Despite what you’ve seen in the media, going to see the dentist isn’t always life’s most hilarious and compelling experience. It doesn’t always include wacky antics with suction or anthropomorphic singing plants eating people. Occasionally, you’ll need to get a problem fixed. Most kids and adults can power through and get their problems resolved with the magic of local anesthesia, a team of folks that are well trained to help, and degree of patience. Sometimes, however, this might not be the best course of action.
There are many circumstances where some patients, particularly very young patients, might be more effectively treated in a different environment. The instruments dentists use to fix teeth need to be able to cut through the hardest substance in your body, so there’s a pretty good chance those instruments will be able to cut through just about anything else that happens to get in the way. If a patient isn’t able to stay still, working in that tiny space may be a risky proposition.
One of the main goals of dental visits for young children is to help them learn how to be dental patients. They need to learn how to sit still while the team gets teeth clean, obtains readable x-rays, and examines them. They need to learn how to deal with the sounds, tastes, smells, and even feels of receiving treatment. These lessons are easily delivered over time, and almost everyone eventually learns how to do it.
For other children, however, we’re not granted the benefit of that long time horizon. If a three year old comes to the dentist with ten teeth needing tooth extractions, nerve treatments, and crowns, that’s asking a lot. It’s a series of appointments that many adults wouldn’t tolerate, and many parents wouldn’t like their children to have to tolerate. It’s hours of time with injections in their mouths, and often the children simply don’t have the ability to sit still for the time required to deliver treatment.
Other children have special needs that make treatment in the office more difficult. They may have sensory concerns that make them intolerant of tastes or sounds. They may have medical needs that require more support systems in case of an emergency.
Other folks are just frankly terrified for whatever reason. For these children, forcing them to get care in the office, while people or restraints hold them still, may be inhumane.
Thankfully, this situation has been going on for as long as there have been both children and dentistry, and there’s an excellent solution. We have anesthesiologists.
Anesthesiologists exist to make otherwise impossible health care tasks possible. A two year old needs to have ear tubes? General anesthesia. A child can’t still still for a critical MRI? General anesthesia. A five year old needs six root canals and eight crowns? General anesthesia. With general anesthesia, a dentist can complete all of the work a child needs in a single appointment. In the case of Chatham Pediatric Dentistry, we treat our patients at UNC’s Ambulatory Care Center.
We prefer to have the peace of mind knowing that we’re working with a robust and highly skilled anesthesia staff that is familiar with treating dental patients. We like having access to excellent pre-operative and post-operative care teams that are comfortable working with younger and special needs patients. We love knowing that they operate as part of the larger UNC Healthcare machine, with access to all of the resources a specialty care hospital provides.
The dentistry performed under general anesthesia is no different than the care provided in the dentists’ office, except that the child’s lips aren’t numb when we’re finished. Children typically go home about an hour after the procedure has finished, and we recommend that they take it easy for the rest of the afternoon. Nearly all children are one hundred percent recovered by the next day. On top of all of that, children don’t associate the treatment with going to the dentists’ office, allowing them to continue their growth as dental patients without the trauma of repeated difficult appointments.
Once the mouth has been restored, now we have the goal of maintaining the teeth free of cavities. We can suggest changes to the child’s oral hygiene regimen and diet, and hopefully we can work with families to make a plan that both kids and their parents can live with. That’s where the real work begins, because it’s the start of a lifetime of healthy habits, which is way easier than a lifetime of Lifetime movies.
