SEN Child - Sedation Flashcards
5-year old girl attends w/ father. Recently dx w/ autism. Attend bad toothache. How mx caries in children?
Focus around relief of pain and prevention of further disease
How should pain relief be managed in children?
Oral analgesia or LA administration
What are behaviour modification techniques which can be used?
Tell show do
Separation from parents - if projecting own anxieties
Desensitisation
Modelling
How to manage reversible pulpits in children>
ART - remove soft caries w/ excavator
Restore tooth w/ GIC
How to manage irreversible pulpits?
Pulpotomy or XLA
How to manage abscess in deciduous teeth?
XLA of tooth
What to consider when extracting deciduous teeth?
Can affect position of permanent teeth
Can children give consent?
Children > 16 years can give consent
If under 16 but Gillick competent they can cosent
How can child be Gillick competent?
Must be able to retain, weight risks and benefits and communicate decision
Who must children not able to consent with attend with?
Adult with parental responsibility
What alternatives are available if child can not manage with just LA?
ART - no LA
Inhalation sedation
GA
What is important to discuss re gA
Want to avoid repeat GA therefore any carious teeth which are unrestorable/ poor prognosis will be removed, even if asymptomatic
What to tell pt/ parents prior GA?
They will attend hospital - for day case in majority of cases
No eating or drinking from midnight
Child will be put to sleep in anaesthetic room - can usually be accompanied by parent
Procedure will be completed
Child will recover before returning to ward
What are risks w/ GA?
1 in 20,000 children suffer serious reaction to anaesthetic drug
Child may feel upset, dizzy, nausea, soreness post GA
How may children with autism present?
May find unfamiliar environments. people stressful
Find bright lights/ loud noises stressful
Aware spectrum and different patients will require varying levels of support
