General Anesthesia
When a child (or a person of any age with a disability) needs extensive dental treatment, general anesthesia is an accepted standard of care. The American Academy of Pediatric Dentistry, the American Dental Association, the American Medical Association, and the U.S. Department of Health and Human Services support this standard. General anesthesia is also an accepted standard of care for situations involving children who have limited comprehension or children who are extremely uncooperative and require dental care that is technically difficult or sensitive to deliver. Often, treatment is first attempted in an office setting with or without sedative medications. However, if there is a lot of work to be done, the hospital is often the best way to safely accomplish treatment.
What is general anesthesia?
General anesthesia is defined as a controlled state of unconsciousness, accompanied by a partial or complete loss of protective reflexes, including the inability to independently maintain an open airway, and respond purposefully to physical stimulation or verbal commands.
A physician or dentist with specialized training can use various medications to provide general anesthesia for patients receiving dental care.
Who should receive general anesthesia for dental treatment?
General anesthesia may be indicated for children with extensive dental needs who are extremely uncooperative, fearful or anxious or for the very young who do not understand how to cope in a cooperative fashion. General anesthesia also can be helpful for children requiring significant surgical procedures or patients having special health care needs.
Is general anesthesia safe?
Dental treatment requiring general anesthesia in hospital environment poses similar risks to those inherent in any surgical procedure for children. The mortality rate for children undergoing general surgery procedures is one in 250,000. Although there is some risk associated with general anesthesia, it can be used safely and effectively when administered by an appropriately trained individual in an appropriately-equipped facility. Precautions are taken to protect your child during general anesthesia; personnel who are trained to manage complications will monitor your child closely.
The use of sedation and general anesthesia in dentistry is safe and effective when properly administered by trained individuals. The American Dental Association strongly supports the right of appropriately trained dentists to use these modalities in the treatment of dental patients and is committed to their safe and effective use.
Your pediatric dentist will discuss the benefits and risks of general anesthesia and why it is recommended for your child.
What special considerations are associated with the general anesthesia appointment?
An anesthesiologist can provide general anesthesia, while a pediatric dentist provides dental treatment. This may be done in either a hospital or dental office.
An adequate preoperative evaluation is the most important part of the general anesthesia process.
Some of the major components of the evaluation include:
- A thorough review of the child's medical history.
- A complete physical examination.
- A review of systems. This means evaluating each of the child's functional systems, such as the: cardiopulmonary, airway, hematologic, central nervous, renal, hepatic, gastrointestinal, endocrine, and metabolic systems.
- Knowledge of the child's current medications and allergies.
- Knowledge of the child's previous anesthetic experiences.6. Diagnostic lab tests and additional consultations.
Adequate monitoring during general anesthesia is essential to ensure that the appropriate level of anesthesia is administered, as well to detect any developing complications.
Patients often are tired following general anesthesia. You will be instructed to let the child rest at home with minimal activity until the next day. Post-operative dietary recommendations also will be given.