BEVERLY HILLS Pediatric Anesthesia

For parents

I focus entirely on your child. The dentist focuses on their teeth.

As a parent myself, I understand this process may be stressful. My goals are the safety and comfort of your child while they're under anesthesia, and to make the process as easy and simple on your family as possible.

Find out more Call (310) 990-3102
Opioid-free anesthesia Needle-free induction One Child, One Anesthesiologist Focused on safety
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Why anesthesia may be recommended

When anesthesia is preferable

Some children are unable to cooperate, anxious, medically complex, or simply need too much dental work to comfortably complete treatment awake. By having them under anesthesia, all of their treatment may be done in one visit while they sleep. The dentist can focus on treating your child uninterrupted.

Unable to cooperate

Some children have a hard time staying still long enough for multiple cavities to be filled, which may make the treatment take longer or become dangerous.

Too anxious

For some, the sound of dental instruments may cause fear and panic, making it difficult for the dentist to complete treatment.

Medically complex

Certain medical conditions may make ordinary in-chair treatment unsafe or impractical.

Lengthy or challenging treatment

Dental work that would take a frightened child multiple visits may be completed in a single session while they sleep.

Pediatric Anesthesia

Your child's anesthesia

For the safety of your child, they will be under general anesthesia so that the dental work can take place in a highly controlled setting while your child is closely monitored. Your child will be breathing on their own, but lying completely still, so the treating dentist can complete all of their work with precision and efficiency.

Your child falls asleep breathing through a soft mask with you by their side holding their hand. After they're under anesthesia, I place an IV and breathing tube for their safety, then we begin the dental work. I stay in the room the entire time to continuously monitor them.

General anesthesia, for their safety

Your child is fully asleep for the whole appointment, not drowsy and half-aware.

Breathing on their own

Your child, closely monitored, breathes on their own while lying still for the dentist to work uninterrupted to maximize their time and effort.

Opioid-free

I use an opioid-free anesthetic for all pediatric cases. Pain is controlled with local anesthetics. Sometimes, kids have some mild pain at home which is usually controlled with over-the-counter pain medications.

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At a glance

From start to finish.

This is the typical process from initial contact to our follow-up.

Before coming in

We medically clear every child before proceeding. This takes place before treatment day to make sure we have everything we need for their safety.

Questionnaire

With our nurse, by phone

A thorough medical questionnaire over the phone — not a form you fill in alone. We hold a conversation, so nothing gets skipped or misread.

Review

I review everything

Your child's medical information is personally reviewed, and I ask for anything that needs clarifying.

Records

Only if needed

If your child has certain medical conditions, we request records from their doctor. I may speak with their doctor directly.

We speak

Before the date

Together we formulate the anesthetic plan best for your child. Every question answered before the appointment, with time to think it over.

  • We thoroughly discuss the pre-op and post-op care with you before the appointment and send you written instructions as well.
  • If you ever have further questions, you can call us and we will discuss it over the phone.

Selecting a stage stops the automatic rotation.

Safety & monitoring

Monitored continuously for the whole appointment.

Before the anesthesia

We make sure your child is medically cleared and safe to undergo anesthesia.

On the day

In-person exam to make sure your child is not suffering from any illness such as flu or cold which may adversely affect their safety.

During the treatment

I personally monitor your child with hospital-grade vital sign monitors in accordance with the American Society of Anesthesiologists' intraoperative monitoring guidelines to make sure their oxygen, heart rate, blood pressure, respiration and temperature are within safe levels. I stay with your child for the entire case and do not leave the room.

Home and after care

Your child recovers in your arms when they first wake up. We will contact you the same day and again the following day to make sure recovery is on track.

Model. Not a patient of this practice.
Anesthesia safety

Anesthesia today is safer than it has ever been, and emergencies are extremely rare. I carry multiple pieces of backup equipment and emergency medications to resolve issues if they arise. I hold current Basic Life Support, Advanced Cardiovascular Life Support and Pediatric Advanced Life Support certification, and have emergency protocols if needed.

Who is in the room

Your child is never left alone.

From the moment your child falls asleep until they are awake and back with you, there are always at least three of us in the treatment room, and I am one of them for the entire appointment.

Me, your Anesthesiologist

Monitoring your child

I stay in the room and closely monitor your child throughout their appointment.

The dentist

Doing the treatment

Your child's dentist works uninterrupted while I manage the anesthesia. Two clinicians, two separate jobs, both focused.

Dental Assistant(s)

1–2 additional hands

Trained assistants work alongside the dentist throughout the treatment, so the work is completed safely and efficiently.

Two PALS certified personnel at all times

Aside from myself, I always make sure that at least one other person in the treatment room has a valid Pediatric Advanced Life Support certification. While emergencies in this setting are rare, training and preparation is of the utmost importance.

Special needs

Every child is different. The anesthetic should be too.

Some children may require other considerations for their comfort and safety, depending on their individual needs. Before the procedure, we have a conversation about your child’s medical and emotional background, what makes them unique, and what measures we can take to lessen any trauma they may experience.

Patients I routinely see

  • Autism spectrum disorder

    Some children may be non-speaking, or communicate with a device or through pictures. Care is taken to have the parent or guardian present, and to keep whatever your child uses to communicate readily available to them. Extra care is taken to make sure their pain and nausea are well managed, as they may be unable to express their discomfort after the procedure.

