Anesthesia for Child's Dental Work
help! My 15 month old has severe tooth decay due to excessive nursing especially at night. My dentist has suggested a temporary filler that releases flouride and brushing religiously. I brush 10 times a day and it's not helping and he isn't ready to cut back on nursing. Dentist wants to wait as long as possible to either fill or cap the teeth, but I'm worried if we wait too long they will have to extract them or at best cap them when if done now they can probably be filled. The problem is that the dentist says he is too young for the gas because he can't keep the mask on. So the options are strapping him down without sedation which seems cruel or general anesthesia which scares me immensely! Anyone have any experience in this? Thank you
I have a special needs son and we have done both. Although we live in the East Bay, we went to UCSF for his dental care because of the sedation - the cost was split between medical ins for the use of the hospital and staff; and dental ins for the dental services.
While I would prefer to keep him sedated for his visit, it becomes an all day event for us. The usual no food after midnight and then recovery time. But, then again he doesn't remember it and we are all better for it. We stopped this because the dentist felt at 4 times a year, it really wasn't a viable option for us.
So we've done the strap down method and it was harder for me than it was for him. He struggled and screamed and then eventually settled down. After the visit, he was upset with me for allowing this to happen him. Needless to say, he recognizes the dentist office now and he becomes fretfully as we wait our turn. Its full blown by the time we're in the chair. However, the screaming session seem to get shorter at each visit. Good luck. Been There
My 2yr. old son has 8 cavities the pedi dentist say may be due to nursing at night. The only way to fix the cavities would be to use general anesthesia for the procedure. I've been to two experienced pediatric dentists and they can offer no other alternatives. And they advise I stop Breast feeding. Does anyone know of any other holistic approaches to this situation??? I am heartbroken, and could really use some advice. Thanks. Jennifer S.
I'm sorry I can't offer any advice on holistic approaches. However, I just want to empathize. I know you are facing a difficult and very worrisome situation. My 2- year-old needed a partial root canal (and crown) and 4 other small cavities filled. I struggled with the idea of general anesthesia, but ultimately was SO glad we went ahead with it. My son was so wary of the dentist as it was. I think he would have been totally terrorized and traumatized if he had had any idea what was going on during his procedure. Instead, he was blissfully unaware. That night he even said ''That was a fun trip to the dentist'' because all he could remember was playing with the trains in the waiting area. There were, of course, risks involved with the anesthesia and he had a really hard time coming out of it, but overall the benefits greatly outweighed the costs for us. Liz O.
I cannot address the issue of nursing or how your child came to have so many cavities at such a young age. I did want to let you know that I had general anesthesia on my child to fill 6 teeth and it actually went pretty well. They squirted something up his nose to make him drowsy and then set up an IV for the general anesthesia. All he remembers is ''yucky medicine up my nose'' and then nothing. It was expensive but much less traumatic than more recently when he needed one filling and the dentist did it with him awake and scared. laura
General anesthesia is scary to most people, and nobody wants it for themselves or their children unless absolutely necessary. First and foremost I would like to say: Stop breastfeeding! The child is 2 years old, the benefits go way down after 13 months of age in terms of the health of their teeth - it actually becomes detrimental to the child's oral health. If you are not going to stop at least brush the child's teeth every time after breastfeeding --- and ESPECIALLY at night. Also floss their teeth once a day using little kid flossers.
In terms of the issue at hand you may have 2 choices:
1. You can get the treatment done with general anesthesia. it's scary, but most likely your child will be just fine, and will have no memory of the experience. It's a one time deal and you are done.
