Behavior Guidance and Sedation

We believe that children do well for dental treatment when care is provided with skill and compassion. We love building rapport with kids so they feel safe and comfortable. We are able to explain procedures and describe upcoming experiences in an honest and child-friendly way. Children tend to respond much better to coaching and behavior guidance when we can work with them one -on -one. Therefore, we suggest our patients are brought to our clinic area alone. with our parents and care providers remaining in the reception area. When care providers are present in the treatment room, children may not allow themselves to take direction from us.

We recognize that all children are unique. They have different life experiences, anxieties, and perceptions or discomfort. Our team is uniquely trained at adapting behavior guidance to your child’s needs. If your child is not coping well or if you change your mind during the appointment, you are welcome to come back to the treatment room during the appointment as well.

Having shared our philosophy to ensure your child’s success, we respect your wishes absolutely. You are always welcome to join your child for their restorative appointment. We ask that you take cues from our clinical team during the appointment. We may ask you to be like a “rock” for your child, though —strong and quiet so we can build that trust and confidence to help them.

We look forward to collaborating with you for a successful appointment.

Some dental procedures are likely to cause acute pain for your child. These include larger fillings and extractions. For these procedures, we will numb your child’s tooth to ensure they are comfortable throughout. Our providers are super talented at administering local anesthetic for children, and most kids don’t even know we numbed their teeth! We use a combination of topical anesthetics and behavior coaching techniques to get your child through.

Sometimes children are too fearful or their treatment needs are too complex to be treated with N2O alone. Oral Conscious sedation is an excellent option to soothe your child’s anxieties. Your child will be offered 1-2 teaspoons of Versed (Midazolam) mixed with flavored Tylenol (acetaminophen) 10 minutes before treatment.

Versed:
A safe and highly effective oral medication with several effects. It is in the same class of drugs as Valium, but stronger and has a shorter duration of effect.

• Anxiolysis: It helps to calm and relax your child and helps decrease panic and anxiety. (this benefit lasts about 40-45 minutes).
• Amnesia: Your child will have a fuzzy memory about the appointment (lasts about 1 hour).
• Muscle Relaxation: Your child’s coordination will be impaired after the appointment (lasts about 2-3 hours).
• Your child will be awake during the appointment and watching a movie of their choosing.

Acetaminophen (Tylenol) or Ibuprofen (Advil/Motrin) mask the taste of the midazolam. And, these analgesics ensure your child already has a pain reliever on board after their dental procedure is complete.

We always pair the oral sedative medication with a mixture of Oxygen/Nitrous oxide. Oxygen ensures your child is well oxygenated and breathing safely. Nitrous oxide is an excellent way to adjust the sedative effect. We still numb the area we are treating with local anesthetic as needed to ensure your child is comfortable.

Parents and Caregivers are not permitted in the clinical area during oral sedation for the safety of your child.

Dental treatment under general anesthesia is a safe and comprehensive way to provide dental care. At Stellar Kids Dentistry, we always have two doctors caring for your child simultaneously. Under the direct care of our board-certified anesthesiologist, your child will be asleep, safe, and comfortable. Our pediatric dentist will ensure your child receives the best dental treatment possible.

We may recommend general anesthesia when your child has:

• Extensive restorative or surgical needs
• Impacted wisdom teeth
• Pre-cooperative age
• Treatment needs for which local anesthetic will be ineffective
• ASD or other special medical/behavioral needs

Our Stellar Kids clinical team is friendly and caring. We do our best to ensure the entire process is comfortable for patients and parents alike. For your child’s maximum safety, they will be brought back to the operating room alone. They will breathe into a mask and will fall ‘asleep’ with the aid of an inhalation anesthetic gas. Once asleep, our anesthesiologist will place an IV and a breathing tube to ensure your child has a safe and secure airway. Then, your pediatric dentist will complete all needed dental treatment. Finally, the breathing tube and IV will be removed before your child wakes up. You and your child will reunite in our recovering room just as they are waking up.

Our anesthesiologist will customize their medication and techniques for your child. During the three phases of deep sedation, the principal medications that our anesthesiologist may administer are:

Induction: Inhalational Sevoflurane
Maintenance: Propofol
Recovery:

• Toradol – to manage postoperative pain and discomfort
• Zofran – to minimize nausea and vomiting
• Dexamethasone – to decrease swelling, nausea, and vomiting.

Parents and Caregivers are not permitted in the operating room at any time during surgery for the safety of your child.

We work with the best out-patient anesthesia providers in Washington State.

M2 Anesthesia: (206) 605-5933
Dr. Marlon Michel and his team have been providing anesthesia services at Stellar Kids Dentistry since 2014. Their doctors are very experienced in pediatric outpatient dental anesthesia. Safety is the highest priority for their skilled and caring providers. M2 has excellent customer service working one-on-one with families to provide safe and affordable pediatric anesthesia.