Expert: Dr Ian Jackson - please note UK based - 9/18/2009

Question
Dr Jackson,

My 8 month old daughter has a broken tooth - the ped dentist has said if we are to crown it to avoid infection it she would have to do it under a general (an hour or less under). If it does get infected to extract would also require a general (15 mins) as she is too young to co-operate. (Second ped dentist said the same). Does the longer they are under make a lot of difference?

I am in Australia. The question is how dangerous is a general on a baby of this age. Does the risk get less the older the child. What are the dangers - can brain development be affected in babies of this age?

Thanks for your time.

Maria

Answer
Hi there Maria
Good question. The simple answer is really that the duration of the anaesthetic makes little difference to the risks.
Anaesthesia in children particularly those under 1 is a specialised area and we (in the UK) only look after these within our hospitals and would not do them in a normal dental clinic. In fact we no longer provide anaesthesia in dental clinics for any age across the UK due to the problems we saw.
The dangers are low as long as those looking after your child are experienced and have the full facilities to do so. In my experience of visiting hospitals in Australia this is largely the case. From the fact that you have seen two paediatric dentists I have to assume you live in (or near) one of the major cities so you have access to excellent facilities.
I know of no evidence that suggests brain development is affected by anaesthesia and indeed my own children have had anaesthetics at a young age.
As to age - anaesthesia gets easier as the child gets older and bigger especially once they are over 3-4 years of age. However does this equate to it being less risky? Suspect it should but again in good centres there is no difference in risk or outcomes.
Not sure that I have helped yor decision much but I hope the above helps. Final decision is for you and your husband.
Kind regards
Dr Ian Jackson