The use of general anaesthesia in children having dental treatment


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Specialist Paediatric Dentist
Paediatric Care
BDSc (Melb), DClinDent (Melb), M.R.A.C.D.S (Paed)

A general anaesthetic (GA) may be required to manage a very young child during a dental procedure or an older child who is anxious undergoing extensive dental treatments.

What is a general anaesthetic?

A GA can be used for kids’ dental care to ensure that the child is fully asleep and able to have dental treatment without any pain. It is given in a day surgery by a doctor called an anaesthetist. The anaesthetist stays with the child during treatment and carefully monitors him or her during dental treatment. Afterwards, the anaesthetist will ensure the child wakes up as comfortably as possible in a “recovery” room.

How will my child be given the anaesthetic?

A GA consists of a combination of medications given either as a gas to breathe in through a mask or as an injection through a cannula (like a thin plastic straw) into a vein. Numbing cream is placed on your child’s arm or hand to reduce the discomfort of the injection. The doctor will decide which method is most appropriate to give anaesthetic to your child.

With children who are extremely nervous, the doctor may choose to give your child a medicine to drink to relieve anxiety before going into theatre.

Why does my child need to go to hospital to have a general anaesthetic?

general anaesthetic

Australian government regulations state that GA for dental treatment may only be given in a hospital, where appropriate medical and safety facilities are available. A GA cannot be given in the dental clinic.

A paediatric dentist may give nitrous oxide sedation (known as happy gas) in the dental clinic. This form of sedation is safe to do in the dental clinic because your child remains awake. However, nitrous oxide sedation may not be suitable for a nervous toddler or phobic child who is too scared of the noises, smells and sensation of receiving dental treatment.

Why should my child not eat or drink before having an anaesthetic?

We know children don’t like being hungry and thirsty. However, fasting is extremely important prior to having a GA. Fasting ensures that your child’s stomach is as empty as possible so to reduce the risk of vomiting during or after dental treatment. (Vomit that enters the airways can be particularly dangerous.)

Paediatric patients at Smile Solutions are required to fast from food and drink according to the Royal Children’s Hospital of Melbourne fasting guidelines. These will be discussed by the hospital nursing staff and by the dentist. When a dentist has an all-day surgical list, younger patients and children with special medical needs must be seen earlier on the list. Consequently, an older, healthier child (for example, aged 6 years and older) might not be treated until the afternoon. We ask parents to be patient and respectful of other children on the list. We know that fasting can be distressing to children and we do our best to offer practical advice during the consultation on how to manage it.

Are parents welcome to stay when the anaesthetic is given?

One parent is allowed to come into theatre to stay until your child is asleep. Once the child is asleep, the parent will return to the waiting room with the theatre nurse.

How safe is anaesthesia and are there any after-effects?

The degree of risk will depend on your child’s medical condition and the nature of the surgery for which anaesthesia is being provided. Dental treatment is a low-risk procedure in comparison to, say, heart surgery. You will be able to discuss any concerns you may have with an anaesthetist before surgery.

Most children recover quickly and are soon back to their usual activities after a GA. Some children may get side-effects from the drugs used. However, these are usually mild. Headaches, nausea and a sore throat can occur but can be treated effectively. Very young children can be tired or disoriented upon waking up. This can be distressing to both the child and parent but these effects usually wear off quickly.

More serious complications of having a GA include an allergic reaction or other reaction to a drug, and breathing difficulties during or after an anaesthetic. These are not common reactions. Your child will be looked after by appropriate medical specialists, even if this involves transferring your child to the Royal Children’s Hospital of Melbourne.

Risks cannot be removed completely but with excellently trained medical staff, modern equipment and drugs, the risks of complications for your child have all reduced. Australia has an impeccable record of safety for anaesthesia in children.

Having a GA for dental work is considered elective surgery. So, to reduce the risk of anaesthesia, we perform treatment only when your child is feeling well and has optimum health. Should your child have a cold or flu on the day of surgery, we will rebook them to a later date.

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*The contents of this blog post are of a general nature only and may not apply to your specific circumstances. As every person is different we always recommend that you visit a qualified dental practitioner to obtain tailored dental advice to suit your own specific needs.

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