Need HELP, Hive!! Can a child be over-sedated w/ Nitrous Oxide by a dentist??

[Amy+2]

My ds10 went to have a small cavity filled.

 

Background info: It was NOT his first cavity, he has had probably 4 maybe 5 filled in the past. When we lived in Ohio we went to the same Pedodontist for almost 8 years, who my kids LOVED! We recently moved to Texas and went to just a Family Dentist Practice right down the road.

 

Anyway, took him in Wednesday for this filling and not only did it take over an hour, when they called me back to speak with me, I walked through the door and when I saw him standing there...I was SHOCKED! His eyes were completely glossed over, he had drool all over his face. I swear he was in a complete fog and unaware it was even me talking to him. (He remembers none of this, btw) His shirt was in a garbage bag that the assistant handed to me as she said, "He got sick when we were finished.". I was speechless. She then proceeds to ask me if he has ever been under Nitrous before and I tell her, "Yes, every filling he has ever had and he has NEVER reacted like this.". She then says, "Did you feed him anything after midnight?"...I'm like, is she kidding me?!?!:blink: When we would go to the Pedodontist in Ohio, they would sometimes fill a small cavity right after our cleaning. It would take 20 minutes, TOPS, and there was never any concern about whether or not he had eaten anything, and he even got to pick the smell he wanted for the gas- bubble gum, grape, etc. Needless to say, I am just floored by this whole conversation and to make it worse they gave him water to drink and when we got home, he threw that up too. Before he threw up though, on the ride home, the only words he spoke were to tell me he could still taste the smell.:sad: By lunchtime, about 1 1/2 hours later, he was completely back to normal, with very little memory of what happened.

 

So, I am angry to say the least...What say the Hive? Over-Sedated or not???

[Stacia]

It sounds like he was over-sedated to me.

 

Yikes.

[i.love.lucy]

Wow! That's a really scary experience! It sounds to me like he was oversedated and I would certainly never take him there again. Can you find a pediatric dentist near you? It sounds to me like this practice is just not familiar enough with kids to have sedated him properly. You also said "when they called you back"...is this one of those places that doesn't let mom back with the kid. I don't do those offices. I have to have access to my kids at all times (unless I needed to wrangle a little one or something).

 

Sorry you and he had to go through that!

[Corraleno]

He was definitely over-sedated.

 

My DD has really bad baby teeth; almost every single tooth has been filled, pulled, or crowned and her four front teeth were capped when she was 2. She always has gas, and when she was tiny she also had the liquid. She has never reacted anything like that. I always go in with her, and I know that the assistant is constantly watching the monitor and watching DD, and she will turn up the nitrous a little if DD seems to be feeling something, and she will turn up the oxygen a little if DD seems a little too sedated. They monitor and adjust it constantly.

 

It sounds like the mix they gave your son was too much nitrous and not enough oxygen, and no one was monitoring it. Also, they should give 100% oxygen for several minutes after the treatment is finished, to make sure the nitrous is out of the blood stream and the child is fully conscious and feeling OK. I would definitely find a new dentist!

 

Jackie

[TwinMominTX]

I would ask for some answers and clarification from the dentist. I'd want to find out if he was over sedated or possibly had an allergic reaction the NO. His reaction doesn't sound normal and I'd want to get to the bottom of it to make sure it didn't happen again.

 

I wouldn't automatically jump to conclusions and immediately go on the defensive, but I'd be firm in getting clarification directly from the dentist for his future safety. They should keep some type of records on how much was administered or what period of time.

 

Poor guy.

[snickelfritz]

I've been over-sedated, so it is possible.

 

Under normal nitrous, I feel a little floaty and very relaxed.

 

When I was over-nitroused, it was hard to breathe in the mixture, the room was spinning and I had thoughts and feelings that were similar to being drunk. "I can't feel my toes. Do I have toes? I'm wiggling my toes, so they're still there. Woo---the room is spinning. Are they talking to me?" I didn't feel nausea, but it was definitely different from normal. I heard the assistant say something and they must have adjusted, because the feeling went away very quickly and was back to normal.

