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Distraction works really well in general; even without VR. The dentist discovered that my 3 year old son has a bit of caries; but she said that filling a cavit

Distraction works really well in general; even without VR. The dentist discovered that my 3 year old son has a bit of caries; but she said that filling a cavity for small kids like him is only possible under anaesthesia. I thought this sounded ridiculous. My girlfriend found a different dentist who specialized on treating kids. She performed the procedure without any anaesthesia or sedatives by using lots of distractions, including a magic wand and elaborate stories about dwarves wandering in the forest of teeths. I wish my dentist distracted me like that :)

olalonde 10y ago
Complete medical newbie here... What is wrong with anaesthesia?
- d33 10y ago
  The risk of any side effects, especially in a yet-to-fully-develop human? I wouldn't be surprised if the list included coma because someone got the dosage wrong. It's just not worth the risk at that point. (Disclaimer: I have nothing to do with medicine)
  - saiya-jin 10y ago
    You are mixing local anesthesia with complete pass-out by using NO2 or similar for surgeries (which has 1:10000 mortality ratio if I recall correctly) and side effects. Local anesthesia can be even in form of spray instead of injection, depends on severity. Heck, once I tried to chew coca leaves and that got me pretty numb in my mouth for quite some time, couldn't articulate properly etc. It's still chemistry put into the body messing up with pain signaling, but I wouldn't worry that much about it (or you'll go crazy with all possible things that could harm a kid one way or the other)
    - rscho 10y ago
      PLEASE do not state fear-mongering numbers without source, especially about medicine! Anesthesia is safer than traveling by plane, nowadays. According to a 10 sec googling, the mortality is now sub 10/million/year, and that's including high-risk populations. source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2697561/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2697561/
      - deleted 10y ago
        [deleted]
      - deleted 10y ago
        [deleted]
      - maxerickson 10y ago
        US commercial airlines haven't had a fatal accident since 2009. I think that's a better apple than 'traveling by plane'.
      - dagw 10y ago
        But even those numbers show that the death rate for kids aged 0-4 is significantly higher[1] than for older kids and young adults. I know that doctors on the whole really try to avoid having to put kids under for just this reason. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2697561/figure/F3/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2697561/figure/...
        rscho 10y ago
        The common guideline is 6 mo and 2 yo. Those ages are commonly viewed as cutoffs for risk levels. In our hospital for example, the presence of an attending will be required for induction/waking up of anesthesia under 2 years old. Under 6 months, the risk of respiratory complication is far greater, which is why surgery is withheld until that age, except in emergencies.
      - saiya-jin 10y ago
        PLEASE understand the meaning of "if I recall correctly". I was wrong. Not everybody is attempting to write a post in an online forum about in form or article for Nature or Science, backchecking every statement in every sentence. Jeez
  - pc86 10y ago
    > I have nothing to do with medicine And yet your response is just supposition ("I wouldn't be surprised if..."). Anesthesia is fine.
- rscho 10y ago
  The classic risk in dental procedures is the dentist using a lidocaine-adrenalin mix, which when injected into a vessel (by mistake), will make your heart race, your blood pressure skyrocket, and provoke a general sense of unease/impending doom. It is also the main reason why many people say they are "allergic" to anesthesia. In fact, the complication profile of amide-class local anesthetics is very safe. As for the interaction of anesthesia with development, scientific evidence is scarce and anesthesia alone does not seem to have such a great impact on the long term. Anyway, I would be far more worried about hypnotic drugs than local anesthetics in that regard.
  - throwanem 10y ago
