General anesthesia is sometimes recommended for children who are unable, by either age or behavior, to cooperate during dental treatment. As this may pose a threat to patient’s own safety, our practice utilizes a certified anesthesiologist (MD) to facilitate in this process. Once general anesthesia is recommended as a potential treatment option, an in-depth discussion between the parents and the pediatric dentist takes place to ensure proper understanding of the procedure and maximize optimal outcome.
• General anesthesia is a controlled state of unconsciousness that eliminates awareness, movement and
discomfort during dental treatment.
• It is very safe. A board certified anesthesiologist (MD) comes to the office and comfortably sedates your child
during the dental procedure.
• All dental work is completed during this single visit.
• If radiographs (X-rays) were not obtained at the initial exam due to fear or uncooperative behavior, they will be
obtained while your child is sleeping, possibly revealing new cavities which will be restored at the same time.
• Since your child is unconscious and pain medications are given during the procedure, your child will not have
any memory of the procedure or feelings of pain and discomfort.
• Unlike conscious oral sedation, where the dentist monitors both the patient’s vital signs and completes the
dental work, two doctors are on site during general anesthesia. The anesthesiologist brings his/her own
monitoring devices and focuses solely on monitoring patient’s vital signs. This allows the pediatric dentist to
fully dedicate his effort on the necessary procedure.
• Prior to your child’s appointment, he/she will be asked to refrain from drinking or eating any fluids and foods. It
is critical that you follow the instructions provided by the anesthesiologist. If your child develops a fever or is
sick on the day of the treatment, it may be necessary to reschedule the appointment to a later date.
• After the treatment, your child will be asked to rest in the comfort of our office until he/she is stable, alert, and
ready to leave. Since patients are often tired following general anesthesia, please allow your child to rest at
home with minimal activity until the next day.
Precautions are taken to protect your child during general anesthesia. Personnel with advanced training will monitor your child closely to prevent and manage complications. Please feel free to discuss the benefits and risks of general anesthesia when it is recommended for your child.
Most children respond well to the treatment described above. Some children, however, occasionally present with behavioral considerations that require more advanced techniques. Pediatric dentists, such as Dr. Kao, are specially trained and familiar with the use of protective stabilization, sedation, and general anesthesia to assist patients.
Children who are very young or have a high level of anxiety with the necessary treatment may require some level of sedation. Sedation is also helpful for children with special needs. There are many safe and effective medications available to help relax the child and promote a good environment for optimal and safe dental treatment.
Sedation dentistry is most helpful for:
• Infants
• Children requiring major treatment
• Children with high anxiety level
• Children with a history of traumatic dental experiences (sound and smell aversion)
• Children with a strong gag reflex
• Children who are medically compromised or have special needs
Sedation is endorsed by the American Dental Association and is an effective way to make many patients comfortable during their dental visit. Before using a sedative or anesthetic, it is important to tell your pediatric dentist about any medications or medical treatment your child is receiving.
Safety is our number one priority. Therefore, it is extremely important that children remain calm and still during dental treatment to avoid unexpected injury to themselves or members of the dental team. For children who are a little nervous or have never received dental procedures, nitrous oxide/oxygen for analgesia can be greatly beneficial in helping children relax.
• It is safe. Children remain awake, responsive, and breathe on their own without assistance.
• Much more oxygen is given than what we breathe in normal room air. This provides a wide margin of safety.
• Nitrous oxide/oxygen is usually breathed through a small mask placed over the nose.
• Dental treatment is more comfortable when children are relaxed.
• It is sometimes known as “laughing gas” because some patients become so comfortable and relaxed that they laugh.
• The pediatric dentists will often request that no food or drink be given to the child before treatment.
• A local anesthetic is usually given to numb the areas that are to be treated so that there is very little discomfort.
• Oxygen is usually given at the end of treatment to remove the effects of nitrous oxide gas.
• Once nitrous oxide is turned off, it only takes seconds for the gas to completely leave the body.
We do not use any form of physical restraint unless absolutely necessary for urgent situations (extractions or injuries sustained secondary to facial trauma). Our main goal is to always keep our patients comfortable to reinforce a positive experience. If your child is worried by the sight, sounds or sensations of dental treatment, he or she may respond more positively with the use of nitrous oxide/oxygen. On the other hand, for patients who may be anxious, fearful, too young to understand dental treatment, or unable to cooperate, additional supplement, such as an oral sedation medication, may help to facilitate a child’s dental treatment.
We invite parents to stay with their children during the initial examination, as well as any future visits. As a team, we can overcome apprehension, gain your child’s confidence, and provide the safest environment. We find that once we establish a certain comfort level, many children feel comfortable in coming to the treatment area by themselves. We also find on occasion that children do better by themselves if they require treatment. You know your child best – it is our goal to make his/her dental visit a great experience and we welcome your ideas and suggestions. For the safety and privacy of all patients, children without an appointment should remain in the reception room with a supervising adult. Our dental staff tailors behavior guidance and management techniques based on your child’s level of comfort with us. We use various techniques to establish positive communication and ensure a happy and comfortable environment.
• Tell-show-do: A verbal explanation of the dental procedure on an age appropriate level, followed by a
demonstration, then completion of procedure.
• Nonverbal communication: Reinforcement and guidance of behavior through appropriate physical contact,
posture, facial expressions and body language.
• Positive reinforcement: Awarding good behavior with verbal praise and rewards.
• Distraction: A technique that diverts the child’s attention from what he/she may perceive as unpleasant. It can
involve taking breaks throughout a procedure if needed.
• Voice control: Moderation of the voice to help direct your child and reinforce appropriate behavior.
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