 

My experience with nitrous (and since they always allow me to drive home, it must be true) is that it is VERY short lived. Once it's turned off (including the time they had it too high) I feel back to normal VERY quickly. So, I would be concerned about a possible reaction to the nitrous in addition to being concerned about being over-nitroused. Definitely talk to your dentist about it.

[Corraleno]

This is from the Clinical Guideline on Appropriate Use of Nitrous Oxide in Pediatric Dental Patients:

 

Nausea and vomiting are the most common adverse effects, occurring in 1 to 10% of patients. A higher incidence is noted with longer administration of nitrous oxide/oxygen, fluctuations in nitrous oxide levels, and increased concentrations of nitrous oxide. Fasting is not required for patients undergoing nitrous oxide analgesia/anxiolysis. However, the practitioner may recommend that only a light meal be consumed in the 2 hours prior to the administration of nitrous oxide. Diffusion hypoxia can occur as a result of rapid release of nitrous oxide from the blood stream into the alveoli, diluting the concentration of oxygen. This may lead to headache and disorientation and can be avoided by administering 100% oxygen after nitrous oxide has been discontinued....

....Once the nitrous oxide flow is terminated, 100% oxygen should be delivered for 3 to 5 minutes. The patient must return to pre-treatment responsiveness before discharge

http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=7498&nbr=4443

 

If a child has had nitrous many times before, with no reaction, and suddenly reacts with vomiting and disorientation, I think it's reasonable to assume that the nitrous was not administered properly. Either the concentration was too high, or not enough oxygen was administered afterwards, or both.

 

Jackie

[ereks mom]

I've been over-sedated, so it is possible.

 

Under normal nitrous, I feel a little floaty and very relaxed.

 

When I was over-nitroused, it was hard to breathe in the mixture, the room was spinning and I had thoughts and feelings that were similar to being drunk. "I can't feel my toes. Do I have toes? I'm wiggling my toes, so they're still there. Woo---the room is spinning. Are they talking to me?" I didn't feel nausea, but it was definitely different from normal. I heard the assistant say something and they must have adjusted, because the feeling went away very quickly and was back to normal.

 

My experience with nitrous (and since they always allow me to drive home, it must be true) is that it is VERY short lived. Once it's turned off (including the time they had it too high) I feel back to normal VERY quickly. So, I would be concerned about a possible reaction to the nitrous in addition to being concerned about being over-nitroused. Definitely talk to your dentist about it.

 

:iagree:

 

I've been over-sedated too, and my experience was a lot like yours, Snickelfritz. I remember the room spinning and I remember blacking out to the point that I was unaware that the dentist was talking to me.

 

A few years before that experience, I had been in a really bad car accident, and while I was under the effects of the nitrous oxide, I had a hallucination that instead of being in the dentist's chair, I was actually in the emergency room after the accident. NOT a pleasant experience AT ALL.

[Amy+2]

Thanks for all the replies!

 

I knew it wasn't right. I just wanted lots of backup and research before going to confront these people about WHY we will be switching dentists, which should be obvious.

 

This morning, the receptionist called to schedule my younger son for his appointment and I tried to nicely let her know that before I scheduled ANY more appointments with them, I would be coming in to talk to them first about the incident with ds10. She became VERY defensive and wanted me to please tell her what the problem was. I just calmly stated that I believed that ds10 was over-sedated and that I would be coming in to speak to them about it. She got very uptight and was again defensive about it. She said that kids vomit quite often after the administration of Nitrous Oxide. :scared: All I could think was, yes, at your dental practice, they probably do.:glare:

[JeneralMom]

Where in Texas are you?

[Amy+2]

:seeya: jenr!

 

We are near/a tiny bit south of the Dallas/Ft Worth area in Mansfield.

 

I see you are from San Antonio. Not close enough for a recommendation, doggone it!

[Ali in OR]

I'll just add that kids can have dental work done without nitrous oxide. We used it once--my dd didn't like it. And our insurance doesn't cover it. For every cavity since then (and my youngest has had many), my kids have not had nitrous. At first they stayed calm with the promise of ice cream that evening (after numbness was gone) or the next day. Now they don't even need that.

