The American Academy of Pediatric Dentistry (AAPD) endorses general anesthesia (GA) for pediatric dental patients who: are unable to cooperate; experience ineffective local anesthesia; are extremely fearful, anxious, or uncommunicative; require significant surgical procedures; can benefit from general anesthesia protecting them from psychological trauma and/or reducing medical risks; and require immediate, comprehensive oral care. Pediatric dentists are trained to recognize the need for hospital-based dental treatment and to work with an anesthesia team to provide optimal care for their patients.
What is General Anesthesia?
General anesthesia makes you both unconscious and unable to feel pain during medical procedures. General anesthesia is commonly produced by a combination of intravenous drugs and inhaled gasses (anesthetics). The "sleep" you experience under general anesthesia is different from regular sleep. The anesthetized brain doesn’t respond to pain signals or surgical manipulations. An anesthesiologist is a specially trained doctor who specializes in all types of anesthesia, including general anesthesia. After you’re asleep (unconscious), your body’s vital functions are monitored and your breathing is assisted and controlled. In our surgery centers, an anesthesiologist and another team member, a certified registered nurse anesthetist (CRNA), work together throughout your child’s procedure to carry out these tasks.
What Are the Risks?
Most healthy people don’t have any problems with general anesthesia. Although many people may have mild, temporary symptoms, general anesthesia itself is exceptionally safe, even for the sickest patients. The risk of long-term complications, much less death, is very small. In general, the risk of complications is more closely related to the type of procedure a patient is undergoing, and their general physical health, than to the anesthesia itself.
Some of the factors that can increase a patient’s risk of complications include:
- Smoking
- Obstructive sleep apnea
- Obesity
- High blood pressure
- Diabetes
- Other medical conditions involving your heart, lungs or kidneys
- Medications, such as aspirin, that can increase bleeding
- History of heavy alcohol use
- Drug allergies
- History of adverse reactions to anesthesia
Rare complications, which may occur more frequently in older adults or in people with serious medical problems, include:
- Temporary mental confusion
- Lung infections
- Stroke
- Heart attack
- Death
What Should I Know Before the Procedure?
General anesthesia relaxes the muscles in the digestive tract and airway that keeps food and acid in the stomach and out of the lungs. That’s why it’s important to follow our doctor’s instructions about when to stop eating and drinking prior to surgery. In most cases, your child should start fasting the night before his or her procedure. They may be able to drink clear fluids, such as water, apple juice or broth, until a few hours before surgery. If your child takes a daily medication, your doctor may tell you to give the medication with a small sip of water during their fasting time. Discuss any medications with our doctors.
Some vitamins and herbal remedies, such as ginseng, garlic, Ginkgo biloba, fish oil or others, may keep blood from clotting normally, interact with other medications or cause other complications. Discuss the types of dietary supplements your child takes with our doctors before his or her surgery.
The anesthesiologist gives the anesthesia medications as a gas that your child breathes from a mask. An intravenous (IV) line is placed after the child is sleep to provide additional medications and fluids. The IV is removed once the child begins to awaken. A member of the anesthesia care team monitors your child continuously during his or her procedure.
What Should I Expect After the Procedure?
When the surgery is complete, the anesthesia medications are discontinued, and your child will gradually awaken either in the operating room or the recovery room. He or she will feel groggy and a little confused when they first awaken. He or she may experience common side effects such as:
- Nausea
- Vomiting
- Dry mouth
- Sore throat
- Shivering
- Sleepiness
- Mild hoarseness
Your child’s doctors will give your child medications after the procedure to reduce pain and nausea. Our patients typically experience minimal nausea, and any pain can be alleviated by over the counter analgesics such as children’s Motrin or Advil.