General Anesthesia for kids dentistry?- UPDATE

[sdmom]

He says there is just no way for the toothbrush to get between the teeth because they are packed so tight together. .

Floss. Parents have to floss for the child. A toothbrush isn't meant to "get between teeth". Sit on the floor with the child's head in your lap. Your hygienist can help with technique.

It's not fun, but has to be done.

 

[scrapquitler]

Floss. Parents have to floss for the child. A toothbrush isn't meant to "get between teeth". Sit on the floor with the child's head in your lap. Your hygienist can help with technique.

It's not fun, but has to be done.

My dd was never able to floss (nor was I able to do it for her) prior to having braces...her teeth were just too close together. Now that her braces are off, some teeth were extracted and things are moved around, she has room in between the teeth to actually floss.

 

[DuckMom]

My older son was born without enamel on several of his teeth and he needed five crowns and four fillings before he was three. The dentist gave us two options ... sedation in a surgical center or multiple office visits with a relaxation drug, a pain drug and, most likely, something they called a wrap that reminded me of a straight jacket. We chose to go with the sedation ... one of the tipping points for me was the probability that he would not enjoy the in-office process, but we would still have to go back several more times. I didn't want to set him up to hate the dentist and I didn't want to have him fearing going back for the other appointments.

We did the surgical center ... and it was hard to walk him into the operating room and lay him down on the bed. The doctor put the gas mask over his face and then he was sleeping. I had to leave before the IV was put in. I was a mess the whole time he was in there, but he came through it well and doesn't remember anything. I cried like crazy when he came into the room ... a nurse was laying on the rolling bed holding him. He was sleeping and had no clue. Do I ever want to do it again? No, but I think it was the right choice for us, and if push came to shove, I probably would go that route again. I don't know how I would have felt if it was being done in the office. Good luck with your decision.

 

[DuckMom]

Just one more thing ... if you do choose to go with anesthesia, try to get the earliest appointment you can. Since they are "going under" the kids have to obey the no food or water for x amount of hours rule, and that was really tough on my son (and us) because his appointment was at 10:30 in the morning ... and ended up getting pushed back. Try for the first appointment of the morning

 

[bumbershoot]

GA is frightening, serious, and a big deal.

I won't do it for teeth, and especially not in an office.

We had a dentist that said DS would hae to have at least 2 (which were obvious, they grew in yellow, turned brown, and were disintegrating) but probably 4 (because of a large cavity) teeth pulled AND he wanted to fill all the "spots" on many other teeth. Wanted GA in his office with coordination with health insurance and anesthesiologist and nurse...we left his office laughing at him.

Foudn someone SANE. He filled the cavity without any lidocaine at all (had it at the ready, but didn't need it), pulled the two teeth with a tiny blip of it at the next appointment. And he's been watching those "spots" now for almost 5 years. They've never needed ANY work at all.

So glad we found someone sane who wasn't going to risk DS's life....

 

[Hannathy]

GA is frightening, serious, and a big deal.

I won't do it for teeth, and especially not in an office.

We had a dentist that said DS would hae to have at least 2 (which were obvious, they grew in yellow, turned brown, and were disintegrating) but probably 4 (because of a large cavity) teeth pulled AND he wanted to fill all the "spots" on many other teeth. Wanted GA in his office with coordination with health insurance and anesthesiologist and nurse...we left his office laughing at him.

Foudn someone SANE. He filled the cavity without any lidocaine at all (had it at the ready, but didn't need it), pulled the two teeth with a tiny blip of it at the next appointment. And he's been watching those "spots" now for almost 5 years. They've never needed ANY work at all.

So glad we found someone sane who wasn't going to risk DS's life....

you can't make generalizations like this, it is obvious you child did not need major dental surgery or work done, any cavity that can be filled without Novocaine is not major. But some children do need major work thru no ones fault. Your child did not need root canals or crowns or caps as some of these kids did and do.

As I said my DD needed major work but hers was able to be done in the office however my son's was too extensive and he needed surgery.

To say surgery is risking their life while it can be true is pretty extreme. It would be like saying you are risking their life sending them to school if they ride in a car. And that is also why everyone is saying make sure there is a dedicated anesthesiologist just watching the anesthesia nothing else when choosing where to have it done.

