Question 1

What are the instructions for my child’s anesthesia for TOMORROW?

Accepted Answer

If your child has any COUGH OR COLD SYMPTOMS now, or in the last couple weeks it is CRITICAL that you contact Dr. Seiden as this may affect your child’s safety for anesthesia in the dental office tomorrow.

***MOST IMPORTANT*** It is critical that your child **DOES NOT EAT** past the following times.  They can have regular food until 9 hours before their arrival time and clear liquids until 3 hours before their arrival time. Clear liquids are ONLY water, apple juice, Gatorade, and Pedialyte.  If you have another clear liquid you want your child to have, please check with first as drinking the wrong liquids may cause DELAY OR CANCELLATION . Things that are **NOT** clear liquids and that they **CAN NOT HAVE** are orange juice, milk or any dairy products, broths, or any other liquids.  If you child eats or drinks at the wrong time, the procedure may be cancelled.

If possible, do NOT take your child to school or daycare on the day of the procedure because they very often get food or snacks at school and daycare.

Your child will receive a general anesthetic.  They will typically go to sleep with an anesthesia mask, and shots can usually be avoided. After they go to sleep with a mask, an IV will be placed, followed by a breathing tube. General anesthesia is very safe, but there are risks. These are things such as allergic reactions, changes in heart rate, blood pressure, injury to lips, gums or teeth, and problems with breathing. More serious things are very uncommon. Common side effects from anesthesia include nausea, sore throat, nose bleeds, and waking up irritable.

It is common for children to have an accident under anesthesia, so if they are recently out of diapers, a pull-up is helpful. Otherwise please bring a change of clothes just in case.

Please BRING A BLANKET of your choosing to keep them snuggly warm during the procedure and any special lovey stuffed animals, etc that are a comfort to them!

Sometimes the breathing tube is placed in the nose to give the dentist space to work in the mouth. A breathing tube placed in the nose has the risk of a nose bleed occurring, typically when the breathing tube is placed or removed.  It is possible, but uncommon, for your child to have a nose bleed at home. If there is dripping blood that does not stop with direct pressure to the nose and tilting the head back, you should call 911 or go to an emergency room. This is very uncommon.  However, it is common when your child sneezes or blows their nose to see small bloody boogers (clots).  This is not a concern.

Question 2

What patients are safe to have their procedure done in a dental office?

Accepted Answer

Patients having office based procedures need to be generally quite healthy. Ideally patients would have NO MEDICAL PROBLEMS, or only MILD medical problems that are very well controlled. Patients with any serious medical problems or medical problems not well controlled are not usually safe for office based anesthesia.
 
Some examples of medical conditions that are not good candidates for office anesthesia
Poorly controlled asthma
Cold symptoms (see above)
Significant sleep apnea or snoring (s

Question 3

Types of anesthesia

Accepted Answer

General anesthesia 
General anesthesia means that you are completely unconscious and will not respond to painful stimulation. Many times you will have difficulty protecting your airway from secretions like your own saliva. Often times a breathing tube may be placed to help protect your airway or assist in breathing. 
 Sedation 
○Sedation exists on a continuum and ranges from mild, moderate to deep sedation. For some procedures, especially in teenagers or adults, sedation may be an appropriate options compared to general anesthesia. Generally sedation involves less medications and can result in a speedier recovery. 
○Sedation in children 
Young children are often not good candidates for sedation because they tend to get disinhibited (wiggly and move a lot) by being in a state that they don't understand. Teens and adults can have sedation, and as long as they are not feeling any pain (because of things like local anesthesia) they can usually hold still and be calm. In a young child in the same situation they often will panic and not hold still, and this is not safe.

Question 4

My child is very anxious about this procedure, are there medications that can be
used to reduce anxiety?

Accepted Answer

It is very common for children to be nervous or anxious about going under anesthesia and having procedures. There are a variety of techniques that can be helpful to reduce anxiety. 
No shots! In most patients, the start of anesthesia can be accomplished without any shots or needles by using an anesthesia mask. This is called an inhalational induction of anesthesia. 
Tablet distraction. Dr. Seiden has pioneered the use of using tablets (iPad) video games as a distraction technique while going to sleep with anesthesia. His research demonstrated that the iPad is often times as effective or more effective than sedating medications.  
Medications. A variety of medications can be used to reduce anxiety. These can be administered as a liquid, injection (shot), or nose spray. If your child can hold still to have an IV placed, then medications can also be administered through the IV to reduce anxiety.

Question 5

Will the anesthesia make me nauseated or throw up?

Accepted Answer

Nausea is one of the more common risk factors from anesthesia and sedation. Patients receive anti-nausea medication during their procedure, but it is still possible to have nausea even with this medication.

Question 6

What patients are safe to have their procedure done in a dental office?

Accepted Answer

○ Patients having office based procedures need to be generally quite healthy. Ideally patients would have NO MEDICAL PROBLEMS, or only MILD medical problems that are very well controlled. Patients with any serious medical problems or medical problems not well controlled are not usually safe for office based anesthesia.
○ Some examples of medical conditions that are not good candidates for office anesthesia
Poorly controlled asthma
Cold symptoms (see above) 
Significantly overweight (a body mass index above 30) LINK BMI CALCULATOR https://www.cdc.gov/healthyweight/bmi/calculator.html 
Sleep apnea or snoring  
○ Snoring can suggest sleep apnea which can cause airway obstruction during anesthesia and when recovering from anesthesia

Question 7

Are there anesthesia risks to the developing brain?

