I have a close relative with a severely autistic boy. He is having some dental procedure next month and will have it done in the hospital under general anesthesia. More kids are being diagnosed so maybe that's the reason.

In my mind, I was weighing the benefit of traumatizing the child vs. anesthesia. I'm not sure that's the right relationship, but it's what I thought about. So many folks are afraid of the dentist? and they're trying to avoid that? It's all I can come up with.

Are you talking about true "general anesthesia" or sedation? Sedation is what one has when one has a colonoscopy - it is NOT general anesthesia. I can't imagine using general anesthesia on a child unless there are serious dental surgery issues being corrected that require the child to be "out" for a significant time (repair cleft palate or some such thing). Even an autistic or developmentally disabled child should be fine with sedation.

I would never allow a dentist to do general anesthesia on a child (or adult!) in his office. This should be done by a boarded anesthesiologist in a hospital setting. There is always risk and the need must always outweigh the risk, not just "convenience".

My daughter is on the spectrum (she is non-verbal as well). She is hypersensitive to loud and high pitch sounds and the tools the dentist uses will cause her to freak out. She has a tooth that's been under observation for a while now. If and when it needs to be filled, she will be put under general anesthesia to minimize the trauma. I agree that for NT (neuro typical) kids, they shouldn't be going under general anesthesia for such procedure. But for autistic kids, it is safer for them as well as for the dentists to do so. It is not ideal but I can't think of any way to get them anesthetized locally while seeing this needle going into their mouths. It was even scary for me to see that going into my mouth let alone for a kid who doesn't understand or unable to communicate.

I was probably mistaken in my first post. It very well could be sedation rather than general anesthesia. But, it is being done at the hospital rather than the Dr. office. (Or maybe i'm not mistaken after reading tweety's post)

https://www.nytimes.com/2012/03/06/health/rise-in-preschool-cavities-prompts-anesthesia-use.html

My question is - is it because kid's dental care is so poor, their diets are so poor that cavities are on the rise? So that when kids go to the dentist they have 5,6. 7 cavities and it's easier to sedate and do all the work at the same time? Because if that's the case there is a bigger worry than just that.

Read your article, Lucille. I think the papoose board would be horribly traumatizing. No easy answer unless it all falls on the shoulders of parents not caring for their childrens dental health.

Why do they need to do such extensive work on teeth that will fall out soon anyway? I understand if the tooth is causing pain or is in danger of needing to be removed early as that can cause spacing issues with adult teeth when they come in. Or if it's already an adult tooth. But just regular fillings?

It just seems risky on baby teeth. I mean general anesthesia, not the mild sedation in a dentist's office.

I had the same question in my head blfenton. I thought, maybe they come from a household that's a certain type. The type to have increased cavities that might also be the type to get anesthesia. That would be alarming. I hear you

I just read this.... "tooth decay in baby teeth affects adult teeth in two ways. The developing adult or permanent tooth is growing directly under the baby tooth. If the decay is extensive the bacteria in the cavity can cause a dental abscess which can spread down to affect the developing adult tooth under it."

Part of the articles indicates there's a growing number of children with multiple cavities. Some of the thoughts about the 'why' is over reliance on bottled (unfluoridated) water.

And it seems the risks of anesthesia may be less than with sedation in young children.

My feeling, based upon decades of seeing dentists because of temperamental gums, is that there is much variation in the quality of dental work between offices, that almost all will exaggerate needs and almost all will overcharge. My current primary MD has mentioned these concerns about dentistry. I would trust the anesthetist. I would be cautious about the dentist.

I didn't see anything in the article that said this approach was on the rise.

Did you note the article opened with the mother of the kid who had problems in 11 of 20 teeth saying that she was too busy to remember to brush his teeth?

I think the use of anesthesia isn't new for required procedures for patients unable to remain still or tolerate the experience (like the very young or those with autism/other conditions). Or when a lot of work is required. For many, the alternative is to not treat the problems, which is worse. Anesthesia is safe.

Healthy diets that limit sugar and juice, using fluoridated water, and regular brushing can avoid dental problems for many. Yes, some people are born with lousy teeth. Others make good teeth lousy with poor habits.

too busy to remember to brush his teeth?

Bingo! That's the group I'm talking about in my same population with increased cavities, who is anesthetizing post.

Two of my grands came from China and the third one of the group has a very high gag reflux. they all have had sedation work. the now 7 year old came to us with his 4 front teeth broken off. they had to pull the broken ones and cap 4more and fill 2 or 3 more.( he was 3 then.) his mouth to copy the dentist is a mess. moonie is right about what she said in her post .When they do anesthesia it is mostly for things ( and on) people who need it for reasons that just a light sedation. I do think that sedation is used more today , as more dentists are trained to do it. I think we now just hear about it a lot more then before, and more kids are getting better care because of it with less fear, and or more trouble.

Our water is not fluoridated - that's a cop-out reason. We have one of the highest quality tap water in the world.

