When Kids Require General Anesthesia Dentistry

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1 North Texas Dentistry a business and lifestyle magazine for north texas dentists When Kids Require General Anesthesia Dentistry Children 1st Dental & Surgery Center

2 cover feature An anesthesiologist monitors EKG and secures the airway for patient safety and comfort prior to dental treatment. When Kids Require General Anesthesia Dentistry Children 1st Dental & Surgery Center by Tina Cauller Imagine you are behind schedule and up next is a screaming, terrified 3-year-old patient who needs a lot of work. The 3-year-old s entire family have been great patients for years and you do not want to lose them. A papoose board is upsetting to the family, your staff and other patients, and the risks and time associated with conscious sedation is really something you like to avoid. This and similar events are typical for dentists all over the country. However, many dentists in the Dallas/Fort Worth area have found a wonderful solution that allows them to keep the entire family as patients and continue working, without interruption, in a productive efficient manner by referring the 3-year-old to Children 1st Dental & Surgery Center.

3 The team of doctors at Children 1st Dental & Surgery Center (C1DS) provide dental treatment for children ages 2-8 in a state licensed Ambulatory Surgical Center (ASC) under deep sedation or general anesthesia and C1DS always refers your patient back to you. The ASC is equipped like a small hospital without overnight accommodations where an anesthesiologist administers the anesthesia and monitors your patient s vitals. C1DS patients not only include children who have difficulty cooperating due to a lack of maturity or an inability to communicate, but children with a mental, physical or medical disability who don t respond adequately to behavioral guidance or conscious sedation. For these children, even obtaining a diagnostic x-ray may not be feasible in a conventional office setting. General anesthesia dentistry is also helpful for children who cannot be treated with local anesthesia because of acute infection, anatomic variations, or allergy. Treatment under general anesthesia may also be indicated when a child needs extensive restoration and/or surgery. Safe, comfortable and efficient For these special dental cases, C1DS offers a safe, ideal alternative by providing both a Medical and Dental Team approach in an ASC setting. The Medical Team is led by a residency-trained anesthesiologist, with a supporting group of registered nurses, that regulate each child s safe, peaceful sleep, similar to hospital based dentistry. The Dental Team is led by the dentist and two registered dental assistants for efficient six-handed dentistry to minimize anesthesia time. This dual team approach, coupled with the latest technology and equipment in a state certified ambulatory surgery center, is the C1DS advantage according to Dr. Craig Jacobs, owner and managing member of C1DS. The process starts with the anesthesiologist medicating the patient to sleep safely and comfortably, followed with an exam, oral photographs and diagnostic digital radiographs to determine the specific treatment. After the necessary treatment plan has been identified by the dentist, it is forwarded and reviewed electronically with parents in a private consultation room for consent. Once informed parental consent is obtained, treatment proceeds immediately and is completed in just one visit. Although the ambulatory surgery center and dual team approach for C1DS is a considerably more costly platform to work in, when compared to a dental office that hires an anesthesiologist to administer general anesthesia or deep sedation, the specialized equipment and expertise of the personnel available at the ASC and C1DS affords an additional layer of patient safety not available in an office. Dr. Jacobs reports, The well being and safety of each child is first and foremost for C1DS and this fundamental concept of safety first at Children 1st Dental & Surgery Center is emphasized in their very name. At Children s 1st Dental & Surgery Center, the patient age demographic is 2-8. Children 1st Dental & Surgery Center has both pediatric dentists and general dentists on staff and all the dentists have extensive experience with operatory dentistry for children. The anesthesiologists at C1DS determine if the patient is a good candidate for general anesthesia by employing the patient classification guidelines established by the American Society of Anesthesiology. Accordingly, patients who meet ASA Class I & ASA Class II are considered good candidates for general anesthesia at the Center. In select cases, an ASA Class III patient can be treated at C1DS with medical clearance from the patient s pediatric physician. A trusted partner for referring dentists Upon completion of treatment, the patient is transferred from the operatory to PACU (Post Anesthesia Care Unit), where the anesthesiologist and PACU nurse monitor each patient s heart rate, temperature, blood pressure, and blood oxygen levels until stable. Prior to discharge, the R.N. provides thorough post-operative instructions to parents, including the importance of proper oral hygiene and preventive care techniques. The Home Care Instructions patients receive at C1DS includes a bold, highlighted entry that reads, PLEASE CALL YOUR FAMILY DEN- TIST in 5 MONTHS to SCHEDULE YOUR CONTINUING CARE VISIT. According to Dr. Jacobs, This reflects the C1DS policy to always refer the patient back to the referring dentist. At the conclusion of care, the treating dentist at C1DS mails a copy of the completed treatment plan to the referring dental office. The C1DS mission is to be the trusted referral source for dentists whose patients, ages 2-8 requiring general anesthesia or deep sedation, can be referred with confidence for safe, vital dental care.

