Dental treatment in children under anesthesia: reviews
Sooner or later, every mother is faced with the fact that the child has a toothache and urgently needs to lead to the dentist. The causes of discomfort may be different. At the same time, if the child has already visited the dental office, persuading him to come there again can be extremely problematic. Often, in order to undergo a simple preventive examination, parents have to persuade for weeks or even to bribe the child with gifts. It is very important that before the visit to the clinic the adults themselves behave correctly, that is, they do not aggravate the situation and do not provoke the child to fear and anxiety.
Recommendations for parents
- Children under three years of age have lowered the pain threshold, which means that the feeling of fear is almost not manifested. This period is ideal for the first visit to the dentist.
- It is desirable that the first visit was introductory and accompanied by an examination of the oral cavity of the child and a recommendation for proper dental cleaning.
- Before the visit to the clinic, it is necessary to conduct an educational conversation with the child, explain that treatment and dental care is an important and obligatory procedure, to show by your own example how important it is to brush your teeth in the morning and in the evening, to play with the child in a thematic game.
- If the small patient behaved courageously and decently at the reception, it is necessary to praise him, tell him about how brave and fearless he is. If the kid is capricious, you should encourage him and say that next time he will surely behave obediently.
- Mom or dad can take the child with him to the reception to show that there is nothing wrong with the treatment. In this case, it is necessary to agree in advance with the doctor about the presence of the child.
If the above recommendations did not help or were not implemented on time and correctly, do not panic. Modern medicine offers a paid, but very effective procedure - the treatment of teeth in children under anesthesia.
Types of anesthesia
To date, the majority of both private and public clinics have in their subordination a high-quality anesthesia service that can individually select and provide anesthesia that causes minimal harm to the body. In order to have an anesthesiologist and resuscitator in her staff, pediatric dentistry should receive a special license from the state, which is not so easy, as there is a list of certain requirements for equipment, drugs and materials, as well as the qualification of an anesthesiologist and resuscitator.
However, in addition to drug anesthesia, there are non-drug anesthesia methods: hypnosis, electroanalgic, and audio-oligizia. Of all these methods, only electroanalgia has gained popularity and is recognized as acting.
Treatment of teeth in children under anesthesia can be of two types: local anesthesia, complete.
Stepwise application of anesthesia
This method involves selective anesthesia by the type of applications. That is, the injection site is previously deprived of sensitivity with a mint spray or gel, and after one or two minutes, an injection with an anesthetic is put.
In the treatment of caries or pulpitis in children for local anesthesia, drugs containing artacoin hydrochloride are used, since it is five times more powerful than novocaine, and less dangerous for the body. In addition, Artacoin hydrochloride is excreted in twenty to twenty-five minutes.
Dental treatment in children under general anesthesia, using drugs based on artacoin hydrochloride, can begin with four years. Artikoinosoderzhashchie drugs are also safe for pregnant and lactating mothers.
To enhance the anesthetic effect and the duration of the drug, often these drugs are supplemented with vasoconstrictors (vasoconstrictors), such as epinephrine, mezatonum, filipressin. Combined local pain relievers, based on artacoin hydrochloride, are produced only in Germany, France and Spain.
Treatment of infant teeth in children under general anesthesia with the use of combined drugs has been shown since five years in the ratio of one to one hundred thousand (artakoin to adrenaline).
At the age of five to seven years, benzocaine- and lidocaine-containing sprays are used as selective or application anesthesia.
Preliminary medical preparation of children before a visit to the dentist
To prepare the child's body for anesthesia and reduce the possibility of side effects, use special drugs, which are called preliminary medication.
There are four components of pain: psychoemotional, sensory, motor, vegetative.
A local anesthetic, such as lidocaine, articoin, benzocaine, removes sensation at the site of the intervention, removing the sensory component, but not replacing the psycho-emotional, motor and vegetative components, so they should be removed after the administration of the analgesic.
By methods of persuasion and suggestion, the psychoemotional component is arrested.
Indications for use
Treatment of teeth in children under anesthesia with drugs that have a calming effect, is shown when:
- chronic mental illness;
- chronic respiratory disease;
- insulin insufficiency;
- diseases of the endocrine system;
- chronic seizures and hysteria;
- increased muscle tone;
- chronic depression;
10-25 minutes before the treatment the child is prescribed an anxiolytic, for example, chlordeazepoxide, better known as "Sibozon", "Napaton", "Seduksin" or "Chlozipid".
Anti-anxiety drug prescribed for children from four years in a dosage of five to ten mg, at the age of seven years - from ten to twenty mg, at the age from fifteen to eighteen years - from twenty to thirty mg per day, for two or three doses. The last dose of diazepam should be drunk fifteen minutes before going to the dentist.
Sedation– alternative to anesthesia
Due to the fact that preliminary medication is not always effective, in modern pediatric dentistry resort to such a method as sedation, or an alternative to anesthesia.
Sedation ("medical sleep") can be deep (complete), that is, entering into a state of sleep and slowing down breathing, and verbal (incomplete), when the patient is able to maintain the relationship and follow the doctor's instructions.
Dental treatment under general anesthesia in children is carried out with the use of inhalation for a few minutes before direct dental intervention, N2 and O2 - ZAKS are used.
At the beginning of the procedure, the child receives a clean O2 and nitrous oxide for a period of fifteen minutes through the mask. The admissible concentration of N2 in a mixture of SANS should not exceed seventy percent. For children under the age of fifteen, thirty percent of nitrogen and seventy percent of pure medical oxygen are usually used.
Introduction to the state of anesthesia with a mixture of ZAKS causes a child to feel light, relaxed, sleepy.
