Hospital Dentistry

Extensive Dental Needs

Dentists performing dental surgery

For some children, treatment in the dental office setting is too difficult due to extensive dental needs coupled with a high level of anxiety or fear. Many very young children (or some older children with special needs)with extensive dental needs have yet to develop coping mechanisms that would allow them to cooperate for dental treatment. These patients are often best treated in a hospital operating room (OR) setting while they are asleep under general anesthesia. General anesthesia is a controlled state of unconsciousness that eliminates awareness, movement and discomfort during dental treatment. When a child is asleep under general anesthesia Dr. Hollowell or Dr. Porter will be able to complete all of the child’s dental treatment in one visit.

Dr. Hollowell and Dr. Porter treat their OR cases at Wake Med Hospital on New Bern Avenue in Raleigh. The general anesthesia is provided by an anesthesiologist who is a physician that specializes in putting people to sleep with general anesthesia. The general anesthesia for a dental case is virtually the same as the general anesthesia provided when a child has a surgery to remove the tonsils or has a hernia repaired. The anesthesiologist will use an anesthetic gas delivered through a breathing tube that will keep the child asleep during the procedure. While the child is asleep Dr. Porter or Dr. Hollowell will be able to complete all of the child’s dental treatment in one visit. The entire procedure is considered outpatient surgery meaning that the child will have the surgery and leave the hospital later that day.

General anesthesia is safe but as with any surgery there is always some risk associated anytime a patient is put to sleep under general anesthesia. It can be used safely and effectively when administered by an appropriately-trained individual in an appropriately-equipped facility such as Wake Med. Dr. Hollowell and Dr. Porter require that any child undergoing dental treatment with general anesthesia must first have a physical evaluation by the child’s primary care medical provider and be cleared for surgery. Some children with pre-existing medical conditions may also need to be evaluated at Wake Med by an anesthesiologist during an evaluation appointment before the actual OR treatment date. Dr. Hollowell or Dr. Porter will be happy to discuss the benefits and risks of general anesthesia if this treatment is recommended for your child.

Points to remember on the day of surgery

  • We do request that two adults accompany the child to the hospital the day of surgery and that at least one remains at the facility at all times. It is also important that one adult is available to watch the child on your drive back home while the other drives.
  • Nothing to eat or drink after midnight. If your child has anything to eat or drink after midnight, their OR procedure CANNOT be completed.
  • A pre-operative physical must be completed within 30 days of the OR appointment. Our staff will provide you with a form that your child’s primary care physician must complete within 30 days of the OR appointment.
  • Please notify our office if your child is sick. Most of the time the procedure is cancelled if your child is sick or running a fever.
  • This procedure will be a same day surgery and your child will be discharged from the hospital on the same day as the treatment. After the procedure is complete your child will recover in the post-operative recovery area until they are stable, alert, and ready to depart.
  • Once your return home your child will likely be tired. It is best to let the child rest at home with minimal activity until the next day.
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