Dental caries is a chronic infectious disease that should be treated as soon as possible after diagnosis. It affects the psychology, general health and sleep patterns of children along with their oral and dental health. However, it is not possible to treat all children in the dental chair. It may be necessary to resort to general anesthesia for children who cannot provide the necessary cooperation, who are very scared, whose caries level is too advanced and who are at an age and behavior that cannot tolerate the intensity of the treatment, who have a nausea reflex, or due to syndrome (Down syndrome, autism, etc.). With general anesthesia, it is possible to treat all teeth in a single session. This provides comfort for the family and the child.
General anaesthesia is not a method that is decided immediately after the first examination. The child’s compliance with the treatments is evaluated and it is applied in children whose treatment is not possible in the clinic despite behavioural guidance techniques.
To Whom Can General Anaesthesia be Applied?
The American Academy of Pediatric Dentistry (AAPD) has reported the indications for dental general anesthesia in children and adolescents as follows: (AAPD. Behavior Guidance for the pediatric dental patient. 2015)
- Patients who are non-compliant due to their psychological or emotional developmental level and/or mental, physical, medical conditions,
- Patients in whom local anesthesia cannot be performed due to acute infection, anatomical variations or allergies,
- Highly fearful and anxious patients,
- Prolonged surgical interventions due to the limited duration of action of local anesthetics,
- Patients who urgently need a large number of dental treatments to be completed,
- Patients in whom the continuity of the individual’s physical development will be maintained and/or medical risks will be reduced.
The child is examined by a general anesthetist and necessary tests are evaluated. The general anesthesiologist decides whether the child should be anesthetized or not. The general anesthetist and his/her team prepare the child for the operation, control the child during the procedure and wake the child up
One hour before the operation, the child is given sedative medication orally or as a suppository and is taken to the operating theatre after being relaxed. The duration of treatment varies according to the patient’s treatments and the number of teeth to be treated. Specialized dentists with experience shorten this period as much as possible. After general anesthesia, the patient is discharged from the hospital on the same day and can easily return to normal life.
After the operation, regular and effective tooth brushing should be continued by the parents until the age of 8 (until the development of fine motor skills). After general anesthesia, children’s anxiety can be reduced over time by evaluating the diet and oral hygiene at regular check-ups at intervals recommended by the dentist and by performing preventive treatments.
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