Is sedation safe for children? How it can help avoid a General Anaesthetic

If your child is anxious about dental treatment, you may have been told they need a general anaesthetic (GA) in hospital to complete their care.

For many families, that can feel overwhelming.

In some cases, however, treatment can be safely carried out using inhalation sedation — allowing children to remain awake, calm and cooperative without needing a hospital-based procedure.

As a Specialist Paediatric Dentist, I regularly support anxious children using behaviour-led techniques and, where appropriate, inhalation sedation to help them accept treatment safely and comfortably.

What is Inhalation Sedation?

Inhalation sedation (sometimes called “happy air”) involves breathing a carefully controlled mixture of nitrous oxide and oxygen through a small, soft nasal hood.

It helps children feel:

• Relaxed

• Less worried

• More confident

• Less sensitive to discomfort

  
  

Importantly, children remain awake, responsive and able to communicate throughout.

They are not asleep.

Is sedation safe for children?

Yes — when provided by appropriately trained clinicians, inhalation sedation is very safe.

Safety measures include:

• Careful medical history assessment

• Continuous supervision

• Oxygen monitoring

• Dose titrated individually

• 100% oxygen given at the end of treatment

  
  

The effects wear off quickly, and most children return to normal within minutes.

It is very different from a general anaesthetic.

How can sedation help avoid a General Anaesthetic?

Some children are referred for general anaesthetic because:

• They are extremely anxious

• Previous dental attempts have failed

• They require multiple treatments

• They are unable to tolerate local anaesthetic

  
  

In many cases, with careful behavioural support and inhalation sedation, children can successfully complete treatment in the dental setting.

This can:

• Avoid a hospital admission

• Avoid full unconsciousness

• Reduce waiting times

• Allow staged, conservative treatment

• Help build long-term dental confidence

  
  

General anaesthetic is sometimes necessary — but it should not always be the first option.

When is sedation appropriate?

Sedation may be suitable for children who:

• Are anxious but communicative

• Have had previous negative experiences

• Need restorative treatment

• Would struggle with injections

• Are motivated but fearful

  
  

It is not suitable for every child, and assessment is always individual.

Behaviour management comes first!

In our practice, we focus first on:

• Tell–Show–Do

• Videoglasses as a distraction

• Positive reinforcement

• Child-centred communication

  
  

Sedation is used as a supportive tool — not a shortcut.

This approach helps children feel safe, respected and in control.

The benefits of avoiding a General Anaesthetic

While general anaesthetic has an important role in paediatric dentistry, avoiding it where possible can:

• Reduce medical risk

• Avoid fasting requirements

• Prevent hospital-related anxiety

• Allow children to develop coping skills

• Provide a more positive dental experience

  
  

For many families, being able to complete treatment calmly in the dental chair is a significant relief.

Frequently asked questions from families that I see

Will my child be asleep during sedation?

No. Your child remains awake and able to respond throughout.

Is sedation the same as general anaesthetic?

No. General anaesthetic causes full unconsciousness in a hospital setting. Inhalation sedation keeps children awake but relaxed.

How quickly does sedation wear off?

Very quickly. Oxygen is given at the end of treatment, and most children feel normal within minutes.

Is sedation suitable for very young children?

Suitability depends on age, communication ability and medical history. Each child is assessed individually.

Can sedation replace general anaesthetic in all cases?

No. Some complex or extensive cases may still require GA. However, many anxious children can be successfully treated using sedation.

Can my child use the videoglasses with the sedation at the same time?

Absolutely! Anecdotal evidence shows that children have a more positive experience of dental treatment when used in combination with sedation.

If your child is anxious about dental treatment, or you have been advised they may require general anaesthetic, we are happy to discuss whether inhalation sedation could be a safe and appropriate alternative.

For further information on inhalation sedation, please find the link to Great Ormond Street Hospital's advice page

Inhalation sedation for dental procedures | Great Ormond Street Hospital