[Amy+2]

I actually asked about not using it, and just letting him listen to his iPod to relax him instead, and they said that was not really an option that they always use nitrous on their younger patients. My insurance does not pay for it either.

 

I realize now that this practice obviously has no tolerance for kids and feels the need to 'knock them out cold' in order to not have any problems or struggles with children who may or may not be scared.

 

My kids are not nor ever have been afraid of the dentist. They loved Dr. Judy back in Ohio. She and her staff were awesome! I guess that this is the price I had to pay for not finding a pediatric dentist for them down here. Shame on me. Sacrificing for convenience and cost. It won't happen again though! Even if they are out of my insurance network, it is worth the slight over cost to have a good dental experience for my boys!

 

I may not even bother with going back in there to speak with them. In this case, maybe SILENCE will speak volumes!!;)

[Old Dominion Heather]

My kids have had LOTS of dental work done including a filling on a three year old and pulling a front tooth of a four year old. NONE of it was ever done with nitrous oxide, though they did numb the area with novicaine. I can't understand why ANY dentist would use the gas unless the kid was fighting them.

[Twinmom]

I can recommend a fabulous pediatric dentist in Richardson...a bit too far, perhaps, but he is awesome! He was once named best ped. dentist in Dallas, teaches at the dental school and could handle my child's rare and difficult dental disorder. His name is Dr. Robert Morgan. He did surgery on my DS while we lived in Dallas and we were just thrilled with the results.

 

If you can't find someone in Mansfield, it may be worth the drive.

[LinRTX]

I know of a great pediatric dentist in Fort Worth, probably about a 30 minute drive. My oldest started going when he was 2--that's 22 years ago. My third has enamel defects and had to have a cap very young. He is very good. All of mine have loved him.

 

Linda

[iammommy]

I'm so sorry your ds went through this. I would not let this drop with the dentist. They did something wrong, I am certain. Needless to say, you need to find another dentist, preferably one who specializes in children. Thank G-d your son is OK.

 

Nan

[homeschoolin'mygirls]

I can recommend a fabulous pediatric dentist in Richardson...a bit too far, perhaps, but he is awesome! He was once named best ped. dentist in Dallas, teaches at the dental school and could handle my child's rare and difficult dental disorder. His name is Dr. Robert Morgan.

 

 

He has an office in Irving as well, which would be closer to Mansfield. We've also had very good experiences with him.

[melmichigan]

This is from the Clinical Guideline on Appropriate Use of Nitrous Oxide in Pediatric Dental Patients:

 

 

http://www.guideline.gov/summary/summary.aspx?ss=15&doc_id=7498&nbr=4443

 

If a child has had nitrous many times before, with no reaction, and suddenly reacts with vomiting and disorientation, I think it's reasonable to assume that the nitrous was not administered properly. Either the concentration was too high, or not enough oxygen was administered afterwards, or both.

 

Jackie

 

:iagree: I would be looking for another dentist.

[Liz CA]

Wow! Good thing I never had nitrous oxide.

 

For the next appointment I would take the child to a pediatric dentist. They are probably more familiar with dosing anaesthesia for children than a dentist who sees primarily adults or at least fewer children than the pediatric dentist.

Pediatric dentists also have often a few "tricks up their sleeve" to calm young people down and make the whole experience less traumatic.

 

I am still remembering my ds first filling. The dentist told him something about bad bugs and a rabbit coming to eat those bugs but he has to scrape them off the tooth which may hurt a little. Forgot the details but I remember my ds trying to be tough and finally asking if the rabbit was done. :001_smile:

[Rebecca VA]

Your absence will not necessarily speak volumes. They may hardly even notice that you haven't come back. You really should write them a letter, at least, detailing everything that happened. You don't have to threaten them or anything, but you should them know that what they did was wrong and that they should change their ways.

 

If you find that your son's reaction has lasting effects, or if another patient of the practice is injured in the future, you will have written proof of what happened this week. You can say that you tried to warn them.

 

It's hard to be confrontational, but you really should say something. At least if you write a letter you won't have to deal with them in person.

