Anesthesia for Child's Dental Work
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Anesthesia for Child's Dental Work
March 2009
help! My 15 month old has severe tooth decay due to excessive nursing
especially at night. My dentist has suggested a temporary filler that
releases flouride and brushing religiously. I brush 10 times a day and
it's not helping and he isn't ready to cut back on nursing. Dentist
wants to wait as long as possible to either fill or cap the teeth, but
I'm worried if we wait too long they will have to extract them or at
best cap them when if done now they can probably be filled. The
problem is that the dentist says he is too young for the gas because
he can't keep the mask on. So the options are strapping him down
without sedation which seems cruel or general anesthesia which scares
me immensely! Anyone have any experience in this?
Thank you
I have a special needs son and we have done both. Although we
live in the East Bay, we went to UCSF for his dental care
because of the sedation - the cost was split between medical ins
for the use of the hospital and staff; and dental ins for the
dental services.
While I would prefer to keep him sedated for his visit, it
becomes an all day event for us. The usual no food after
midnight and then recovery time. But, then again he doesn't
remember it and we are all better for it. We stopped this
because the dentist felt at 4 times a year, it really wasn't a
viable option for us.
So we've done the strap down method and it was harder for me
than it was for him. He struggled and screamed and then
eventually settled down. After the visit, he was upset with me
for allowing this to happen him. Needless to say, he recognizes
the dentist office now and he becomes fretfully as we wait our
turn. Its full blown by the time we're in the chair. However,
the screaming session seem to get shorter at each visit.
Good luck.
Been There
March 2008
My 2yr. old son has 8 cavities the pedi dentist say may be due to nursing at
night. The
only way to fix the cavities would be to use general anesthesia for the
procedure. I've
been to two experienced pediatric dentists and they can offer no other
alternatives.
And they advise I stop Breast feeding. Does anyone know of any other holistic
approaches to this situation??? I am heartbroken, and could really use some
advice.
Thanks. Jennifer S.
I'm sorry I can't offer any advice on holistic approaches. However, I
just want to
empathize. I know you are facing a difficult and very worrisome
situation. My 2-
year-old needed a partial root canal (and crown) and 4 other small
cavities filled. I
struggled with the idea of general anesthesia, but ultimately was SO glad
we went
ahead with it. My son was so wary of the dentist as it was. I think he
would have
been totally terrorized and traumatized if he had had any idea what was
going on
during his procedure. Instead, he was blissfully unaware. That night he
even said
''That was a fun trip to the dentist'' because all he could remember was
playing with
the trains in the waiting area. There were, of course, risks involved
with the
anesthesia and he had a really hard time coming out of it, but overall the
benefits
greatly outweighed the costs for us.
Liz O.
I cannot address the issue of nursing or how your child came to have so
many cavities
at such a young age. I did want to let you know that I had general
anesthesia on my
child to fill 6 teeth and it actually went pretty well. They squirted
something up his
nose to make him drowsy and then set up an IV for the general anesthesia.
All he
remembers is ''yucky medicine up my nose'' and then nothing. It was
expensive but
much less traumatic than more recently when he needed one filling and the
dentist did
it with him awake and scared.
laura
General anesthesia is scary to most people, and nobody wants it
for themselves or their children unless absolutely necessary.
First and foremost I would like to say: Stop breastfeeding! The
child is 2 years old, the benefits go way down after 13 months
of age in terms of the health of their teeth - it actually
becomes detrimental to the child's oral health. If you are not
going to stop at least brush the child's teeth every time after
breastfeeding --- and ESPECIALLY at night. Also floss their
teeth once a day using little kid flossers.
In terms of the issue at hand you may have 2 choices:
1. You can get the treatment done with general anesthesia. it's
scary, but most likely your child will be just fine, and will
have no memory of the experience. It's a one time deal and you
are done.
2. You can find a pediatric dentist who will use oral sedation
(where the child is awake, but sedated) in combination with a
papoose board. A papoose board is a restraining device, much
like a straight jacket that holds the child in place while the
dental work is done. 2 or 3 appointments may be needed to
finish the dental treatment. This may be medicaly less scary,
but may lead to long term major dental phobia for your child.
