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Nitrous Oxide vs Conscious Sedation for 4 Year Old Dental Treatment

Hey moms! So, my 4yr old son has 2 cavities on his 2 top front teeth that need to be fixed. I've been given the choice between using Nitrous Oxide (laughing gas) or "Conscious Sedation", which from what I understand, will be a cocktail of 3 different meds that will be administered orally before the procedure. At this point we're leaning towards the conscious sedation because I'm afraid that the gas won't be enough of a pain blocker and I would hate for my little guy's first experience with dental work to be a bad one. I should mention that he's been really good during his routine teeth cleanings and the work will be done by a pediatric dentist. However, he had a rough time with his last round of shots at the pediatrician's (6 mnths ago) and still talks about how bad it was. I guess I'm just curious to hear others experiences with either procedure and any pros/cons...

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Good Morning L.,
My two children ages 14 & 12 were deathly affraid of the Dentest. Both had a very tramatic experience. We now go to a pediatric dentist and he uses the laughing gas, Both of my kids love him. My doughter ended up not even getting the shot to numb, she just did the gas. Hope this helps. J

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Good Morning L.,
My two children ages 14 & 12 were deathly affraid of the Dentest. Both had a very tramatic experience. We now go to a pediatric dentist and he uses the laughing gas, Both of my kids love him. My doughter ended up not even getting the shot to numb, she just did the gas. Hope this helps. J

My son, who is four, just had his first dental procedure this past summer and had the nitrous oxide. He did wonderful and he even fell asleep during the procedure! They said that he probably fell asleep because he was so relaxed.

I will say that I was a nervous wreck the whole time, but what mom wouldn't be? He had no after pain and I was very impressed with the whole procedure and would do it again if needed.

Hi Linnetteyou know your child better than anyone. so far has he had good experiences with the dentist? Do you have a good child dentist who will make him comfortable and be patient with him? If you have any doubt my opinion is go with the conscious sedation the child will not remember what happened at all and you want the dentist to be a postive experience because you have several more years of child visits and just from personal experience try to make them as pleasant as possible. make sure your dentist is reputable and the anesthesiologist is on hand the whole time. Most insurances cover this when the child is 5 or under if you get a note from the dentist stating the child has fear issues with the dentist. good luck. it will be ok.one more thing i know you said he had a rough time with the shots at the doctor, my daughters dentist had to administer the sedation through a shot and although my daughter was scared she does not remember a thing.it was harder on me than her i think. its not easy watching your child being sedated but it was for the best she goes to the dentist no problem.sorry after reading the following comments what we had was NOT a kiddie cocktail she was put to sleep with one shot and the anesthesiologist was right there the whole time they wieghed her and everything went beautifully Dr. Libby on Channel 8 in phoenix did the several proceedures on my daughter and I wish i knew that option existed before i tried all the others " oxide" " kiddie cocktail" "just shots" this was amazing because there is no memory of the scary proceedure.

My 3 daughter had both done on her. The first time they did the Nitrous Oxide. It worked really well. She even fell asleep for awhile. But, since she had to have a lot of work done, it took a long time. She started to put her hand to her mouth after about an hour. I don't know if she started to feel or she was just feeling anxious. They ended up having to stop half way through (which was at 2 1/2 teeth). She never complained about it. For the second half of the procedure she had the conscious sedation. Which was scheduled a couple of months later. She did great before and after. She still loves going to the dentist. If i knew what i know now, i would have choosen the conscious sedation the first time. I didnt have a problem with the nitrous oxide, but, me and my daughter could have been saved a whole second trip to the dentist. I would say, that if its not such a big procedure go with the nitrous oxide.

Hey L.,

We just went through this with my 4 year old daughter. I took her to 3 different pediatric dentists this time around because she had cavities filled when she was 2 and it was a disaster. She had the kiddie cocktail the first time, and it made her combative. They papoosed her, and she freaked out. I regret it to this day. She didn't forget anything-still talks about it: "remember when I went to the dentist and I couldn't get away?" I finally felt comfortable with the last dentist we consulted with. She told me that it isn't unusual for kids who are strong-willed to have an adverse reaction to the narcotic part of the kiddie cocktail. Instead, they gave her a medication equivalent to a strong dose of Benadryl. After she relaxed a bit, they took her back and gave her the nitrous. I was there the whole time, outside the room, but able to observe. There were a few tears toward the end, but I think all-in-all my daughter did exceptionally well considering her first experience. Our dentist told me from the beginning that if Ellie protested too much, they would stop the procedure, and we'd try again another time. I would extract that same promise from your dentist. If your son does well now, you may not have to worry about the aforementioned information, but it should give you pause to know that all children do not respond to the kiddie cocktail in the same way. I'd find out exactly what they are going to give him and ask about the narcotic part of the cocktail, then go with your gut. Don't let them restrain him, whatever you do. It was terrible, and it's definitely had long term consequences for my daughter. You can always go back another day if you have to.

