Sooner or later, every mother faces the fact that the child has a toothache and urgently needs to be taken to the dentist. The causes of discomfort may be different. Moreover, if the child has already been to 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 bribe a child with gifts. It is very important that before going to the clinic the adults themselves behave correctly, that is, they do not escalate the situation and do not provoke the child to fear and anxiety.
Recommendations to parents
- In children under three years of age, the pain threshold is lowered , which means that a feeling of fear is almost not manifested. This period is ideal for a first visit to the dentist.
- It is advisable that the first visit be a fact-finding visit and be accompanied by an examination of the child’s oral cavity and a recommendation for proper brushing.
- Before visiting the clinic, it is necessary to conduct an educational conversation with the child, explain that treatment and dental care is an important and mandatory procedure, show by your own example how important it is to brush your teeth in the morning and evening, and play a thematic game with the child.
- If a small patient behaved courageously and with dignity at the reception, it is necessary to praise him, to talk about how brave and fearless he is. If the kid was capricious, you should cheer him up and say that next time he will probably behave obediently.
- Moms or dads can take a child with them to show that there is nothing wrong with the treatment. In this case, you should 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 - dental treatment in children under general anesthesia.
Types of Anesthesia
Today, most private as well as public clinics have a subordinate service of anesthesiologists, which can individually select and provide anesthesia, which causes minimal harm to the body. In order to have an anesthesiologist and resuscitator on staff, pediatric dentistry must obtain 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 qualifications for an anesthetist and resuscitator.
However, in addition to drug anesthesia, there are non-drug methods of anesthesia: hypnosis, electroanalysis, audioanalysis. Of all these methods, only electroanalgia has gained popularity and is recognized as valid.
Dental treatment in children under anesthesia can be of two types: local anesthesia, complete.
Phase application pain relief
This method involves selective anesthesia by type of application. That is, the injection site is previously deprived of sensitivity using a mint spray or gel, and after one to two minutes an injection with an anesthetic is given.
In the treatment of caries or pulpitis in children, preparations containing artakoin hydrochloride are used for local anesthesia, since it is five times more powerful than novocaine and also less dangerous for the body. In addition, artakoin hydrochloride is excreted from the body in twenty-twenty-five minutes.
Dental treatment in children under general anesthesia using drugs based on artacoin hydrochloride, you can start from four years old. Articoin-containing drugs are also safe for pregnant and lactating mothers.
To enhance the anesthetic effect and duration of the drug, such drugs are often supplemented with vasoconstrictors (vasoconstrictors), such as adrenaline, mesatone, filipressin. Combined local painkillers based on artacoin hydrochloride are produced only in Germany, France and Spain.
The treatment of milk teeth in children under anesthesia with the use of combined drugs is shown starting from five years in the ratio of one to one hundred thousand (artakoin to adrenaline).
At the age of five to seven years, benzocaino- and lidocaine-containing sprays are used as selective or application anesthesia.
Preliminary medical preparation of children before visiting the dentist
To prepare the child’s body for anesthesia and reduce the possibility of side effects, special preparations are used, which are usually called preliminary drug preparation.
There are four components of pain: psycho-emotional, sensory, motor, autonomic.
A local anesthetic, such as lidocaine, artikoin, benzocaine, removes the sensitivity at the site of the intervention by removing the sensory component, but not stopping the emotional, motor and autonomic components, so they should be removed after the administration of the analgesic.
The methods of persuasion and suggestion stop the psycho-emotional component.
Indications for use
Dentistry in children under general anesthesia medicines having calming effect, shown for:
- chronically occurring mental illness;
- chronic respiratory disease;
- insulin deficiency;
- endocrine system diseases;
- chronic seizures and hysteria;
- increased muscle tone;
- chronic depression;
- phobias.
10-25 minutes before treatment, the child is prescribed an anxiolytic, for example, chlordeazepoxide, better known as Sibozon, Napaton, Seduxin or Chlozipid.
An anti-anxiety drug is prescribed for children from four years old in a dosage of five to ten mg, at the age of seven years - from ten to twenty mg, at the age of fifteen to eighteen years - from twenty to thirty mg per day, for two to three doses. The last dose of diazepam should be drunk fifteen minutes before visiting the dentist.
Sedation - an alternative to anesthesia
Due to the fact that preliminary medical preparation is not always effective, in modern pediatric dentistry they resort to such a method as sedation, or an alternative to anesthesia.
Sedation ("therapeutic sleep") can be deep (complete), that is, entering a state of sleep and slowing breathing, and verbal (incomplete), when the patient is able to maintain interconnection and follow the instructions of the doctor.
Dental treatment under general anesthesia in children is carried out with the use of inhalation several minutes before the immediate dental intervention, nitrous oxide N2 and O2 - ZACS are used.
At the beginning of the procedure, the child receives pure O2 and nitrous oxide N2 through the mask for fifteen minutes. The permissible concentration of N2 in the ZAKS mixture should not exceed seventy percent. Thirty percent of nitrogen and seventy percent of pure medical oxygen are usually used for children under the age of fifteen.
Introduction to anesthesia with a mixture of ZACS causes a child to feel light, relaxed, drowsy.