Or you may be lucky and your child may remember nothing anyway.
general dentist and mother
Jan 2008
I would like some advice and reccomendations on pediatric
dentist in the Bay Area. I have a hyperactive 4 year old. i
just took him to a pediatric Dentist in pinole. They
reccomended iv sedation because they said theyr'e was no other
way but to put him out to work on x-rays, and four cavaties. I
would like to know more about iv sedation and the risks
involved before i proceed with on my son. Any comments and
emails would be helpful in this dilemma i am having. Thank you
naomi
Our son had sedation before he had 4 fillings & 4 root canals,
all at the age of 2 1/2. The thinking behind this was the same
as your dentist's -- a young child cannot be expected to sit
through a long dental procedure. Even if he could, he likely
wouldn't go to another dentist as long as he lived! Because we
knew the risks of any anesthesia, we were referred to Ed
Matsuishi in El Cerrito. He contracts with a pediatric
anesthesiologist from Children's Hospital. We were greatly
reassured to be under the care of an expert, and the entire
experience was excellent. If your Pinole dentist does not use a
pediatric anesthesiologist, I'd recommend calling Dr. Matsuishi.
By the way, my son LOVES going to the dentist 4 years later!
Christine
I would definitely get a second opinion from another dentist. My
daughter got her first fillings when she was 2.9 with only a
local anesthetic. Her dentist, Dr. Doshi, was TERRIFIC in keeping
her engaged, distracted, and completely pain-free. She used a
q-tip to dab some topical anesthetic (''sleepy juice'') on my
daughter's gum, then held the needle in such a way that her hand
blocked it from my daughter's view. While she was putting in the
filling (''giving your teeth a shower''), she held my daughter's
attention by telling her a story. She even had me blow up latex
gloves and draw faces on them.
My daughter is now 9 and has had a lot of fillings since then.
(Sigh...) She was recently VERY surprised to learn that there
were shots involved in her dental work -- Dr. Doshi had been so
skillful at numbing the gum and concealing the needle that my
daughter had never realized she was getting a shot. She still
doesn't know there's a drill involved! Dr. Doshi rocks. I don't
have her phone # handy but her office is on Regent Street right
near Alta Bates.
Of course, a lot depends on your child's temperament. You're the
best judge of what he is capable of. Maybe a skillful dentist
plus a big ol' bribe if he sits still -- some coveted toy as a
reward -- will be enough to get him through this visit. Or maybe
the sedation will be less traumatic for him. Trust your
instincts. Also, as the mom of a child with bad teeth I can tell
you that there are more of these visits in your future, and you
should also be thinking about how you want your son's experience
with dentistry to be.
Jennifer
Hi,
So, we are going through the same thing right now. Our 4 year
old has 6 cavities that our new dentist wants to fill. His name
is Dr. Matsuishi, in El Cerrito on Stockton Street. He was
recommended by our pediatrician. Here is what he told me.
In children this young the most important thing is not letting
them become tramatized from the dental experience. Once a month,
he has an anesthesiologist come from Children's Hospital and in
order of age/weight(?) puts them under. He said that he starts
the process with a puff through the nose. He said that within
minutes of finishing up - that the child comes to. He said that
my child would not remember anything and that he would be groggy
the rest of the day, and therefore should not go back to school.
I know I haven't yet gone through the experience, but I felt
confident in the Doctor and what he was saying. I originally
took him to my dentist - they noted the cavities - but said that
they did not want to treat him. I liked that Dr. M has someone
from Children's handling the medication part. The staff was
extremely attentive and my child was the center of attention.
They let me hold him the whole time at our first visit. It was
very kid-friendly. He really tried to connect with my child.
Best of luck.
Elizabeth
June 2007
Does anyone have experience with kid's dental surgery under
general anesthesia? My son is 6 years old. We were told that he
has two extra teeth growing on his upper molar (could only be
seen through x-ray). The plan is to cut into his gum and then
go search and try to pull the two teeth out.
We're very nervous abut putting him to sleep under general
anesthesia since he is so young. His surgeon says that now-a-
days its normal to use general anesthesia even extracting a
wisdom tooth. But when I did it (as an adult), I was only give
a local anesthesia.
Has anyone gone through this type of surgery with your children
and under general anesthesia? How did you and your child feel
then and afterwards?
Who was your surgeon? We have Dr. Thomas Love, in Oakland, near
Summit Hospital. Anyone know anything about him?
Thank you.
