IN OFFICE GENERAL ANESTHESIA
Safety Concerns for General Anesthesia in the Dental Office
Prior to the day of surgery, we will spend time talking to you about your child to make sure that the office setting will be a safe and appropriate place to provide anesthesia for him or her. If we think that your child has a pre-existing illness that would jeopardize their safety under general anesthesia in the office, alternative treatment options will be recommended.
In accordance with the California Board of Dental Examiners, we carry all of the routine emergency equipment including extra oxygen tanks, breathing equipment, emergency drugs, and a defibrillator. In essence, our anesthesiologists have the same type of equipment and medication that would be available within the operating room of a hospital or surgery center.
The main concern with this type of anesthesia in the pediatric patient is to maintain an open airway and adequate breathing. This is routine for an anesthesiologist. Their expertise lies in managing the unconscious patient and making sure their breathing and all other physiologic functions are maintained. They continually monitor the patient's level of anesthesia, vital signs and breathing throughout the treatment, never leaving them during the procedure.
The risk of an allergic reaction during general anesthesia is very remote. It has been reported in the literature with propofol but it is very rare. If your child is allergic to eggs or to soy, we would not use this particular anesthetic during sedation since there is an increase in risk of an allergic reaction to propofol in the presence of these food allergies. Similarly, if gas anesthesia is used for your child's maintenance anesthetic, there is a very remote possibility of developing an untoward reaction known as malignant hyperthermia but we are equipped with dantrolene, the treatment, if this exceedingly rare condition occurs.
While the assumed risks of general anesthesia are greater than that of other treatment options, if this is suggested for your child, the benefits of treatment this way have been deemed to outweigh the risks. Most pediatric medical literature places the risk of a serious reaction in the range of 1 in 25,000 to 1 in 200,000, far better than the assumed risk of even driving a car daily.
The inherent risks if this is not chosen are multiple appointments, potential for physical restraint to complete treatment and possible emotional and/or physical injury to your child in order to complete their dental treatment. The risks of NO treatment include tooth pain, infection, swelling, the spread of new decay, damage to their developing adult teeth and possible life threatening hospitalization from a dental infection.