2. You can find a pediatric dentist who will use oral sedation (where the child is awake, but sedated) in combination with a papoose board. A papoose board is a restraining device, much like a straight jacket that holds the child in place while the dental work is done. 2 or 3 appointments may be needed to finish the dental treatment. This may be medicaly less scary, but may lead to long term major dental phobia for your child. Or you may be lucky and your child may remember nothing anyway. general dentist and mother
I would like some advice and reccomendations on pediatric dentist in the Bay Area. I have a hyperactive 4 year old. i just took him to a pediatric Dentist in pinole. They reccomended iv sedation because they said theyr'e was no other way but to put him out to work on x-rays, and four cavaties. I would like to know more about iv sedation and the risks involved before i proceed with on my son. Any comments and emails would be helpful in this dilemma i am having. Thank you naomi
Our son had sedation before he had 4 fillings & 4 root canals, all at the age of 2 1/2. The thinking behind this was the same as your dentist's -- a young child cannot be expected to sit through a long dental procedure. Even if he could, he likely wouldn't go to another dentist as long as he lived! Because we knew the risks of any anesthesia, we were referred to Ed Matsuishi in El Cerrito. He contracts with a pediatric anesthesiologist from Children's Hospital. We were greatly reassured to be under the care of an expert, and the entire experience was excellent. If your Pinole dentist does not use a pediatric anesthesiologist, I'd recommend calling Dr. Matsuishi. By the way, my son LOVES going to the dentist 4 years later! Christine
I would definitely get a second opinion from another dentist. My daughter got her first fillings when she was 2.9 with only a local anesthetic. Her dentist, Dr. Doshi, was TERRIFIC in keeping her engaged, distracted, and completely pain-free. She used a q-tip to dab some topical anesthetic (''sleepy juice'') on my daughter's gum, then held the needle in such a way that her hand blocked it from my daughter's view. While she was putting in the filling (''giving your teeth a shower''), she held my daughter's attention by telling her a story. She even had me blow up latex gloves and draw faces on them.
My daughter is now 9 and has had a lot of fillings since then. (Sigh...) She was recently VERY surprised to learn that there were shots involved in her dental work -- Dr. Doshi had been so skillful at numbing the gum and concealing the needle that my daughter had never realized she was getting a shot. She still doesn't know there's a drill involved! Dr. Doshi rocks. I don't have her phone # handy but her office is on Regent Street right near Alta Bates.
Of course, a lot depends on your child's temperament. You're the best judge of what he is capable of. Maybe a skillful dentist plus a big ol' bribe if he sits still -- some coveted toy as a reward -- will be enough to get him through this visit. Or maybe the sedation will be less traumatic for him. Trust your instincts. Also, as the mom of a child with bad teeth I can tell you that there are more of these visits in your future, and you should also be thinking about how you want your son's experience with dentistry to be. Jennifer
So, we are going through the same thing right now. Our 4 year old has 6 cavities that our new dentist wants to fill. His name is Dr. Matsuishi, in El Cerrito on Stockton Street. He was recommended by our pediatrician. Here is what he told me.
In children this young the most important thing is not letting them become tramatized from the dental experience. Once a month, he has an anesthesiologist come from Children's Hospital and in order of age/weight(?) puts them under. He said that he starts the process with a puff through the nose. He said that within minutes of finishing up - that the child comes to. He said that my child would not remember anything and that he would be groggy the rest of the day, and therefore should not go back to school.
I know I haven't yet gone through the experience, but I felt confident in the Doctor and what he was saying. I originally took him to my dentist - they noted the cavities - but said that they did not want to treat him. I liked that Dr. M has someone from Children's handling the medication part. The staff was extremely attentive and my child was the center of attention. They let me hold him the whole time at our first visit. It was very kid-friendly. He really tried to connect with my child.
Best of luck. Elizabeth
Does anyone have experience with kid's dental surgery under general anesthesia? My son is 6 years old. We were told that he has two extra teeth growing on his upper molar (could only be seen through x-ray). The plan is to cut into his gum and then go search and try to pull the two teeth out.
We're very nervous abut putting him to sleep under general anesthesia since he is so young. His surgeon says that now-a- days its normal to use general anesthesia even extracting a wisdom tooth. But when I did it (as an adult), I was only give a local anesthesia.
Has anyone gone through this type of surgery with your children and under general anesthesia? How did you and your child feel then and afterwards?
Who was your surgeon? We have Dr. Thomas Love, in Oakland, near Summit Hospital. Anyone know anything about him? Thank you.
I've had 3 wisdom teeth out under local anesthetic without discomfort or emotional trauma, even though two of the teeth were impacted and the dentist had to cut the gum, and the other broke and was quite difficult to remove. I had no complications during recovery, unlike some of my friends who opted for general. One suffered dry socket and both seemed to feel the experience was much more of a ''big deal'' than what I experienced. My theory is that people are foggy coming off general and more likely to do something ill advised, like drinking from a straw, or otherwise not following the dentists instructions properly. I don't know what the real statistics are for complication rates for local vs. general; a sample of 3 is pretty dicey for drawing reliable conclusions.