I've had 3 wisdom teeth out under local anesthetic without
discomfort or emotional trauma, even though two of the teeth
were impacted and the dentist had to cut the gum, and the other
broke and was quite difficult to remove. I had no complications
during recovery, unlike some of my friends who opted for
general. One suffered dry socket and both seemed to feel the
experience was much more of a ''big deal'' than what I
experienced. My theory is that people are foggy coming off
general and more likely to do something ill advised, like
drinking from a straw, or otherwise not following the dentists
instructions properly. I don't know what the real statistics are
for complication rates for local vs. general; a sample of 3 is
pretty dicey for drawing reliable conclusions.
Having the procedure under local can be psychologically
difficult for some people (seeing the scalpel, imagining what's
going on in there). For a 6 year old with minimal if any
experience with fillings, novocain, drills etc, it could be
difficult. I'd definitly consider both your son's dental
experience and temperment before committing to local
anaesthesia.
I went under general anaesthetic at five to have my tonsils
removed. It was definitely a big deal, but not traumatic. I
remember mask and the countdown clearly, but I don't remember
much of the recovery--I vaguely recall feeling pretty punchy,
but it was many moons ago. But I don't think going under general
at 6 is inherently more risky than doing it as an adult.
Carrie
Do not do any surgery on your child until you feel comfortable
with the decision. I went to four orthodontists and the oral
surgeon (whom I already knew) for opinions before feeling
comfortable with a decision to extract my child's teeth. You
will not regret the little extra effort to gain the peace of
mind. Research your options. Oral surgeons will give free
consultations. I recommend Bryan R Krey, DMD Ph: 510-848-1055.
Feel empowered in your health care choices!
I completely understand your worry. My 2-year-old needed general anesthesia for
dental work and I was a wreck. I cried while he was under. However, his experience
was much better than mine! That night he said to me, ''That trip was fun''. And I
said,
''what trip?'', and he said ''to the dentist''. That being said, he was VERY
grumpy,
tearful, and lethargic for about 2 hours after waking up from the surgery. But then
he
was back to his normal self. Also, my understanding is that the general anesthesia
used for dental work is not as ''deep'' as that used for major surgery. I believe
the
anesthesia is very low risk, although at the time I was still very worried about it.
Good
luck. Your child will be fine.
anon
Jan 2006
My daughter has 5 cavities (2 behind her front 2
teeth, 1 on the front, and 2 on 2 separate top
molars). She's 26 months old and we are looking for a
gentle dentist who would help us to fill her cavities
without using anesthesia. We've been to a pediatric
dentist and the first thing they told us is that they
want to sedate her for the procedure, that I can't be
with her in or during the process, and to stop
breastfeeding her. WE're looking for a dentist who
will look after her emotional needs as well as
physical. She's very afraid of the dentist and I
think that if we found someone who paid a little
attention to her and spoke her language (and let us
take the time we needed for her to be comfortable
there) that she might be a little bit more
cooperative. Does anyone know of a dentist who has who
could help us with our situation? What have others
done who've had a little one with dental caries? Any
help would trully be appreciated.
kathleen
Look into laser dentistry. It is a quick and anesthesia-free way of repairing cavities. Drs. William Gianni and William Tenant in Berkeley do both laser and conventional dentistry. I went to Dr. Gianni for the first time this summer and it was great. No drills, no anesthesia, no pain. Removing the cavity with the laser pulse took less than a minute. It didn't hurt at all. It just felt like a little tap-tap-tap. The longest part was filling the cavity, which was only about 5 minutes. I don't know if they work with children so you should give them a call to find out. Dr. Gianni was very nice and I can imagine he would be good with children. (510) 848 3143.
Alexis
Vivian Lopez, D.D.S. and an assistant name Tanya, are amazing! They really connect with my son and take their time and talk to him in a child appropriate way. We just go for regular check ups with them, but at 18 mos, he had about the same amount of decay as your daughter. Email me for more info.
Vivian Lopez is on Telegraph near Ashby in Berkeley.
andalove
I was saddened to read how your daughter already has cavities. I highly encourage you to read about Dr. Weston A. Price's work as he proved how the teeth reflect overall nutritional status. He was able to remediate shallow cavities in children with the use of vitamin A rich foods and raw milk. For information on both, go to www.westonaprice.org and www.realmilk.com.
As for dentists who can help, I suggest the team at 1313 Gilman (Rusta, et alia).
They are biological dentists and have expertise compatible to the principles of WA Price. They are especially good with kids.