And to call the dentist insane is insulting. I'm sure he doesn't recommend major work and anesthesia just for kicks. you may disagree on the spots and I have done that to but to say he wanted to give your child anesthesia just for fun is crazy.

 

[ktlm]

Had the 2nd opinion today. We only told the pediatric dentist about the regular dentist and what he told us. We did not want to tell him about the other pediatric dentist because we wanted a completely independent opinion from him. His findings and opinions were exactly the same as the other pediatric dentist. Exact same treatment plan too. Makes me feel better about the first dentist, but I'm still not happy about the GA idea. I was really hoping that since the regular dentist only found 2 cavities that the first pediatric guy was nuts or just trying to make money. We checked with a couple of other highly recommended pediatric dentists in the area (by regular dentist; pediatrician; and other people we know), and they all do GA in their office setting too- either through a traveling anesthesiologist like the 1st pediatric, nurse anesthesists, and one actually does it himself with a nurse monitoring (if we are going to do it, I would definitely want someone separate handling it so they are focused on it the whole time). So, I'm a stressed out Mom right now. The first dentist, who DD preferred, can't get her in until late May, so I guess we have some time to think about it and talk to some more people.

 

[squirrel]

I know when my sister's and I needed to have our wisdom teeth extracted my Aunt a dental assistant told my mom that my sister (middle child) should not have it done in the office as she had never been under GA.

My youngest sister and I both had our toncills out when we were younger so it was safe for us to have them extracted in the office as we hadn't had a reaction to GA.

The dentist didn't extract mine when he was supose to (before I turned 18 and wasn't covered under my dad's plan) so I had to wait to get them extracted at the hospital. Unfortunately one came in sideways while waiting. I was in pain for a day or two (weekend) and by the time I saw him on Monday, he just pulled it in the chair.

 

[WantToGoNow]

A few years back my dd7 (then 3) had to have dental surgery. Her sinuses back up and causes a huge lump in the roof of her mouth (discovered this on Christmas Day). A week later she had several teeth abcess and her face swelled horribly and she was in severe pain. She was hospitalized - was there for 5 days while they tried to figure out if the sinuses were causing the teeth issue or if the teeth issue was totally separate from the sinuses (they were connected). She ended up have 2 teeth pulled, 2 crowned and 2 filled. She spent another couple of days after the surgery. Our medical insurance covered the hospital charges but we did have to pay for the dentist that did the work.

 

[ktlm]

Had the 2nd opinion today. We only told the pediatric dentist about the regular dentist and what he told us. We did not want to tell him about the other pediatric dentist because we wanted a completely independent opinion from him. His findings and opinions were exactly the same as the other pediatric dentist. Exact same treatment plan too. Makes me feel better about the first dentist, but I'm still not happy about the GA idea. I was really hoping that since the regular dentist only found 2 cavities that the first pediatric guy was nuts or just trying to make money. We checked with a couple of other highly recommended pediatric dentists in the area (by regular dentist; pediatrician; and other people we know), and they all do GA in their office setting too- either through a traveling anesthesiologist like the 1st pediatric, nurse anesthesists, and one actually does it himself with a nurse monitoring (if we are going to do it, I would definitely want someone separate handling it so they are focused on it the whole time). So, I'm a stressed out Mom right now. The first dentist, who DD preferred, can't get her in until late May, so I guess we have some time to think about it and talk to some more people.

Edit--- Oh I should add that we have another reason contributing to the cavities now too. DD has allergies and as a result does a lot of mouth breathing, especially last fall and this spring as we had a bad allergy season. The mouth breathing leads to the mouth being dryer, which means less protective saliva and more cavities. Apparently kids with allergies and asthma on the whole have significantly more cavities. Between the crowding and the mouth breathing, she has two really big factors against her for cavities. We were told to go very easy on drinks with sugar in them- juice etc., because liquid is the most likely culprit to be able to get between her teeth.

 

[scrapquitler]

Just one more thing ... if you do choose to go with anesthesia, try to get the earliest appointment you can. Since they are "going under" the kids have to obey the no food or water for x amount of hours rule, and that was really tough on my son (and us) because his appointment was at 10:30 in the morning ... and ended up getting pushed back. Try for the first appointment of the morning

This is excellent advise. My DS had his oral surgery scheduled for Noon, no food or drink after midnight. It was almost 2:00 before they took him in for the surgery, he was VERY hungry and thirsty by then, and as a result, he was kind of miserable.