There are few large systems that don't claim to be "one of the highest quality tap waters in the world". San Francisco and its surrounding area has, like BC, snow-melt water. SF's water from the Sierra is mostly sediment free because it's captured high up in granite mountains. It's very fresh and delicious tasting.

I recently watched a UK documentary, which followed two children--a toddler and a preschooler--who had to have general anesthesia for dental extractions due to poor dental care and too much sugar. IIRC they were done in a hospital, because of the children's ages. These were extreme cases of rotting baby teeth, not fillings.

There are a couple of other kids featured, for other health reasons, so you might have to scroll through. YouTube video

I've also seen documentaries on the effect of soft drinks (mainly Mt Dew in Appalachia) on children's teeth in this country.

When I was a kid, I had two cavities that needed filling and the dentist did that with nitrus oxide (laughing gas). It was an anxiolithic, meaning it relieved anxiety but didn't put me to sleep. Are they still doing that?

Other than unusual situations, like a few mentioned here, if you opt for sedation at what age are you going to decide this child is now ready to learn to JUST DEAL WITH IT. All this insulation parenting drives me INSANE.

Arcy, do you really consider the autistic spectrum to be an “unusual situation” these days? I take issue with your Just Deal with It phrase, even though I assume you are talking of those you perceive to be the “neurotypical” children. The autistic spectrum is wide, and covers those who appear very high functioning and neurotypical yet still have extreme hypersensitivity and sensory processing disorders, that make tolerating traditional dental care a huge struggle. It is far more widespread of a spectrum than you may realize.

In her younger years my nonverbal autistic daughter was unable to tolerate the simplest of dental procedures, so I am quite familiar with why special needs dentistry in a surgical setting is on the rise; my daughter has undergone this now twice, with no complications. I have never encountered any special needs dental professional who would attempt serious sedation outside of a hospital setting. Was never offered nitrous, as i understand it, its too unpredictable how these types of drugs effect the neuroatypical. We have been working on this her whole life, many years of slowly exposing her to the dental chair, and watching me, her mother undergo standard dental procedures, now at age 18, she can finally cooperate with X-rays and cleanings. But not sure there will ever be a day when she could tolerate the sound and sensation of the dentist drill, for instance.

Some water supplies have a natural fluoride level that indicates additional is unwarranted.

I hit submit too early. From our personal experience, there is a real shortage in special needs dentistry providers, judging by talks with other parents and the long wait time we experience to even get a consultation at several practices. Any dental student looking for job security should consider entering this field, it’s clear to me the demand surpasses the current supply.

I never even considered that there would be a need for special needs dentists, but it makes sense.

I think it's also important to consider how children can develop phobias when being forced to just deal with it. A lot of adults fear the dentist because of unpleasant experiences as a child. When someone develops a fear of the dentist, their dental hygiene for the rest of their life usually suffers for it.

As an example, my husband hasn't been to the dentist in almost 15 years. It drives me nuts but I can't force him to go. It's going to take a life-threatening infection to make him go, and that's the sad reality of how phobias can be. The individual needs to be cosidered in making these types of decisions.

We have well water and it does not have fluoride in it. My kids would get fluoride treatments at the dentist office when they were young. Now, DH and I use mouthwash with fluoride.

''We have well water and it does not have fluoride in it.''

How do you know it has no fluoride in it?

Special needs dentistry is often done at hospitals (because of the availability of anesthesiologists) and is almost always available at dental schools. Many community hospitals have dental clinics too.

Albert, private well water can be tested and should be tested regularly.

In many parts of the country where there was mining fluoride occurs naturally and would be in the water from wells. Elmer is correct about testing regularly. Especially the older wider mouthed wells as things can be washed into the well heading.

My daughter's 7 yr old child needed extensive dental work due too many carries. The decision was made to use general anesthesia and do all the work in one sitting. All went well, until . . . an unexpected bill arrived. It was $3000 for the Anesthesiologist. The dentist had engaged an independent contractor and the cost was never discussed. That cost was not covered by her insurance. My daughter could not afford the bill. Help came her from Mom and Dad.

Beware!

Elmer, you are correct that special needs hospital dentistry is available at dental schools. I live in a state with one school of dentistry. Our wait - from initial consult with general dentist, to the procedure being performed: October 2017 to May 2018. I know a fantastic private dentist practice in a neighboring state- even longer time wait. He finally found a second hospital dentist to join his practice, but admits he could use more.

I’ve met many many parents over the years in dental waiting rooms and hospitals. I have yet to meet a parent who was doing this for convenience, (what’s convenient about a seven month wait?) or indulgent parenting/spoiled brat scenario. What oftentimes appears to be a bad parent/spoiled brat is actually a stressed parent of a child with a challenging behavior or sensory disorder. Us moms of the spectrum usually recognize this very quickly when we see it, and I try to be patient with those who do not.

My cousin’s child had hospital dentistry done, not special needs, but severe tooth decay- genetic, environmental, I don’t know- even though cousin was a model parent when it came to diet, discipline, and any other parent blame I can think of.

A lot of folks seem awfully opinionated or judgemental about a situation they seem to have little real life experience in.