Pediatric Provisions: Does Insurance Cover Sedatives for Kids?

Many people get nervous when it comes time for their dental appointment, and children are no exception. An estimated 20 to 50 percent of kids struggle with anxiety, regardless of the reason for their visit to their pediatric provider.

Your dentist can provide sedation to help them feel calmer and more comfortable throughout their examination or procedure, but many parents are unsure whether their dental insurance includes these medications. If your child is dreading an upcoming appointment and you’d like to ease their worry, continue reading to learn more about it!

Can Kids Undergo Dental Sedation?

One of the first questions many parents and guardians have is whether the medications used for dental sedation are safe for children. Thankfully, there’s more than one type of sedation, so if your little one is allergic to or doesn’t respond to one kind, they might still benefit from the remaining options.

For instance, nitrous oxide (laughing gas) is inhaled through a mask placed over your kid’s nose while the dentist works. It slows their brain’s response to external stimuli but keeps them awake, so they remain relaxed but conscious. This is considered safe for most people if a professional administers it.

If that’s not feasible for whatever reason, IV sedation is also considered safe, though our team will closely monitor your child’s status while it’s administered to ensure their safety. The effects of this drug are considered more intense and might be reserved for those with extreme anxiety or invasive or complex treatments.

Does Insurance Cover Dental Sedation for Kids?

Dental insurance is set up to promote preventative care by covering up to 100 percent of basic services, though it might only cover 50 to 80 percent of other treatments required to address problem areas, like root canals, dental crowns, or other restorations.

Unfortunately, most plans categorize sedation as a “luxury” and unnecessary for improving patients’ dental health, so they don’t always include it among their benefits. However, there may be exceptions in certain circumstances. For example, if your child must undergo oral surgery to improve their dental health,  general anesthesia may be deemed medically necessary, and therefore might be covered by your policy.

How Much Does Dental Sedation Usually Cost?

It’s natural to wonder how much you might expect to pay out-of-pocket for dental sedation for your child, though the final amount depends significantly on their unique situation. These medications can range anywhere from $150 to $200 for mild sedatives, though it could be more or less based on your location, your provider, the length of your child’s procedure, etc.

If you think your child might benefit from sedation, the best way to learn more about the cost and whether they’re a good candidate is to consult their pediatric dentist!

Meet the Author

Dr. Amar Singh has a decade of experience helping children aged 0 to 18 build and maintain their happiest, healthiest smiles. He earned his dental doctorate from the Howard University College of Dentistry, and today is a Board-Certified Pediatric Dentist and a trusted member of several prestigious organizations, including the American Dental Association. He provides a complete array of services for still-developing teeth, including nitrous oxide and general anesthesia to help your kid feel comfortable throughout their procedure. You can request an appointment on the website or by calling (215) 874-3786.