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FAQ:  Pediatric - Children's Dentistry



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Question:
My five year old boy has two cavities on his lower front teeth. Our dentist -- we are new to him-- wants them filled and said he was going to use nitrous oxide as a sedative. My questions:
   1. At age five does he really need fillings on baby teeth that will come out in the coming years?
   2. I saw a "horror" story on TV a few years ago where a four year old boy died as he was sedated by his dentist who assured the parents there was positively no risk. Are there any documented cases of children dying or suffering problems related to nitrous oxide sedation? ...Rick

Answer:
Rick, thank you for the great question. First, nitrous oxide is the safest sedative agent known and to date. There has NEVER been a toxic/lethal case when using nitrous oxide alone. (when monitored correctly!) However, there have been fatalities with local anesthesia; but not nitrous oxide.

So, using nitrous oxide is highly recommended and I use it on almost every operative procedure in my office. The cavities on your child's front teeth (bottom) usually are lost between the ages of 6-7. It depends on the amount of root remaining and the severity of the decay which would determine if I would restore these teeth or not. These teeth are very small and it is hard for these teeth to hold/keep the restoration. If there is not much root remaining, I would probably not restore them.

Now, dentists always seem to get a very bad rap. The show you probably saw was 20/20 and they do this yearly. (the reason I know this is because I always receive several phone calls after it is shown) The sedations that they were speaking of were general anesthesia cases where children are completely asleep. All sedations do have some risk involved. However, as mentioned earlier, nitrous oxide is very, very safe. Without radiographs, I can only assume the scenerio. Your pediatric dentist will better inform you and since he/she has the x-rays, they will have a more definitive answer.

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