Saturday, November 20, 2010


Maybe some of you can sympathize with this 4-year-old girl...seeing the dentist can be terrifying.

My favorite pediatric dental patients are the ones that the anesthetist can put softly to sleep. We (the patient and I) seem to get along better this way.

My inclination has been that dental cases are the ones that anesthetists like to avoid. We need access in the mouth to restore and extract teeth and the anesthetist needs access to the larynx to secure the airway. I'm constantly redirecting their tube away from the teeth and the anesthetists are following behind resecuring the tube with more tape. Here, reintubating the patient after too many adjustments and failure to retain a tight seal. We should push for more nasal intubation.

Our hope in pediatric dental cases is to never need to take the child back to the OR for dental care again because of cost and general anesthetic risk. We are aggressive and treat with extractions, SSC's, and preventative restorations. Our hope is that if the uncooperative child needs care again, it won't be until they are 7 or 8 years of age and able to behave in the clinic.

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