Nori Hudson, NC
We experienced the full range of dental traumas when my daughter was that age (an extraction, restraints, verbally abusive dentists, sedation, etc.) Sedation with a low dose of valium paired with nitrous, administered by a reputable pediatric dentist, turned out to be the best approach for us. Mostly because my daughter did not have to be restrained and had only fuzzy memories of the experience after the fact. Once she was afraid of the dentist, nothing else really worked. After we got the initial work done, we went back to working with the dentist on helping her feel better, and after a few years she was no longer afraid. As for the dentist's advice to stop breastfeeding, I listened to what they had to say, did a little
reading, and quietly ignored it. I hope someone else will know
the dentist who can calm her without meds, but this was my experience.
been there
I'm sure I won't be the only one who suggests you find a NEW DENTIST! There are many pediatric dentists out there who do not blame breastfeeding for everything, and will welcome you to stay with your child during any procedure. Check the archives and ask around.
R.K.
When my then 28-month old son was found to have 8 (!) cavities, we were referred to Dr Edward Matsuishi in El Cerrito. Dr. Ed was very understanding and kind to me and my son, and did NOT recommend eliminating breast-feeding (which I did then and continue to do now -- though I HAVE given up night nursing!). I appreciated his advice, which was mainly to cut out sugars from the child's diet, esp juice, but keep breastfeeding as long as the milk doesn't ''pool'' in the mouth -- don't let the child fall asleep while nursing!
As for anasthesia, I invite you to re-think your position on it. Though we were scared at the prospect, the thought of putting my son through multiple visits to have fillings was unthinkable. The anesthesia was actually BETTER in that the work gets done all at once, and the child has no memory of it (and thus does not compound the fear of dentists).
Dr. Ed hires an outside pediatric anasthesiologist from Children's Hospital to administer the anesthesia. They are well-trained in anasthesia and ER procedures, and do this all day every day. We were there with the anasthesiologist and our child in the waiting room, while he administered a sort of Valium-like drug in my son's nose (he did this cleverly and non-traumatically -- the idea is it relaxes the child before the actual anasthesia is administered). We did sit with our son during the first part of the anasthesia, until he fell asleep. Then we left the room.
Afterwards, he was given to us to hold as he gradually woke up.
We were very happy with the results, and are so glad we did it this way (and believe me, we were VERY concerned). Good luck to you.
Christine
I highly recommend the pediatric dentist office of Dr. Katsura & Miahara. I don't know what their policy is for anesthesia for younger kids, but my 4 year-old has had her cavities filled (using just local anesthesia) in their office, and they are excellent, very family-oriented. Parents can go in with the kids, and sometimes they can actually lay down on the chair and hold the kid on top of them. Their office is full of toys, pictures, books and nice stuff that really attracts the kids and makes them feel more comfortable.
On the other hand, my daughter also had dental work done when she was 20 months-old (at a different office) and they gave her a mild sedative, which really didn't do much. She was wide awake and fully aware for the whole time, and, needless to say, it was very traumatic both for her and for us hearing her cry so hard. I really wish they had given her full anesthesia.
In summary, I do advice that you take her to a pediatric dentistry office, it's worht paying the difference, and trust what they think is more recommendable for your kid (w/ or wo/ anesthesia).
Toni
I recommend the practice of Wampler et al. Our daughter started there (with cavities) at about 18 months. They worked with us and particularly with her to help her get comfortable. Also they were open to our preference to do less permanent ''scoop and fill''
filings, which are less durable, but less invasive. They started out ''counting her teeth'' and ''painting'' them with flouride varnish, and only did the scoop and fill when she was comfortable enough to tolerate it. She also sat on mommy's lap, and at first we practiced at home with a mask and gloves the dentist gave us, then daddy ''helped'' at the dentist and she would open wide for me and let the dentist work. These last parts were more our inventions then something suggested by the dentists, but they were always willing to work with us.
BTW, we paid out of pocket to go to Wampler et al., after trying the UCSF clinic and having a horrible experience with a pre-doc student with no pediatric training. There is considerable difference in what different pediatric dentists think is ''necessary'' as far as general anesthetic, strapping the kids to boards, etc. It's worth it to find someone to work with who is gentle and willing to work with you, so your kid forms a good feeling toward the dentist. Our daughter is now (at age 7) a model patient at a clinic which accepts our (Healthy Families) insurance and even gets excited about going to the dentist.
Peter
Our pediatric dentist is WONDERFUL. Dr. Miyahara, 528-1526 or 848-6494. She is extremely sweet and gentle. I hear the other dentists in the practice are also great.
