Your Child And Nitrous Oxide

Some Benefits of Nitrous Oxide Analgesia:

  • Provides mild relaxation
  • Mild pain reliever, enabling our dentist to do small fillings without numbing
  • Reduces gag reflex
  • Has no residual effects following the appointment
  • Patient receives five minutes of 100% oxygen before leaving the chair

Before Your Child’s Nitrous Oxide Appointment

Some children will cry upon seeing a parent after treatment. (This may happen as the nitrous oxide leaves their system.) Please avoid showing emotion as this may increase your child’s distress. Always be positive about their visit.

Some children become nauseous after receiving N20 if they have had food or milk. To lessen this side effect, please DO NOT allow your child to eat solid foods or have anything to drink (other than clear liquids) for at least three hours before their dental visit.

If your child is congested a couple of days before, or on, the treatment date, we will need to reschedule this appointment. You will need to give our office as much notice as possible in order to avoid a broken appointment fee.

Your Child And Valium

Valium Facts:

  • Mild, safe, anti-anxiety medication. Your child will not be “knocked out”
  • It is very safe yet not too strong, so your child will be conscious throughout the procedure.
  • We use it in conjunction with nitrous oxide to help keep your child comfortable for their appointment. Nitrous oxide is very effective if someone is calm but if a patient is agitated, it may not be enough. Valium will often keep a child calm enough to allow the nitrous oxide to be effective.
  • It will also help minimize the gag reflex.
  • Comes in either a liquid or pill form (not chewable)
  • Rarely interacts with other medications

Before Your Child’s Valium Appointment

  • Make sure they have nothing to eat or drink three hours prior to their dental appointment.
  • Have a parent or responsible adult administer the valium at home, an hour prior to their dental appointment.
  • Valium remains in the system for up to six hours, so you must supervise your child for at least six hours after the dose. Do not have your child return to school the day they receive valium.
  • Only bring the patient with you to their appointment. Keep siblings (older or younger) at home, unless they are also being seen by Dr. Scott L. Weinstein that same day.
  • Make sure your child keeps their chin up on the drive home and that they are breathing well.
  • If your child develops a cough, cold, congestion or fever a couple of days before (or on the treatment date), we will need to reschedule their appointment. You will need to contact our office with as much notice as possible to avoid being charged a broken appointment fee.

Pre-Sedation and General Anesthesia Instructions

A sedation or hospital fee is required to schedule these appointments. The estimated portion (not covered by insurance) is due two weeks prior to the appointment. Unfortunately, we are unable to make exceptions to this policy.

  • Treatment may change during the procedure, especially if we do not have X-rays available prior or if the child was very uncooperative for an ideal dental examination. Full payment is requested at the time of service.
  • If your child is sick or has congestion within several days of the appointment, please contact our office at 704-752-1900. Our team can see if they need to be rescheduled to another time.
  • Make sure your child has nothing to eat or drink after midnight on the night before their appointment.
  • Please make sure there is no nail polish on your child’s fingers or toes, since we may be attaching a special monitor at these locations.
  • Ideally, two responsible adults should accompany the child to the appointment.
  • Make sure you arrive at least 15 minutes early if the appointment is at Ballantyne Pediatric Dentistry. If the procedure is being done at the hospital, please arrive at the specified time.

Sedation & Hospital Dentistry

Nitrous Oxide

Nitrous oxide, or laughing gas, is the most frequent method for easing mild to moderate anxiety in children. It is also a mild analgesic and enables Dr. Weinstein to do small fillings without the need of an injection. When used for larger restorations, it makes the numbing a lot easier for children. Nitrous oxide can be easily administered through a small mask that fits over your child’s nose. Your child will be asked to breathe through their nose and not through their mouth. As the gas begins to work, your child will become calm, although they will still be awake and able to talk with our dentist.

At the end of your child’s appointment, they will resume breathing regular oxygen for five minutes, and all the effects of nitrous oxide will disappear. Nitrous oxide is an adjunct but may not always be adequate for very anxious children.

