At Evansville Pediatric Dentistry, we routinely treat comprehensive cases in a hospital setting. Children with severe anxiety and are unable to cooperate in a traditional office setting are often candidates for treatment under general anesthesia. Often these patients are very young, have complex medical histories or require extensive dental treatment.
These are the cases wherein conscious sedation is not quite enough to manage the child’s behavior and fears. General anesthesia is also recommended for our patients with special needs who cannot be treated in a traditional office setting because of many different limitations.
General anesthesia patients receive medications to cause them to become unconscious and asleep while receiving dental care. This would be the same as if he/she was having their tonsils removed, ear tubes, or hernia repaired. This is performed in a hospital or outpatient setting only.
While the assumed risks are greater than that of other treatment options, if this is suggested for your child, the benefits of treatment this way have been deemed to outweigh the risks. Most pediatric medical literature places the risk of a serious reaction in the range of 1 in 25,000 to 1 in 200,000, far better than the assumed risk of even driving a car daily.
The inherent risks if this is not chosen are multiple appointments, potential for physical restraint to complete treatment and possible emotional and/or physical injury to your child in order to complete their dental treatment. The risks of NO treatment include tooth pain, infection, swelling, the spread of new decay, damage to their developing adult teeth and possible life threatening hospitalization from a dental infection.
In most cases, we complete all of the needed dental treatment in one visit. Once the treatment is completed, the child is awakened and taken to a recovery area. Parents are often brought to this area to be with their children as they recover. The child is discharged once doctors determine that he or she is alert and sufficiently awake to leave the hospital.
Outpatient hospital dentistry is available at St. Mary’s Medical Center and St Mary’s Surgicare in Evansville, Indiana.
Prior to your appointment:
- Please notify us of any change in your child’s health. Do not bring your child for treatment with a fever, ear infection or cold. Should your child become ill, contact us to see if it is necessary to postpone the appointment.
You must tell the doctor of any drugs that your child is currently taking (prescribed, over-the-counter, or herbal medications) and any drug reactions and/or change in medical history.
- If you have dental insurance, your co-payment must be paid in full at least one week before the scheduled surgery. A treatment estimate will be provided to let you know the balance due. If the co-payment is not received, we may have to cancel the surgery.
- Contact our office one week before the surgery at (812) 479-8609. We will inform you of any last minute details or changes to the surgery start time.
- Your child MUST HAVE NOTHING TO EAT OR DRINK after midnight the night before the surgery. (If your child has anything at all to eat or drink, the surgery will be cancelled and cannot be rescheduled.)
- You should report to the surgery center at least 1 hour prior to the scheduled appointment time.
- The child’s parent or legal guardian must remain at the hospital or surgical site waiting room during the complete procedure.
After the appointment:
- ACTIVITY: The medication may still affect your child for 24 hours. Whether he/she feels drowsy or seems fully awake, they may lack their usual coordination. Your child needs careful watching to prevent falls and accidents.
- NAUSEA: Your child may experience some nausea or vomiting from the anesthesia. If so, please only give clear liquids until the nausea/vomiting has stopped.
- DIET: Your child can be given clear liquids (ice chips, 7-up, Gatorade, Jell-O, or any liquid you can see through) for the first 1-2 hours. If your child has no problems with nausea, then he/she may have a “light” meal (soup, ice cream, crackers, etc.). Should vomiting occur, return to the clear liquid diet. A soft bland diet may be tolerated easily for the first 1-2 days. If there is no nausea or vomiting, your child can gradually eat solid foods after the first few hours. Please do not allow your child to hard or sticky candy from now on, as this can damage the teeth that were fixed.
- PAIN: It is important that your child be kept comfortable during the healing time following dental treatment. We commonly see children refuse to eat or drink when they are having severe mouth pain. Acetaminophen or ibuprofen medications should be given per the instructions on the package. Avoid the use of aspirin.
- CARE OF MOUTH: It is of vital importance that the teeth be cleaned during the initial healing stages. Remember the Rule of 3’s. Teeth need to be brushed three times a day for three minutes at a time during the first three weeks following dental treatment. This brushing must be done by an adult since children will be very reluctant to properly brush their teeth. Use only a soft bristled toothbrush to brush their teeth. It may help to run warm water over the toothbrush to soften the bristles. It is normal to notice a small amount of bleeding after brushing the teeth.
- WHAT TO EXPECT: It is common for a slight amount of bleeding to continue for 2-3 hours following any extractions or extensive treatment. This small amount of blood usually appears excessive because it is mixed with saliva. Should an abnormal amount of bleeding occur, it can be easily controlled by taking a moist wash cloth and having your child bite on it (applying pressure to the bleeding area). Pressure for 10-15 minutes will control minor bleeding. It is common to have a low grade fever for the first 24 hours. Acetaminophen or ibuprofen medications should control the fever.
WHEN TO CALL THE DENTIST:
- Noisy or difficult breathing.
- Refusal to eat after the first 12 hours following treatment.
- Persistent vomiting.
- Fever over 101 F
- Excessive bleeding.
- Persistent pain