Accepted Answer

We are still learning about the effects of anesthesia on the developing brain of young children (children under 3). Current recommendations are to avoid general anesthesia in children under 3 unless the risk of not having the procedure is also significant. Current evidence has demonstrated that for short procedures (less than 1 hour) there is not a detectable difference in neurodevelopment between children who have had anesthesia and those who have not. Visit SmartTots for more information.

Question 8

Will there be an IV placed?

Accepted Answer

An IV is necessary to be able to deliver medications as part of general anesthesia and sedation as well as any emergency drugs that might be needed. The IV will be in place after the procedure, but will be removed once the patient is awake and safe. It does not hurt to have an IV removed more than having a band-aid taken off. For young children and those scared of needles, the IV can usually be placed once under anesthesia. This is done by going to sleep with an anesthesia mask.

Question 9

Will there be a breathing tube?

Accepted Answer

For many procedures with general anesthesia a breathing tube is necessary. A breathing tube helps prevent anything inappropriate from entering the lungs during the procedure. A breathing tube also allows a way to deliver anesthesia gases that keep you asleep.  When possible, a breathing tube is placed in the nose because then the dentist has more space to work in the mouth.

Question 10

Why is the breathing tube sometimes placed in the nose?

Accepted Answer

For dental procedures, a nasally placed breathing tube allows the dentist to work in the mouth without the breathing tube getting in the way of your mouth opening and closing. This gives the dentist more space to work.

Question 11

Can you get a nose bleed from a nasal tube?

Accepted Answer

Yes. When a nasal breathing tube is placed it is very common to have some nose bleeding. Usually this just happens when the tube is placed. It however can also happen when the tube is removed. When you go home you may notice some small amounts of blood from the nose, especially if sneezing or blowing your nose (bloody boogers). This is ok. But if you see fresh dripping blood that does not stop with pressure to the nose you should seek medical attention at the nearest emergency room or all 911.

Question 12

Can anesthesia be started without any shots or needles?

Accepted Answer

Yes. In many circumstances, especially with young children, anesthesia can be started by breathing anesthesia gas through a mask. This is called a "mask induction of anesthesia." Dr. Seiden will review with you if this is an appropriate technique and other options to make the start of anesthesia as calm as possible.

Question 13

When do I have to stop eating? (Also known as NPO or fasting time)

Accepted Answer

○Clear liquids: 2 hours before scheduled arrival time 
Clear liquids are, for example, water, apple juice, Gatorade, Pedialyte, black coffee. 
Clear liquids are NOT: orange juice, milk, anything with dairy, any kind of broths or soups.
○ Breast milk: 4 hours before schedule arrival time 
○ Formula: 6 hours before schedule arrival time 
○ Solid foods: 8 hours before scheduled arrival time

Question 14

Why can't I eat before my procedure?

Accepted Answer

When receiving anesthesia or sedation, the stomach must be empty. There is a risk of vomiting during anesthesia, and if there are food or liquids in the stomach there is a risk those contents could end up in the lungs. This is called an aspiration and can result in a life threatening pneumonia. Unless it is an emergency procedure, these fasting times are required for safety. If not followed your procedure may be postponed or cancelled

Question 15

What if I have a cough or cold before my procedure?

Accepted Answer

○ It is not ideal to have a cough or cold symptoms before anesthesia, and often times if you have such symptoms your procedure may be postponed until you are healthy.
 ○ Cold symptoms that are concerning include: 
Fever above 101 degrees
Wet sounding cough or cough where you cough stuff up (also known as a productive cough)
Wheezing like asthma patients have
Runny nose with thick or greenish color
Currently testing positive for COVID-19

Question 16

Does insurance cover the anesthesia fees?

Accepted Answer

If you have private medical insurance (for example Aetna, Blue Cross, Kaiser), medical insurance sometimes will cover the anesthesia fees.  You should contact your insurance provider if you wish to explore this coverage.  Mobile Dreams does not bill insurance, so if you have private medical insurance you will be responsible for the anesthesia fee at the time of your appointment.  Mobile Dreams is able to provide documentation needed to attempt reimbursement from medical insurance.  Please note that it is typically your medical insurance, not your dental insurance, that may possibly provide reimbursement for anesthesia services.

Question 17

What are the risks of anesthesia?

Accepted Answer

General anesthesia is very safe, but there are risks with any medical procedure. Common side effects from anesthesia include nausea and vomiting, sore throat, and waking up irritable. Other possible reactions include allergic reactions, changes in heart rate, blood pressure, or problems with breathing. More serious reactions are very uncommon. While exceedingly uncommon, it is possible to have more serious reactions from anesthesia that could result in death, stroke, heart attack, or other injury.

Frequently Asked Questions

What are the instructions for my child’s anesthesia for TOMORROW?

What patients are safe to have their procedure done in a dental office?

Types of anesthesia

My child is very anxious about this procedure, are there medications that can be used to reduce anxiety?

Will the anesthesia make me nauseated or throw up?

What patients are safe to have their procedure done in a dental office?

Are there anesthesia risks to the developing brain?

Will there be an IV placed?

Will there be a breathing tube?

Why is the breathing tube sometimes placed in the nose?

Can you get a nose bleed from a nasal tube?

Can anesthesia be started without any shots or needles?

When do I have to stop eating? (Also known as NPO or fasting time)

Why can't I eat before my procedure?

What if I have a cough or cold before my procedure?

Does insurance cover the anesthesia fees?

What are the risks of anesthesia?

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