GA vs. oral sedation ????

[Reha]

Ok, so my son is now 3. I was hoping that he would magically be 'ok' witht he dentist working in his mouth....but I still don't see it happening.

As far as I can tell, GA or oral sedation are my 2 options. He has extensive decay : , so I know it will be a lot of work.

I found 2 good dentists that will do one or the other. The GA would be in-office with a real anesthesologist monitoring him the whole time. While I have always thought that in-office GA sounded risky, the more I research it, the more I feel comfortable with it. I have been doing research all afternoon on the different drugs used. Honestly, I really don't like the idea of him being in the hospital at all...hospital germs really scare me.

I am worried that the oral sedation won't be enough for him. He has already had a really bad experience with another dentist (and that was just the initial exam).

It is so hard for me. My son has never had one tiny it of drugs ever...not at birth, not even a tylenol...nothing!! So, it is so hard for me to face giving him drugs to sedate him. But, I know his teeth are just getting worse, and I need to do something fast. : :

Any advice?

[canadianchick]

Sorry I do not have any advice... my daughter loves going to the dentist! But I wanted to say I'm sorry you and your son are going through this.

[Reha]

Thanks Kim!

Also, those of you who have seen research that has convinced you to go one way or another (GA or oral sedation)....I would love to see it!!

[Strong Mama]

I will be dealing with this soon. Very soon. Actually my son(almost 3) goes in for his next cleaning and an update from dentist as to what to do about decay. His last cleaning went well(6 months ago) and he had the decay then. Dentist gave us floride, and it has slowed down the decay significantly, but they still need doing.

I am making dh handle it. I cant do it.

[Boobs]

My ds is actually going in for GA on Thursday. We tried to go the sedation route last month and based on the extent of the decay and the level of cooperation (or lack thereof), they decided that GA would be the safer way to go.
He'll be having it done at a children's hospital.

[kaPOW!]

Wow, I hope everybody's treatment goes well, I'm sure that it will!!

We're going to have my son's teeth fixed using GA in April. We decided that we were most comfortable with GA in a hospital (Emanuel) because of the close monitoring, the trained staff, and the proximity to all the expertise and equipment that might be necessary should something go wrong.

Good luck with whatever you decide, I know how difficult it is.

[mamaMAMAma]

DD#2 (almost 3) will be going in this Thursay for 1 or 2 fillings. We're going to the dentist every month or so to get her used to sitting in the chair and letting him work on her teeth. The dentist thought she might be able to handle the filling without anesthesia. Keeping my fingers crossed. He said laughing gas might help or it might really freak her out.

[Ruthe]

What I have been told by two different dentists is that oral sedation is the least controllable form of sedation and they both felt that it was actually the most risky. If a child is given too much oral sedation medication it is not easily reversable; it's already in them.
One dentist I spoke to did in office general anesthesia, and one did in-hospital general anesthesia. I choose in hospital because there is more than one trained person around who knows how to handle an anesthesia emergency; jmo but that made me feel a bit safer.

[Electra375]

I went through the decision making process this summer to fall - as in it took me a long time to make the decision for my 4 yr old who also had extensive dental issues. I went to 3 dentist and our pedi to collect information before I spent the agonzing months to make the decision.

I consulted the pedi whom I like, she said she did not recommend oral sedation b/c it has an undetermined effect and length of effects could result in a child having breathing issues on the way home in the back of the car with no one noticing. She made her point.
She also did not agree with in office GA, she really thinks that it is unsafe as do I.
She helped me to have our ins pay for the Surgery Center (out patient surgery center attacked to the local hospital) for GA. THe pedi dentist uses this facility for all GA procedures.

Now in NoVA I found all the pedi dentist seem to use a roving anethesiologist and have the GA in the office. I personally was just not comfortable with this. He also did not accept nor participate any insurance it was a pay out of pocket. Our ins would have paid if it were a dentist who did the anethesia, but that is equally unsafe.

It was a hard decision to make, but I took the advice of the pedi I trust, used a pedi dentist who made sense, and also took into account my ds2's special medical needs such as a heart murmur which was probably #1 reason I would not do GA in an office the what ifs for him were to great, I felt better with him in a facility that could handle any complications that might occur.

It all went well. Any child coming out of GA is hard to watch, fussy, then calm back and forth for hours. My dd had just gas anethesia for her eye surgery and she was the same way. The surgery center was really great w us and were very good with ds2. They let my dh go back while they gassed him out, then they did the nasal breathing tube and IV sedations. The iv was left in until he woke up as a safety and that was probably the worst part for ds2.

[Hannah]

When my daughter was 2.5 we agonized over the same thing. We ultimately decided to do GA in the hospital. I'm very happy with the decision and I feel that we did the best thing for her. It wasn't too hard on her. She was angry when she woke up, she was trying to pull her IV out and the nurses got it out of her fast. She was fussy and coughing for about an hour, after that she was fairly normal. She wanted to eat popsicles for the next four days though.

