An Introduction to My Dental Anesthesia Practice
The fear of pain, the sound of drilling, and separation from parents make many children anxious when they go to a dentist's office. Dentists often use nitrous oxide or moderately sedating drinks to ease children's worries, so they can cooperate.
Despite this, some children still will not tolerate any dental procedures. In addition, extensive work requires children to remain calm and still for impossibly long amounts of time. For these children, I come to the dental office and provide a deeper level of sedation, eliminating all fears and ensuring that anxious children will cooperate and allow the dentist to complete dental care safely and efficiently.
Deep sedation in healthy patients is very safe when performed by a physician who is an experienced and board certified anesthesiologist. Because I specialize in the care of babies and small children, I extend this safety to the very youngest patients.
I use state of the art monitoring to ensure your child is asleep, comfortable, and safe during the whole procedure and to minimize the time your child is asleep and the time it takes to fully awaken.
For your child's procedure, I will provide anesthesia using the highest quality equipment in a precise, safe manner. By avoiding expensive hospital facility fees, you may save thousands of dollars compared to what you would pay to have the same procedure at a hospital.
The California Dental Board tightly regulates who may provide dental anesthesia and enforces detailed, stringent standards stating what special anesthesia equipment and drugs must be present. I always surpass these standards and use the most advanced, compact, hospital grade equipment and monitors.
How Will the Anesthesia Affect My Child Afterwards?
After the dental treatment, children tend to emerge rapidly from anesthesia feeling pain free, a little disoriented, and comfortably rested. Usually, patients can safely leave the office 20 minutes after the procedure. It is common to sleep part of the day, eat a light meal and be fresh and completely recuperated by the next morning. Complications are highly unusual with my technique.
Who Will Administer My Child's Anesthesia?
I personally perform all aspects of the anesthetic, and your child will remain under my direct, constant supervision until discharged home. You rarely find a medical doctor like me sedating dental patients. Usually, if sedation is offered, it is provided by a dentist. The skills and medical judgment I have refined over years of hospital work caring for critically ill children and adults during complex operations should give you confidence that your child will be safe in my hands.
After earning a B.S.degree in Biophysics and Biochemistry from Stanford University, I completed both medical school and four years of additional specialized anesthesiology training at the University of California, San Francisco School of Medicine (UCSF). This program is widely regarded as one of the top anesthesia training programs in the world. I have served on the UCSF and Stanford clinical faculty and published 19 scientific articles, abstracts, and book chapters. I have extensive experience in dental sedation and hold a Dental Board of California "General Anesthesia Permit."
What to Expect
I will contact you one or two days before the scheduled dental procedure to find out about any health problems your child may have, review the eating and drinking instructions, and discuss the details of his or her personalized anesthesia plan.
At the time of the dental appointment, the parent usually walks the child to the procedure area. The child sits in the parent's lap and goes to sleep by taking a few breaths of a bubble gum flavored gas while I tell a simple story. After the parent returns to the waiting area, I painlessly start a child sized intravenous line, attach the monitoring equipment, and deepen the anesthetic to the required level.
For patients with disabilities or those who cannot cooperate, I may start the anesthesia while still in the waiting area by injecting relaxing medicine into your child's arm. This feels like a vaccination. After 3 minutes, your child will be drowsy and will not recall anything further.
At the end of the procedure, the dentist will meet you in the waiting area and discuss what was done. I will continue monitoring your child, and reunite the two of you as soon as he or she begins to wake up. Although your child may be grumpy for a little while, there are no long-term side effects.
Pre Anesthesia Instructions
Eating and drinking: For safety, it is extremely important that your child have an empty stomach. Vomiting of food during anesthesia may be life threatening. For this reason, on the day of the appointment, your child must not have any food or milk for 8 hours prior to the procedure. If he or she eats, the sedation will be rescheduled. Eating colored gelatin or drinking water, sports drinks, apple juice, or other beverages that are also transparent and pulp-free up to 3 hours before the time of the appointment is acceptable.
For example, if the appointment is at 9:00 A.M., your child may have clear liquids until 6:00 A.M., but not after that time. An adult must supervise the child constantly on the day of the appointment to make sure the child does not eat. Do not leave your child unattended or send your child to school or day care.
Illness: If your child develops a cough, nausea, or fever, please call the dental office or page me, so I may speak with you to assess the situation and determine if we can safely proceed.
Medications: If your child takes any prescribed medication, continue it on the day of the appointment. If it is an oral medication, let your child take it with a small sip of water. If it is an inhaler, have your child use it at the usual time.
Clothing: I recommend loose fitting, easily removed clothes for the dental procedure. The shirt layer closest to the skin should be short sleeved. Please bring a change of clothing and a warm blanket. If appropriate, have your child wear a diaper and bring an extra one.
Adult Escort: A responsible adult must accompany the child to the office and remain there during the procedure.
Post Anesthesia Instructions
Supervision: Anesthetic medications may cause drowsiness and impaired coordination. Therefore, a responsible adult must directly supervise your child for 12 hours following the anesthesia. Until recovery is complete, allow your child to rest and observe him or her closely. Do not allow swimming, biking, skating, or playing with other children.
Eating: Limit oral intake to liquids for the first few hours. Begin with water and follow with clear juice. If teeth were extracted, do not use a straw. Soft food may be consumed following the liquids. If your child is not hungry, do not force him or her to eat, but encourage as much liquid as tolerated.
The estimated anesthesia fee is based upon the dentist's estimated procedure time plus 45 minutes. Depending on how much time the dentist actually takes to complete the procedure, the actual charge may be greater than or less than the estimate. My minimum charge is for two hours. For patients 10 years of age and older, there is an additional charge per case to cover the added medication cost. I require a deposit to confirm your sedation appointment. Payment of the balance of the fee is due at the procedure's conclusion and may be made by MasterCard, Visa, or cash.
The anesthesia fee is separate from the dentist's, and while not covered by many dental policies, it is typically covered for children under the age of 7 years and for other children and adults with medical problems or disabilities by non-HMO (and some HMO) medical insurance carriers.
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