IV Sedation Information and Instructions
IV or intravenous deep sedation is used to safety sedate your child to the point where dental procedures can be done safely and painlessly for an indefinite period of time. IV sedation at Tiny Teeth Pediatric Dentistry is administered by Special Anesthesia Services, a group of Nurse Anesthetists (CRNAs) who specialize in caring for patients needing sedation in the dental office setting. Your child's sedation will be performed solely by the CRNA, and they will not perform any other component of the dental procedure.
If your child is being sedated in our office with IV sedation there are some very important pre-operative and post-operative instructions both from our office and from Special Anesthesia Services. All of these instructions will be reviewed by our office prior to your child’s sedation but links have been included for your reference if they are lost or forgotten.
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Many parents are scared about starting an IV in their child, which is required to administer sedation medications. Special Anesthesia Services has vast experience in this area and has many methods to accomplish this goal. In cooperative children this is accomplished utilizing a local anesthetic on the skin, which is administered just under the surface of the skin. Your child will experience only a slight sting. In children who are unable to cooperate they may give them an intramuscular injection without them knowing it. They will ask the child to give their parent a “big bear hug”; the parent should hug the child tightly, keeping their arms clear of the upper part of their child’s buttocks. The injection will be administered quickly right through the clothing, and they will try to convince the child that a “mosquito” has bitten them; the reaction of children can vary greatly. Many children don’t cry, some cry slightly and some respond vigorously. Within several minutes the child will be unaware of their surroundings, and then an IV can safely be placed. Occasionally a parent will prefer to tell their child that they will be getting a shot. They will be happy to do this, but experience leads them to favor the surprise approach, as the child doesn’t become apprehensive, and doesn’t tighten their muscles prior to the injection. After the IV is placed, it will be used to administer sedative drugs, and any additional medications that may be necessary.
IV sedation medication is typically composed of an amnestic/hypnotic called Diprivan (propofol). This is administered according to the child’s weight. An EKG monitors the heart rhythm. A pulse oximeter monitors blood oxygen levels. An automatic blood pressure monitor is also used. Close observation is employed. Patients are usually ready to leave the office within one hour of the conclusion of the procedure. They will be able to sit without any undesirable symptoms, their vital signs will be stable, they will be responding in an appropriate fashion and will display appropriate, but diminished, physical coordination. Children are discharged when somewhat drowsy, and will usually require carrying. They must have adult supervision for the remainder of the day and not be allowed to participate in any activities in which lack of coordination or alertness would endanger them.
IV sedation is not appropriate for all children. There are certain medical and physical limitations that may not make your child a good candidate for IV sedation. For this reason it is very important that any medical condition or medication use be shared with both the pediatric dentist and the anesthetists at Special Anesthesia Services.
Information for Special Anesthesia Services
Special Anesthesia Services is a separate business than Tiny Teeth Pediatric Dentistry and payment for their services is handled directly by their office. Some charges will be covered by insurance. Many times, medical insurances will pay the anesthesia charges for children under the age of six, patients with a mental or physical handicap, or patients with a medical necessity. They participate in Blue Cross / Blue Shield, and Coventry / Preferred Health Systems / Preferred Plans of Kansas insurances only. They can do a predetermination with these insurances to find out if there is coverage for our services.
Other insurances will do predeterminations, but they don’t do these through their office. Their staff will be glad to assist you with the information you’ll need when contacting your insurance company to determine if you’re covered.
Special Anesthesia Services does expect payment on the day of service. This would be all BCBS or Coventry/PPK/PHS deductibles and co-payments, as well as payment in full for all other insurances or those without insurance coverage.
Special Anesthesia Services accepts cash, personal checks, cashier’s checks, money orders, traveler’s checks, Visa, Mastercard, Discover, American Express, and debit cards. Additionally, they offer a payment plan from Care Credit. For more information please contact the SAS office at (316) 788-5939 or visit the website at www.sleepinsafety.com.