 

[ktlm]

My dd was never able to floss (nor was I able to do it for her) prior to having braces...her teeth were just too close together.

That is pretty much DD. Her teeth are so close together, it is near impossible to get the floss between them. One of the dentists suggested that after she has juice or a sugary drink that she have a few swallows of water and vigorously rinse it around her mouth.

UPDATE- Well we talked to a total of 7 pediatric dentist offices in town in addition to the 2 dentists who actually saw DD. All of the offices except for 1 did general anesthesia in their own office. Several of them used the same mobile unit board certified dentist anesthesiologist as the first pediatric dentist DD saw. Turns out he does the GA for between 40-50 kids each month and his mobile unit has all of the equipment that an emergency room has in case there is a problem. He has been doing it 19 years, and only had one issue with one child which was the vomiting I posted about earlier. (I'm guessing he is probably the reason that hardly any of the pediatric dentists use a surgery center around here). The one pediatric dentist that did not use in office GA did use a surgery center, but she had only been a practicing dentist for 2 years. I'm sure she is great, but I wasn't okay with that with the amount of work DD needed and her crowding issues. So... we wound up going with the 1st dentist who DD really liked.

They had a cancellation last Thursday due to the patient having an ear infection and they offered the spot to DD since we had reported earlier that week that one tooth had started giving her pain. I was a very stressed out Mom and didn't sleep at all the night before. It went great! The dentist and the anesthesiologist were both great with DD. We had explained to DD that they were going to give her something to make her go to sleep, and when she woke up she probably would not feel that good for a while. Since her tooth had actually started hurting, she really wanted it fixed ASAP, and didn't complain a bit. She had to be there at 7:30 a.m. They sat DD on DH's lap in the dental chair and gave her a teddy bear as hers to keep. They put a pink mask over her face until she was asleep (harder for us than for her as the anesthesiologist was great with her and had her completely at ease) and then had us leave the room before they placed the IV and breathing tube. It took them approximately an hour and a half to do the work. Once they got in and were able to get a good look, they had to do 2 "baby root canals" with crowns, and 6 fillings (supposed to be 5, but they discovered another tooth was starting to decay where it was rubbing up against the decay on the adjoining tooth where they were doing a filling). When they were done, they brought her into a room with us and laid her on a mattress while she was still asleep. The anesthesiolgist told us that she was no longer under and that they had transitioned her with a drug from GA to "regular" sleep. He told us the longer she slept the better and not to do anything to wake her up because the more time they have to let the GA wear off, the better and less upset they wake up. Of course, we weren't that lucky and DD woke up pretty soon, I'd say about 15 minutes. It was a rough 30 minutes after that. She was not happy. We got "I feel funny" "I don't like this" "I've never felt like this before" "I feel weird and my mouth feels funny and hurts", and some crying. Then she saw the IV bandage on her hand and got mad. She started demanding it be removed and saying "I want to go home" "I'm not happy" "Where is this room- This isn't where I went to sleep"; " I don't like it here". "Tell them I'm not happy and to let me go home!" That is pretty much when we knew she was just fine.

The minute they took off the IV bandage and told her she could go home, she was fine. Never another complaint or whimper. Within an hour of when she got home, aside from still being just a little unsteady on her feet, she was pretty much normal and even in a good mood since she fully expected to be pampered the rest of the day. She had been told that she was required to take it easy and couldn't run around the rest of the day. She only complained of one spot in her mouth still hurting a little. By the end of the day, after getting presents, ice cream (on the dentist's list of appropriate soft foods for the rest of the day) and undivided attention, she declared it a "really fun wonderful day", and didn't want to go to bed because she knew the next day it would be back to normal. The next day she had no mouth soreness at all, and convinced her Grandma to let her have 10 chicken nuggets for lunch. I'm so glad it's over!