Good luck,


I worked as a dental assistant at a pediatric dentists office for several years and I would recommend conscious sedation. Nitrous Oxide definately works for most people but sometimes even that didn't help enough and we weren't able to get the work done. When we used the conscious sedation the kids were much more relaxed and we were better able to get the work done quickly and efficiently. You will need to keep a close eye on your little one after the procedure until the medicine wears off which you wouldn't have to do with nitrous but if it were my child I would do the conscious sedation. The nice thing about conscious sedation is they don't really remember what happened so even if it is a difficult experience the odds of him remembering it are slim.

I feel for you because our youngest had dental work done about 2 months ago. She has had severe episodes of ketotic hypoglcemia and when she fasts, her b/s drops dangerously and is difficult to arouse. We had actually put hers off for about 12 mo with dental advice because with conscious sedation they have to have fasting prior to the procedure.

Our kids have had experience with both and they do 'not' remember the sleepy juice day at all, which is nice in that aspect. My oldest still remembers the injections and the nitrous route.

Just keep in mind, that you want the first available appt for the little ones (fasting is harder on them and easier if the majority of the time is while they are normally sleeping). Also, have a drink of juice or something on hand when he/she does wake up. It will help them and you! They may sleep the rest of the day as well so don't plan on alot of activity.

Best of luck!

Hey I've had both done with my 3 yr old and will never do conscious sedation unless it was the only option. I also recommend getting a second opinion. I ended up taking my child to a regular dentist over a pediatric dentist and he filled what we were told was a major cavity needing a pulpotimy (I no longer trust pediatric dentists) Another thing I didn't like about the conscious sedation was that he was strapped down to a board and we were not allowed to be in the room with him. He had bruising on his neck for a month afterwards. With the nitrous oxide my son was also given the shot that they would use to work on your teeth (though I am sure a smaller dose) Therefore he didn't feel the pain.
*ON a side note my regular dentist is also my cousin which I am ten times more comfortable with working on my precious babies.

I feel for you- we had to do this last year and we researched every option. My daughter was 5 at the time and it was not a fun decision.
We went with the sedation- she drank the cocktail and did not like it. They had to put her in a little straightjacket and my husband was back their the whole time. She still felt the injections etc but did not remember anything. It was not easy for my husband to watch but important that we knew what was happening.
They will most likely push for you to not be back there so they can do their job- however I dont ever see anyone allowing their child to go back with strangers and feel comfortable. I think it is because of how they still do react to everything even though they have the meds. They failed to tell us that so my husband was caught off guard.
I hate to be so detailed- not to make things worse but to give you an honest experience one parent to another. You deserve to know all of it and make the best decision for your son. If you want to talk more we can, just let me know:)

I wouldn't choose either for my child that young if I could do something different. Being conscious and trapped in your body while someone manipulates it is horrifying and the stuff nightmares are made of - whether you can react to pain or not the brain processes it and remembers. Be sure you are not letting them put any metal fillings in as well or your son will start to suffer from heavy metal poisoning. Have you sought the opinion of a more holistic dentist? There is a nice lady in Green Valley that I took my son to after the man we had been using botched the same filling twice. Also, now that I know about it, I would try Sangre de Drago before I let any dentist touch my kid and give him drugs or install toxic substances. Good luck.

My son has had extensive dental work (more virulent form of bacteria in his mouth per the dentist!) and we went with conscious sedation because he tends to fight the meds and won't fall asleep with just the laughing gas. There is very little risk with either but I think it depends on your child's temperment. I didn't want my son to remember any of the procedure and that works best with conscious sedation (he was just 3 for the first procedure - 7 cavities that formed over a 6 month period!). Now he is 8 and only remembers going to sleep and waking up sometime after the procedure.
Good Luck
M. B.

So sorry you and your son have to deal with this. It isn't fun! My son had the conscious sedation when he had just turned 6. They called it the "kiddie coctail". Everything went well for him. He says now that if he had to have more dental work done, he would want to do the kiddie coctail again. Hope everything goes okay for you guys.

My DD#1 who is now 5 had two caps put on when she had just turned 4. We did the conscious sedation and it turned out wonderfully. First was the kiddie cocktail. Then she was put on the chair and wrapped in a blanket that she chose. (This is done for the dentist's safety as well as the child's. Heck, the dentist is in your child's mouth with sharp instruments... don't want a wiggly child when there's sharp things in their mouth!) Where I go, they ask that the parent(s) wait in the waiting room which is 15-20 feet away, but if you want to stay they have no problem with that. I waited in the waiting room because I had to bring my DD#2, so every 10 minutes another assistant would come out and let me know what was going on. The dentist and the dental assistant did the work while my DD#1 told stories and jokes. After the procedure, the dentist gave me juice and jello to give to my DD#1. Later that day and the next morning, they called to see how she was doing. DD#1 doesn't remember a thing. So for DD#1, conscious sedation was the way to go! It worked great, although nerve-wracking for me!

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