Filling a Lot of Cavities - local or general anesthesia?

Mommy1!

Sun, Jul 23 2017, 12:55 pm

Being a busy working mom, I kept pushing off my daughter's first visit to the dentist until she turned 5 (Yes, I know, that wasn't something I should have pushed off). I ba'h have had one cavity my entire life but she must have gotten my husband's teeth; I was pretty shocked when the dentist told me she had 10 cavities!

He said that since the cavities are in her molers which don't fall out until ~10 yrs, I should get them filled and suggested the following two routes:
1) Multiple visits with local anesthesia where they fill a few cavities each time.
2) General anesthesia in the hospital where they take care of all 10 cavities at once.

Can anyone help me out with this? I really don't know what the best option is!

Thanks in advance!

octopus

Sun, Jul 23 2017, 1:05 pm

I would never run to put my kid under general anesthesia . Only if it was a necessity. You won't have to go 10 separate times to regular dentist to fill. Probably 4 times for each side of the mouth. Can't you try local at least once and see how it goes? One of my kids once had 8 cavities. And I was so annoyed because I'm on top of these things, but some kids have bad teeth. I spaced out each appointment by at least two weeks to give my little one time to recover.

amother

Firebrick

Sun, Jul 23 2017, 3:11 pm

was told to do GA for my daughter (she was abt 3 1/2 @ the time & needed abt 8 teeth fixed up) she is generally very anxious at drs and I knew it would be easier for all of us. but I didn't want to jump to put her to sleep. I went for a 2'nd opinion to a very kid friendly dr and he did it in one shot. I can't vouch for his work but am happy we got it done so quick.

I really prepped her beforehand and we spent a lot of $ in the toy store! she did relatively well at the dentist b'H.

Miri7

Sun, Jul 23 2017, 3:56 pm

I would definitely do local. There have been a number of child deaths due to general anesthesia in dental offices.

If you choose to do general, find a pediatric dental anesthesiologist who will come and do the anesthesia while the dentist does the dental work. The anesthesiologist will be focused solely on the anesthesia and will be far more experienced and prepared to deal with any emergencies that could arise.

While sometimes general anesthesia is necessary, like for heart surgery, I would never choose that when local is an option.

Ruchel

Mon, Jul 24 2017, 2:35 pm

Is 4 or 5 cessions with the "drowsy" med (they said it's laughing gas) better than one with general anaesthesia? I have that dilemma for my 5 year old. Tht's the choice we are proposed with, unless we just want the regular way and hold him down while he struggles (no thanks).
Do dentists in USA do it in their cabinet and on their own? In France it's always at hospital or clinic with an anaesthesist like real surgery.

octopus

Mon, Jul 24 2017, 3:35 pm

Ruchel wrote:

It sounds like if op would go general anesthesia route, she will be going to hospital. There are ped dentists that use general anesthesia in-office. And there have been a number of deaths in the news. If op would choose general, better to do it in the hospital.

amother

Amber

Mon, Jul 24 2017, 3:45 pm

Ruchel wrote:

I'm in Canada and had the same choice. I've used laughing gas as an option for a little work. General anesthesia is not done at the doctor's office or the hospital, it is done at a special clinic. I've done it 5 times and would do it again if necessary.

mamaleh

Tue, Jul 25 2017, 8:55 pm

My 5yo needed a bunch of work (also pushed off a first visit) spread throughout her mouth dentist offered 5-6 sessions in office with gas or one trip to the hospital. This DD has some sensory issues and sitting still is not one of her strengths. We opted for general and I'm sooo glad we did. It was one day and done, so less anxiety and scheduling issues. Any soreness was all at once, so only 1-2 days of 'soft foods' instead of a few sets of it. And...She has no negative associations with the dentist.

Mommy1!

