Increasingly, dental treatment in children that begins with standard visits is followed by further treatment under anesthesia.
The most challenging age group, from the point of view of treatment, is preschool children. The reasons for this are the child's immature psychophysiological system, peculiarities of child’s nervous system and body as a whole.
Why Is Anesthesia?
At different periods of life the child does something or doesn’t, not because they do not want, or they are naughty or spoiled, or the dentist can’t reach out to a child, but because they are simply unable to do it!
That is why, it is essential for the dentist to set attainable goals and tasks for a little patient during the first visit! That means dentist should develop a treatment plan the child can cope with. As a rule, during the first visit the dentist exams the child’s teeth (even at this stage the child's behaviour may help the dentist to come to certain conclusions), speaks to the parents and develops a treatment plan suggesting the number of visits, the scope of work during each visit and the cost of treatment.
Tooth Extraction under Anesthesia without Fear
If the age, communicative skills, and lack of strong fear permit, the child has teeth cleaning. This procedure helps to teach the child how to behave in a dental chair, to establish the relationship between the child, the dentist, and the dentist’s assistant. In fact, it is a brief rehearsal for the patient before the upcoming treatment. The dentist can perform a more accurate exam of the teeth cleaned from plaque and predict the child’s behaviour responses during other dental procedures.
At this stage, the dentist can tell parents that the treatment can be too stressful for their child because the child is wary and negative about even such a simple procedure as teeth cleaning. The dentist might offer to start treating a “not the worst" tooth, and, in case of failure, to continue with treatment under general anesthesia, i.e., in the child’s sleep.
Teeth Treatment under General Anesthesia in Children
Another important reason for treatment under general anesthesia is an extensive and complicated treatment. The more teeth need treatment, the more visits are required to meet the patient’s needs. Dentists speak of accumulated "dental fatigue" when the patient feels more and more tired and reluctant to tolerate dental treatment from visit to visit (anesthesia, preparation - "drilling", root canal treatment, tooth extraction, etc.). Therefore, given the treatment plan, child’s age and behaviour, during the first examination the pediatric dentist can warn the parents that the first few visits are likely to be effective (at first), but the child can be so tired that further treatment may continue only under anesthesia. Sometimes it doesn’t become evident immediately, but in the course of treatment.
The dentist’s task is to understand in time that the child's psychological resources are exhausted, and it is not possible to carry on with effective treatment because the patient no longer cooperates with the dentist. At this stage, treatment under general anesthesia is recommended. "Why not from the very beginning? Why did we need those visits that ended in treatment under anesthesia anyway?" many parents ask. These first visits are not a waste. The child forms a positive image of a dentist as they realize that a dentist won't force any treatment on them. It will help to form a child's dental culture in the future.