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What if my child needs a dental procedure?

The aim of this page is to provide you, as carers or parents, with all the relevant information regarding your child's dental procedure and answer some of the common concerns and queries.

 

What if my child needs a dental procedure / surgery in hospital?

Dental treatment involving fillings and simple tooth removal can often be carried out using injections to numb the child's mouth. It is also possible to add sedation, which makes the child feel drowsy, and helps to relax children who are anxious or afraid.

For some children however a general anaesthetic may be the only option, especially the very young, those with severe anxiety or those with disabilities or additional needs. This is usually a reasonably short procedure so can be carried out in a paediatric day surgery.

General anaesthesia is a state of controlled unconsciousness and freedom from pain.

Anaesthetics are the drugs (gases and injections) that are used to start and maintain anaesthesia.

When the operation is finished the anaesthetic is stopped and your child regains consciousness ('wakes up'). General anaesthetics are given by anaesthetists. They are doctors with specialist training and are experts at looking after patients when they are anaesthetised. The anaesthetist stays with your child all the time during the operation and carefully monitors him or her.

What should I tell my child about the anaesthetic?

This will depend on the age of your child, how anxious they are about the procedure and how much you judge they can understand.

It may be enough to explain that some of their teeth are poorly and need to be removed or fixed. You can explain that the doctor will give them some medicine which will make them go to sleep while their teeth are removed or filled. The doctor will look after them while they are asleep and will help them wake up at the end of the operation. They will also be given medicine to make sure they don’t feel too sore afterwards.

Older children may want to know more.

Do encourage your child to talk about the operation. Books, games and stories can help. Many hospitals have play staff who can give explanations and encourage discussion through play.

You may be able to visit the department/operating theatre before the procedure and speak to the staff.

What should I do if my child is unwell?

If your child has a cough, cold or a running nose or is otherwise unwell it may not be possible to go ahead with the anaesthetic and operation. If you have any doubts please contact the hospital for advice before attending for the appointment.

Why is it important for my child not to eat or drink before the anaesthetic? ('nil by mouth')

If there is food or liquid in your child's stomach during the anaesthetic, it could come up into the back of the throat and then go into his or her lungs. This would cause choking, or serious damage to the lungs, and so is very dangerous.

Your local hospital will give instructions about when your child must stop eating and drinking.

Please do not let your child have sweets or chewing gum as these fill the stomach with saliva and increase the risk of vomiting

How will my child be given the anaesthetic?

Your child will either have anaesthetic gas to breathe through a face-mask or an injection through a cannula. (A cannula is a thin plastic tube placed, using a needle, into a vein on the back of the hand or the arm.

Once the cannula is in place, the needle is removed.) Anaesthetic cream is commonly placed on a child's hand or arm to make the skin numb and reduce the pain when the cannula is put in. The cream takes up to an hour to work, so please make sure it is not removed.

You can stay with your child while the anaesthetic starts to work. Your child will usually become unconscious on the operating table or trolley in the anaesthetic room. If your child is unhappy to leave you, it is usually possible to start the anaesthetic with your child on your lap and then transfer him or her to the operating table when unconscious.

Once your child is unconscious you will be asked to return to the waiting room. The anaesthetist will stay with your child throughout the operation. To make them more comfortable, most children are given some type of pain relief either before, during or after the operation.

Your dentist or anaesthetist will tell you more about what is planned for your child. Once the operation is completed your child will be taken to the recovery room. A trained recovery nurse will look after your child and once he or she is responding to the nurse's voice you will be able to be with your child again.

Children usually wake up within 5 to 15 minutes of the end of the operation. When your child first wakes up he or she is likely to be a bit confused and may cry for a short time. Some children are upset by the taste of blood in their mouth. If local anaesthetic has been given, they may not like the numb feeling in their mouth. They may also feel some pain, in which case more pain relief medicine will be given.

Most children settle quickly and can soon have a drink. After very short operations children can usually go home after one hour.

For longer operations recovery will take longer but most children will be able to go home within two hours. Afterwards it is common for children to feel dizzy and a bit sick for a few hours, be sick occasionally and have some pain or discomfort for a few hours.

You can help by giving your child pain relieving medicine regularly as prescribed. If you have any concerns about your child when you get home, you should contact the hospital using the telephone number provided.

 

How safe is general anaesthesia for dental treatment and what are the risks?

With modern anaesthesia, serious problems are uncommon.

Risk cannot be removed completely but when a patient is fit and healthy and the operation is a small one, as many dental operations are, the risk of a life-threatening problem is about 1 in 400,000. This risk is considerably less than that of your child being seriously injured in a road accident.

My child has learning disabilities or has special medical problems. Are there any extra risks with the anaesthetic?

There may be a small increase in risk but this risk should be outweighed by the benefits of your child's treatment.

Each child is different and will be carefully assessed before their operation so that their treatment can be tailored to their needs.

Sometimes children with serious medical problems who need a general anaesthetic for their dental treatment need to be admitted to hospital rather than go home the same day. This allows full preparation for their operation and the anaesthetic and a longer recovery period afterwards.

Special Care Dentistry Service

Solent Health NHS Trust run a Special Care Dentistry Service for children and Adults that have an impairment / disability or complex medical condition across Hampshire.

You can read more about the service here.

Dental Passport

You can also download and complete a Dental Passport for your child using the external link on the right of this page.

This document explains everything the Dentist may need to know about your child, especially if they have trouble communicating their needs.

You can also see the Dental Passport here.

Source: http://www.patient.co.uk

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