5.4 Advanced behavior guidance Techniques—Continued
Deep Sedation
Description: Deep sedation can be used safely and effectively with children unable to receive oral health care in the usual manner for reasons of age or cognitive, physical, or medical condition. The decision to use deep sedation must take into consideration the following: (1) alternative techniques that could be used instead; (2) the child’s oral health needs; (3) the effect of deep sedation on the quality of oral health care; (4) the child’s emotional and cognitive developmental levels; (5) the child’s medical and physical condition; (6) the need to diagnose and treat; (7) the safety of the child, dentist, and staff; and (8) parents’ understanding and acceptance.
Objectives:
- Reduce or eliminate anxiety
- Reduce untoward movement and reactions to oral health procedures, thus creating a safer environment for providing care
- Increase tolerance for long appointments
- Raise the child’s pain threshold
Indications:
- A fearful, anxious child for whom basic behavior guidance has not been successful
- A child who cannot cooperate owing to a lack of psychological or emotional maturity and/or cognitive, physical, or medical disability
- A child for whom the use of sedation may protect the developing psyche and/or reduce medical risk
Contraindications:
- A cooperative child with minimal oral health needs
- Predisposing medical conditions that would make deep sedation inadvisable
Written informed consent must be obtained from a parent before deep sedation is used. The child’s record should include (1) informed consent and (2) indication for use.
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