Preoperative Instructions

Preoperative Instructions

Your Child And Nitrous Oxide

Some benefits of Nitrous Oxide Analgesia:

Provides mild relaxation
Mild pain reliever, enabling us to do small fillings without numbing
Reduces gag reflex
Has no residual effects following the appointment
Patient receives 5 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 (honeymoon type feeling is over from nitrous because it is out of their system. Please avoid showing emotion as your child will follow your lead. Be positive about the visit.


Some children do become nauseous after receiving N20 if they have had food/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 3 hours prior to 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 contact our office with as much notice as possible to avoid having a broken appointment fee charged to your child’s account.

Your Child And Valium

Valium Facts:

Mild, very safe, anti-anxiety medication, your child will not be “knocked out”
It is very safe yet it is not very strong, so please do not expect it to”knock your child out.”
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 a gag reflex.
Comes in either a liquid or pill form (not chewable)
Rarely interacts with other medications

Before Your Child’s Valium Appointment

Nothing to eat or drink 3 hours prior to their dental appointment.
To be given by a parent or responsible adult at home, 1 hour prior to their dental appointment.
Valium remains in the system for up to 6 hours, so you must supervise your child for at least 6 hours after the dose, and your child may not return to school that day.
Only bring the patient with you to their appointment, no siblings (older or younger) that are not being seen by the dentist that day.
Make sure child keeps his/her chin up while driving 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 this appointment. You will need to contact our office with as much notice as possible to avoid being charged a broken appointment fee.

Pre-sedation/General Anesthesia Instructions

The sedation/hospital fee is required to schedule these appointments, and the estimated portion not covered by insurance is due 2 weeks prior to the appointment. Unfortunately, we are unable to make exceptions to this policy.


Treatment may change during the course of the procedure, especially if we do not have x-rays available prior, the child was very uncooperative for an ideal dental examination, etc. Payment of the remainder of the estimated portion 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 to see if they should be rescheduled to another time.
Nothing to eat/drink after midnight the night before the appointment
Please make sure there is no nail polish on your child’s fingers/toes, as we may be using a special monitor to attach there.
Ideally, 2 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 and the specified time if the procedure is being done at the hospital

Sedation & Hospital Dentistry

Nitrous Oxide

Nitrous oxide, or laughing gas, is the most frequently used method for easing mild to moderate anxiety in children. It is also a mild analgesic enabling Dr. Scott to do small fillings without the need of an injection. And when utilized for larger restorations, it makes the numbing a lot easier for your child. Administered through a small mask that fits over your child’s nose, it is an effective way to calm anxiety. Your child will be asked to breathe through his or her nose and not through their mouth. As the gas begins to work, your child will become calm, although he or she will still be awake and able to talk with the dentist.


At the end of your child’s appointment, he or she will resume breathing regular oxygen for 5 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 more severe fear and anxiety and cooperate with dental procedures. Dr. Scott utilizes Versed which not only has minimal risk in causing any respiratory depression but has the added benefit of an amnesiac (loss of memory) effect. Most children will not even remember the procedure. It is a very safe and cost-effective option. Dr. Scott holds a moderate conscious sedation permit and is also an evaluator for dental office sedation permitting for the North Carolina State Board of Dental Examiners. He also follows 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 and have inability to cooperate in a normal dental setting such as apprehensive children, very young children, and children with special needs, that would not work well under oral conscious sedation. Dr. Scott 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. He or she 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. He or she will probably be ready to resume their normal schedule the next day.


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 the parent is able to sit with the child.


Dr. Cangemi requires the office to pay him 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 to either your dental or medical insurance provider for reimbursement but 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 the nurturing environment at CMC. As 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 lifetime fear of dental treatment for your child.


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 that have 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 experience difficulty achieving numbness
  • Children who need oral surgery or other dental treatment that would be difficult for the child to tolerate while awake

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



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 not. Therefore, dental insurance is never a pay all; it’s 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, takes 80% of that fee and considers it customary. Included in the survey or discounted clinics that take dental maintenance organizations (DMO) plans, which bring down the average. The fee-for-service specialty dentist have in private practice will have fees that insurance companies define as higher than usual and customary. Our practice is a high-quality practice, offering the very best in dental services available! We are not a cut rate practice rather we offer total dental care for our patients as we want them to keep their teeth in an optimum state for a lifetime.

What Our Clients Say...

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  • "Excellent service and care. I 'm very happy I chose Ballantyne Peadiatrics for my daughter. Thank you"

    -Megan Mehta

    May 05 2016
  • "They work really well with children. This was my son\'s first time going to the dentist and they made both my boys feel very comfortable and it was just an excellent overall experience Thank you do much"

    -Felicia Hernandez

    Mar 16 2016
  • "Great service, kid-friendly, very knowledgeable dentist and staff."


    Mar 16 2016