Tuesday, November 25, 2008

Does a child with special needs need treatment under General Anesthesia?

The dental treatment of a child with special needs is a challenge because very often the child cannot cooperate. Is the pediatric dentist right in posting such children under general anesthesia, or are there alternatives to be explored before we rush to fill in that hospital admission slip. DCSN asked some leading practioners of Pediatric Dentistry to give us their opinion on the issue. Each of them is given a rating corresponding to their inclination towards 
Chairside management under LA 
or
Management Under GA or Nitrous Oxide 

Prof Dr Usha Mohan Das 

 

 

Prof Dr PB Sood                       

Dr Anil Kumar Reddy    

   

 

Prof Dr Amitha Hegde                 

Prof Dr MS Muthu 

 

 

Prof Dr AR Prabhakar        

Prof Dr Ponnudurai A  


 

Dr Ashwin Jawdekar

  



Prof Dr Sashikiran

 

 

 

Our Take
As a site that has been stressing the improtance of prevention, we ideally believe that we should prevent the child from ever requiring operative treatment. However, blissful as this scenario may seem, it is highly unlikely. After taking into consideration the opinions of our experts the editorial team of DCSN recommends that every child must be given a chance to cooperate. We would be failing as pedodontists if we did not attempt to manage the child on the dental chair. We understand that this may not always work, and that invariably a few children will have to be posted under General Anesthesia, but we do not subscribe to the philosophy that a possible failure to manage the child on the chairside is reason enough to defer treatment to the operating theater.
Our Advice to parents is that, you must give your child every right to co-operate on the Dentist's chair before you agree to let the child be placed under general anesthesia.
Dr Sharat Chandra Pani
Editor
DCSN

2 comments:

Anonymous said...

Pediatric dentist are no doubt adept at managing children a lot better and special children require a different approach. After all, cooperation for treatment happens only after effective communication can happen between the dentist and the child. i would however beg to differ with our collegue who prefers to shoot pediatric dentist who use GA(may our pediatric dentist tribe increase!!) that it is essential to grade special patients to be posted under GA. Itis like giving a diagnosis of dental caries to wide range of spectrum of lesions from a white spot to grossly destructed tooth. A child with mild problems is definitely a patient for LA and dental chair but in cases where the enforced treatment is likely to result in more harm and risk due to unobtainable cooperation, it is worthy to post under GA. Moreover, posting is not a child's play, since most of these patients are not ASA 1 or 2 but ASA 3 or 4. so a pediatric dentist who posts these patients fully understands the risk/benefit ratio of such a procedure. kindly provide specific info about special patient subgroup before asking for opinion

Anonymous said...

i agree with you 100% even the behavioural management is the hardest way to treat the special needs but it the way to use your talent and enjoy the love response of the child when cooperate
it may took more time and effort but it is rewardable way of treatment