Benefits of sedation
The kid sees and hears everything that happens around, but does not feel any discomfort at the same time. The supply of a mixture for anesthesia and removal of the oxygen mask occurs with the help of high-quality automated equipment. By the end of the dental procedure, the nitrous oxide decreases and the concentration of pure oxygen is increased to one hundred percent, after which the mask is removed. The effect of SAS goes through five to ten minutes.
Sedation mixture though has a certain analgesic property, but it may not be enough for complex dental operations, therefore, dental treatment under anesthesia in children occurs with additional local anesthesia.
Usually a mixture of ZAKS is used, starting from the age of four, when it is already possible to establish contact with the child. One of the main tasks in this case of both the dentist and the parents is to persuade the baby to put on the mask himself. To do this, use aromatic oils that cause the child's desire to breathe gas without coercion.
Foreign practice of dental clinics uses a display of your favorite cartoons and fairy tales of a child during "medical sleep".
Dental treatment under general anesthesia in children with sedation can be considered an absolutely harmless procedure, as it is used in all developed countries of the world.
Children's dentistry in Russia
It's no secret that this area is the youngest and at the same time the most complex branch of medicine, which includes many directions.
The founder of dentistry for children can be considered AK Limberg, who since 1901 headed the eponymous chair in the medical college of St. Petersburg.
In 1974-1975, clinical examination of children in dental offices was officially adopted, as well as anesthesia during the execution of severe operations.
In 1985, the specialty "children's dentist" was officially included in the nomenclature of medical specialties.
To date, high-quality children's dental clinics are available in every city. In addition to standard procedures such as therapy, maxillofacial surgery, neonatal surgery, children's orthodontics and prosthetics, medical examination and treatment, some hospitals may offer sedation or general anesthesia.
Review of children's dental clinics
How is dentistry treated for children under anesthesia in Moscow? The cost of sedation, the clinic that performs it, are listed below.
In the Russian capital, a number of clinics can offer such a service:
- "Baby and Carlson" - the cost of nitrous oxide sedation (30 minutes) is 2500 rubles. The clinic also provides treatment services in conditions of general anesthesia. The cost of narcosis "Sevoran" (30 minutes) is 4,500 rubles. The price of one minute of general anesthesia is 165 rubles.
- International Medical Center "ON Clinic" provides the following services: inhalation anesthesia (30 minutes) - 5500 rubles.
- Family dental clinic "Nutcracker" cost of sedation with nitrous oxide (30 minutes) - 2940 rubles. General anesthesia (30 minutes) - 5940 rubles. The medical institution also provides a pre-medication service - 1500 rubles.
Not only in Moscow, teeth are treated under anesthesia in children. Novosibirsk also offers similar services:
- Dental Clinic "Style Dent" - dentistry for children under general anesthesia (1 hour) costs 5500 rubles. Anesthesia can be injected through an oxygen mask or by injection.
- "Center of Dentistry" - an hour of anesthesia in the clinic costs 3900 rubles.
- "Road Clinical Hospital" - information on the site says that the cost of anesthesia is 25% of the cost of treatment.
Also, the treatment of teeth under anesthesia in children Minsk dental clinics:
- "Center for Family Dentistry" - intravenous narcosis 78 Belarusian rubles (2,530 Russian rubles).
- The Melissa Medical Center also provides anesthesiologist services for babies - the cost of the service must be recognized in the clinic individually.
Perhaps in other cities, dental treatment under anesthesia in children. Krasnoyarsk does not lag behind Moscow and also provides services of sedation and general anesthesia:
- Center of Dentistry "ASTRA" - uses the drug "Sevoran", the duration and cost of the service can be obtained from the attending physician or consultant.
- "University Center of Dentistry" - the reception is conducted by a pediatric anesthesiologist, who, according to the indications and age of the child, recommends the type and cost of anesthesia.
Dental treatment in children under anesthesia: reviews
Most children panic fear doctors, and therefore every trip to the clinic is accompanied by hysterics, tears and whims. In order not to harm the child's psyche, many mothers resort to dental treatment under anesthesia. The advantage of this method is that the child breathes in an amusing gas and falls asleep without fear of a doctor and drill.
This is how the teeth are treated with a child under general anesthesia. You will read the comments of your parents below.
Often, mothers, before taking their child to the doctor, ask advice from friends and acquaintances. Private clinics offering dental services, such as dental treatment under anesthesia, are particularly popular. Many people say that the anesthesiologist appoints a blood and urine test, an examination of the child by the therapist. A separate criterion is good health during the treatment period, that is, the presence of temperature or cough is unacceptable. Do not perform operations on an empty stomach. After treatment, depending on the age of the baby, migraine, nausea, vomiting, anxiety, lethargy can be observed, parents note. All this should normally go through 12-14 hours. Especially the treatment of teeth with a mixture of ZAKS or the drug "Sevoran" is recommended by mothers of children with poor health.
Dental treatment in children under anesthesia, reviews of doctors
Experts note that for the entire time of the existence of the drug "Sevoran" a huge number of children have been treated, most of which are babies with a disease of the central nervous system. Thus doctors remind, that necessary condition is carrying out of medical manipulations under the control of the high-grade expert-anaesthesiologist and реаниматолога. The clinic should have expensive high-quality equipment: an apparatus for artificial ventilation, respiratory apparatus, modern anesthetics, powerful tracking equipment. It is especially important that anesthesia is safe for the health of the baby and does not cause unpleasant side effects.
Most often, moms begin to plan this procedure when the children are actively spoiled teeth - about 3-4 years. Dental treatment for a child (3 years) under anesthesia takes approximately 4 hours and passes without complications.