However, I can't imagine she or any other dentist could possibly fill cavities in a toddler without general anesthesia. My children have not had fillings, but I've had many myself. Have you had fillings? The sound of the drill alone would make it impossible for my children to sit still and if they didn't I imagine they could get injured. Additionally, the pain involved in filling an unanesthetized too would be unbearable for a child. It is for me as an adult. I think the best to hope for is a local rather than a general anesthetic, but I believe even then the situation (noise,
intrusion) would be intolerable for most small children and their consequent agitation would make it impossible to fill a tooth safely.
Liz O.
My five year old just had to have a cavity filled and our dentist recommended that he go ahead and fill it without anaesthetic, because the pain of the injection and the pain of the procedure would be roughly equivalent (the cavity was shallow), and our son might not be willing to let the doctor proceed after he put the Novacaine in.
I let him proceed, and my son, who is very sensitive, came through with flying colors.
I would highly recommend our dentist (mine and my sons') for gentleness and caring. His name is Eric Citron. (510)849-1660.
heather
It sounds like what you are dealing with is as much a values conflct as one over appropriate medical care. It would probably be worthwhile for you to talk to several dentists to find one with whom you feel you can communicate better than your daughter's current dentist.
Our daughter sees San Francisco pediatric dentist David Rothman, and has since she was a toddler. I think she gets excellent care, and she loves going to the dentist. Our situation is somewhat different from yours in that she has never had a cavity so we've never had to face the issues you are facing, but I've found that Dr. Rothman shares my family's values which makes everything much easier. He has two offices, one on Union St. and one on Ocean Ave.
Good luck!
Lisa
I take my 12 year old and my 26 month old to Dr. Leticia Mendoza-Sobel
on Grand ave. at the Oakland/Piedmont border.
She is the best!
When my 12 year old was about 3 we had a horrible experience with a
doctor that reluctantly let me in the room during the procedures (8
cavities.) When I took her to Dr. Mendoza she first did a series of
''behavior modification'' appointments where she had us come in when no
body else was in the office just to talk to her about the office and the
equipment and the procedures and encouraged her to ask questions and
just got her to feel very confortable. They always asked my daughter if
she wanted me to come in with her. Dr. Mendoza invited us to ''behavior
modification'' as soon as the second child was 6 months old and now both
my kids look forward to going to the dentist. I know she is there only
part time now but I understand that her practice partner Dr. Negron is
pretty good too.
veronica
May 2004
After reading some earlier postings about pediatric dentistry
and general anesthesia, I am worried that my child had dental
work by a local pediatric dentist without the proper precautions
taken. She had over a dozen cavities and was given a liquid
which knocked her out after about 30 minutes. The dentist also
gave her laughing gas and used restraints and a dental dam and
head brace. The dentist's assistant administered the liquid to
her and they monitored her heartbeat by using a clip onto her
foot. I doubt very much that she was an anesthesiologist--she
answered the phones the rest of the time!!! I may have been
tres ignorant of the procedures, but could they even undertake
this risky dental work under general anesthetic without an
anesthsiologist being present? I am very nervous about this and
doubt I will ever return to that dentist. Can anybody explain
the requirements to me?
Very concerned mom
This sounded extremely alarming. I felt rather sick after
reading your email - I was so sorry for your child! (It
reminded me of trauma at the dentist when I was a child I
think.)
I fully sympathise and support your concerns.
One question is - were all those cavities necessary to fill?
It seems rather a large number, and in any case, when baby
teeth are replaced relatively soon by the second set, was this
really necessary?
I think you might do well to find another dentist. I
understand general anaesthesia always carries risk, and a good
dentist should, I think, be able to fill cavities with the
agreement and cooperation of most children - that's part of the
skill of a paediatric dentist, to reassure and help them with
the experience. My own children, amazingly, carry none of my
fears of the dentist.
I really would find a more understanding dentist, who will
take better care of your child.
Good luck,
Jan
I think your concerns are right on. You should share them with
either Dr. Ed Matsuishi of El Cerrito or Dr. Perry of Alameda,
pediatric dentists who do oral surgery in their office with
anesthesiologists from Children's Hospital. When our daughter
had oral surgery at 2 1/2 years old, we discussed this issue
with her pediatrician, a few other pediatricians (my husband's a
pediatric nurse), and our dentist. All of them said that
although dentists do put people out in their offices without an
anesthesiologist present, it is too risky.