Having the procedure under local can be psychologically difficult for some people (seeing the scalpel, imagining what's going on in there). For a 6 year old with minimal if any experience with fillings, novocain, drills etc, it could be difficult. I'd definitly consider both your son's dental experience and temperment before committing to local anaesthesia.
I went under general anaesthetic at five to have my tonsils removed. It was definitely a big deal, but not traumatic. I remember mask and the countdown clearly, but I don't remember much of the recovery--I vaguely recall feeling pretty punchy, but it was many moons ago. But I don't think going under general at 6 is inherently more risky than doing it as an adult. Carrie
Do not do any surgery on your child until you feel comfortable with the decision. I went to four orthodontists and the oral surgeon (whom I already knew) for opinions before feeling comfortable with a decision to extract my child's teeth. You will not regret the little extra effort to gain the peace of mind. Research your options. Oral surgeons will give free consultations. I recommend Bryan R Krey, DMD Ph: 510-848-1055. Feel empowered in your health care choices!
I completely understand your worry. My 2-year-old needed general anesthesia for dental work and I was a wreck. I cried while he was under. However, his experience was much better than mine! That night he said to me, ''That trip was fun''. And I said, ''what trip?'', and he said ''to the dentist''. That being said, he was VERY grumpy, tearful, and lethargic for about 2 hours after waking up from the surgery. But then he was back to his normal self. Also, my understanding is that the general anesthesia used for dental work is not as ''deep'' as that used for major surgery. I believe the anesthesia is very low risk, although at the time I was still very worried about it. Good luck. Your child will be fine. anon
My daughter has 5 cavities (2 behind her front 2 teeth, 1 on the front, and 2 on 2 separate top molars). She's 26 months old and we are looking for a gentle dentist who would help us to fill her cavities without using anesthesia. We've been to a pediatric dentist and the first thing they told us is that they want to sedate her for the procedure, that I can't be with her in or during the process, and to stop breastfeeding her. WE're looking for a dentist who will look after her emotional needs as well as physical. She's very afraid of the dentist and I think that if we found someone who paid a little attention to her and spoke her language (and let us take the time we needed for her to be comfortable there) that she might be a little bit more cooperative. Does anyone know of a dentist who has who could help us with our situation? What have others done who've had a little one with dental caries? Any help would trully be appreciated. kathleen
Look into laser dentistry. It is a quick and anesthesia-free way of repairing cavities. Drs. William Gianni and William Tenant in Berkeley do both laser and conventional dentistry. I went to Dr. Gianni for the first time this summer and it was great. No drills, no anesthesia, no pain. Removing the cavity with the laser pulse took less than a minute. It didn't hurt at all. It just felt like a little tap-tap-tap. The longest part was filling the cavity, which was only about 5 minutes. I don't know if they work with children so you should give them a call to find out. Dr. Gianni was very nice and I can imagine he would be good with children. (510) 848 3143. Alexis
Vivian Lopez, D.D.S. and an assistant name Tanya, are amazing! They really connect with my son and take their time and talk to him in a child appropriate way. We just go for regular check ups with them, but at 18 mos, he had about the same amount of decay as your daughter. Email me for more info. Vivian Lopez is on Telegraph near Ashby in Berkeley. andalove
I was saddened to read how your daughter already has cavities. I highly encourage you to read about Dr. Weston A. Price's work as he proved how the teeth reflect overall nutritional status. He was able to remediate shallow cavities in children with the use of vitamin A rich foods and raw milk. For information on both, go to www.westonaprice.org and www.realmilk.com. As for dentists who can help, I suggest the team at 1313 Gilman (Rusta, et alia). They are biological dentists and have expertise compatible to the principles of WA Price. They are especially good with kids. Nori Hudson, NC
We experienced the full range of dental traumas when my daughter was that age (an extraction, restraints, verbally abusive dentists, sedation, etc.) Sedation with a low dose of valium paired with nitrous, administered by a reputable pediatric dentist, turned out to be the best approach for us. Mostly because my daughter did not have to be restrained and had only fuzzy memories of the experience after the fact. Once she was afraid of the dentist, nothing else really worked. After we got the initial work done, we went back to working with the dentist on helping her feel better, and after a few years she was no longer afraid. As for the dentist's advice to stop breastfeeding, I listened to what they had to say, did a little reading, and quietly ignored it. I hope someone else will know the dentist who can calm her without meds, but this was my experience. been there
I'm sure I won't be the only one who suggests you find a NEW DENTIST! There are many pediatric dentists out there who do not blame breastfeeding for everything, and will welcome you to stay with your child during any procedure. Check the archives and ask around. R.K.