    > a lidocaine-adrenalin mix, which when injected into a vessel (by mistake), will make your heart race, your blood pressure skyrocket, and provoke a general sense of unease/impending doom Wait, that's not supposed to happen? I pretty much just figured oh well, it's epi, what are you gonna do.
  - masklinn 10y ago
    > The classic risk in dental procedures is the dentist using a lidocaine-adrenalin mix, which when injected into a vessel (by mistake), will make your heart race, your blood pressure skyrocket, and provoke a general sense of unease/impending doom. And there's a fun side-effect, or at least I had that: body learns to completely blow up under stress. Before I went through that I had very low stress impact (psychological stress had no physical impact), since then stressful situations almost lock me up (heart racing, muscles contracting, …). It's really quite annoying.
  - viewer5 10y ago
    > and provoke a general sense of unease/impending doom Oh shit I thought I was just weird. Do you have any more information on that? I felt that when I was getting a crown put in, it was horrifying, "impending doom" is the perfect description. It also happened the (one) time I donated blood, though I don't remember being given any injections or anything though; but I felt that EXACT same "impending doom" sensation; at the time I thought basically "well this is the end, they accidentally took too much blood and I'm going to die now". I felt cold to the core and started sweating horribly and spontaneously, just like the time at the dentist.
westmeal 10y ago
I definitely agree that it works wonders. When I was a child I had a dentist work on my teeth using the same technique, albeit it was jokes instead of story-telling.
Aaargh20318 10y ago
As a kid, I had a dentist who refused to use local anaesthesia, he thought it was 'bullshit' and I shouldn't be able to feel anything. The pain was indescribable. I'm still traumatised by it and haven't been to the dentist in years. I would literally shit my pants out of fear (not exaggerating here, I would have to wear a diaper to undergo regular treatment even with local anaesthetics). Just the though of being operated on while fully conscious gives me the shivers. The only thing I can image being scarier is when they have to do brain surgery and they wake you up halfway through while your skull is open. I'm currently on a waiting list for a specialist at the local hospital where they can treat you under general anaesthesia. It's the only way I can be treated after my childhood experiences. unfortunately the waiting list is long. I just hope it's my turn before something starts to really hurt. I had one treatment under GA before, about 8 years ago, and it was the first and only non-traumatic dentist experience in my life. It was such a huge difference with the 'regular' experience that I simply can't understand why dentists insist on letting people experience the torture. I think they are all secretly sadists that get off on hurting people. I'm not trying to scare you, just make sure your kid is okay with it because it could fuck him up for life.
- wil421 10y ago
  My friend was in the Marines and had to get is wisdom teeth removed. Lucky for him they were training Marine dentist at his base. He said they wiped some type of numbing gel and proceeded to grab his wisdom teeeth out with pliers. The trainee couldn't get them out so the instructor climbed on his chest and yanked them out.
  - wmblaettler 10y ago
    I can confirm. I had the same experience minus the trainee. Had my wisdom teeth extracted while in the Marines. It was over in less than 30 seconds - no time for anesthesia to kick in nor do I remember him administering any. Crack, crack, yank - done.
    - sandworm101 10y ago
      Much depends on the position of the teeth. Pulling some with pliers would cause so much bleeding that choking could kill the patient (teeth still well below gum line).
coldtea 10y ago
So you risk a kids excruciating pain on the mere promise of a doctor being good with distractions? And for what?
pavel_lishin 10y ago
Do you mean general anesthesia, or local, or just the nitrous oxide? If the cavity doesn't reach the nerve, it's probably painless. But if any serious dental work needs to be done that's going to hurt, telling jokes isn't going to do it. Signed, someone who grew up under the soviet dental system that didn't use anesthesia, and consequently suffered what would amounts to torture during several visits.

