Treatment of teeth under anesthesia in children

Dental treatment is often accompanied by painful sensations, and in children also panic fear. Not every kid can prepare for the procedure properly and explain what "ukolchik" is doing in order to subsequently not be hurt.

Modern methods of anesthesia in pediatric dentistry meet high safety requirements, so parents can trust a specialist regarding the chosen method. For more information, you can find out in detail what is the difference between modern methods of anesthesia in the treatment of teeth in children.

Kinds of anesthesia

Not every private dental clinic provides children with anesthesia treatment. To introduce such a service into your price list, you need to obtain an appropriate license, which requires high qualification from anesthesiologists and the entire accompanying staff, as well as equipping with modern equipment. Such a rigorous approach allows for treatment in children with no risk, which is very important for any parent.

In addition to the known anesthesia, there are non-pharmacological methods of anesthesia, which include:

• 

  Electroanalgesia

  hypnosis;

• electroanalgesia;
• audioanalgesia.

These methods are very rarely used, because they require special training, and real experts in this field are difficult to find. In some cases, electroanalgesia is used, but the emphasis is on local or general anesthesia.

Local anesthesia in children

Local anesthesia in children's dentistry is performed in two stages. First, an application anesthetic is done, which is aimed at reducing the sensitivity of the site, where an injection of anesthetic will be injected. For "freezing" use aerosols or gels, which, as a rule, are pleasant to the taste and smell. After a couple of minutes, the anesthesiologist injects with a local anesthetic.

There are many different anesthetics for local anesthesia, but for children, articaine-based drugs are usually used. They have a pronounced effect, superior in their qualities to drugs based on novocaine, besides they rarely cause allergic reactions, do not differ in toxicity, are quickly eliminated from the body. Articaine is allowed with 4 years of , it can be used during pregnancy and lactation. This once again confirms its safety in terms of impact on the body.

Anesthetics based on articaine are half excreted after 20 minutes. In some cases, the drug is combined with other substances that narrow the blood vessels to extend the period of its action. They include:

• epinephrine( epinephrine);
• norepinephrine( norepinephrine);
• felipressin( octapressin);
• mezaton.

Combined anesthetics with the main active substance in the form of articaine include Articaine INIBSA( Spain), Alfacaine and Septanest( France), Ubistesin( Germany) .

Articaine in combination with vasoconstrictors is allowed for local anesthesia in children from the age of five. Dosage is calculated according to age:

• 5 years - 0.6 ml;
• 6 years - 0.8 ml;
• 7 years - 1 ml;
• 8-14 years - 1.5 ml.

Before injection of articaine, the injection site is anaesthetized with gels and sprays based on benzocaine and lidocaine.

Dental treatment under general anesthesia - what should I know?

General anesthesia is a method of anesthesia, during which the child's mind "disconnects" due to braking of the brain. It is carried out in several stages:

1. preparation .The task of the dentist and parents is to create a game situation, during which the child will be ready to put on the mask and breathe a little in it. To avoid fear and nervousness, we can say that so the child will become an astronaut. A few seconds is enough to put the child into an anesthetic;
2. preliminary inspection .As soon as the child falls asleep, the doctor once again evaluates the situation with the teeth and calls the approximate time that he needs for treatment. After this, the parents must leave the room;
3. connection of equipment. Before the treatment to the child, the equipment that monitors the vital processes that take place in the body is connected. During the entire treatment, anesthetists are nearby and follow the indications;
4. teeth treatment .Under general anesthesia, the dentist can not only solve complex, painful problems that can not be performed under local anesthesia, but also treat several teeth at once, which is always a stress for the child in the usual situation;
5. withdrawal from anesthesia .Once the treatment is completed, the parents are invited back to the dental office, the anesthetists remove the child from the state of anesthesia. Waking up, the child will see the same room, parents, in his mind does not postpone information about the treatment, the situation will seem ordinary.
6. rehabilitation .At this stage, the child in the company with his parents remains in the playroom, where he can recover, drink tea, watch cartoons. After 10-15 minutes the body will return to normal. Within an hour the doctor assesses the situation, in case of complications such as nausea, vomiting or dizziness, take timely measures. If the rehabilitation is successful, the child can go home.

In pediatric dentistry for general anesthesia apply Sevofluran and its varieties Supran and Sevoran .The drugs are characterized by a high degree of safety, they do not irritate the respiratory tract, do not increase intracranial pressure, do not promote the development of renal and hepatic insufficiency.

The product has a quick action: from the first inputs the child will feel drowsy. It takes no more than two minutes to enter into the state of anesthesia. The effect of the drug after stopping its feeding is calculated for 10-15 minutes, since it is completely eliminated from the body with breathing.