Benefits of Sedation
The kid sees and hears everything that happens around, but does not feel any discomfort. The supply of the mixture for anesthesia and the removal of the oxygen mask occurs using high-quality automated equipment. By the time the dental procedure is completed, there is an inverse decrease in nitrous oxide and an increase in the concentration of pure oxygen up to one hundred percent, after which the mask is removed. The effect of ZAKS passes after five to ten minutes.
Sedative mixture even 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, the ZACS mixture is used starting from four years, when it is already possible to establish contact with the child. One of the main tasks in this case, both for the dentist and for parents, is to persuade the baby to put on the mask himself. To do this, use aromatic oils, causing the child to desire to breathe gas without coercion.
Foreign practice of dental clinics uses the display of your favorite cartoons and fairy tales of the child during the "therapeutic sleep".
Dental treatment under general anesthesia in children using sedation can be considered an absolutely harmless procedure, since it is used in all developed countries of the world.
Pediatric Dentistry in Russia
It is no secret that this area is the youngest and at the same time the most complex branch of medicine, which includes many areas.
The founder of dentistry for children can be considered A.K. Limberg, who since 1901 headed the department of the same name at the Medical College of St. Petersburg.
In 1974-1975, the medical examination of children in dental surgeries was officially adopted, as well as the use of anesthesia during heavy operations.
In 1985, the specialty "pediatric dentist" was officially introduced into the nomenclature of medical specialties.
Today, upscale children's dental clinics are in every city. In addition to standard procedures, such as therapy, oral and maxillofacial surgery, neonatal surgery, pediatric orthodontics and prosthetics, physical examinations and treatments, some hospitals may offer sedation or general anesthesia.
Overview of children's dental clinics
How is dental treatment for children under general anesthesia in Moscow? The cost of sedation, the clinics performing it are indicated below.
In the capital of Russia, a number of clinics can offer this service:
- “Kid and Carlson” - the cost of nitrous oxide sedation (30 minutes) is 2500 rubles. The clinic also provides treatment services under general anesthesia. The cost of anesthesia "Sevoran" (30 minutes) is 4500 rubles. The price of one minute of general anesthesia is 165 rubles.
- The International Medical Center “ON Clinics” provides the following services: inhalation anesthesia (30 minutes) - 5500 rubles.
- The Nutcracker family dental clinic the cost of sedation with nitrous oxide (30 minutes) - 2940 rubles. General anesthesia (30 minutes) - 5940 rubles. The medical institution also provides premedication service - 1,500 rubles.
Not only in Moscow is dental treatment under anesthesia in children. Novosibirsk also offers similar services:
- Dental clinic "Dent Style" - dental treatment for babies under general anesthesia (1 hour) costs 5500 rubles. Anesthesia can be administered through an oxygen mask or by injection.
- "Dentistry Center" - an hour of anesthesia in the clinic costs 3900 rubles.
- “Road Clinical Hospital” - the information on the site says that the cost of anesthesia is 25% of the cost of treatment.
Minsk dental clinics also carry out dental treatment under anesthesia in children:
- “Family Dentistry Center” - intravenous anesthesia of 78 Belarusian rubles (2,530 Russian rubles).
- The Melissa Medical Center also provides anesthesiologist services for babies - the cost of the service must be found in the clinic individually.
Perhaps in other cities, dental treatment under anesthesia in children. Krasnoyarsk does not lag behind Moscow and also provides sedation and general anesthesia services:
- Dentistry Center "ASTREA" - uses the drug "Sevoran", the duration and cost of the service can be obtained from your doctor or consultant.
- "University Center of Dentistry" - the reception is conducted by a pediatric anesthetist, who, according to the testimony and age of the child, recommends the type and cost of anesthesia.
Dental treatment in children under anesthesia: reviews
Most children are panicky afraid of doctors, and therefore every trip to the clinic is accompanied by tantrums, tears and moods. In order not to harm the psyche of the baby, many mothers resort to dental treatment under anesthesia. The advantage of this method is that the child inhales the laughing gas and falls asleep without fear of the doctor and drill.
So, the child undergoes dental treatment under general anesthesia. Reviews you will read the parents below.
Often, mothers, before taking their child to the doctor, ask friends and acquaintances for advice. Private clinics offering dental services such as dental treatment under general anesthesia are particularly popular. Many note that at the consultation, the anesthetist prescribes a blood and urine test, and a physician examines the child. A separate criterion is good health during the treatment period, that is, the presence of a 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 may occur, parents say. All this normally should pass in 12-14 hours. Especially the treatment of teeth with a mixture of ZACS or the drug "Sevoran" is recommended by mothers of children with poor health.
Dental treatment in children under general anesthesia, reviews of doctors
Experts note that over the entire life of the Sevoran preparation, a huge number of children have been treated, most of which are babies with a central nervous system disease. At the same time, doctors remind that the necessary condition is to carry out medical procedures under the supervision of a highly qualified specialist anesthetist and resuscitator. The clinic should have expensive high-quality equipment: a ventilator, respiratory devices, modern anesthetics, and powerful follow-up equipment. It is especially important that anesthesia is safe for the baby's health and does not cause unpleasant side effects.
Most often, mothers begin to plan this procedure, when the teeth actively deteriorate in children - about 3-4 years. Dentistry for a child (3 years) under general anesthesia takes about 4 hours and passes without complications.