Comprehensive Guide to Pediatric Dentistry under General Anesthesia (Narcose) at Leident

Dental anxiety (dental phobia) is a very common challenge for children and their parents. Sometimes, the anxiety is so severe, or the dental decay is so extensive, that treatment under normal circumstances becomes impossible. In such situations, Leident Dental Practice in Leiderdorp offers a safe, scientific, and stress-free solution: Pediatric Dentistry under General Anesthesia (Narcose).

Our primary goal at Leident is to ensure your child achieves perfect oral health without any pain, fear, or traumatic memories. In this comprehensive guide, we cover everything a caring parent needs to know before, during, and after the treatment day.

Why Choose Treatment Under General Anesthesia?

Many parents hesitate between mild sedation and general anesthesia. General anesthesia is the ideal method for young, uncooperative children, or those requiring extensive and complex treatments (like multiple root canals and crowns). During narcose, your child falls into a deep sleep, feels absolutely no pain, and is unaware of the passing time. This allows our specialized dentists to perform all necessary high-quality treatments in a single session, sparing your child from multiple stressful visits.

Pre-Treatment: Essential Preparations at Home

Following our pre-anesthesia guidelines strictly is the ultimate guarantee of your child’s safety. Please adhere carefully to the following rules set by the Leident anesthesia team.

Strict Fasting Rules (Nuchter blijven)

The most critical rule of anesthesia is an empty stomach. Ignoring this can cause stomach acid to flow back into the lungs (aspiration), severely endangering your child’s life. If these times are not respected, the treatment will be canceled immediately:

• Treatments before 12:00 PM: Your child must not eat anything after 00:00 (midnight) the night before.
• Treatments after 12:00 PM: Your child is allowed to eat exactly 1 rusk (beschuitje) at 06:00 AM. No solid food is permitted after this time.
• Liquid intake: Up to 2 hours before the operation, your child may only drink water or tea (without milk). Consuming milk, juice, soda, or any other liquids is strictly prohibited.

Other Important Preparations

• Dental appliances: If your child has a removable partial denture or orthodontic plate, it must be removed before the anesthesia begins.
• Nails: To ensure the oxygen sensor works perfectly on the finger, artificial nails, gel nails, or nail polish must be removed from at least one finger.
• Jewelry: Please remove all jewelry, necklaces, and piercings (especially oral piercings) at home.

Psychological Preparation: Talking to Your Child

Children are highly perceptive and quickly pick up on your anxiety. We recommend the following approach:

• Use positive language: Instead of words like “needle” or “pain”, tell them: “We are going to see a friendly tooth doctor. You will wear a cool space mask, take a nice nap, and when you wake up, the sugar bugs will be gone!”
• Stay calm: Trust the specialized team at Leident. Your calmness will directly transfer to your child.

The Day of Treatment: The Process at Leident

Our planning team will notify you of the exact time 1 to 2 days in advance. Please arrive at least 30 minutes early.

1. Final Medical Screening

First, the anesthesiologist will review your child’s comprehensive medical questionnaire to assess their health and minimize risks. If the health risks are deemed too high, the treatment may be canceled.

2. Vital Signs Monitoring

Before starting, your child will receive stickers on their chest to monitor heart rhythm, a blood pressure cuff, and a small oxygen sensor on their finger.

3. IV Insertion & The “Laughing Gas” Trick

We use Total Intravenous Anesthesia (TIVA), which requires an IV (infuus) in the hand or forearm. Good news: If your child is afraid of needles, just let us know! Before the IV insertion, we can make your child drowsy and relaxed using a laughing gas mask (lachgas). This ensures the initial prick is entirely stress-free.

4. Falling Asleep & Parent Presence

We use highly modern, short-acting medications like propofol and remifentanil. You can be right by your child’s side during this moment. You may hold their hand or even let them sit on your lap until they fall asleep. Once asleep, we will guide you to our comfortable waiting room.

Reassurance: We do not use muscle relaxants, meaning it is scientifically impossible for your child to be awake but unable to move.

Recovery and Post-Treatment Care

After the dental work is finished, the medication is stopped, and your child will quickly wake up in the dental chair. They will then be moved via wheelchair to a relaxing recovery room. As soon as they wake up, you will be right there with them.

Going Home & Diet

Once the anesthesiologist approves, you may take your child home. The first 24 hours are crucial:

• Do not leave your child alone for the first 24 hours after the anesthesia. They need plenty of rest.
• Diet: Start with cool, sweet liquids (like apple juice or water). If they tolerate liquids well without nausea, you can introduce lukewarm, soft foods (like blended soup or puree). Avoid hot, spicy, or hard foods on the first day.

Safety and Rare Risks

Anesthesia is one of the safest medical specialties today. In fact, driving to the clinic is statistically more dangerous than the anesthesia itself! However, we must inform you of very rare risks and how we manage them:

• Minor tooth damage: During the insertion of the breathing tube, there is a very rare chance of minor damage to a tooth.
• Aspiration: As emphasized, if fasting rules are ignored, stomach acid can enter the lungs and cause severe pneumonia.
• Fluctuations in blood pressure or heart rhythm: These can be caused by the medication, but our specialist manages them perfectly with specialized drugs.
• Asthma attack: If your child has asthma, ensure they use their inhalers on the morning of the treatment and bring the medication to the clinic.
• Nausea (PONV): Due to our modern medications, nausea is rare. If it occurs, we treat it effectively with anti-nausea medication.