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Wednesday, April 23, 2014
Pediatric dentistry - hospital or office?
My four year old daughter has had several surgeries and had been sedated six times in her young life. She now needs 10 dental fillings. Her dentist is a pediatric dentist and has experience in dealing with highly anxious children. Her dentist tried conscious sedation and she became sick and the procedure was unsuccessful. Her dentist wants to admit her to the hospital for general anesthesia. I am unsure what is best for her. Should I insist on trying conscious sedation again? Is conscious sedation safer than general anesthesia? Is it harmful to go under general anesthesia so many times in her young life? She has not had any problems with general anesthesia in the past. Which would be less harmful to her body? She has rods in her spine, a bicuspid valve defect, has had a fundopyloroplasty, has had choanal atresia repair on her right sinus, tubes in her ears, her adenoids removed. She has been in very good health this past year. Thank you in advance for any response.
Your daughter has a number of significant medical problems so it sounds like a wise decision to have the dental procedure done in hospital under general anesthesia. In the hands of competent practitioners this is safe enough to satisfy a concerned parent. A fully equipped and staffed hospital is a far better setting than a dentist's office in which to conduct a relatively lengthy procedure of this sort.
Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University