When my then 28-month old son was found to have 8 (!) cavities, we were referred to Dr Edward Matsuishi in El Cerrito. Dr. Ed was very understanding and kind to me and my son, and did NOT recommend eliminating breast-feeding (which I did then and continue to do now -- though I HAVE given up night nursing!). I appreciated his advice, which was mainly to cut out sugars from the child's diet, esp juice, but keep breastfeeding as long as the milk doesn't ''pool'' in the mouth -- don't let the child fall asleep while nursing! As for anasthesia, I invite you to re-think your position on it. Though we were scared at the prospect, the thought of putting my son through multiple visits to have fillings was unthinkable. The anesthesia was actually BETTER in that the work gets done all at once, and the child has no memory of it (and thus does not compound the fear of dentists).
Dr. Ed hires an outside pediatric anasthesiologist from Children's Hospital to administer the anesthesia. They are well-trained in anasthesia and ER procedures, and do this all day every day. We were there with the anasthesiologist and our child in the waiting room, while he administered a sort of Valium-like drug in my son's nose (he did this cleverly and non-traumatically -- the idea is it relaxes the child before the actual anasthesia is administered). We did sit with our son during the first part of the anasthesia, until he fell asleep. Then we left the room. Afterwards, he was given to us to hold as he gradually woke up. We were very happy with the results, and are so glad we did it this way (and believe me, we were VERY concerned). Good luck to you. Christine
I highly recommend the pediatric dentist office of Dr. Katsura & Miahara. I don't know what their policy is for anesthesia for younger kids, but my 4 year-old has had her cavities filled (using just local anesthesia) in their office, and they are excellent, very family-oriented. Parents can go in with the kids, and sometimes they can actually lay down on the chair and hold the kid on top of them. Their office is full of toys, pictures, books and nice stuff that really attracts the kids and makes them feel more comfortable.
On the other hand, my daughter also had dental work done when she was 20 months-old (at a different office) and they gave her a mild sedative, which really didn't do much. She was wide awake and fully aware for the whole time, and, needless to say, it was very traumatic both for her and for us hearing her cry so hard. I really wish they had given her full anesthesia.
In summary, I do advice that you take her to a pediatric dentistry office, it's worht paying the difference, and trust what they think is more recommendable for your kid (w/ or wo/ anesthesia). Toni
I recommend the practice of Wampler et al. Our daughter started there (with cavities) at about 18 months. They worked with us and particularly with her to help her get comfortable. Also they were open to our preference to do less permanent ''scoop and fill'' filings, which are less durable, but less invasive. They started out ''counting her teeth'' and ''painting'' them with flouride varnish, and only did the scoop and fill when she was comfortable enough to tolerate it. She also sat on mommy's lap, and at first we practiced at home with a mask and gloves the dentist gave us, then daddy ''helped'' at the dentist and she would open wide for me and let the dentist work. These last parts were more our inventions then something suggested by the dentists, but they were always willing to work with us. BTW, we paid out of pocket to go to Wampler et al., after trying the UCSF clinic and having a horrible experience with a pre-doc student with no pediatric training. There is considerable difference in what different pediatric dentists think is ''necessary'' as far as general anesthetic, strapping the kids to boards, etc. It's worth it to find someone to work with who is gentle and willing to work with you, so your kid forms a good feeling toward the dentist. Our daughter is now (at age 7) a model patient at a clinic which accepts our (Healthy Families) insurance and even gets excited about going to the dentist. Peter
Our pediatric dentist is WONDERFUL. Dr. Miyahara, 528-1526 or 848-6494. She is extremely sweet and gentle. I hear the other dentists in the practice are also great. However, I can't imagine she or any other dentist could possibly fill cavities in a toddler without general anesthesia. My children have not had fillings, but I've had many myself. Have you had fillings? The sound of the drill alone would make it impossible for my children to sit still and if they didn't I imagine they could get injured. Additionally, the pain involved in filling an unanesthetized too would be unbearable for a child. It is for me as an adult. I think the best to hope for is a local rather than a general anesthetic, but I believe even then the situation (noise, intrusion) would be intolerable for most small children and their consequent agitation would make it impossible to fill a tooth safely. Liz O.
