How can this service be provided safely in the dental office?
Our practice is committed to providing anesthesia services for special need patients and have done so for many years. Safety always begins with preparation and planning. As with all special need patients our attention to details, such as a thorough review of the patient’s history and co-existing medical and behavioral conditions as well as a detailed pre-treatment discussion with their family or guardians enables us to properly prepare for and effectively treat children and adults with Down Syndrome.
We routinely require a pre-procedural medical evaluation from your child’s primary care doctor. However, where complex medical conditions exist, we take it upon ourselves to reach out to their physician and specialists to discuss your child’s individual needs, limitations, and disabilities. The information that is obtained allows us to customize each patient’s anesthetic which always includes very short acting anesthetics and comprehensive monitoring and may include sedative pre-medication. We consistently observe that Down Syndrome patients are very sensitive to anesthetics. However, with the right combination of medications, the wake-up and time to discharge is typically not noticeably delayed.
Individuals with Down Syndrome can have a wide range of conditions which must be evaluated to establish their suitability to be treated in an office setting. These conditions can include congenital heart disorders, upper neck instability, sleep apnea and obesity. It is essential for us to learn about these conditions in advance of the procedure so don’t be concerned if we ask a lot of questions. Once this information is shared, it’s our task, along with your child’s physicians, to determine the most appropriate treatment setting. In some situations, an advanced care environment may be most appropriate. Fortunately, for many patients who are not severely affected by these conditions, an office-based anesthetic is safe and effective.
Dental Services for special need populations continue to be limited due to restrictions in access to care through hospitals and ambulatory surgery centers. Advances in anesthesia monitoring and anesthetic medications are enabling the office-based environment to offer an alternative to the traditional hospital outpatient setting where wait times for treatment can be greater than a year.