Parent’s Perspective on General Anesthesia for Children’s Dentistry

An interview with Kathleen Hale, D.D.S., owner of Bath and Dansville Dental Professionals.

Interviewer: “Dr. Kathleen, you have an outstanding reputation and decades of experience in providing pediatric dentistry in combination with sedation. Your practice is very unusual in that you provide children with dental care while under general anesthesia in your private office. This level of care is typically only available to children through hospitals. For parents whose children need this level of care, working though a hospital system for dental care can be so difficult, expensive, and time consuming, one could reasonably say that it is not available to most parents. For those parents who are successful in working through the system, the wait for an appointment to treat their child is often more than a year, during which time the child’s dental problems can get significantly worse”.

Interviewer: “Dr. Kathleen, general anesthesia is the highest level of sedation. These children are completely out, just as they would be in an operating room. They feel nothing, remember nothing, and typically get all their dental treatment completed in a single sedation appointment. My first question on behalf of the parents of these children; is this really safe and why a private office rather than the hospital operating room?”

Dr. Kathleen: “Dr. Lucas is an M.D. anesthesiologist, the same kind of doctor who would be doing the child’s anesthesia in a hospital. Dr. Lucas and his team, and my licensed dental assistant Kathy, and I have been providing moderate to deep sedation dentistry for children together as a team for over 12 years. Dr. Lucas and I each have over 25 years of experience in our respective fields. We have treated sedated children as young as 9 months up to adults 80 years old. Dr. Lucas’s team is fully equipped to properly sedate and monitor the patient, and they have all the equipment and drugs available to handle difficulties. Yes, it is very safe.”

“The private office setting has many advantages for the child and parent compared to a hospital. For the family, the entire atmosphere is much more relaxed, less intimidating for the parents and the child. It does not smell or sound or look like a hospital. The child is not exposed to hospital infections and diseases. From our perspective, it is much easier to provide great care efficiently working in dental treatment room specifically designed and equipped for doing dentistry, as opposed to trying to do dentistry while standing over a child laid out flat on an adult sized operating room table, with operating room lights and equipment. The patient is more comfortable, we are more comfortable, and therefore can do a better job in less time. Less time means lower cost and increased safety for the patient.”

Interviewer: “Why do some parents and patients want or need this level of sedation?”

Dr. Kathleen: “Many of these patients are special needs patients who can’t really be treated successfully without sedation. Other patients may have extreme anxiety and simply can’t sit still or cooperate enough to receive treatment. Some parents have children that need a large amount of care. These parents are faced with the choice of either spending time and effort and money making numerous dental visits with time lost from work and school and multiple difficult experiences for the child, verses getting everything done in one sedation appointment where the child sleeps through the appointment.”

“We also treat patients sent to us by other family dentists or pediatric dentists who were unsuccessful in treating the child using the more typical techniques.

“Parents are often concerned that their child has a good experience at the dentist. For children needing extensive care, or children having special needs, or high anxiety, or behavior management issues, sedation is a safer, less traumatic, easier way to give the child the best possible care with minimal hassle and drama for the parents and child. We can create a positive experience and hopefully eliminate the progression of an anxious fear filled child growing into an even more anxious adult who then avoids or refuses getting the care they need.”

“Some adult and child patients with severe anxiety or neurological developmental conditions will need sedation for all their visits. However, for many children, by creating a positive experience for the child, earning their trust, decreasing their fear, we can successfully transition them away from needing sedation. They can become regular dental patients receiving care without any sedation. That’s always a win for everyone.”

Interviewer: “Could you briefly explain the typical experience from the patient perspective?”

Dr. Kathleen: “The experience is very positive for the child. Their parents are with them the entire time they are awake. The child meets Dr. Lucas. He is a parent himself, is super friendly and great with kids. He answers the parent’s and the child’s questions. He explains to the child in terms the child can understand, what is going to happen. Then mom or dad or child gently holds the face mask near the child’s face and the child falls asleep. After the procedure, while the child is beginning to wake up, the parents are brought back into the room. Because of the amnesia effects of the anesthesia, the kids typically don’t remember anything, including the ride home. From the child’s perspective, they fell asleep and a few minutes later they were on their way home.”

Interviewer: “This really sounds like a wonderful service and experience for the patients who need this. Is this covered by insurance at all? Do you accept Medicaid or Fidelis?”

Dr. Kathleen: “Yes, some medical and dental insurance will provide some assistance. No, we are not in-network providers of the social services programs, but we do provide services to many of these patients outside of that system. Qualifying for public assistance does not exclude them from receiving care. We ask parents to confirm with their insurance what kind of coverage is available. Sometimes I need to send a narrative or certain documentation as to the necessity of the sedation for this patient. My staff is great at helping patients receive their full insurance benefits.”

Interviewer: “Doctor, thank you for your time today. This really sounds like something more people would take advantage of, if they knew the option exists. Is there anything else you would like to say before we close?”

Dr. Kathleen: “Thank you for helping us make people aware. My team and I really love helping these patients who struggle in getting the treatment they need. It is personally fulfilling to really help people, to make a difference. That’s why we become doctors. We want the best possible care and experience for these kids and it’s a privilege to be able to offer this service.”