Photo by Jelleke Vanooteghem on Unsplash
Dr Viktorija Golovčuka, paediatric dentist at the ‘Zobu feja’ dental clinic, has talked about the first time children visit their dentists, and situations when dental treatments on children require general anaesthesia.
Your child’s first visit to the dentist’s
At what age should a child be taken to an oral hygienist, or a dentist? Is there a difference in which of the specialists should come first?
It is recommended that the child visits the dentist for the first time at 1. The dentist is the first of the specialists you should plan on visiting, so that they can assess the condition of the teeth and the oral cavity, and recommend proper dental and mouth care, as well as dietary habits to the parents.
How frequent should preventative check-ups be for children?
They should take place every 3—6 months, depending of the risk of tooth decay, which is determined by the dentist during the first visit.
What should parents do, so that the child isn’t scared of the doctor?
Plan the first appointment as early as possible, so that the child develops a positive view of dentistry. Don’t wait until they start complaining about toothaches. If the teeth do indeed need treatment, then we recommend a tooth hygienist appointment before the treatment, so that the child can prepare for the things the dentist will do during it. Preparing the child before the dentist appointment at home is also important. Parents should not scare their children with the upcoming visit to the dentist. When describing it, don’t ever use phrases like ‘it won’t hurt’, ‘don’t be afraid, it’s not scary’, ‘syringes’ etc. Let the dentist explain everything directly to the child. It often surprises parents that we recommend getting dental check-ups as soon as the child’s first tooth comes through; however, parents should know that regular appointments with the dentist are important for keeping the oral cavity healthy. It is the paediatric dentist who will teach the child correct techniques for cleaning their teeth, and avoid damaging them. They earlier the visit to the dentist’s, the sooner we’ll determine the condition of the child’s mouth, about the growth of the teeth, development of the lower jaw, dental occlusion, and detect problems early, preventing them from manifesting in the future.
Dental treatment under general anaesthesia
What should one doe if treatment under general anaesthesia is recommended?
The important factor is the ability to communicate, to establish a dialogue with the child; the patient’s age is also significant. If the child is anxious, afraid, won’t open the mouth, and refuses to cooperate, then general anaesthesia may be one of the option, because forcing a treatment onto the child is not something that the child needs, and it will leave life-long trauma.
The child having tooth decay is an unambiguous clue to poor eating and drinking habits, as well as insufficient dental hygiene in the family. Unfortunately, damaged teeth in children are the result of ignorance and bad habits of their parents.
The drugs used for anaesthesia today are safe and well-proven, and have no harmful health effects. If the correct dosage is used, and it is determined individually for every patient, there are no complications. Sad to say, many parents are not particularly-well informed about the use of general anaesthesia in dentistry, and there is a common preconception of its being harmful, which leads to parents not taking their child to the dentist at all. However, medicine in general, and drugs in particular, have progressed a lot in recent times.
In what situations is treatment under general anaesthesia recommended?
1. For children under the age of 3.
At such an early age, the patient cannot sit calmly in the chair; it is hard to establish an emotional connection and do the treatment in an effective way. Typically, this is about minor damage to the teeth, and treating it doesn’t require the child to sit in the chair for a long time, but if there already have been unsuccessful treatment attempts, then anaesthesia may be the answer.
2. If many teeth are affected.
Even children who are positively inclined sometimes find it difficult to handle a long appointment, and all the things the dentist has to do.
It’s not uncommon for positive attitude to wane after the first visit, because of the child’s personality or mood, and they just start refusing treatment.
3. Children with special needs.
This includes children with special development, with allergic reactions to anaesthetic drugs, with neurological disorders.
4. If the child panics before the treatment.
Children typically get scared without any negative experience with dental treatments. It’s worse if you have to hold the child in the chair by force, all while trying to treat or pull their teeth out. That can make one scared of dentists for life. There have been cases of children starting to stutter after such ‘treatments’. We do not condone forcing children to stay in the dental chair!
How does treatment take place under general anaesthesia?
Our doctors always try to establish rapport with the child, of course. This is why our clinic has a special tooth fairy school. Nevertheless, general anaesthesia is unavoidable sometimes.
We use the latest anaesthesia equipment and system monitoring devices by Drager. The general anaesthesia is provided by an experienced team, comprising an anaesthesiologist and an anaesthesiology nurse. The treatment itself is done by a paediatric dentist and a medical assistant who are trained to work on anaesthetised patients. Our team uses Sevoran, which is currently the safest drug for this.
Our clinic uses unique and advanced methods for treating, repairing and maintaining children’s teeth:
- Baby tooth root canal treatment
- Front tooth repair
- Installation of a placeholder in the event of early loss of a tooth
- Front tooth prosthetics
We fight for preserving every tooth, because the consequences of losing your teeth early can be serious:
- Incorrect development of dental occlusion
- Incorrect development of the lower jaw
- Speech development problems
- Psychological problems
What are the practical aspects of treatment involving anaesthesia?
During the consult, we assess the condition of the oral cavity and determine what treatment is necessary, as well as the time needed for that treatment. We take x-rays if necessary. The date and time for the treatment is only determined after the child undergoes a complete examination by the anaesthesiologist and the dentist during the consult. The consultation is also very important for the parents, because get the chance to get information about the anaesthesia and the planned treatment from the specialists. Before the treatment takes place, we will also need a referral by the family physician that describes the condition of the child’s health, as well as blood test results, to assess the child’s health in general.
On the day of the procedure, the parents bring the child to the clinic and spend the entire time with the child in the surgery. We typically agree with the child that they’ll just have to deflate the balloon (breathe the gas in), and go home afterwards. There’s no need for more details, because the child will not remember the treatment anyway.
After it is over, the child will stay under for some 20—30 minutes. After the child wakes up, we monitor them for 1—1.5 hours. If everything is fine, the parents are allowed to take the child home.
Photo by Jelleke Vanooteghem on Unsplash