FOCUS ON: KEEP YOUR CHILD SAFE
Written by David Kohn

Dr. Myron Yaster

Is There A consent Form?
Don't Scare Your Child Beforehand
Sedation Is Safe If Done Right

(CBS) All kids have to visit the dentist.
And many will need to undergo painful
procedures, for which they'll need sedation
or anesthesia. How can you ensure that
your child gets the safest treatment
possible?
We talked to Dr. Myron Yaster, an expert on
Pediatric pain management. Dr. Yaster is a
anesthesiologist, a pediatrician, an associate
professor of anesthesiology, critical care
medicine and pediatrics at John Hopkins
University, as well as the author of a widly
used handbook on how to safely and
effectively sedate and anesthetize kids.

Dr. Taster also has first-hand experience as a worried parent.
Last month, his own son was sedated during oral surgery to
remove an extra tooth. (The dentist followed correct
procedures, and there were no complications.)

Here are some of Dr. Yaster's tips:
Dr. Yaster emphatically believes that sedation and
anesthesia have a place in dentistry, especially with
children, who may be impossible to operate on
otherwise. He argues that when dentists follow proper
procedures, there aren't any problems. "Its when
they fail to follow guidelines and the drugs that
they're using. Sometimes, they lose that respect.
You get away with it, you get away with it, you get
away with it. Then catastrophe happens"

Many parents instill in their children a dread of going
to the dentist. This can excerbate any anxiety they may
already feel. Ephasize to your kids that visiting the
dentist is not something to be afraid of. They'll tend to
be less nervous, and the question of whether or not to
use sedation or general anesthesia may not even come
up.

Start taking your child to the dentist at a young age so
that he or she will not enter the dentist's office for the
first time with severe dental problems. This way, there
will be less chance that serios and possibly painful
procedure will be necessary.

If a dentist or oral surgeon wants to put your child
under, ask him or her about qualifications of the
person who's will provide sedation. There should be
someone whose sole job is to monitor the unconscios
patient. So there must be at least two other people attending
the operation. This person must know how to
resuscitate someone, understand the drugs involved in
the procedure, and know how to use the equipment
involved. Ask the dentist if this person has experience
with advanced pediatric life support and advanced
trauma life support.

Will monitoring devices be used in the operation? The
dentist should minimally have a pulse oximeter, which
measures how much oxygen is in the bloodstream.
He or she should also have an EKG machine, which
measures heart rate, and a device that measures blood
pressure.

Another question: Is there a facility to take care of
patient until recovery? Just because the surgeon is done
doesn't mean the procedure is over. Until the patient
returns to pre-sedation level of consciousness,
monitoring must continue.

Does the dentist ask you to sign a consent form for
sedation? If not, this is a "red flag ," Dr. Yaster says.
"If there's no concent form, that usually means
they're just blowing the whole thing off."

Before any procedure involving sedation or anesthesia,
the dentist should do a physical examination. Even an
apparently healthy child may have health problems,
astma for example, that could complicate the
operation.

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