My five year old just had to have a cavity filled and our dentist recommended that he go ahead and fill it without anaesthetic, because the pain of the injection and the pain of the procedure would be roughly equivalent (the cavity was shallow), and our son might not be willing to let the doctor proceed after he put the Novacaine in. I let him proceed, and my son, who is very sensitive, came through with flying colors. I would highly recommend our dentist (mine and my sons') for gentleness and caring. His name is Eric Citron. (510)849-1660. heather
It sounds like what you are dealing with is as much a values conflct as one over appropriate medical care. It would probably be worthwhile for you to talk to several dentists to find one with whom you feel you can communicate better than your daughter's current dentist. Our daughter sees San Francisco pediatric dentist David Rothman, and has since she was a toddler. I think she gets excellent care, and she loves going to the dentist. Our situation is somewhat different from yours in that she has never had a cavity so we've never had to face the issues you are facing, but I've found that Dr. Rothman shares my family's values which makes everything much easier. He has two offices, one on Union St. and one on Ocean Ave. Good luck! Lisa
I take my 12 year old and my 26 month old to Dr. Leticia Mendoza-Sobel on Grand ave. at the Oakland/Piedmont border. She is the best! When my 12 year old was about 3 we had a horrible experience with a doctor that reluctantly let me in the room during the procedures (8 cavities.) When I took her to Dr. Mendoza she first did a series of ''behavior modification'' appointments where she had us come in when no body else was in the office just to talk to her about the office and the equipment and the procedures and encouraged her to ask questions and just got her to feel very confortable. They always asked my daughter if she wanted me to come in with her. Dr. Mendoza invited us to ''behavior modification'' as soon as the second child was 6 months old and now both my kids look forward to going to the dentist. I know she is there only part time now but I understand that her practice partner Dr. Negron is pretty good too. veronica
After reading some earlier postings about pediatric dentistry and general anesthesia, I am worried that my child had dental work by a local pediatric dentist without the proper precautions taken. She had over a dozen cavities and was given a liquid which knocked her out after about 30 minutes. The dentist also gave her laughing gas and used restraints and a dental dam and head brace. The dentist's assistant administered the liquid to her and they monitored her heartbeat by using a clip onto her foot. I doubt very much that she was an anesthesiologist--she answered the phones the rest of the time!!! I may have been tres ignorant of the procedures, but could they even undertake this risky dental work under general anesthetic without an anesthsiologist being present? I am very nervous about this and doubt I will ever return to that dentist. Can anybody explain the requirements to me? Very concerned mom
This sounded extremely alarming. I felt rather sick after reading your email - I was so sorry for your child! (It reminded me of trauma at the dentist when I was a child I think.) I fully sympathise and support your concerns.
One question is - were all those cavities necessary to fill? It seems rather a large number, and in any case, when baby teeth are replaced relatively soon by the second set, was this really necessary? I think you might do well to find another dentist. I understand general anaesthesia always carries risk, and a good dentist should, I think, be able to fill cavities with the agreement and cooperation of most children - that's part of the skill of a paediatric dentist, to reassure and help them with the experience. My own children, amazingly, carry none of my fears of the dentist. I really would find a more understanding dentist, who will take better care of your child. Good luck, Jan
I think your concerns are right on. You should share them with either Dr. Ed Matsuishi of El Cerrito or Dr. Perry of Alameda, pediatric dentists who do oral surgery in their office with anesthesiologists from Children's Hospital. When our daughter had oral surgery at 2 1/2 years old, we discussed this issue with her pediatrician, a few other pediatricians (my husband's a pediatric nurse), and our dentist. All of them said that although dentists do put people out in their offices without an anesthesiologist present, it is too risky. Sarah
My 22 month old son has cavities on nearly all his upper teeth which have developed over about 6 months. I am still nursing him, but have been advised to wean soon. At least one cavity is so large the dentist wants to do a root canal and has recommended general anesthesia for that and filling the other cavities. An anesthesiologist from Childrens Hospital comes to the dental office to do the anesthesia.