Sarah
June 2003
My 22 month old son has cavities on nearly all his upper teeth
which have developed over about 6 months. I am still nursing him,
but have been advised to wean soon. At least one cavity is so
large the dentist wants to do a root canal and has recommended
general anesthesia for that and filling the other cavities. An
anesthesiologist from Childrens Hospital comes to the dental
office to do the anesthesia.
I got a second opinion from my friend's dentist and he agreed
with our current dentist. My son is very big and strong for his
age and we all feel he would fight without some kind of sedation.
I am very nervous about him having any dental work at his age,
especially general anesthesia. This dentist filled my 4 year old
daughter's cavities using nitrous oxide and all went well.
I would appreciate hearing from anyone who has gone through a
similar dental situation with a toddler or whose child has had
general anesthesia and how it went.
My son (now 4) has had general anesthesia twice, once at age 17
mos. (to get a foreign object out of his bronchial tube) and
once at 33 mos. (to have a cyst removed from his neck). Our
situation was easier than yours, because we didn't have any
choice about the procedures, but I can tell you that the
anesthesiologists at Children's Hospital are great. The hardest part is
your kid getting cranky from not being able to eat or drink
beforehand, and the next hardest part is they can be a little
upset when they wake up, but our son got over that quickly when
he saw the giant lollipop we'd brought him. The lollipop, in
fact, is the only thing he remembers about the whole process.
Good luck.
Fran
Hi, my two year old nursing daughter had two root canals and
caps done under general anesthesia and everything turned out
fine. Dr. Mitsuishi (SP?) gave the second opinion and did the
procedure. I was very scared and did not go because of how I
cried when she had a tooth pulled but my husband said she was
not scared or difficult. She nursed a couple of hours later and
there was not problem. The dentist called that night to check up
on her and she was fine. We also tried to do it without the
anesthesia but she was to wiggly. Good luck.
Cherene
General Anesthesia for Child's Cavity?
May 2002
I would like to hear from parents who have had their child's
teeth repaired under general anesthesia or who found a way to
get major work done without it.
My 7 year old daughter needs 3 crowns on her baby molars, and 2
fillings on her permanent molars. We went this morning to have
some of the work done. The dentist administered nitrous oxide,
plugged her into watching a movie, and started the work. My
daughter got nauseus from the ''magic gas'' and started to get
scared when the drilling started. She has had her teeth drilled
a little by another dentist, so I don't think the drill itself
bothered her. She said later that there was just too much going
on. The dentist couldn't get her to stay still, so he
recommended stopping and doing the repairs next time with my
daughter under general anesthesia. They have anesthesiologists
come in on special days to monitor everything and run an IV,
etc. I have read all of the posts about the pediatric dentists
in the area. I am wondering if I should go ahead and have this
office do the repairs, or flee to another practice. Maybe my
daughter would have a better feeling with a different dentist or
approach?
Jeanne
My son just had general anesthesia to have several cavities
filled and one crown done. He is 3 years old. It was done at
Dr. Matsuishi's office in El Cerrito and it sounds from your
description of the office that you went there too. We had seen
two other dentists previously and both agreed with the
recommendation for general anesthesia. The dentist has the
anesthesiologist from Children's Hospital come to his office
and the child is monitored through the whole thing. My son did
fine although I was nervous. Dr. Matsuishi is very good but it
was expensive. One benefit is that your child won't be
traumatized by the procedure because she will be asleep. Also,
my son now swears that he was awake through the whole thing and
was very brave. I, of course, agree with him and tell him how
proud we were of him for being so brave. Good luck. Feel free
to email if you want to discuss our experience.
Shannon
We had the same recommendation given to us by a respected
pediatric dentist in El Cerrito. We balked at the price (over
$1000) as well as the necessity of putting my daughter under so
we went for a 2nd opinion. Dr Neil Katsura and Dr. Miyahara
(practices in Berkeley, Albany and Lafayette) saw my daughter for
1 minute before announcing she would be ''easy'' and absolutely
did not need to be put under. We have been very happy with both
dentists and both of my kids enjoy going to the dentist. We've
had fillings and crowns done with no complaint from the kids.
Dr. Miyahara is particularly gentle, but both dentists are great
with kids. I would recommend getting a 2nd opinion.