I'm glad we went with the GA. To anyone considering it, I would recommend doing your research like we did before agreeing to it. I wouldn't go into it lightly. You want to know who is doing the GA; their credentials; their track record; how routine this is in your community (some places the surgical center is still common and standard); what drugs they use; whether a breathing tube is placed ( if it is GA, that should definitely be a part of it); and most importantly what monitoring they do during the anesthesia, who is doing the monitoring, and what emergency equipment they have in the event that something were to go wrong.

For those of you with little ones, I would also recommend getting them to a pediatric dentist and not just a general dentist around their first birthday. I love my dentist and he is really good, but I can't shake the feeling that if we had taken DD to the pediatric early instead of taking her to the the general and following his timeline, this probably would have been caught before it got to the extent it was.

Thanks so much to my Disfriends for helping me get through this scary experience!

 

[thebeesknees]

Glad to hear that it went so well. Thank goodness it's all over now!

 

[DuckMom]

I'm so glad you had a good experience and your daughter is doing well. Never fun, but I know it must be a relief to have it finally done

 

[DopeyDame]

So glad it's all over and that everything went well! Awesome job to you for doing your research and making a really informed decision!

 

[badblackpug]

How does a 5 year old get nine cavities?!

I think it would be very difficult for a 5 year old to have such extensive procedures, especially a root canal, without being under general anesthesia.

I have Ehlers-Danlos syndrome. One of the manifestations is a high, arched palate with dental crowding, and weak enamel. As a child I had extensive dental work. My teeth were very crowded. Teeth overlapped teeth. Teeth came in in front of and behind teeth. My teeth were so crowded that it was impossible to get in between them.

GA is frightening, serious, and a big deal.

I won't do it for teeth, and especially not in an office.

We had a dentist that said DS would hae to have at least 2 (which were obvious, they grew in yellow, turned brown, and were disintegrating) but probably 4 (because of a large cavity) teeth pulled AND he wanted to fill all the "spots" on many other teeth. Wanted GA in his office with coordination with health insurance and anesthesiologist and nurse...we left his office laughing at him.

Foudn someone SANE. He filled the cavity without any lidocaine at all (had it at the ready, but didn't need it), pulled the two teeth with a tiny blip of it at the next appointment. And he's been watching those "spots" now for almost 5 years. They've never needed ANY work at all.

So glad we found someone sane who wasn't going to risk DS's life....

This is a completely unfair and, honestly, ridiculous statement. Yes, general anesthesia is serious, and it does carry certain risks, but to suggest that someone is "insane" and "wants to risk your son's life" for suggesting it is just plain ignorant. As I stated above, I have had multiple dental procedures as a child. From the age of 5 until I was in high school. None of them were done under general. The were painful and traumatizing and have lead to a lifelong fear of dentists. To the point now where I require a sedative to just get my teeth cleaned.

It is great that you son was able to tolerate this type of treatment, but not all children are.

 

[QVCshopper]

OP-Glad your DD is doing well. My DD6.5 had her tonsils out before age 3, and that was a scary experience as well. Anyway, she also has the crowded teeth issue. We floss, use the sonic care, and fluoride two times a day. But, it's still a problem because she literally has no room in there and so, the cavities form, especially in one very tight spot.

I just took her to an orthodontist we know and respect for many years, and he's going to start her on an upper and lower palette extender. While she's young, she's very large for her age (she’s at least the size of an 8 year old). He thinks by growing her palette now, her teeth will fall out and come in better and then she can get braces once all of that happens, without having to pull teeth later on. Since she's so large for her age, she might be done with braces before the average child. Just wanted you to know what might be in your future as well.

I meet with the orthodonist next week to find out more, and while she's one of the youngest children he's worked on, she's at least 4'4" and he said "mature" bodywise. Hope it goes well; she took the X-rays and molds very very well.

Oh, and to make you feel better, my FIL and BIL are dentists and they say kids with cavities can grow up to have very healthy adult teeth. That's one reason why we're trying the orthodonist thing already and implementing excellent oral care for her adult teeth.

 

[FloAway]

I think it's an excellent idea to start an orthodontist care this early. However most people who know they need to get that service, can't, because it'll cause a financial burden on them, and won't know how to get out of it along the road. Thankfully, even if you don't have some kind of health insurance, many will work with you, this way you'll maintain the health of your teeth while getting personal relationship with your dentist. If you don't mind, search if Seattle dentists are the right fit for you.