The anesthesiologists and nurses at Pediatric Dental Anesthesia Associates have years of experience in caring for patients with special needs and about 30% of our patients have a special needs diagnosis including Autism, Down’s Syndrome, Cerebral Palsy, and other syndromes. We look forward to providing the compassionate, convenient, and medically specialized care for your child.
While studies show that patients with autism and other syndromes often have a lower prevalence of dental caries, unfortunately, they are more likely to require general anesthesia for dental procedures.
Of importance to the anesthetic care of autistic patients is the common desire to maintain a consistent and predictable environment. Any behavioral manifestations such as inflexible nonfunctional routines and repetitive motor movements are adapted into anesthesia management.
Pre-anesthetic planning will include a discussion of your child’s likes and dislikes. Also, any phobias or anxiety triggers should be discussed including stereotypical behavioral patterns. It may be helpful to make use of the child’s preferences including video games, DVDs, or a cherished object. We will be seeking your input and discuss what would work best for your child on issues such as injections, masks, or intravenous catheters that are required to begin the anesthetic. The anesthetic will be designed to minimize breaks in your child’s routine. We will encourage your child using positive verbal reinforcement, distraction, and rewards. We will avoid any unnecessary restraint.
It is important for transportation home that you bring another adult to help either drive or supervise your child during the drive home.
Our anesthesiologists care for hundreds of patients with syndromes each year and are some of the most experienced special-needs anesthesiologists in the country. Your child’s safety and comfort are our primary concerns as well as our emphasis on quickly reintegrating your child back into their routine.
Although the exact prevalence of autism is often disputed it is believed that it may be as high as 1:150. The diagnostic criteria are somewhat subjective and thus the range quoted is often 1:150 to 1:500.
Many are reporting an increasing incidence and the diagnostic criteria are evolving. There is a male predominance (at least 5:1) and a strong genetic basis. There is a 60 to 90% concordance in identical twins and it is more frequent in siblings. There are multiple gene loci that are linked to other genetic syndromes.
Autism is characterized by poor communication, poor social interaction, and ritualistic behaviors. While language communication is impaired there is a wide spectrum of abilities from totally nonverbal to advanced speech with limitation and idiosyncratic language. There is often poor “joint” activity and attention. This includes poor eye contact and resistance to physical contact. There is also a spectrum of intellectual ability from mental retardation to advanced intellectual ability with abnormal processing.
