In my experience there are 2 extremes of parents’ response to General Anaesthesia (GA) for dental treatment of their children.
One end of the spectrum is a ready acceptance, even request for their child to be treated under General Anaesthesia (GA)
The other end is a total resistance to GA. Where they stand in the spectrum is often dependent on a few variables. In the context of local parents, my perception is
- Age of child is inversely related to GA acceptance
- Severity of the dental condition, eg an abscess with pain and swelling would rank higher in GA need than asymptomatic cavities
- Preconditioning i.e what they have heard or read about GA, or prior experience to it
- Cost of the whole procedure
- Time considerations eg not free to come for multiple visits or medical tourism
Parents are usually most concerned about the risks of GA to a young child
They are not wrong. This is where a good Paediatric Dentist comes in to give advice and to answer lingering questions, even after the decision is made.
The worst event of GA is death, or brain damage. (1:250,000) which is lower than the risk of a road traffic accident, yet we get into our cars everyday!
This GA risk must be balanced against the risk of doing nothing. The most common condition requiring GA is Early Childhood Caries (ECC) a severe and aggressive form of decay. The risk of dying from ECC is very low but the affected have a poor quality of life in terms of pain, days off from school, inability to thrive. Paediatric Dentists, by virtue of their training and experience are the right people to manage ECC. They can guide you in your important decision, rehabilitate your child and institute good oral habits which will carry them into adulthood. Putting your child under GA is not our primary aim but often when children present with an advanced stage of ECC, we have no choice.
The risk of general anaesthesia must be balanced against the risk of doing nothing
Some parents are under the impression that GA can be made safer, if the treatment is broken up into several GAs. I always tell parents that GA is like crossing a road. There is a possibility of being knocked down by a car, so we don’t want to cross the road flippantly many times. We want to take the risk once, accomplish what we need to do on the other side of the road, and not cross this road again! While crossing the road, we want to do it safely – like using a pedestrian crossing, and looking left and right. In the context of GA, it would be obeying our fasting instructions and deferring the appointment if child is unwell.
What about sedation?
Parents are also under the impression that sedation is safer than GA. This is not true especially if sedation is not done under a controlled environment with skilled personnel and resuscitation facilities.
Very young kids are not suitable for sedation, especially if the procedure is long.
Talk to your PD about your options.
They are there to help you.
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