Cary Pediatric Dentistry
Robert D. Elliott, D.M.D., M.S.
Julie R. Molina, D.D.S., M.S.

540 New Waverly Place, Suite 300
Cary, NC 27518
(919) 852-1322

Regular office hours:
M-Th: 8:20am-5pm,
Closed for lunch 1pm-2pm
Fridays: 8:20am-3pm

Summer Hours:
July 22 – August 29, 2019
Monday through Friday 8am-3pm

Triple Sedation (Chloral Hydrate, Hydroxyzine & Meperidine)


For moderate to long treatment procedures, no oral medicine has proven more safe or effective for anxious or difficult children five years of age or younger than chloral hydrate when used in combination with hydroxyzine (vistaril) and meperidine (demerol).

Useful characteristics include :

  • Induction of sleep planes/somnolence or sedation

Minimal risk characteristics and side effects can include :

  • periods of agitation (pre and post sedation)
  • extended somnolence (difficulty in arousal)
  • upset stomach

When used in combination with hydroxyzine (an anti-emetic or anti-vomiting medicine), an upset stomach is usually prevented. Addition of meperidine has been found to permit lower doses of chloral hydrate use, reducing the potential for somnolence and significantly shortening recovery. Meperidine also has the characteristics of providing analgesia (pain control) to increase sedative and calming effects to prevent arousal when stimulated with the dental drill or injection of novocaine. The properly sedated patient will appear asleep but still retains the ability to respond to Dr. Elliott’s or Dr. Molina’s voice.

Dr. Elliott and Dr. Molina uses the triple combination of chloral hydrate, hydroxyzine and meperidine to:

  • allow the patient to “sleep” during their dental treatment (somnolence),
  • prevent the patient from remembering any portion of their dental treatment (retro-amnesia) even if they were to awake during the procedure, which in turn decreases any anxiety about coming to the dentist and promotes a positive attitude toward dentistry,
  • utilize a systemic pain medication (analgesia) which often will prevent the need for a shot of local anesthesia (novocaine) and decreases the arousal of the patient during treatment.

Dr. Elliott or Dr. Molina will give your child these medicines in a liquid form. They can be taken by cup or by a “squirter” (syringed in the mouth similar to children’s Advil or Tylenol). The onset of action is usually between 45-60 minutes. During this time, you and your child may watch a movie in Cary Pediatric Dentistry special “movie room” where there is a rocking chair, a futon couch and a TV/VCR for your comfort.

After this initial pre-op sedation time, Dr. Elliott or Dr. Molina will carry your child to the treatment room and place them in a “hug blanket” for their comfort and protection during treatment. These medicines give Dr. Elliott or Dr. Molina a “window of opportunity” of approximately 45 minutes treatment time. Once the procedures are completed, Dr. Elliott or Dr. Molina will arouse your child and bring them back up front where he will review the post-sedation instructions with you.

This triple combination loses it’s potential to consciously sedate children who are
older than five years old or weighing more than 50-60 pounds.

Our mission is to provide specialized and comprehensive care for infants, children, and adolescents in a friendly, safe, and state-of-the-art environment with a focus on prevention and education for the families. Dr. Elliott, Dr. Molina, and our TEAM are here to positively change this generation’s view of going to the dentist, one child at a time.