[Amy+2]

Thanks TX ladies for the reference! I will be checking into this!:)

 

Also, I agree with you Rebecca VA. Probably best to let them know where I stand. I do plan on going into their office and confronting them face to face, NICELY, and then as I exit, asking for my kids' dental x-rays and records!:tongue_smilie:

[OHGrandma]

My daughter needed dental work very young, maybe about 3. She never got nitrous and didn't even know she got a shot until she was at least 8; our family dentist was very good with kids. But when I started taking our grandson to the same dentist at about 6, GS spazzed out so bad the dentist stopped in the middle of working on a small cavity. I took him to a pediatric dentist that prescribed valium, then used N.O. & a newer replacement for novacaine. I was always in the room with him(and our kids), and an assistant was always present. We've done that 3 times for him and he's never been anywhere near as loopy as you've described your son when he left the chair.

[Rhonda in TX]

They are not a pediatric dentist, but they work very hard at pampering their patients.

 

DS (my child with sensory issues) had to have a cavity filled. We had told him he would have to have a shot. DS had been in the chair for awhile and said, "Aren't you going to give me a shot?" The dentist replied, "I already did." Now THAT is a good dentist. :)

[2cents]

We never use the nitrous. We've found that the local is enough for most procedures. I had my wisdom teeth pulled with a local too. The nitrous actually kinda scares me.

[Laurie4b]

I would call your pediatrician and get advice from him.

[rjand6more]

I'm a dental hygienist.

 

My son needed a filling when he was 5 1/2. He had nitrous(he was very nervous...) He vomited. I assisted and I am sure he was not over sedated. The office is right, kids do sometimes throw up after. It can depend on if they just ate.

 

I would seriously prefer a gen dentist to a ped dentist almost in all situations. Why? I have seen the 5-10 min fillings and the 10 min stainless crowns that come out of these offices. At every ped office I know, the cleaning appointments are only 15 min!! I have friends(also hygienists) who have become so frustrated that they were not allowed enough time to do a good job.

[courtney.byrum]

Sounds like he definitely had to much nitrous and was allowed time to recover. My son (5) recently had nitrous oxide because he had to have 2 teeth pulled due to the adult teeth coming in behind the baby teeth. He was absolutely fine afterward with a few minutes of oxygen.

 

Our ped dentists are great with the kids. Each apt takes a good length of time and they get a thorough cleaning as well as quite some time with the dentist.

[Suzanne in ABQ]

His eyes were completely glossed over, he had drool all over his face. I swear he was in a complete fog and unaware it was even me talking to him.

 

 

I agree that it seems he was over sedated. But I'm quite surprised they even let him leave in this condition. He should have been in the chair, with 100% oxygen, until he was feeling completely normal again.

[Alphabetika]

I'm so sorry you and your son went through this. Given the reactions of the staff, I would advise finding a new dentist, and telling this dentist why you've done so.

 

My oldest dd had to have four adult teeth pulled for orthodontic reasons when she was 13. Our insurance doesn't cover nitrous but we sprang for it in this case because the dentist told us that many patients are disturbed by the sound of their teeth cracking (which they sometimes have to do to get them out) and their heads being wrenched around a bit. She left it up to us, and of course was also going to give novocaine. We actually left it up to dd - she's not afriad of the dentist but I thought she might appreciate the extra relaxation, and she chose to try it.

 

I was so thankful we did the nitrous because the procedure took longer than expected and was apparently more "violent" than they expected (the kid has good roots!) Anyway, when they called me back to get her, I got there just as they took the teensy little nose mask off. She looked up and me and said, "Hi, Mom." I had not had any nitrous experience and was amazed at how normal she was. As soon as she stopped breathing it, she was herself again. I thought she would at least be woozy, but no. We went home and she had as normal a day as she could have with gauze stuffed in every nook and cranny of her mouth. We still have the little bag of teeth hanging on our fridge two years later. :tongue_smilie:

 

I've since learned that dh's stepsister is so terrified of the dentist that she gets nitrous every time, even just for a cleaning. Wow - it cost us $150 extra, so it's not something we'd do every time, but if either of my other dd's ever has to have a procedure like this again, I will consider it well worth the $!