Sooner or later, every mom is faced withthat a 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 in the dental office, to persuade him to come there again can be extremely problematic. Often, in order to pass a simple routine inspection, parents have weeks to persuade or even bribe the child with gifts. It is very important that before going to the clinic the adults themselves behaved correctly, that is, they did not force the situation and provoke the child to fear and anxiety.
Recommendations for parents
- In children up to three years, the pain threshold is lowered, which means that the feeling of fear is almost not manifested. This period is ideal for the first visit to the dentist.
- It is desirable that the first visit was an introductory one and was accompanied by an inspection of the child’s oral cavity and a recommendation for proper teeth cleaning.
- Before you visit the clinic, you need to spend withchild education conversation, explain that treatment and care of teeth is an important and mandatory procedure, show by example how important it is to brush your teeth in the morning and evening, to play a thematic game with your child.
- If the little patient behaved courageously andadequately at the reception, you need to praise him, tell about how brave and fearless he is. If the baby is capricious, you should cheer him up and say that the next time he will surely behave obediently.
- Moms or dads can take the child with them to the reception to show that there is nothing wrong with 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 orWere not executed 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
На сегодняшний день большинство как частных, так and state clinics have in their subordination a high-class service of anesthesiologists, which can individually select and provide pain relief that 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 to do, as there is a list of specific requirements for equipment, preparations and materials, as well as anesthesiologist and resuscitator qualifications.
Однако кроме медикаментозного наркоза, существуют and non-pharmacological methods of anesthesia: hypnosis, electroanalgiziya, audioanalgiziya. Of all these methods, only electroanalgia has gained popularity and is recognized as valid.
Dental treatment in children under general anesthesia can be of two types: local anesthesia, complete.
Phased application of anesthesia
Данный способ предполагает выборочное anesthesia on the type of applications. That is, a pre-injection site is deprived of sensitivity with a mint spray or gel, and after one or two minutes an injection is given with an anesthetic.
In the treatment of caries or pulpitis in children forlocal anesthesia is used drugs containing artacoxin hydrochloride, because it is five times more powerful than novocaine, and less dangerous for the body. In addition, artacoin hydrochloride is eliminated from the body in twenty to twenty-five minutes.
Dental treatment in children under anesthesia, using drugs based on artacoin hydrochloride, you can start with four years. Artico-containing preparations are also safe for pregnant and lactating mothers.
To enhance the anesthetic effect andthe duration of the drug is often such drugs are complemented by vasoconstrictors (vasoconstrictor substances), such as adrenaline, mezaton, filipressin. Combined local anesthetics based on artacoin hydrochloride are produced only in Germany, France and Spain.
The treatment of milk teeth in children under general anesthesia with the use of combined preparations has been shown since five years in a ratio of one to one hundred thousand (artacoin to adrenaline).
At the age of five to seven years, benzocaine and lidocaine 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 drugs are used, which are commonly called pre-medication preparation.
There are four components of pain: psycho-emotional, sensory, motor, vegetative.
Local pain medication, such as lidocaine,articoin, benzocaine, removes sensitivity at the site of intervention, removing the sensory component, but not stopping the psycho-emotional, motor and autonomic components, so they must be removed after the introduction of the analgesic.
The methods of persuasion and suggestion stop the psycho-emotional component.
Indications for use
Dental treatment in children under anesthesia drugs that have sedative effect, shown with:
- chronic mental illness;
- chronic respiratory disease;
- insulin deficiency;
- endocrine system diseases;
- chronic seizures and hysteria;
- increased muscle tone;
- chronic depression;
- phobias.
10-25 minutes prior to treatment, an anxiolytic is prescribed to the child, for example, chlordeazepoxide, better known as "Sibozon", "Napathon", "Seduxin" or "Chlozipid".
Anti-anxiety drug is prescribed to children fromfour years at a dosage of from five to ten mg, at the age of seven years - from ten to twenty mg, at the age of from fifteen to eighteen years - from twenty to thirty mg per day, for two or three doses. The last dose of diazepam should be drunk fifteen minutes before visiting the dentist.
Sedation - 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 ("healing sleep") can be deep(complete), that is, entering a state of sleep and slowing breathing, and impotent (incomplete), when the patient is able to maintain the relationship and follow the instructions of the doctor.
Dental treatment under general anesthesia in children is carried out with the use of inhalation a few minutes before the immediate dental intervention; nitrous oxide N2 and O2 - DAX is used.
В начале процедуры ребенок в течение пятнадцати minutes through the mask gets pure O2 and nitrous oxide N2. The permissible concentration of N2 in the SAC mixture should not exceed seventy percent. For children under fifteen, thirty percent nitrogen and seventy percent pure medical oxygen are commonly used.
Introduction to the state of anesthesia with a mixture of SACS causes a feeling of lightness, relaxation, drowsiness in a child.
Benefits of sedation
The kid sees and hears everything that happens around,but does not feel discomfort. Submission of the mixture for anesthesia and removal of the oxygen mask occurs with the help of high-class automated equipment. By the time the dental procedure is completed, the nitrogen oxide is reversed and the concentration of pure oxygen increases to one hundred percent, after which the mask is removed. The effect of ZAX 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.
Typically, a ZACS mixture is used starting at fouryears 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 the 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 "children's dentist" was officially introduced into the nomenclature of medical specialties.
Today, upscale children'sThere are dental clinics 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 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:
- "Baby and Carlson" - the cost of nitrous oxidesedation (30 minutes) is 2500 rubles. The clinic also provides treatment services under general anesthesia. The cost of anesthesia "Sevoran" (30 minutes) is 4,500 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 costnitrous oxide sedation (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 general anesthesia: reviews
Most children are panicky afraid of doctors, andtherefore, 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 todoctor, ask for advice from friends and acquaintances. 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, examination of the child by a therapist. 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 can occur, parents say. All this normally should pass in 12-14 hours. Especially the treatment of teeth with ZAKS mixture or Sevoran is recommended by mothers of children with poor health.
Dental treatment in children under anesthesia, reviews of doctors
Experts note that for all the timethe existence of the drug "Sevoran" was treated a huge number of children, most of whom are babies with a disease of the central nervous system. At the same time, doctors remind that the necessary condition is the conduct of medical manipulations 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 the 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 - at about 3-4 years old. Dentistry for a child (3 years) under general anesthesia takes about 4 hours and passes without complications.