Naomi
I had exactly the same experience with my six-year-old boy last
summer. He needed seven filings in his teeth. The pediatric
dentist started the procedure using the gas and the TV set, and
my child got scared, cried, and wouldn't open his mouth. Our
dentist also suggested general anesthesia.
We ended up with changing a practice. We are seeing now Dr.
Katsura. He doesn't use nitrous oxide, nor a TV set. My son is
looking forward to each visit, and we have successfully
completed the whole procedure in four visits
Tikva
It sounds like your daughter is currently seeing a pediatric
dentist. The personal experience that I have with dentristy
with a GA done for pediatric patients is as an RN caring for ped
pts. post-anesthesia. Checkthat the anesthetist has pediatric
training and is comfortable with pediatric patients. Obviously
if they are working for a ped. dentist they would be, but it
never hurts to ask. As for your daughter, she will have to be
NPO (nothing by mouth) from midnight on the night before the
procedure so it is good to request an early morning apointment.
It is very important to ensure that she strictly adheres to
this - I've known anesthetists who have cancelled the case
because a child has chewed gum! (there is a risk to the child if
they have eaten/drank anything so anesthestists take this
seriously) After the procedure, depending on the type of
anesthesia used, the length of the procedure, and how the child
fell asleep (if calm, most kids wake up calm - if crying, same),
your daughter will stay in recovery for about 1 hour - more or
less depending on the facility's policy&how your daughter is
doing. She will probably be given some fluids/popcicles to
trial before she goes home. It's common for kids to have some
vomiting after dental work if they've swallowed any blood after
they wake up. If she has an IV they can give her fluids and
anti-nausea meds if she does seem to be vomiting a lot. Also,
you can ask to be in the room when she goes to sleep - they can
give her gas and put the IV in after she is asleep (as a parent
you will leave once she does go to sleep and before the IV)
This usually helps kids to stay calm. As soon as your daughter
wakes from the procedure you can ask to be called. I have cared
for a range of children of all age groups who have had dental
work done with a GA and I'd say that if the work is important it
will be done well if the child is still (asleep). Of course,
nothing is without risks and you need to discuss those with the
dentist and anesthetist. Most importantly you have to trust how
you feel about it. If you have any more questions, please feel
free to email me.
Lisa
My almost-three-year-old daughter recently had dental work done on
her two front teeth, for which she received general anesthesia.
The dentist and the anesthesiologist were both extremely
understanding about my concerns and provided detailed information
about the procedure. Not only were they were both experienced
with little children, they were also very kind, gentle, and even
fun for my daughter to be around (before they knocked her out).
Before my daughter had her dental work done, I had spoken with
parents about their experiences regarding general anesthesia for
such things, and they invariably recommended it. As I understand
it, the only alternative is to somehow restrain the hapless child
while the dentist does his job... FYI, my daughter's teeth are
100% fixed and she came out of the anesthesia just as healthy and
sound as she went into it.
Miki
Valium for Child's Cavity?
Jan 1999
My 5 year old has a cavity that needs to be filled. Upon scheduling the
appointment with the pediatric dentist, he handed me an envelope with some
valium to give her the morning of the appointment. He said it would reduce
her anxiety. I am hesitant to give my child valium. Have any parents had
experience with this type of situation? Does anyone have any suggestions how
to best prepare my child for her appointment Thanks in advance. Marcella
June 1999
Yesterday we took our son to the dentist
for the first time to have his teeth checked out. We were told that
his teeth need some fillings. The doctor gave us a tranquilizer
called "Valium" to be given to him an hour before his next visit. We
appreciate any advice on the practice.
Hi,
My 3-year-old son recently went for his first dentist visit and I found out
he had some small cavities, too. I took him back for the fillings, and he
had them done with no medication at all, and did not feel any pain. He sat
very still in the chair.
He may be an unusual case, the dentist and the assistant both
commented on how good he was. If your son sat still for the initial visit,
he may do okay for the fillings. Or, maybe the dentist felt the cavities
were deep enough to hit a nerve? Valium is pretty mild for adults, I think
it helps relieve fear, but I don't think it's really a tranquilizer or
painkiller. I would call their office to find out more.
Good Luck!
Sabine (6/99)
I've not yet taken my 3 year old to the dentist and have
been wondering when to start. I am *not* an expert on
this topic (children and/or dentistry) and have not researched
it at all; however! After seeing a show on Dateline
(? maybe 20/20 or 60 minutes) about children going to the
dentist to receive treatment for things as "routine"
as getting a cavity filled, I have virtually ruled out taking
my child in for a routine checkup let alone to get a cavity filled.
