San Jose Dental Surgery Center Children's Dental & General Anesthesia (Sleep) Center

General Anesthesia and Your Child

For most parents, the thought of their child undergoing general anesthesia is by far the most frightening part of any planned surgery. This is understandable, since anesthesia is unfamiliar to most families. Furthermore, the media occasionally reports on a terrifying story of a life threatening problem associated with a surgical anesthetic. In reality, though, modern anesthesia is extremely safe. It is only because it is so safe - with millions of uncomplicated anesthetics administered every year - that such problems are considered news at all. Here are answers to some commonly asked questions. 

Why would a child need sedation or general anesthesia just to have teeth fixed?

Unfortunately, many children suffer from serious, potentially painful dental diseases. Unlike such health conditions as colds or flu, dental diseases won't go away on their own. When treatment is required for a serious dental condition, sedation or general anesthesia may be recommended to make delivery of that required treatment possible in a safe and comfortable manner. Without treatment, dental diseases can adversely affect, learning, communication, nutrition and other activities necessary for normal growth and development.

Is there a safer, less risky way to treat a child's teeth?

When a child (or a person of any age with a disability) needs extensive dental treatment, general anesthesia is an accepted standard of care. This standard is supported by the American Academy of Pediatric Dentistry, the American Dental Association, the American Medical Association, and the U.S. Department of Health and Human Services. 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.

Is General Anesthesia safe?

Modern anesthesia is extremely safe.  Millions of people have general anesthesia every year without any difficulty. The actual risk of a fatal event under anesthesia (for an otherwise healthy child) is about 1 in 300,000. To put that number into perspective, the risk of death from an unexpected reaction to penicillin is about 1 in 80,000. The risk of a fatal automobile accident while riding in a car (in the United States, over a one year period) is about 1 in 6500. 

Do you use a papoose or strap my child down for dental treatment?

The answer is NO.  To most parents, it is inhumane to strap a child down for dental treatment.  This may cause permanent trauma to a child’s mental state.  Dental papoose/strapping devices have been banned in many countries.

Who will give my child anesthesia? Can I meet that doctor ahead of time?

Your child's anesthetic will be given by a fully trained and experienced attending anesthesiologist.
You will meet this doctor just before the surgery.

What if my child is allergic to anesthesia? Can you test for that?

There really is no anesthesia allergy, but there is a very rare condition in which people have a bad reaction to certain anesthetic agents. This is a congenital muscle disease (malignant hyperthermia), which causes a patient to be unstable under anesthesia. Every anesthesiologist knows about this and how to react if this scenario occurs. However, there is no reason to test for this ahead of time (by muscle biopsy) in the absence of anything else that might suggest that the disease is present.  

Can I be there when my child goes to sleep?

Our main concern is, of course, the safety of your child.  Parents or visitors are not allowed in the operating room while your child is undergoing general anesthesia. Seeing a parent having a strong emotional reaction is not reassuring to the child, and may actually be worse than having to go through the procedure alone. And it goes without saying that having a parent faint is not only frightening to the child, but also would result in the need to direct medical attention away from the patient!  We want to pay 100% attention to your child.

Can I stay during the procedure?

Parents are not allowed in the operating room during the surgery itself, even if they are physicians. This is potentially disruptive. Once again, your child's safety is our primary concern.

Can I be there when my child wakes up?

This is another very common request.  We do all we can to make sure that you are separated from your child for the shortest amount of time possible.

While most children are, to some degree, awake by the time you are reunited with them, they are slowly emerging from a very deep sleep, and usually don't remember much until later on in the recovery period. We know that it is hard to be separated from them when they are going through a stressful experience. We always do our best to keep that time as short as possible.

Why is my child crying in the recovery room?

Unlike adults, most children do cry in the recovery room, especially if they are very young or have had a painful procedure. This is not because children feel more pain than adults, or get less pain medication. It is because there are many things in this environment that cause stress, and children tend to cry in stressful situations.

In addition, children are often disoriented, frightened, nauseated, hungry and dehydrated after surgery. All of these things can add to stress. However, children usually feel better within 30 minutes or so, once they have woken up more fully and have had something to eat or drink.

***Special Thanks to Dr. Michael Rothschild, M.D.

Source: The American Academy of Pediatric Dentistry