Large number of people is afraid of going to the dentist. They feel it as unpleasant experience. In certain cases, anxiety or dental fear is severe that may dread the thought of going to the dentist, that they cancel appointments, delay seeking care, and sometimes wind up needing more invasive and painful procedures as a result. Anxious patients cannot tolerate even routine cleanings and check-ups. Conscious sedation dentistry allows patients to relax and accept the dental treatment quietly. Dentist can accomplish in one visit what might have otherwise taken several appointments. Gum treatments, implants, smile restorations, and more can be accomplished comfortably. Dental Sedation techniques include nitrous oxide (laughing gas), oral conscious sedation, and intravenous sedation. Many patients prefer nitrous oxide, which is a gas that is mixed with oxygen and inhaled through a small nose piece during a planned procedure. With oral conscious sedation, the patient takes a small pill before an appointment, which produces a delightful feeling of relaxation and NO memory of the procedure. Patients with special needs, or those requiring lengthy visits, might need intravenous sedation. Intravenous sedation is anesthesia administered through a vein during the dental visit to ensure comfort and maximum relaxation.

In children, concsious sedation can decrease the anxiety and fear of dental procedures and allow treatmen to be completed effectively and efficiently in save situation to child and staff. differen rout have been used to delivered the sedation such as inalation of nitrous oxide/oxygen via nasal mask which minly indicated for apprehensive child who can communicate well with others and also to manage high gaging reflex.

Oral sedation used in children either single agent or combination of more than one drugs. currently, the most common oral sedative drugs are midazolam, hydroxazine, mepridine.also intranasal sedation can be used and the druge of choice is midazolam.Pediatric dentist who are planned to use sedation shoul have enough training and use monitors during sedation for patient safety.

I don't totally agree with conscious sedation ...I have seen patients who after the treatment under conscious sedation still have anxiety and fear....I guess such patients if treated with good behaviour management can be handled it might take some time but nothing is impossible..

decision making skills is what we have to develope, esp., when working on children

i have not seen any pediatiric surgeon using behavior management to deliver treatment . They have concluded that to deliver best , do under GA.

In my opinion if a child is anxious or visibly nervous use of pharmacologic methods is good for both..

Possibly G.A is a better option than conscious sedation.

GA is any day better, other than cost implication, we are in total control of airway and CVS, why try heroic attempt on near impossible case ( trying to manage by Non Pharmacological methods) to prove you are Pedodontist.

conscious sedation has its own demerits. ie., It is used in co-operative, but anxious child. which can always be managed with behavior shaping techniques

i think if more no. of children are taken under GA at paediatric dental clinic that means he/she is not a good paedodontist!

I Had recently visited Queen Mary Hospital ( prince philip dental college) of Hongkong university as academic visitor and had observed numerous cases in their OT.. They even do minor extractions and impactions and other minor surgical procedures under GA / sedation..It mainly depends upon patient's compliance , socioeconomic status and also the need of it depending upon the age , neurologic status and systemic conditions thus involved..Hence practicing dentistry under GA/sedation isnt that bad if patient is interested and also to avoid any medicolegal situations thereafter if options arent given to patients prior to any surgical procedure involving risk.Informed consent is a must