Sedation for dental treatment

[Meowsmol]

My dd needs dental treatment but is terrified. How do we find a dentist who will do this?
In the last 2 years we've tried 4 dentists non can do treatment.
Dd has autism and really bad teeth. She has enamel hypoplasia ( no enamel)
We cannot find a nhs dentist and cannot afford private.
What can we do?

I hate to be the bearer of bad news, but we couldn’t even find anybody to do this for us in 2007. I would say your chance is now are zero.
I would also say that if you can get the NHS to do it under general anaesthetic that would be 100% better than sedation
We paid an arm and a leg for sedation in a private clinic and it was bloody traumatic for all of us mainly the kid obviously. But I seriously regretted it and I think it was about £1000 in 2007 so it’s probably about five now

Our local hospital has specialist dentist services which deal with kids with additional needs. My autistic teen was referred by our regular dentist. However they wouldn’t not do sedation I tried but she wiggled out the baby tooth causing issue. They were very patient and used to dealing with highly anxious young people. It’s worth asking. She needs corrective treatment next with braces but we are waiting till older. Some dental training hospitals may have a clinic too

Do the hospital offer anything.
Our hospital offer treatment for children and adults with disability/special needs...
Sounds really tough for you all

My DS has had to be referred to the community dentist for work under inhalation sedation.

He is very nervous and has a poor diet due to ARFID. They even managed to do an extraction this way.

I assume that community dentists might not exist in all areas but may be worth looking to see if this is an option near you.

Best of luck

don't think there will be that many places that'll do paediatric sedation in the community. She does sound like a very standard GA dental list patient. If multiple dentists have struggled it's probably worth exploring GA next.

She needs to be referred to specialist dentist services with the NHS. My children have asd and ld they both receive specialist dental care. When my son needed to have a tooth removed he was given a general anaesthetic on a day unit to have the treatment.

In some areas you can self refer to the community dental service who specialise in treatment of people with difficulties .

In some areas a GP can do it but in most areas you have to be referred by a dentist , but there are waiting lists , in our area around two years.

A private dentist can refer to community service if you cannot find a NHS dentist to refer. Alternatively if your daughter is in pain you can phone 111 for an emergency dentist who may not be able to do anything but will probably be able to refer to community.

If your daughter is need to use a private dentist for referral you will probably be paying £50 to £80 for the assesment . Make sure when you ring up you explain what the problem is and that you need a referral to the community service.

Good luck.

This is a core part of the work of a specialist children's dental service on the NHS. You need to be referred to them - your GDP should be able to do it.

The team I work with (I'm an anaesthetist) will do some stuff under entonox sedation, some with behavioural approaches and some with GA. I only see the GA part of the workload.

Can I just caution that once you are in the system approach what they propose with an open mind - they might not think sedation is the best option.

For my GA work (not just dental) I deal with a lot of kids with autism. I get about 80% of them through their anaesthetic without using pre - GA sedation because I and the team around me have specialist skills at gaining trust/ working with young people with autism.

I appreciate giving a GA tends to be a shorter contact time to managing to complete an entire dental treatment plan but there are similarities - things tend to go awry for me when I can't build rapport with the caregiver e.g if they have a fixed plan in their head and can't/won't engage in a two way dialogue about other options. I might not know your kid but I know what will be asked of them at each point in the process.

Situations where it has gone wrong have worked in both directions - me not managing to give a GA at all after the caregivers flatly rejected me plan for a premed, or me being forced into giving a premed with all the attendant risks when I felt behavioural support would have been more appropriate.

My focus in these situations is to use the time I have to give each child a positive experience that will also help them engage with future healthcare in as straightforward a way as possible.

I had an amazing Mum recently who was understandably anxious as her child has had negative experiences in the past and was really keen to advocate for them. I felt quite strongly that what she wanted wasn't the best option for various reasons (one of which was safety). However, despite this disagreement we had a really productive two way dialogue, and agreed a multi-stage plan together. She then supported me really well in "selling" the plan to her child. In the end option A went really well and I think her child will be much more confident if they find themselves needing hospital care in the future.