The positive qualities of Sevoflurane is that it is combined with all medications used in dentistry, and after its administration, the side effects expressed in the drowsiness or hyperactivity of the child are minimal.

Indications for various types of anesthesia

Local anesthesia is used in the process of complex medical procedures. The main indications include the following list of dental problems:

• 

  Multiple caries of infant teeth

  advanced form of caries;

• removal of the tooth or its nerve endings;
• purulent inflammatory processes of the jawbone and joints;
• surgical interventions;
• neuralgia of the facial nerve.

In some cases, local anesthesia for children is not possible because of panic fear of visiting a dental office. In this case, it is recommended to undergo general anesthesia treatment. For him, there are special indications:

• long treatment period .Children are advised not to visit the dentist once for more than 30 minutes. If there is a need to treat several teeth at once, the doctor can prescribe general anesthesia. The method will help you at once perform actions that require at least five visits. Frequent visits to the doctor are a stressful condition for the child, they can develop into dentofobia. At an older age, a person will experience fear of dental treatment and postpone visiting a specialist for as long as possible, which will adversely affect the condition of the teeth;
• is a small age of the patient .In rare cases, even the smallest patients are forced to visit the dentist with serious problems. They are not yet able to sit still for a long time and keep their mouth open largely because they do not understand what they want. General anesthesia in this case will allow the dentist to solve the problem quickly and without risk of damaging the oral cavity due to the fact that the baby suddenly jerked his head;
• psychological and psychiatric disorders .Children with an easily excitable nervous system are not able to easily transfer even fast dental treatment. In addition, general anesthesia will save their psyche from a stressful situation. This includes dentofobia, cerebral palsy, oligophrenia, allergies to local anesthetics.

Pros and cons of the use of anesthesia in pediatric dentistry

The main advantage of application of anesthesia in dentistry is the lack of pain .This helps to avoid stress, the child will not form a negative attitude towards dentists. After treatment, the baby will not remember the frightening sounds and the specific smell of medicines. In addition, the use of general anesthesia will help the dentist cure all the teeth and, if necessary, remove at a time. With standard treatment, all procedures would stretch for several campaigns to the doctor.

Speaking of minuses of , mention should be made of side effects, which consist of nausea, dizziness, sometimes vomiting and general weakness or, conversely, hyperactivity. If all the dentist's requirements are met, a good clinic is selected, and the child's health information is disclosed, children's anesthesia rarely has complications, as the requirements for this procedure are very high, and doctors are constantly checking their skill level.

If any of the above is not observed, the risk of developing thrombosis, cerebral stroke, myocardial infarction, lung inflammation may increase. It is for this purpose that the stage of rehabilitation is important, during which the specialist checks the child's condition and changes in vitally important parameters within an hour.

For children, a complication factor for anesthesia is abstinence from eating , because you can not eat several hours before the procedure and two hours after it. This condition helps to avoid emetic pushes, which are a frequent complication in children after withdrawal from anesthesia. Even after the passage of the specified time, one should not heavily burden the stomach, it is preferable to give light food.

The presence of risk makes anesthesia not the most perfect method, but in some situations it is necessary. Alternatively, there is another method - sedation .With its help, the patient does not feel fear during the procedure, but in addition will have to enter painkillers, since nitrous oxide does not relieve the painful sensations.

Contraindications

As a rule, local anesthesia has no special contraindications, except intolerance of the components that make up its composition. This is one of the relatively safe methods, which are abandoned because of indications for general anesthesia in children. Another obstacle may be traumatic injuries of the maxillofacial area, which changed the topography of bone canals, soft tissues and nerve trunks.

General anesthesia has more contraindications. These include:

• infectious diseases;
• rickets;
• asthma;
• pneumonia;
• blood diseases;
• heart failure;
• diabetes mellitus.

Before passing the treatment the doctor will without fail prescribe a blood test, a visit to the cardiologist and other specialists who will give an opinion about the possibility of prescribing general anesthesia.

Price for anesthesiologists

The prices for anesthesia vary depending on the clinic and region chosen, but it should be noted that in this issue, one should focus on the high qualification of personnel who will responsibly approach the evaluation of the child's health and choose the right method of anesthesia and the appropriate drug.

On average, prices fluctuate at the following level:

• Local anesthesia - from 400 rubles per injection ;
• General anesthesia - 3500-4000 rubles per treatment for 30 minutes ;
• Sedation - 1200-1500 rubles per treatment for 30 minutes .

Parents' reviews

In some cases, you have to agree with the dentist and decide on the method of anesthetics. An experienced dentist always evaluates the risk and the availability of alternative options, so he will not prescribe a treatment based on personal preferences. The child's interests, his state of health and perception of the situation are always brought to the forefront, which is proved by the parents' feedback.