultation with a paediatrician.

The duration of the procedure depends on the amount of necessary work. For example, extraction of a tooth in a child may take 15–20 minutes, and in an adult – up to 30 minutes. Tooth decay treatment takes up to an hour, and pulpitis – up to 1.5 hours. Procedures like implantation may last longer.

Features of sedation and types of the procedure

One common mistake among patients is equating anaesthesia with sedation. In reality, these are different pain control methods.

Under general anaesthesia, drugs completely “switch off” consciousness, blocking the central nervous system. As a result, artificial support of breathing and heart function is needed.

Sedation works more gently. It causes muscle relaxation and puts the patient into a state of light sleep without suppressing vital functions. In mild sedation, a person may remain conscious and respond to the doctor’s requests. Sensitivity is partially preserved, so the procedure is often supplemented with local anaesthesia.

In dentistry, general anaesthesia is rarely used. An alternative is sedation – it ensures patient comfort but is easier for the body to tolerate. With the correct drug and dosage, this method causes no complications. Awakening happens immediately after the procedure, and within 15–20 minutes the patient feels normal.

Types of sedation:

• Intravenous – the drug is injected through a catheter into a vein.
• Inhalation – an aerosol is used, inhaled through a mask.
• Combined – combines both methods for enhanced effect.

The optimal sedation option is chosen by the doctor, considering the patient's condition, the amount and duration of the treatment.

At Gallant Clinic, modern drugs with proven effectiveness and safety are used. As a result, the patient enters medication-induced sleep. The drugs allow for depth control and let the patient quickly return to normal after the procedure.

How to prepare children for dental treatment in sleep

Before the procedure, the dentist evaluates not only the condition of the oral cavity but also the general health status. It’s important to inform the doctor about chronic diseases, allergies, and other individual features. This helps choose a safe and effective sedative.

To exclude possible contraindications, the doctor may prescribe:

• general and biochemical blood tests;
• blood clotting test;
• tests for HIV, hepatitis B and C;
• electrocardiogram (ECG);
• consultation with a therapist or paediatrician.

The day before the procedure, it’s necessary to avoid food for at least 6 hours and water – for 2 hours. Infants can be fed no later than 4 hours before sedation.

If the patient has chronic diseases or is taking medications, it’s worth discussing this with the doctor in advance to receive personalised recommendations.

How does treatment in medication-induced sleep proceed?

Dental treatment in sleep requires careful patient preparation and takes place in several stages:

1. Consultation with a dentist – the doctor determines the necessary procedures and selects the sedative drugs.
2. Examinations – the patient provides blood tests, ECG, and, if needed, consults with the anaesthesiologist and other specialists.
3. Treatment procedure – the patient is put into medication-induced sleep, and all necessary manipulations are carried out.

The therapy looks like this:

1. The patient comes to the clinic at the scheduled time, sits in the dental chair, and receives the sedative – by injection via catheter into a vein or by aerosol through a mask. In children, inhalation sedation is usually used.
2. Within 1–2 minutes, the patient falls asleep. Then a monitoring device is connected to track vital signs like breathing and heartbeat. The anaesthesiologist monitors these during the entire procedure and adjusts the drug dose if necessary.
3. The dentist performs the necessary manipulations – from caries treatment and filling to tooth extraction or implantation.
4. After the treatment, the anaesthesiologist wakes the patient from medication-induced sleep.

In paediatric dentistry, sedation is most often used, which does not significantly affect the central nervous system and does not disturb breathing or other vital functions. After the procedure, the anaesthesiologist stops the drug administration, and the child wakes up in a few minutes – usually within 5 to 10 minutes.