Your child's general anaesthetic for dental treatment

This informaion explains what to expect when your child has a general anaesthetic for dental treatment. It is part of a series about anaesthetics and related topics written by a partnership of patient representatives, parents and anaesthetists.

You can find more information in other leaflets in the series. You can get these leaflets, and large print copies, from the Royal College of Anaesthetists website, in the ‘For Patients’ section. They may also be available from the anaesthetic department in your hospital.

The series will include the following:

• Anaesthesia explained
• You and your anaesthetic (a summary of the above)
• Your Child’s anaesthetic
• Your spinal anaesthetic
• Epidurals for pain relief after surgery
• Headache after an epidural or spinal anaesthetic
• Local anaesthesia for your eye operation
• Your tonsillectomy as day surgery
• Your anaesthetic for aortic surgery
• Anaesthetic choices for hip and knee replacement

Dental treatment involving fillings and simple tooth removal can often be carried out using injections to numb the child’s mouth.

For some children however, especially the very young, a general anaesthetic may be the only option.

You may have some concerns and questions about general anaesthesia and this leaflet is designed to help you.

If you would like further information then please ask your dentist or the nurses and anaesthetists at your hospital. They are here to help.

General anaesthesia is a state of controlled unconsciousness during which your child feels nothing.

Anaesthetics are the drugs (gases and injections) that are used to induce (start) and maintain anaesthesia.

When the operation is finished the anaesthetic is stopped and your child regains consciousness (‘wakes up’).

Anaesthetics are only given by anaesthetists. They are doctors with specialist training and are experts at looking after patients when they are anaesthetised. The anaesthetist stays with your child all the time during the operation and carefully monitors him or her.

Government regulations state that general anaesthesia for dental treatment may only be given in hospital where all the appropriate safety facilities are available. General anaesthetics cannot be given at your dentist’s surgery.

With modern anaesthesia, serious problems are uncommon. Risk cannot be removed completely but when a patient is fit and healthy and the operation is a small one, as many dental operations are, the risk of a life-threatening problem is about 1 in 400,000. This risk is considerably less than that of your child being seriously injured in a road accident.

Yes, there may be an increase in risk depending on the medical condition but this risk should be outweighed by the benefits of your child’s treatment. Each child is different and will be assessed before their operation so that their treatment can be tailored to their needs.

Sometimes children with serious medical problems who need a general anaesthetic for their dental treatment need to be admitted to hospital prior to their general anaesthetic for special preparation, or may need to be referred to the Children’s Hospital. Your dentist should make this referral.

This will depend on the age of your child and how much you judge they can understand.

It may be enough to explain that some of their teeth are poorly and need to be removed before they cause pain. You can explain that the doctor will give them some medicine which will make them go to sleep while their teeth are removed. Afterwards they will wake up.

Older children may want to know more. Do encourage your child to talk about the operation. Books, games and stories can help.

Children are seen at a pre-assessment clinic prior to the date of surgery to discuss the medical history and to answer any questions you may have, and to finalise the treatment plan.

If your child has a chesty cough, cold or a running nose or is otherwise unwell it may be not be possible to go ahead with the anaesthetic and operation.

If you have any doubts please contact the hospital for advice before attending for the appointment.

If there is food or liquid in your child’s stomach during the anaesthetic, it could come up into the back of the throat and then go into his or her lungs. This would cause choking, or serious damage to the lungs, and CAN BE VERY DANGEROUS.

Your hospital will give instructions about when your child must stop eating and drinking. Failure to follow these instructions can have very dangerous consequences for your child, and the procedure will have to be postponed.

Please do not let your child have sweets or chewing gum as these fill the stomach with saliva and increase the risk of vomiting.

Your child can either have:

• Anaesthetic gas to breathe through a face-mask or a small mask placed over the nose. This smells pleasant and the anaesthesia comes on after just a few breaths. Recovery is rapid.
• Occasionally older children may prefer an injection through a cannula. (A cannula is a thin plastic tube placed using a needle into a vein on the back of the hand or arm. Once the cannula is in place the needle is removed.)

The final decision is usually made by the anaesthetist, after discussing the options with you and your child. Nothing will happen unless you understand and agree with what has been planned.

If your child has had an anaesthetic before and would like to ‘go to sleep’ in the same way, or alternatively, has had an unpleasant experience, please tell the anaesthetist.

We encourage a parent, adult relative or guardian to stay with the child until anaesthetised. However a PARENT or LEGAL GUARDIAN MUST accompany your child to hospital as only such a person is able to give written consent for the procedure to be performed.

Your child will usually be anaesthetised (‘go to sleep’) in a dental chair or trolley.

If you’re your child is unhappy to leave you, it is usually possible to start the anaesthetic with your child on your lap and then transfer him or her to the chair when unconscious.

Once your child is unconscious you will be asked to return to the waiting room or recovery room.

This depends on the length of the operation.

• Simple removal of teeth may only take one or two minutes
• Recovery will occur quickly, usually within about five minutes

If the operation takes longer, then your child will receive more anaesthetic and recovery will take a little longer. Your child will usually be conscious within several minutes after the completion of treatment.

Once the operation is completed your child will regain consciousness. Once your child is sufficiently awake he or she will be returned to you. You will be asked to wait until he or she is recovered sufficiently before you leave.

When your child first wakes up he or she is likely to be a bit confused and may cry for a short time. Children will have had local anaesthetic injected around the sockets of the teeth extracted, while anaesthetised. They are unlikely to wake in significant pain.

Most children will be able to go home within a short while following the procedure.

It is common for some children to:

• feel dizzy and a bit sick for a few hours
• be sick occasionally, especially if they have swallowed a little blood
• have some pain or discomfort for a few hours

You can help by giving your child pain relieving medicine regularly as prescribed rather than waiting for him or her to complain.

If you have any concerns about your child when you get home, you should contact the hospital using the telephone number provided.

You will have to be guided by how your child feels. Some children still don’t feel quite right the following day and may need to stay of school.

It may be advisable to avoid taking part in vigorous exercise or sports for a few days after treatment.

21 Portland Place 
London WC18 1PY

Phone: 0207 613 1650
Fax: 0207631 4352

Email: info@aagbi.org
Website: www.aagbi.org 

This organisation works to promote the development of anaesthesia and the welfare of anaesthetists and their patients in Great Britain and Ireland.

48-49 Russell Square
London
WC18 4JY

Phone: 020 7813 1900
Fax: 020 7813 1876

Email: info@rcoa.ac.uk 
Website: www.rcoa.ac.uk 

This organisation is responsible for standards in anaesthesia, critical care and pain management throughout the UK.

64 Wimpole Street
London W1G BYS

Phone: 0207 563 4563
Fax: 0207 487 5232

Website: www.bda-dentistry.org.uk