4 The C1DS team approach allows the pediatric dentist to focus on treatment while the anesthesiologist insures patient s stable vitals and peaceful sleep in a state certified Ambulatory Surgical Center dedicated exclusively to children s dentistry. C1DS photographs and x-rays help determine the treatment plan. Full mouth restoration case referred to C1DS. All treatment was completed in one visit.

5 At Children 1st Dental & Surgery Center, patient safety is enhanced by reducing anesthesia time with six-handed dentistry. Helping parents defeat the real bedtime monster Most parents would do anything for the safety and happiness of their child. However, the same parent that reads a nightly bedtime story and chases away the imagined monster under the bed may be ignoring a real bedtime monster. The most caring parents may not be aware that tucking their child in at night with a sippy cup of juice or a bottle of milk, or nursing at bedtime exposes their child s teeth to a dangerous attack by sugar and acids over a period of hours and greatly increases the chance for cavities. Cavities can develop on the lingual surface of the front teeth and progress without notice until they reach a severe stage. According to the Centers for Disease Control and Prevention, the number of preschool-age children with cavities is climbing. Dentists commonly report an increased incidence of children who have 6-10 cavities at their very first dental visit. This troubling trend is occurring in families of all income levels. In some cases, dental decay is extensive and severe. If a child develops a dental abscess, he or she may need immediate care to avoid a potentially life-threatening emergency. The path to prevention Parents may not realize that they need to start brushing their child s teeth at age one with fluoride toothpaste. There is a common belief that the health of primary teeth is unimportant because they will fall out as the child matures. In fact, primary teeth are critically important for chewing, speech and jaw development, and self-esteem. They serve as placeholders for the permanent teeth, and if the permanent teeth develop in an unhealthy mouth, they are at greater risk for decay as well. The staff at C1DS help parents become informed defenders of their children s oral health. Educating parents about healthful oral habits gives them the tools they need to protect their child s health and to encourage kids to take responsibility for their own health as they become more independent.

6 With treatment complete, the anesthesiologist, RN and RDA transfer the patient from the operatory to the PACU. An anesthesiologist and RN monitor the patient in the five-station PACU recovery prior to discharge. WHAT REFERRING DENTISTS ARE SAYING We refer to Children 1st because we know we'll get our patients back. It's been close to two years since we began referring to them and the feedback from the parents of our patients has been excellent. We receive a detailed completed treatment plan and Children 1st has even referred patients who don't need sedation to us. Before Children 1st, we used to refer our patients to a pediatric dentist in the area, but they began recalling our patients so we ended the relationship. We have a true partner in Children 1st Dental & Surgery Center. Dr. Suzanne Appolito, Dr. Susan Edwards, Dr. Sarah Cantrell Dentistry for Children (214) Gus Thomasson Suite 127, Mesquite, TX We enjoy referring to Children 1st because they can get our patients treated within the same week. They complete the treatment in one visit and we can count on them sending the patients right back to us. They have a very simple referring process and they guide us every step of the way. They really care about our patients and understand the importance of a partnership. Dr. Sneha Ramolia, Dr. Mike Parks Clean Dental (469) Spring Ave, Dallas, TX Referring dentists confidently send their patients to Children 1st, knowing they will receive the best care. They can also feel confident that their patients will always be directed back to their office for follow-up care. Recalling patients is not part of the Children 1st business model. With centers in both Mesquite and Grand Prairie, Children 1st is able to serve children all over the DFW area, and has referral relationships with more than 300 dental offices. Children 1st Dental & Surgery Centers accept most dental insurance plans, as well as Medicaid and CHIP. The multilingual staff can converse in English, Spanish, Vietnamese, German and American Sign Language. n For more information about Children 1st Dental & Surgery Center, call (855) or visit Children 1st Dental & Surgery Centers n Mesquite 2690 N. Galloway Avenue (972) n Grand Prairie 3055 W. Bardin Rd. #400 (214) reprinted from NORTH TEXAS DENTISTRY