Cavities in a 4 y/o-GA or try it awake?

[Curlyfry7]

My 4 y/o DS has 5 cavities. (possibly due to his severe reflux, but anyhow)
Our dentist treats a lot of kids and felt we should try him for one cavity, just using locals, etc like an adult, and see how he does.

I'm concerned about him freaking out-he is very emotional, although he did MUCH MUCH MUCH better for the cleaning than I thought he would. I don't want to completely traumatize him by all that stuff going on when he's awake. Plus he'll have to do it at least a couple more times. But at the same time, I am concerned about the risks of general anesthesia if we go that route.

We need to decide fairly soon as they are pretty deep cavities. Any opinions/thoughts/experiences?

Thanks!

[MCatLvrMom2A&X]

I would try him awake first. We did that with ds who was unable to be still unfortunatly so we found a dentist who could do in office sedation. I wasnt willing to risk GA at all and ds did great with the sedation (2 oral meds, novican and nitrus) and dosnt have any fear of the dentist now and asks to go back.

[deditus]

My dd has had several fillings done at the office with nitrous. She did awesome! She loves her dentist and he was super, super fast. She didn't really need much drilling though, the worst spots were the back of her two front teeth and he scooped those out. Our dentist said he could try one and see how she did, and she did so well that he just kept going and got them all done at once. I was so glad to have it done and not have to go through the stress of GA.

[momtoalexsarah]

If there is just 5 to do I would try 1 and if it goes well do the rest that way. If it was more then 5 or there was more work to be done I would have it done under GA. GA is far safer then in the past - my one child has had 7 GA's and my other DD 1 GA and both have gone great

[karanyavel]

I'd try it awake, preferably with nitrous or maybe an oral sedative.

I had extensive dental work done while awake as a small child, including three root canals in one session when I was 3 years old. The nitrous was must-have for me, mostly for anxiety. I also had some teeth extracted and many, many fillings before I was 5. (I had bottle rot.)

As long as I had the nitrous, getting dental work wasn't a really big deal for me when I was little. Depends so much on the kid, though. I had an outrageously high pain tolerance as a child but the sound of the drill scared the crap out of me.

--K

[HRJ]

We had 6 teeth done awake starting when my son was 22 mos old.  Not sure if it was his reflux or vitamin D deficiency (in me and him).  They did 1 tooth at a time except 2 at the last visit (5 visits total).  Our dentist said we could do awake w/ novacaine only OR general.  He did not feel that nitrous or any other medications were safe in young children.  He felt that they could actually rev them up, and this was around the time the girl in Chicago died from medications given during dental work.

We opted to do awake for two reasons: my insurance would not cover the anesthesiologist or operating room (1,000s of dollars - I think maybe 3-4k) and also I didn't feel it was safe.  If I felt I really wanted to do it, i would have taken the money out of savings. 

It was not fun.  The first visit he cried until he threw up, but my dad held him during it (it was more than I could take).  The dentist recommended that dad or grandpa go in w/ him b/c they don't do as well when mom is there.  He has gone on to have 6 more teeth done (there is usually a new cavity at each visit and he's almost 6 now).  He goes in and sits like a champ now.  When he was younger, he would pray for his dentist and pretend to call him on the phone.

It was HARD, but we got through it, and it hasn't scarred him.  I really think having a good, patient dentist is key. 

[HRJ]

Also, I think it is VERY important to have a dentist that will let a parent or grandparent back go back w/ the child.  Some will not allow it, and some strap them to a papoose board to restrain them.  My dad held my son tight so his arms would flail and get in the way, but he was w/ someone he trusted.  I really think that is imporant.