Thu, Jul 27 2017, 1:03 pm

UGH! Just called the dentist to say that I would like to do local and the receptionist made me feel so guilty. She said it would be 4 visits to do all four sides and there would be numbness for 2 hours after each time. Anyone have experience with a good dentist in Lakewood? Or experience with Jersey Shore hospital's dentistry work? I am new to this city and this whole dental issue thing... THANKS!

amother

Periwinkle

Thu, Jul 27 2017, 1:35 pm

I've done both ways. One son I did in Jersey Shore. He was young, had a lot of dental trauma, and needed tons of work. It was no big deal. Jersey Shore was very child friendly and we were home a few hours later. My son has no recollection of the experience.
Recently, I switched to a real pediatric dentist who does not take medicaid. I find the Medicaid dentists fill every unnecessary cavity and try to schlep it out into many visits-so they can bill insurance.
Now that I use this practice, I figured that we could start doing the work in office. Although 3 year old has a bunch of cavities, I discussed with this dentist which are the most necessary to fill and he agreed to try it and see how he does. He is so great with the kids that my son keeps asking if we can go to the dentist again.
Many dentists will push you to do it in the hospital because it is easier for them. They don't want to deal with crying, young kids for multiple visits. They prefer to have a sleeping patient and charge insurance a huge sum.

Ima_Shelli

Thu, Jul 27 2017, 1:47 pm

amother wrote:

Many dentists will push you to do it in the hospital because it is easier for them. They don't want to deal with crying, young kids for multiple visits. They prefer to have a sleeping patient and charge insurance a huge sum.

This^^^

I would go for a second opinion and try to find a kid-friendly dentist who will do this in the office under local. And by local I mean lidocaine, nothing more.

I would avoid any sort of anesthesia in a dentist's office, it is unsafe. You need a separate person monitoring the airway if any sort of sedation is used. This is where fatalities have happened.

I would also avoid going to the OR unless absolutely necessary. The second opinion will help tell you if this is absolutely necessary. Get a third opinion if need be. Although the OR is a much safer way to administer general anesthesia, this is never something to do lightly. Especially for kids, anesthesia can have long-term risks and I have found that pediatric dentists are rather quick to push this approach as it is lucrative and requires less work on their parts since the kids are sleeping.

Best option would be to find a great dentist who knows how to actually be patient and work with your kid with local (lidocaine) only.

DO NOT LET THE RECEPTIONIST guilt you. You are doing what's best for your kid.

amother

Yellow

Thu, Jul 27 2017, 2:16 pm

Ima_Shelli wrote:

How many pediatric dentists would you try with a kid who is literally kicking and screaming out of genuine fear, and who gags and throws up, before giving up on finding someone who can work on him/her without general anesthesia?

ETA: I would wonder at a dentist recommending GA just because there is a lot of work to be done. If the kid is even semi-cooperative and the work can be accomplished in a number of visits, I don't see the reason to do GA. To me, the reason to consider GA is when the child has extreme fear or other issues that make it near impossible to work on him/her (as I described above) and there is a significant amount of work to be done.

Ima_Shelli

Thu, Jul 27 2017, 2:30 pm

amother wrote:

My kids were neither kicking nor screaming when the OR was mentioned as being the only way to fill their (multiple) cavities.

I didn't just stamm take them for a second opinion- I asked around for a dentist who was good with kids in the office. And they were able to tolerate the fillings just fine over the course of 1-2 (or 3) visits.

amother

Silver

Thu, Jul 27 2017, 2:30 pm

I'm not sure what you are feeling guilty about?

the receptionist is not thinking about money - she's thinking about your child. General Anesthesia - would by far be easier for your child. The problem is, there is a risk of complication. Likely, the receptionist's experience is that every patient that she has dealt with who has had GA, has been fine... so from her POV... GA is the better choice.

But this dentist did offer you local... so I'm not sure why you'd run to find a second dentist... who will be offering the same thing.

amother

Yellow

Thu, Jul 27 2017, 2:47 pm

Ima_Shelli wrote:

Makes sense. I agree that dentists should not push GA just because there is a lot of work, and I would move on from a dentist who did so, or at least insist they attempt without GA. However, my point was just that IME dentists recommend GA as a last resort for a child who is extremely fearful, uncooperative, etc. In that case I was asking a sincere question of how many pediatric dentists people would try in the hopes of finding one who could successfully work on their fearful and uncooperative child before deciding to opt for GA.

OP, if your child can handle it and is basically cooperative I would definitely agree to opt for local anesthesia, even if it means many appointments. I would try to spread them out and to schedule them all in advance so I could work out a schedule that would be manageable for my child and for me.