olalonde 10y ago

Complete medical newbie here... What is wrong with anaesthesia?

d33 10y ago
The risk of any side effects, especially in a yet-to-fully-develop human? I wouldn't be surprised if the list included coma because someone got the dosage wrong. It's just not worth the risk at that point. (Disclaimer: I have nothing to do with medicine)
- saiya-jin 10y ago
  You are mixing local anesthesia with complete pass-out by using NO2 or similar for surgeries (which has 1:10000 mortality ratio if I recall correctly) and side effects. Local anesthesia can be even in form of spray instead of injection, depends on severity. Heck, once I tried to chew coca leaves and that got me pretty numb in my mouth for quite some time, couldn't articulate properly etc. It's still chemistry put into the body messing up with pain signaling, but I wouldn't worry that much about it (or you'll go crazy with all possible things that could harm a kid one way or the other)
  - rscho 10y ago
    PLEASE do not state fear-mongering numbers without source, especially about medicine! Anesthesia is safer than traveling by plane, nowadays. According to a 10 sec googling, the mortality is now sub 10/million/year, and that's including high-risk populations. source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2697561/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2697561/
    - deleted 10y ago
      [deleted]
    - deleted 10y ago
      [deleted]
    - maxerickson 10y ago
      US commercial airlines haven't had a fatal accident since 2009. I think that's a better apple than 'traveling by plane'.
    - dagw 10y ago
      But even those numbers show that the death rate for kids aged 0-4 is significantly higher[1] than for older kids and young adults. I know that doctors on the whole really try to avoid having to put kids under for just this reason. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2697561/figure/F3/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2697561/figure/...
      - rscho 10y ago
        The common guideline is 6 mo and 2 yo. Those ages are commonly viewed as cutoffs for risk levels. In our hospital for example, the presence of an attending will be required for induction/waking up of anesthesia under 2 years old. Under 6 months, the risk of respiratory complication is far greater, which is why surgery is withheld until that age, except in emergencies.
    - saiya-jin 10y ago
      PLEASE understand the meaning of "if I recall correctly". I was wrong. Not everybody is attempting to write a post in an online forum about in form or article for Nature or Science, backchecking every statement in every sentence. Jeez
- pc86 10y ago
  > I have nothing to do with medicine And yet your response is just supposition ("I wouldn't be surprised if..."). Anesthesia is fine.
rscho 10y ago
The classic risk in dental procedures is the dentist using a lidocaine-adrenalin mix, which when injected into a vessel (by mistake), will make your heart race, your blood pressure skyrocket, and provoke a general sense of unease/impending doom. It is also the main reason why many people say they are "allergic" to anesthesia. In fact, the complication profile of amide-class local anesthetics is very safe. As for the interaction of anesthesia with development, scientific evidence is scarce and anesthesia alone does not seem to have such a great impact on the long term. Anyway, I would be far more worried about hypnotic drugs than local anesthetics in that regard.
- throwanem 10y ago
  > a lidocaine-adrenalin mix, which when injected into a vessel (by mistake), will make your heart race, your blood pressure skyrocket, and provoke a general sense of unease/impending doom Wait, that's not supposed to happen? I pretty much just figured oh well, it's epi, what are you gonna do.
- masklinn 10y ago
  > The classic risk in dental procedures is the dentist using a lidocaine-adrenalin mix, which when injected into a vessel (by mistake), will make your heart race, your blood pressure skyrocket, and provoke a general sense of unease/impending doom. And there's a fun side-effect, or at least I had that: body learns to completely blow up under stress. Before I went through that I had very low stress impact (psychological stress had no physical impact), since then stressful situations almost lock me up (heart racing, muscles contracting, …). It's really quite annoying.
- viewer5 10y ago
  > and provoke a general sense of unease/impending doom Oh shit I thought I was just weird. Do you have any more information on that? I felt that when I was getting a crown put in, it was horrifying, "impending doom" is the perfect description. It also happened the (one) time I donated blood, though I don't remember being given any injections or anything though; but I felt that EXACT same "impending doom" sensation; at the time I thought basically "well this is the end, they accidentally took too much blood and I'm going to die now". I felt cold to the core and started sweating horribly and spontaneously, just like the time at the dentist.

westmeal 10y ago

I definitely agree that it works wonders. When I was a child I had a dentist work on my teeth using the same technique, albeit it was jokes instead of story-telling.

Aaargh20318 10y ago

As a kid, I had a dentist who refused to use local anaesthesia, he thought it was 'bullshit' and I shouldn't be able to feel anything. The pain was indescribable. I'm still traumatised by it and haven't been to the dentist in years. I would literally shit my pants out of fear (not exaggerating here, I would have to wear a diaper to undergo regular treatment even with local anaesthetics). Just the though of being operated on while fully conscious gives me the shivers. The only thing I can image being scarier is when they have to do brain surgery and they wake you up halfway through while your skull is open. I'm currently on a waiting list for a specialist at the local hospital where they can treat you under general anaesthesia. It's the only way I can be treated after my childhood experiences. unfortunately the waiting list is long. I just hope it's my turn before something starts to really hurt. I had one treatment under GA before, about 8 years ago, and it was the first and only non-traumatic dentist experience in my life. It was such a huge difference with the 'regular' experience that I simply can't understand why dentists insist on letting people experience the torture. I think they are all secretly sadists that get off on hurting people. I'm not trying to scare you, just make sure your kid is okay with it because it could fuck him up for life.

wil421 10y ago
My friend was in the Marines and had to get is wisdom teeth removed. Lucky for him they were training Marine dentist at his base. He said they wiped some type of numbing gel and proceeded to grab his wisdom teeeth out with pliers. The trainee couldn't get them out so the instructor climbed on his chest and yanked them out.
- wmblaettler 10y ago
  I can confirm. I had the same experience minus the trainee. Had my wisdom teeth extracted while in the Marines. It was over in less than 30 seconds - no time for anesthesia to kick in nor do I remember him administering any. Crack, crack, yank - done.
  - sandworm101 10y ago
    Much depends on the position of the teeth. Pulling some with pliers would cause so much bleeding that choking could kill the patient (teeth still well below gum line).

coldtea 10y ago

So you risk a kids excruciating pain on the mere promise of a doctor being good with distractions? And for what?

pavel_lishin 10y ago

Do you mean general anesthesia, or local, or just the nitrous oxide? If the cavity doesn't reach the nerve, it's probably painless. But if any serious dental work needs to be done that's going to hurt, telling jokes isn't going to do it. Signed, someone who grew up under the soviet dental system that didn't use anesthesia, and consequently suffered what would amounts to torture during several visits.