Higher level care, such as sedation dentistry or hospital dentistry, requires additional training for the doctor. Typically, privilege and licensure is granted after completing a residency program (2-4 years of additional training after dental school) and regulated by state boards and hospitals. Dr. Pinkerton has completed an Advanced Education in General Dentistry, a Pediatric Dental Residency and is a board certified Diplomate in the American Board of Pediatric Dentistry. She currently has active staff privilege at Animas Surgical Hospital and maintains state certification for minimal sedation. She has been performing sedation and hospital dentistry for 15 years.
Nitrous oxide, also known as “laughing gas”, is commonly used to make treatment more comfortable. This sedation is inhaled through a mask that allows you to breathe in the medication and induces a state of relaxation. Local anesthetic will be administered in conjunction with nitrous oxide to eliminate pain.
Conscious sedation is a behavior management technique employed for patients who are not able to tolerate dental treatment easily in the office with nitrous oxide. Conscious sedation is a depressed level of awareness often produced by taking an oral medication. Your child is still awake and breathing without support, but may exhibit significant drowsiness. Sedations can only be provided by qualified, state certified dentists and an evaluation by a pediatrician is required.
In some cases where there exists significant decay on multiple teeth and the child is too young to tolerate treatment in the office setting, comprehensive dental rehabilitation can be performed in the operating room under general anesthesia.
Your child has completed comprehensive dental rehabilitation under general anesthesia. Expect your child may be sleepy, irritable, or emotional after general anesthesia and complete recovery is expected in 24 hours. Light activity for the rest of the day is recommended. Avoid activities like heavy lifting, running and swimming, driving motorized vehicles or toys, and jumping on trampolines for the rest of the surgery day. Additionally, your child may have a bloody nose and sore throat from the breathing tube. Provide Tylenol or Motrin for pain management. Resume gentle brushing this evening. A clean mouth will heal faster than a dirty mouth! You may skip toothpaste for the first two days. Expect the gum tissue to bleed around crowns and extractions during brushing for several weeks.
Below are some guidelines for the treatment provided:
Stainless steel crowns (silver caps) – There are little cuts and scrapes on your child’s gums from the tooth preparation for a stainless steel crown. Additionally, the crown will seat below the gumline and can blanch the tissue temporarily. These actions could be uncomfortable for your child for several days. Over the counter Tylenol or Motrin are recommended for pain management. Pain for 5 days is expected. Pain beyond 7 days is not normal; please contact the dental clinic for evaluation. Soft diet is recommended after surgery. Graduate to more solid foods as tolerated. Sticky foods and candies like taffy, chews, gummies, suckers, hard candies, caramels can pull dental crowns off and should be avoided. If a crown should debond, please keep the crown and call the office to be rebonded.
Extractions (tooth removal) - If your child had a tooth extracted, expect mild pain or discomfort in that area and provide pain management with over the counter analgesics. Your child may have a special medical packing in the tooth socket to control bleeding. This packing will not need to be removed, but dissolve naturally over the next weeks. If the packing dislodges prematurely, it typically does not need to be replaced. If a metal space maintainer was placed, avoid sticky candies and food that can debond the appliance. In rare cases, your child will require sutures. Sutures are resorbable and will dissolve within 14 days. Please discourage your child from picking or pulling on stitches.
Please contact the office if you have any questions about healing, care for additional procedures, or extended pain. (970) 259-0600