Why? The Dateline show featured several families who had lost a young
child (to death) due to something going wrong while the child was
anesthetized. According to the Dateline report, dentists comprise
the only health profession that does NOT employ professional
anesthesiologists-- unlike medical doctors, surgeons, hospitals, etc.
Rather, the official dental association (ADA?-- Am. Dental Assoc.)
spokesman replied (on the show), when asked why they do not employ
professional anesthesiologists, "We use people who have been trained
in anesthesiological administration." A bottom line of the show
(as I understood it) is that dentists view children (2, 3, 4, 8 year
olds) as little adults, who can handle the same medical procedures
as adults-- whether it is anesthesia or other drugs. I believe
children's systems are different than those of adults and are much
more sensitive than adults to almost everything (chemicals,
pesticides, anesthesia, as well as drugs such as valium).
It was terrifying to hear this Dateline story about the treatment
of children by the dental profession and to see that there are
children dying for "simply" getting their cavity filled!
After the show, I've wondered whether in some cases it might be better
to just let the cavity exist (unless of course it is painful).
Afterall, a 5-year old is going to lose his baby teeth in a few years.
This is my own unprofessional first-response reaction to what I saw
on Dateline. I do realize that there can be (perhaps significant)
repercussions for not filling a cavity (e.g, maybe the gums would
become compromised and affect the permanent teeth later on), however,
my gut instinct tells me that in all but severe cases, it might be
ok to leave a small cavity alone. I will be researching the
alternative literature on this to see what dental treatment
my child should or should not receive.
I do not want to alarm you or anyone, but I would certainly
want to have had someone tell me about this Dateline show had
I not seen it and a dentist told me to give valium to my child
to "reduce anxiety". I would have many questions, e.g.,
Is there ANY possibility of an adverse reaction to the
combination of valium and either local or general anesthesiain a young
child?
I too am hesitant to send my son to the dentist and have his
cavity filled. I have heard too many horror stories and feel more
comfortable waiting until he is much older and stronger. Am I causing
him more harm than good in doing this? I know that children loose most
of their teeth at a later age, so is there really a rush to do this?
Monica
On dentists and anesthesia -- my child is impossible at the
dentist. However, no dentist I have gone to was able or willing to
use general anesthesia. They wanted me to go to an oral surgeon for
that. I believe general anesthesia is risky and would be very
reluctant to do it except when absolutely necessary. I would like to
know if the children in the last issue (dateline?) died from
novacaine injections, nitrous oxide, or general anesthesia? Finally,
my child has a cavity that is really bad and causes her considerable
pain from time to time. I am getting worried, as I understand this
can damage the jaw and even cause internal infections of one sort or
another. I am ready for valium, and will try it if I can find a
dentist who will do it. Maybe I will take some too.
Lynn
In response to the concerns about young children getting fillings, I
wanted to share my almost-three-year-old daughter's experience and
recommend her dentist, Dr. Neil Katsura, for his handing of her filling.
My daughter tends to be pretty calm at doctor's visits, so I do not know
how Dr. Katsura would handle a child who is uncomfortable or afraid of
the dentist (I expect well)--but he certainly helped make my daughter's
first filling a literally painless experience. On her first, routine
visit to Dr. Katsura, it was discovered that my daughter had a major
cavity (possibly caused, the dentist speculated, by her drinking milk at
bedtime without brushing her teeth again afterward). The dentist put in
a temporary filling, and we scheduled an appointment for a permanent
filling for the week before she was to turn three years old. We asked
whether the filling could wait until she was a bit older, but the
dentist was adamant that the cavity be filled as soon as possible.
Dr. Katsura and his assistant did several things to make my daughter
feel at ease and to distract her from the procedure. They tested the
drill on her fingernail, so she could get a sense of the sound and
action of the drill. As he was drilling, Dr. Katsura talked to her,
describing a picture he was supposedly drawing on her tooth. When he
put the actual filling in, he said he was putting a star in her tooth.
My daughter remained quiet and cooperative throughout the entire
procedure and seems to have no negative feelings about the dentist's
office. Dr. Katsura's number at his office on Ensenada, off Solano
Avenue, is 510-528-1546. He works out of another office in Berkeley, as
well; the Ensenada office could give you that number. Good luck.
Elisa
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