I got a second opinion from my friend's dentist and he agreed with our current dentist. My son is very big and strong for his age and we all feel he would fight without some kind of sedation. I am very nervous about him having any dental work at his age, especially general anesthesia. This dentist filled my 4 year old daughter's cavities using nitrous oxide and all went well.
I would appreciate hearing from anyone who has gone through a similar dental situation with a toddler or whose child has had general anesthesia and how it went.
My son (now 4) has had general anesthesia twice, once at age 17 mos. (to get a foreign object out of his bronchial tube) and once at 33 mos. (to have a cyst removed from his neck). Our situation was easier than yours, because we didn't have any choice about the procedures, but I can tell you that the anesthesiologists at Children's Hospital are great. The hardest part is your kid getting cranky from not being able to eat or drink beforehand, and the next hardest part is they can be a little upset when they wake up, but our son got over that quickly when he saw the giant lollipop we'd brought him. The lollipop, in fact, is the only thing he remembers about the whole process. Good luck. Fran
Hi, my two year old nursing daughter had two root canals and caps done under general anesthesia and everything turned out fine. Dr. Mitsuishi (SP?) gave the second opinion and did the procedure. I was very scared and did not go because of how I cried when she had a tooth pulled but my husband said she was not scared or difficult. She nursed a couple of hours later and there was not problem. The dentist called that night to check up on her and she was fine. We also tried to do it without the anesthesia but she was to wiggly. Good luck. Cherene
I would like to hear from parents who have had their child's teeth repaired under general anesthesia or who found a way to get major work done without it. My 7 year old daughter needs 3 crowns on her baby molars, and 2 fillings on her permanent molars. We went this morning to have some of the work done. The dentist administered nitrous oxide, plugged her into watching a movie, and started the work. My daughter got nauseus from the ''magic gas'' and started to get scared when the drilling started. She has had her teeth drilled a little by another dentist, so I don't think the drill itself bothered her. She said later that there was just too much going on. The dentist couldn't get her to stay still, so he recommended stopping and doing the repairs next time with my daughter under general anesthesia. They have anesthesiologists come in on special days to monitor everything and run an IV, etc. I have read all of the posts about the pediatric dentists in the area. I am wondering if I should go ahead and have this office do the repairs, or flee to another practice. Maybe my daughter would have a better feeling with a different dentist or approach? Jeanne
My son just had general anesthesia to have several cavities filled and one crown done. He is 3 years old. It was done at Dr. Matsuishi's office in El Cerrito and it sounds from your description of the office that you went there too. We had seen two other dentists previously and both agreed with the recommendation for general anesthesia. The dentist has the anesthesiologist from Children's Hospital come to his office and the child is monitored through the whole thing. My son did fine although I was nervous. Dr. Matsuishi is very good but it was expensive. One benefit is that your child won't be traumatized by the procedure because she will be asleep. Also, my son now swears that he was awake through the whole thing and was very brave. I, of course, agree with him and tell him how proud we were of him for being so brave. Good luck. Feel free to email if you want to discuss our experience. Shannon
We had the same recommendation given to us by a respected pediatric dentist in El Cerrito. We balked at the price (over $1000) as well as the necessity of putting my daughter under so we went for a 2nd opinion. Dr Neil Katsura and Dr. Miyahara (practices in Berkeley, Albany and Lafayette) saw my daughter for 1 minute before announcing she would be ''easy'' and absolutely did not need to be put under. We have been very happy with both dentists and both of my kids enjoy going to the dentist. We've had fillings and crowns done with no complaint from the kids. Dr. Miyahara is particularly gentle, but both dentists are great with kids. I would recommend getting a 2nd opinion. Naomi
