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Sometimes a child needs medicine to feel calm or sleepy so the dentist can safely finish treatment. Here is what sedation is, how to get ready, and what grown-ups should ask.
Sedation is medicine that helps your body and mind relax during a dental visit. With lighter sedation you feel calm and a little sleepy, and you can still talk. With deeper sedation you feel very sleepy. The dental team watches you closely the whole time.
Your goal today: learn what sedation is, what the day is like, and how you and your grown-up can get ready.
Your grown-up will be with you before and after. The team checks on you the whole time, and you rest until you feel ready to go home.
Sedation medicine is only given at the dental office or hospital, where trained people can watch you. It is never given at home.
Every office plans sedation a little differently, but the day usually goes like this:
Sedation is a range, from light to deep. The AAPD and the American Academy of Pediatrics describe three levels.
Calm and relaxed. You are awake and answer normally when someone talks to you.
Drowsy. You still respond when someone talks to you or touches you lightly.
Very sleepy. You wake only with repeated or strong prompting, so the team watches extra closely.
Only at the dental office or hospital, where trained people can watch you. Never at home.
You rest while you wake up, and you go home when the team says you are ready.
Who it is for. The AAPD says sedation may be used for children who are fearful or anxious when gentler approaches have not worked, children who cannot cooperate because of age, development, or a medical or physical condition, and children for whom sedation may protect their emotional well-being or reduce medical risk. It is not recommended for a cooperative child with minimal dental needs, or when a child’s health makes sedation unwise. The dentist should discuss the risks, benefits and alternatives with you and get your consent first.
Why safety steps matter. The most serious problems with sedation involve breathing. That is why the AAP and AAPD guideline calls for a careful health check that includes the airway (for example, very large tonsils), fasting before planned sedation, trained staff, continuous monitoring, emergency equipment on hand, a recovery area, and discharge only when your child is back to their usual level of alertness. Healthy children are usually good candidates; children with significant medical conditions or special health care needs need individual planning and sometimes a specialist or anesthesiologist.
Follow the office’s eating and drinking instructions exactly; the guideline sets different minimum times for clear liquids, breast milk, formula and food. Tell the team about every medicine and supplement. Never give sedating medicine at home before the visit. If your child still rides in a car seat, bring a second adult so one can drive and one can watch your child. Ask for the office’s 24-hour phone number.
The AAPD asks dentists to look at your child’s medical, dental and social history, temperament and dental needs, and to consider other approaches first. If sedation is recommended, the dentist should explain the risks, benefits and alternatives, including waiting, before you decide.
Sedation can be used safely when the right steps are in place. The AAP and AAPD guideline calls for a health evaluation, an airway check, fasting before planned sedation, enough trained staff to treat your child and to monitor them, monitoring equipment, emergency medicines and equipment, a recovery area and clear discharge instructions. It is fine to ask who will monitor your child and what training they have.
Sedation can weaken the reflexes that protect the airway. If the stomach is not empty, food or liquid could go into the lungs. That is rare, but it is serious, so the guideline sets minimum fasting times that differ for clear liquids, breast milk, formula and food. Ask the office whether your child should take their usual medicines that day.
Some medicines and herbal supplements, such as St. John’s wort, ginkgo or valerian, can change how sedation medicines work, making them stronger or longer lasting. The guideline calls a careful drug history a vital part of safe sedation.
A parent or other responsible adult must take your child home. The guideline prefers two adults for children who still ride in a car seat, so one can drive while the other watches the child’s head position to keep the airway open. If only one adult can come, tell the office, because a longer observation time may be needed.
Follow the written instructions you are given, including limits on activity and what your child can eat and drink. The guideline says families should get a 24-hour phone number for the dental team. Call it with any concerns. For an emergency, such as trouble breathing, call 911.
General anesthesia is a controlled state of unconsciousness given by a trained anesthesia provider, in a hospital, surgery center or dental office. The AAPD lists reasons such as a child who cannot cooperate because of a medical or developmental condition, very young or extremely anxious children with a lot of treatment needed, infections where numbing does not work, and urgent care after injury or severe infection. It is not used for a healthy, cooperative child with minimal needs, or for convenience. Research on possible effects of anesthesia in young children is ongoing, so the benefits are weighed against possible risks.
Nitrous oxide on its own usually gives a light, relaxed state, and the child stays awake. Combining it with other sedating medicines can make sedation deeper, which calls for more monitoring. See Nitrous oxide.
The clinical statements on this page come from the AAPD best practice on behavior guidance and the AAP and AAPD guideline on monitoring and managing children before, during and after sedation. Medicine names, doses and exact fasting times are clinical details for the treating team and are left out on purpose.
Review status: pending. No named reviewer or review date yet.
This website is for education only and does not replace care from your dentist, physician, or emergency services.