General Anesthesia is the use inhalational gas (Sevoflurane) via nasal intubation to prevent or reduce the feeling of pain or sensation during surgery or other painful procedures. A board-certified MD pediatric anesthesiologist has additional specialized training that certifies him or her to care for children. The goal is to make and keep the patient completely unconscious (or “asleep”) during the operation, with no sensations, feeling of pain, awareness, movement, or memory of the surgery. This is done in order to achieve full mouth high quality care compassionately.
Anesthesia is safer than it has ever been, especially when delivered by a board certified pediatric anesthesiologist, in a hospital setting, where extensive and proper monitoring and personnel exist .
Pediatric anesthesiologists treat children from the newborn period through the teenage years, and beyond in healthy well, fearful/anxious, and medically compromised children. They choose to make pediatric care the core of their medical practice, and the unique nature of medical and surgical care of children is learned from advanced training and experience in practice. They monitor your child’s major body functions (such as breathing, heart rate and rhythm, body temperature, blood pressure, and blood oxygen levels) throughout the surgery, address any problems that might arise during surgery, manage any pain your child may have after surgery, keep your child as comfortable as possible before, during, and after surgery.
Many parents express “fear,” “worry,” and “concern,” as well as some level of anxiety during GA and prior to treatment. However, after treatment under GA is complete, parents reported a lessening and improvement in the amount of dental pain, sleeping pattern, eating habits and acceptance of parental tooth brushing. Additionally, research indicates that postoperative discomfort is mild and subsides substantially over the first week after surgery. In fact, a systematic review of the literature found that “oral rehabilitation under GA results in the immediate improvement of the children’s oral health and physical, emotional and social quality of life. It also has a positive impact on the family. Additionally, parental acceptance of GA over more physical management techniques has increased dramatically, because of expectations of safety and compassionate treatment of their child.
Hospital operating rooms are sterile environments and allowing a parent in the operating room poses risks that affect sterility. This is subject to the pediatric anesthesiologist. Typically, parents are not allowed into the operating room as there are up to 5 personnel caring for your child
It takes about 30 minutes for the pediatric anesthesiologist to properly prepare your child for dental care (Mask induction, IV, intubation, taping, draping). X-rays and a cleaning proceed next with the pediatric dentist, along with forming a new, up to date, treatment plan. Although a treatment plan was given by your referring dentist, our dental surgeons want to ensure all information is up to date, and therefore, will write up their own treatment plans based on their own clinical and radiographic exams.
If a primary tooth has the potential to become a cavity, we place a sealant on the tooth to protect it. Small cavities receive white filling. Larger cavities receive silver fillings. Very large cavities may receive a baby root canal and a stainless-steel crown (stainless steel in the back, white crowns in the front). If the cavity has caused an infection in the tooth, it is extracted.
The decision is made by the board-certified pediatric dentists on what is best for your child. We take into consideration how long the tooth is going to remain in the mouth. Our surgeons legally cannot leave any dental caries untreated. Depending on the amount and extent of decay, the total anesthesia time is typically 2-3 hours.
Your pediatrician knows your child best and MUST be informed of the use of general anesthesia. We need them to clear your child for surgery in order for us to proceed, along with any other pediatric specialists your child sees. This paperwork must be completed within 30 days of the surgery and is a strict requirement by the hospitals.
Forms will be provided to you and can be faxed back once completed by your child’s pediatrician. We then forward the paperwork to the hospital for their own review, and the hospital will follow up with a presurgical evaluation over the phone to ensure all information is accurate and up to date to ensure safety.
It is your responsibility to ensure all paperwork is completely timely and sent to us for review. We reserve the right to cancel any cases that do not follow our strict protocols. It is because of these strict protocols that we have such vast success with outcomes. It is only for the benefit of your child.
We utilize your medical insurance to preauthorize coverage for general anesthesia in a hospital setting, depending on your deductibles and copays met. This is done by us as a courtesy but is between the hospital and yourself. Anesthesia fees typically are between 500-2500 depending on deductibles/copays.
We utilize your dental insurance to preauthorize coverage for all dental treatment needed. Dental insurance does not cover all treatment and only serve as an adjunct to help with costs. Fees are subject to maximums, deductibles, in/out of network coverage and a variety of other factors
For example, Hospital code D9420- hospital call code, is typically not a covered dental code but will be preauthorized. D9420 requires the pediatric dentist to do dental work in a hospital setting. There is a lot of preparation in order for a dentist to leave his set location to complete work on a patient in a different setting, ie: get pre-cert from the patients’ medical insurance by typing out a long and detailed narrative along with submitting records, etc., in order for medical insurance to cover the outpatient room and the anesthesiologist. The dentist also cannot see other patients on that day due to not being in the office.
Medical insurances do not cover the code D9420 since it is a dental procedure specifically billed by the dentist.
Once your child is out of surgery, the post op recovery nurses are ensuring proper vital signs as your child awakens. We will try to have the parents back as soon as possible, but is subject to clearance by the anesthesiologist and the recovery nurse. The dental surgeon will review post operatively all dental treatment completed, and give post op instructions/emergency numbers. Patients typically are discharged within 2 hours of waking up, and most are able to return to school the next day.
We would be happy to connect you with a previous parent of a child who already underwent their procedure. Direct parent to parent contact can be calming.
We would also be happy to connect you with any of our dental surgeons over the phone
We would also ask that you direct any anesthesia related questions to the department of pediatric anesthesiologist at Lurie Children’s/Advocate Lutheran
Review, sign, and submit completed PDSA agreement paperwork, including any copays, deductibles and non-covered services
Schedule a surgery date at a specific hospital with one of our surgeons (1-3 months)
Complete and provide History/Physical forms and any medical consult clearances needed within the next 30 days from date of surgery, by your child pediatrician or pediatric specialist and fax back to
Await a pre-surgery phone call from the hospital regarding time and instructions for surgery (must follow pre surgery guidelines per hospital instructions)
Complete full mouth rehab, and follow up with 1 day, 7-day post op phone calls
Full surgical report and X-rays provided to referring doctors for routine care and follow-up care
We look forward to completing your child’s dental care needs safely, compassionately, and with the highest and utmost quality of care. We treat our patients as our own children, and only seek the best, most ethical/moral treatment and outcomes.