[Ruthe]

Electra: I am also in NoVa, and found a local pediatric dentist who does in-hospital GA for kids. They are out there! 7 years ago, with a different child, we did the in-office GA thing with another child and it was really stressful for me (although we had a good outcome.)

[BookGoddess]

You take your child to the hospital for the general anesthesia but I'm fuzzy on what happens after that. Can someone fill me in on how exactly the GA process works. Do you bring the unconscious child back to the dental office? But how would that work since I imagine the child would be hooked up to different monitors and machines. Does an ambulance transport the child back to the dentist? Or, does the dentist come to the hospital and do the dental work there? But does a hospital have the necessary dental equipment for the dentist to do his thing.

[Cassandra M.]

Originally Posted by BookGoddess

You take your child to the hospital for the general anesthesia but I'm fuzzy on what happens after that. Can someone fill me in on how exactly the GA process works. Do you bring the unconscious child back to the dental office? But how would that work since I imagine the child would be hooked up to different monitors and machines. Does an ambulance transport the child back to the dentist? Or, does the dentist come to the hospital and do the dental work there? But does a hospital have the necessary dental equipment for the dentist to do his thing.

The dentist does all the work in the hospital.

The pediatric dentists around here will not do GA in the office, only in a hospital setting, because they feel it's too risky. There was a news story about a little girl who died from GA in an office setting not too long ago.

[Reha]

Originally Posted by Cassandra M.

The pediatric dentists around here will not do GA in the office, only in a hospital setting, because they feel it's too risky. There was a news story about a little girl who died from GA in an office setting not too long ago.

But there are also cases of children (And others) dying from GA in the hospital. I did just recently read while researching that there hasn't been a single case of death in pediatric dentisty when using GA in office when the proper GA guidelines (I can't remember the official name of their guidelines).

I thought that was interesting.

While I can see the comfort of seeing the hospital as safer, I also know that MANY mistakes are made in hospitals which result in morbidity and mortality.

[Cassandra M.]

Originally Posted by Lennon

But there are also cases of children (And others) dying from GA in the hospital. I did just recently read while researching that there hasn't been a single case of death in pediatric dentisty when using GA in office when the proper GA guidelines (I can't remember the official name of their guidelines).

I thought that was interesting.

While I can see the comfort of seeing the hospital as safer, I also know that MANY mistakes are made in hospitals which result in morbidity and mortality.

Well I definitely don't doubt it. I've read that there's a 1 in 10,000 risk of dying with GA in hospital, and that office GA is more risky, but can also see how it would totally depend on the practitioner. I know hospitals aren't the best place to be either.

I think I'd do your research until you find something in your gut that you feel comfortable with.

We did oral sedation in office (Versed) but the amount of work needed was fairly short. Any longer and I would have chosen GA.

We also did a lot of waiting, to the point of needed extractions in his front four teeth. He just turned three when I finally got the extractions with oral sedation, and he did great. I know there's a risk with that too though.

It is such a tough situation, I really feel for anyone who has to deal with it...not an easy decision at all.

[mamasgirls]

My dd had GA in a Children's hospital- I felt that was the best choice for us. What I like, though- is she has no memory of it, and no fear of the dentist. That was one of my biggest worries with oral sedation, and I didn't want to traumatize her having to make multiple trips to the dentist to have her teeth fixed.

Good luck in your decision- it is such a difficult one to make.

[Cassandra M.]

I want to add, with oral sedation, they are still awake, and while they are drugged and sluggish, they still tend to resist and complain about procedures. I can't imagine making them go through it longer than 25 minutes.

That is just my experience though, so take it for what it's worth.

Good luck and I hope after this, you can get a fresh start. I have definitely been in your shoes and I wouldn't wish it on anyone!

[Reha]

I just wanted to say thanks so much to everyone who replied!

I don't know how long the work will take (will find out better after Tuesday), but I do know that his front 4 teeth will need to be pulled, and he has at least 7 cavities that I can see in his other teeth. :

This is definitely one of the hardest things I have had to deal with in my life as a parent. I look forward to getting it all taken care of and starting fresh.

[Boobs]

I just wanted to update and let you know that my ds (23mos) just had GA this Thursday and it went really great. He did very well with the GA and they were able to put the kindercaps on all 4 of his front teeth. He was very upset when he woke up, but back to his old self within 20 minutes. We went straight from the recovery room to the car and he nursed on the drive home. He hasn't had any pain since. I do think that GA was the best decision for us and couldn't be happier with how it all went.
We had it done in the dental surgery part of a children's hospital.

[kaPOW!]

Originally Posted by Boobs

I just wanted to update and let you know that my ds (23mos) just had GA this Thursday and it went really great. He did very well with the GA and they were able to put the kindercaps on all 4 of his front teeth. He was very upset when he woke up, but back to his old self within 20 minutes. We went straight from the recovery room to the car and he nursed on the drive home. He hasn't had any pain since. I do think that GA was the best decision for us and couldn't be happier with how it all went.
We had it done in the dental surgery part of a children's hospital.

That's great news!!! Thanks for updating