During an emergency dental visit in which a tooth is to be extracted due to extensive pulpal involvement, a moderately mentally challenged 5-year-old child becomes physically combative. The parents are unable to calm the child. What should the dentist do?
For any child patient, it is imperative to discuss any kind of physical restraint with the parent to obtain an informed consent. An informed consent includes recommended treatment, reasonable alternatives to that treatment, and the risk of no treatment. If the dentist wants to use a firm voice control, it is recommended that a discussion take place beforehand, as well.
Discuss the situation with the parents.
Force the nitrous oxide nosepiece over the child’s mouth and nose.
Use the hand over mouth exercise (HOME).
Use a firm voice control.