Oral Conscious Sedation

Moderate oral conscious sedation can help your child to cope with severe fear or anxiety and cooperate with dental procedures. Dr. Weinstein utilizes Versed sedative, which not only has little risk for respiratory depression but has an amnesiac (loss of memory) effect. This means that most children will not even remember the procedure. It is a very safe and cost-effective option. Dr. Weinstein holds a moderate conscious sedation permit. Our dentist is also an evaluator for dental office sedation permitting for the North Carolina State Board of Dental Examiners. For each patient, he will follow the sedation guidelines of the American Academy of Pediatric Dentistry.

General Anesthesia

General anesthesia sedation is recommended for children that have a high level of anxiety or have an inability to cooperate in a normal dental setting. This may include nervous children, very young children or children with special needs that would not work well under oral conscious sedation. Dr. Weinstein will perform the dental treatment in our office; however, your child will have the benefit of general anesthesia administered and monitored by our dental anesthesiologist, Dr. Charles Cangemi.

General anesthesia will put your child into a deep sleep. They will be unable to feel pain or move around. Dr. Charles Cangemi is trained to deliver medication, monitor your child during the procedure and handle any complications that may occur.

To prepare your child for general anesthesia, follow the guidelines given to you by the doctor regarding food and fluid intake before and after the procedure. Discuss the procedure with your child using simple terms that he or she can understand. Let your child rest quietly at home after the procedure. They will most likely be ready to resume their normal schedule the day after their procedure.

The child’s parent or legal guardian must remain at the office during the entire procedure both induction and wake up. Because of the important nature of the treatment, we strongly recommend that a second adult be available to drive the child home so that one parent is able to sit with the child.

Dr. Cangemi requires our office to pay for the anesthesia fees at the time of service. Therefore, we collect his estimated charges prior to the date of the procedure. He sets his own fees and is not in-network with any insurance provider. It is at your discretion if you wish to file a claim with either your dental or medical insurance provider for reimbursement. Our office cannot make any estimates or guarantees about the reimbursement for these out-of-pocket costs. Our staff will be happy to give you the proper codes to assist you in filing your claim.

Pediatric Hospital Dentistry

If your child cannot receive dental care in a traditional dental office, our practice offers gentle and effective dental care to infants, children and adolescents in our nurturing environment. We are one of the only pediatric dentists in the area to offer this unique service. Our pediatric dentist has the distinctive ability to understand the specific needs of children who need dental care but cannot cooperate for safe dental treatment. Through hospital dentistry, you can eliminate the struggles and trauma that can lead to a child’s lifetime fear of dental treatment.

Is hospital dentistry right for my child?

Pediatric hospital dentistry services are ideal for:

  • Physically, emotionally or developmentally challenged children who are unable to hold still for dental treatment
  • Children with a severe gag reflex.
  • Children with complex medical conditions that make it unsafe to receive dental care in an office situation.
  • Children who have allergies to local anesthetics or are resistant to numbing treatments.
  • Children who need oral surgery or other serious treatments that would be difficult for a child to tolerate while awake.

For these situations, the use of general anesthesia may be the best option for your family.

Insurance

Here are some details regarding Insurance:

Your dental insurance is based upon a contract between your employer and the insurance company. Should questions arise regarding your dental insurance benefits, it is best for you to contact your employer or insurance company directly.

Dental insurance benefits differ greatly from general health insurance benefits. In 1971, dental insurance benefits were approximately $1,000 per year. Figuring a 3% rate of inflation per year, you should be receiving $3,300 per year in dental benefits. Your premiums have increased, but your benefits have not. Therefore, dental insurance is never a pay all; it is only an aid.

You may receive a notification from your insurance company stating the dental fees are higher than usual and customary. An insurance company surveys a geographic area, calculates an average fee and takes 80% of that fee and considers it customary. Included in the survey are discounted clinics that take dental maintenance organizations (DMO) plans, which bring down the average. The fee-for-service dentists in private practices will have fees that insurance companies define as higher than usual and customary. Our practice is a high-quality practice, offering the some of the best dental services available! We are not a cut-rate practice. Instead, we offer total dental care for our patients to keep their teeth healthy for life. If you have any questions before your child’s dental operation in Charlotte, North Carolina, phone our office at 704-752-1900.