I had exactly the same experience with my six-year-old boy last summer. He needed seven filings in his teeth. The pediatric dentist started the procedure using the gas and the TV set, and my child got scared, cried, and wouldn't open his mouth. Our dentist also suggested general anesthesia. We ended up with changing a practice. We are seeing now Dr. Katsura. He doesn't use nitrous oxide, nor a TV set. My son is looking forward to each visit, and we have successfully completed the whole procedure in four visits Tikva
It sounds like your daughter is currently seeing a pediatric dentist. The personal experience that I have with dentristy with a GA done for pediatric patients is as an RN caring for ped pts. post-anesthesia. Checkthat the anesthetist has pediatric training and is comfortable with pediatric patients. Obviously if they are working for a ped. dentist they would be, but it never hurts to ask. As for your daughter, she will have to be NPO (nothing by mouth) from midnight on the night before the procedure so it is good to request an early morning apointment. It is very important to ensure that she strictly adheres to this - I've known anesthetists who have cancelled the case because a child has chewed gum! (there is a risk to the child if they have eaten/drank anything so anesthestists take this seriously) After the procedure, depending on the type of anesthesia used, the length of the procedure, and how the child fell asleep (if calm, most kids wake up calm - if crying, same), your daughter will stay in recovery for about 1 hour - more or less depending on the facility's policy your daughter is doing. She will probably be given some fluids/popcicles to trial before she goes home. It's common for kids to have some vomiting after dental work if they've swallowed any blood after they wake up. If she has an IV they can give her fluids and anti-nausea meds if she does seem to be vomiting a lot. Also, you can ask to be in the room when she goes to sleep - they can give her gas and put the IV in after she is asleep (as a parent you will leave once she does go to sleep and before the IV) This usually helps kids to stay calm. As soon as your daughter wakes from the procedure you can ask to be called. I have cared for a range of children of all age groups who have had dental work done with a GA and I'd say that if the work is important it will be done well if the child is still (asleep). Of course, nothing is without risks and you need to discuss those with the dentist and anesthetist. Most importantly you have to trust how you feel about it. If you have any more questions, please feel free to email me. Lisa
My almost-three-year-old daughter recently had dental work done on her two front teeth, for which she received general anesthesia. The dentist and the anesthesiologist were both extremely understanding about my concerns and provided detailed information about the procedure. Not only were they were both experienced with little children, they were also very kind, gentle, and even fun for my daughter to be around (before they knocked her out). Before my daughter had her dental work done, I had spoken with parents about their experiences regarding general anesthesia for such things, and they invariably recommended it. As I understand it, the only alternative is to somehow restrain the hapless child while the dentist does his job... FYI, my daughter's teeth are 100% fixed and she came out of the anesthesia just as healthy and sound as she went into it. Miki
My 5 year old has a cavity that needs to be filled. Upon scheduling the appointment with the pediatric dentist, he handed me an envelope with some valium to give her the morning of the appointment. He said it would reduce her anxiety. I am hesitant to give my child valium. Have any parents had experience with this type of situation? Does anyone have any suggestions how to best prepare my child for her appointment Thanks in advance. Marcella
Yesterday we took our son to the dentist for the first time to have his teeth checked out. We were told that his teeth need some fillings. The doctor gave us a tranquilizer called Valium to be given to him an hour before his next visit. We appreciate any advice on the practice.
Hi, My 3-year-old son recently went for his first dentist visit and I found out he had some small cavities, too. I took him back for the fillings, and he had them done with no medication at all, and did not feel any pain. He sat very still in the chair.
