Pediatric Dentistry

Hospital Dentistry

Welcome to the hospital dentistry section! This section is for children or those with special needs who may need general anesthesia to provide safe, comfortable dental treatment. Hospital dentistry is a method of managing pain and anxiety during professional dental care through the use of general anesthesia. Dr. Adams provides comprehensive dental care while your child is asleep under the care of an Anesthesiologist. This care is provided at Maui Memorial Medical Center.

A child may need general anesthesia for dental work if a tooth or number of teeth absolutely needs to be fixed and the child cannot cooperate for the appointment.

General anesthesia is a form of deep sedation, and is used when nitrous-oxide and/or oral sedation is contraindicated. Longer, more complicated treatment may require general anesthesia. General anesthesia is usually a gas that is breathed in by the child, and is administered by an anesthesiologist. Because the child is placed in a deep sedative state, the child must be continuously monitored. Tonsillectomies, ear tubes, and other surgeries are all done under general anesthesia.

General Anesthesia?

Caries (cavities) do not always have to be restored. If it is early and still affects only the enamel surface, it can be reversed with better oral hygiene (timely brushing) and topical fluoride treatments. Advanced caries through the enamel is irreversible and should be restored due to the possibility of dental pain, infection, and early tooth loss. Children that have caries that are irreversible must have their caries treated.

The child that needs dental treatment, but cannot tolerate it in the dental office most likely requires general anesthesia to complete the treatment.

• Toddlers with nursing caries or multiple caries
• Older children who are unable to tolerate in-office treatment
• Children with special needs – autism, cerebral palsy, various syndromes, etc.

What are the risks?

When a child is deeply sedated, breathing slows down. As breathing slows, the risks of airway complications rise. For this reason, the anesthesiologist controls the breathing of the child. This control minimizes airway complications and allows for surgeries to be done predictably and as safe as possible.

What is most important?

• Your child is properly prepared for general anesthesia
• The anesthesiologist is trained in pediatrics and treats them each day
• Your pediatric dentist is well-versed treating children under general anesthesia, is efficient, and very meticulous.

What are the benefits?

Treating children in a painless, non-traumatic setting has many long-term benefits:

• Treatment is painless.
• Treatment is safe. Restraint of children for dental work can be unsafe for the child and dentist.
• Your child receives all dental work at one time, eliminating the trauma of multiple dental visits and decreasing the amount of time out of the parent’s schedule.
• Your child is allowed to stay positive about the dentist, which has been shown to promote a long-term positive attitude about dental care.
• Treatment is done with the highest quality in mind, allowing for long lasting restorations. Restraint of children for dental work leads to lower quality restorations, which have a higher chance of failure and re-treatment. Under general anesthesia, practitioners can be meticulous.

Natural looking restorations require cooperation. General anesthesia allows for excellent esthetics and longevity.