What sedation/options can you provide?
We provide the full spectrum of anesthetic options from oral sedation, to intravenous sedation and general anesthesia. Depending on individual needs adult patients benefit most from IV sedation and general anesthesia while for the paediatric patient we typically useoral sedation or general anesthesia.
What is the indication for paediatric Oral sedation vs General Anesthesia?
Generally speaking oral sedation is recommended for very quick procedures that last 30-40 minutes. We do not re-dose oral medication once it starts to wear off for safety reasons; therefore, if the work cannot be completed on that day, another appointment may be necessary. Oral sedation medicine is bitter tasting and multiple oral sedation appointments generally result in the child refusing to drink the medicine. For more extensive procedures requiring we would recommend general anesthesia.
Is anesthesia safe?
Our surgical centre has one doctor provide the anesthetic while a separate dentist provides the treatment. Therefore, each doctor can focus on their respective tasks and patient care is never outsourced to nurses or CDAs. Patients are fully monitored and another anesthetic case is not started until the previous patient has met discharge criteria. Our office is accredited for general anesthesia by the College of Dental Surgeons of B.C. Our suite is routinely inspected by biomedical engineers, physician anaesthesiologists and other dentists to ensure all anesthesia equipment, emergency equipment and drugs are up-to-date and properly maintained.
In terms of morbidity and mortality of ambulatory dental surgery centres: Nkansah et al reported a mortality rate of 1.4 deaths per 1 million anesthetics. El-Mowafy et al (Results presented at the American Association of Dental Research (AADR) Annual Meeting & Exhibition in Fort Lauderdale FL March 22, 2018, manuscript in preparation) reported a mortality rate of 0.8 deaths per 1 million anaesthetics, and a serious morbidity rate of 0.25 events per 1 million anaesthetics. Cumulatively, this represents a mortality of approximately 1 death per 1 million anesthetics over an approximate 40-year period (1973-2016), which is an enviable safety record for anesthesia administration in any health care setting. (As a reference: Schiff et al examined mortality and morbidity of ASA I and II patients in hospital-based settings over an approximate ten- year period from 1999-2010. This study estimated 7 deaths per 1 million anesthetics attributed to anesthesia administration. ) Private surgical centers provide a patient-friendly environment away from MRSA and other nasty bugs that can be contracted in hospitals, to ensure an experience for the patient that is far more pleasant and personalized than any hospital OR.
What are the neuocognitive effects of anesthesia?
The neurocognitive effects of anesthesia are currently being investigated and a number of large prospective trials are underway. Although emerging studies are encouraging (Preliminary data from the GAS trial can be found here) and do not reflect the same response seen in animal studies, which prompted the investigations, more data is required. The greatest at risk seem to be very young patients, less than 2 years old, that require multiple anesthetics. Our dental anesthetics are performed on children age 3 years and up, which puts us outside the highest risk window. Additionally, dentistry a short procedure and is minimally invasive, therefore the dosages of the medication required to keep the patient asleep are at an absolute minimum. For more information please click the links below
Can parent stay in the OR during treatment?
As in hospital operating rooms (OR), a parent is welcome be present to help put the child off to sleep but once this is done, we kindly request the parent wait in the reception area. Parental presence in the OR re-directs the attention from your child to the parent, lengthens the treatment time and this cumulates in greater unnecessary risk.
What does anesthesia cost?
The anesthetic cost depends on a number of factors, type of anesthetic and length of time of the procedure. Please contact the office for a consultation for a treatment plan and estimate.
Do you accept patients onthe Healthy Kids program?
Yes, we do.
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