Some children need help coping with the fear of the unknown or anxiety of the known. A five year old boy from Milwaukie, Oregon recently needed oral sedation for his dental care.
This child had several decayed molars and the cavity on one tooth was especially deep. Since his older sister had told him that we were going to use a big shot and yank out his tooth, he got really scared.
To reduce his anxiety, we recommended using a medicine called Triazolam (Halcion) and nitrous oxide gas (laughing gas). His mother asked about the safety of these sedation medications.
Nitrous oxide advantages:
it is a pretty good analgesic pain reliever
giving a good euphoric feeling
used with more oxygen than room air
the effects go away as soon as it is turned off
reduces anxieties for kids that understand the need
does not put kids to sleep at the dose we use
is completely reversed by another drug we keep available called Flumazenil or Romazicon.
We have never had to use it, but it is nice to know Flumazenil is there for emergencies.
Triazolam has a fairly short half life so it takes about 45-60 minutes to take effect, then it is worn off usually after three hours.
Often kids become stumbly with poor balance while the Halcion is effective. Parents should stand by to hold hands and remind their child to not move around much until the medicine is worn off.
Much more relaxed after taking the triazolam, this Milwaukie kid was able to sit in the dental chair, breathe the nitrous oxide gas, and get a pulpotomy and a composite white filling without any worry.
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