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Dental care. (Respond).

R 210 (June, 02) has a 20-year-old son who is mentally retarded with a dental cavity and is seeking advice on how to handle dental care with special needs children.

I am an anesthesiologist and the parent of a 17-year-old with severe developmental delays. My son requires general anesthesia for dental work and other examinations. First of all, you need to find a dentist who is experienced in working with patients under anesthesia. You can call your local children's hospital, ask for the anesthesiologist on call and ask which dentists frequently bring patients into the operating room for dental work. There are many things you can do to help the procedure go more easily. Ask your physician for EMLA cream. This is a local anesthetic cream that can be applied to numb the skin so that he will not feel the IV needle. It needs to be applied two hours before starting the IV. You can ask to stay with him until he is asleep and be called to be with him before he wakes up, if this would help him remain calm. You will need to find out whether he will need to be completely asleep or just sedated (there are pros and cons to both), depending on what needs to be done and what you anticipate his reaction will be. If he does need to be completely asleep, ask for something to prevent vomiting. Anesthesia is extremely safe these days, but because of the special needs issues you have to be a little more demanding than the average parent usually is.

--AH, via EP Web Site

There are several options to control the movements of your son so that his dental care can be completed. One such option is to admit your son to a surgical center for outpatient general anesthesia. In many large cities there are anesthesiologists who have office-based practices and will come to the dentist's office to administer the anesthesia. If your son will not allow his dentist even to clean his teeth, then starting an IV line will be a challenge. An anesthesiologist can sedate your son in such a way so that an IV line can be started safely and without injuring your son. Office based anesthesia administered by someone other than the doctor performing the dental procedure is both cost effective and far safer than any other method.

--RS, DDS, via EP Web Site

My 13-year-old son, who has cerebral palsy, has a wonderful dentist whom he sees regularly. Fourteen months ago, he had an accident that necessitated emergency oral surgery. The oral surgeon expertly put him to sleep to do the work. A few months ago, as a result of this same accident, my son needed a root canal. The endodontist performed the work at the oral surgeon's office so that my son could again be put to sleep. This coordination was essential in completing the work.

--TB, via EP Web Site
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Publication:The Exceptional Parent
Date:Sep 1, 2002
Previous Article:Sign language concerns. (Respond).
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