He may be an unusual case, the dentist and the assistant both commented on how good he was. If your son sat still for the initial visit, he may do okay for the fillings. Or, maybe the dentist felt the cavities were deep enough to hit a nerve? Valium is pretty mild for adults, I think it helps relieve fear, but I don't think it's really a tranquilizer or painkiller. I would call their office to find out more. Good Luck! Sabine (6/99)
I've not yet taken my 3 year old to the dentist and have been wondering when to start. I am *not* an expert on this topic (children and/or dentistry) and have not researched it at all; however! After seeing a show on Dateline (? maybe 20/20 or 60 minutes) about children going to the dentist to receive treatment for things as routine as getting a cavity filled, I have virtually ruled out taking my child in for a routine checkup let alone to get a cavity filled. Why? The Dateline show featured several families who had lost a young child (to death) due to something going wrong while the child was anesthetized. According to the Dateline report, dentists comprise the only health profession that does NOT employ professional anesthesiologists-- unlike medical doctors, surgeons, hospitals, etc. Rather, the official dental association (ADA?-- Am. Dental Assoc.) spokesman replied (on the show), when asked why they do not employ professional anesthesiologists, We use people who have been trained in anesthesiological administration. A bottom line of the show (as I understood it) is that dentists view children (2, 3, 4, 8 year olds) as little adults, who can handle the same medical procedures as adults-- whether it is anesthesia or other drugs. I believe children's systems are different than those of adults and are much more sensitive than adults to almost everything (chemicals, pesticides, anesthesia, as well as drugs such as valium). It was terrifying to hear this Dateline story about the treatment of children by the dental profession and to see that there are children dying for simply getting their cavity filled! After the show, I've wondered whether in some cases it might be better to just let the cavity exist (unless of course it is painful). Afterall, a 5-year old is going to lose his baby teeth in a few years. This is my own unprofessional first-response reaction to what I saw on Dateline. I do realize that there can be (perhaps significant) repercussions for not filling a cavity (e.g, maybe the gums would become compromised and affect the permanent teeth later on), however, my gut instinct tells me that in all but severe cases, it might be ok to leave a small cavity alone. I will be researching the alternative literature on this to see what dental treatment my child should or should not receive. I do not want to alarm you or anyone, but I would certainly want to have had someone tell me about this Dateline show had I not seen it and a dentist told me to give valium to my child to reduce anxiety. I would have many questions, e.g., Is there ANY possibility of an adverse reaction to the combination of valium and either local or general anesthesiain a young child?
I too am hesitant to send my son to the dentist and have his cavity filled. I have heard too many horror stories and feel more comfortable waiting until he is much older and stronger. Am I causing him more harm than good in doing this? I know that children loose most of their teeth at a later age, so is there really a rush to do this? Monica
On dentists and anesthesia -- my child is impossible at the dentist. However, no dentist I have gone to was able or willing to use general anesthesia. They wanted me to go to an oral surgeon for that. I believe general anesthesia is risky and would be very reluctant to do it except when absolutely necessary. I would like to know if the children in the last issue (dateline?) died from novacaine injections, nitrous oxide, or general anesthesia? Finally, my child has a cavity that is really bad and causes her considerable pain from time to time. I am getting worried, as I understand this can damage the jaw and even cause internal infections of one sort or another. I am ready for valium, and will try it if I can find a dentist who will do it. Maybe I will take some too. Lynn
In response to the concerns about young children getting fillings, I wanted to share my almost-three-year-old daughter's experience and recommend her dentist, Dr. Neil Katsura, for his handing of her filling. My daughter tends to be pretty calm at doctor's visits, so I do not know how Dr. Katsura would handle a child who is uncomfortable or afraid of the dentist (I expect well)--but he certainly helped make my daughter's first filling a literally painless experience. On her first, routine visit to Dr. Katsura, it was discovered that my daughter had a major cavity (possibly caused, the dentist speculated, by her drinking milk at bedtime without brushing her teeth again afterward). The dentist put in a temporary filling, and we scheduled an appointment for a permanent filling for the week before she was to turn three years old. We asked whether the filling could wait until she was a bit older, but the dentist was adamant that the cavity be filled as soon as possible. Dr. Katsura and his assistant did several things to make my daughter feel at ease and to distract her from the procedure. They tested the drill on her fingernail, so she could get a sense of the sound and action of the drill. As he was drilling, Dr. Katsura talked to her, describing a picture he was supposedly drawing on her tooth. When he put the actual filling in, he said he was putting a star in her tooth. My daughter remained quiet and cooperative throughout the entire procedure and seems to have no negative feelings about the dentist's office. Dr. Katsura's number at his office on Ensenada, off Solano Avenue, is 510-528-1546. He works out of another office in Berkeley, as well; the Ensenada office could give you that number. Good luck. Elisa