  • Sensory needs

    What may be an ambient level of light, noise, taste and touch for some may be sensory overload for others. If we can reduce the sensory stimulation, whatever it may be for your child, they will likely have a calmer and less traumatic experience.

  • ADD and ADHD

    Children and adults who have full awareness and understanding, but are unable to stay still for the dental work or the IV, may require pre-anesthesia sedation.

  • Developmental delay

    Some patients may not be able to comprehend dental care or anesthesia, and are unable to sit still for the procedure. Therefore, pre-anesthesia sedation may be required.

  • Epilepsy and seizure disorders

    We will review their seizure history, usual anti-seizure medications, recent seizure control and known triggers before anesthesia and individualize your child’s medication timing and anesthetic plan. Do not give, skip or change seizure medication on treatment day unless you have been given specific instructions.

  • Severe dental anxiety, or a difficult past experience

    Severe anxiety or a bad experience at the dental office may stay with a child into adulthood. Therefore, having an in-depth conversation about what may have caused the past trauma, and how to make the child feel more comfortable and safe before anesthesia, may improve their perception of the dental office for the future.

How we accommodate

  • We see the whole child, not just their chart

    Before the treatment, we have a discussion regarding what may help soothe your child, what they are most afraid of, and how we can adjust our usual routine to help them feel more comfortable. Often, a few small changes can make a significant difference in reducing your child’s anxiety.

  • We plan together

    We formulate a treatment plan together that will work for your child. Often I will ask you and their favorite comfort toy or blanket to be present in the room with them to help ease them as they fall asleep.

  • Sedation before general anesthesia

    Most children are given an oral sedative, which I provide, to help them relax before going under anesthesia. The drink takes effect in about 15 minutes, after which your child is noticeably calmer and more comfortable. Only then do we go back to the treatment room, where they breathe in anesthesia gas and fall asleep. This avoids the thing most children are afraid of: a needle while they are awake.

  • Medications on treatment day

    Depending on your child’s medical history, I may ask you to either give or skip their medications on the day of the procedure. You will have both verbal and written instructions, and a direct line to us for any last-minute questions.

  • Fasting for a sensitive child

    An empty stomach before anesthesia is a safety requirement, and a hard one to follow for a child who may not understand why breakfast is not coming. We will prioritize very young children and children with special needs for the first case of the day or an early start wherever reasonably possible.

If your child has a personal challenge or medical diagnosis not listed above, it does not rule them out of anesthesia. Contact us and we will talk through it together.

Some children may not be candidates for anesthesia in a dental office, depending on their individual medical diagnosis. Our medical questionnaire, done over the phone, helps us decide together on the safest place to take care of your child.

Frequently asked questions

Common questions

Why does my child need anesthesia?
Some children are unable to cooperate, anxious, medically complex, or simply need too much dental work to comfortably complete treatment awake. By having them under anesthesia, all of their treatment may be done in one visit while they sleep. The dentist can focus on treating your child uninterrupted.
Will my child feel pain?
They will not feel pain or remember anything from the procedure while they are under anesthesia. After your child is asleep, we numb any areas in their mouth where they might otherwise feel pain. The numbing medication typically lasts one to three hours, and as it wears off you may give them over-the-counter pain medicine if they have any discomfort at home.
Will my child remember anything from the dental work?
No. They will be completely asleep through the dental work and wake up in your arms when all of the work is complete.
Will my child wake up in the middle of the procedure?
It is extremely unlikely that your child wakes up in the middle of the procedure while they are under anesthesia. After 9+ years of practicing, it has yet to happen where one of my patients has experienced “awareness” under anesthesia.
Is anesthesia safe?

General anesthesia has risks. My job is to identify those risks before the appointment, select appropriate patients and settings, continuously monitor your child, and be prepared to recognize and treat problems immediately.

Anesthesia is safer today than it has ever been. I bring hospital-grade monitors and use them in accordance with the American Society of Anesthesiologists' intraoperative monitoring guidelines — oxygen, heart rate, blood pressure, respiration and temperature, continuously, for the entire appointment. I am board certified by the American Board of Anesthesiology and hold a general anesthesia permit with Pediatric Endorsement from the Dental Board of California. I medically clear every child before administering anesthesia, including obtaining medical records or speaking with your child's physician if needed. I anesthetize one child at a time so they have my undivided attention.

What level of sedation will my child get — minimal, moderate, deep, or general anesthesia?
For the safety of your child, they will be under general anesthesia so that the dental work can take place in a highly controlled setting while your child is closely monitored. Your child will be breathing on their own, but lying completely still, so the treating dentist can complete all of their work with precision and efficiency.
How will my child be monitored before, during and after?

Before the anesthesia, we make sure your child is medically cleared and safe to undergo anesthesia.

On the day, an in-person exam makes sure your child is not suffering from any illness such as flu or cold which may adversely affect their safety.

During the treatment, I personally monitor your child with hospital-grade vital sign monitors in accordance with the American Society of Anesthesiologists' intraoperative monitoring guidelines to make sure their oxygen, heart rate, blood pressure, respiration and temperature are within safe levels. I stay with your child for the entire case and do not leave the room.

Afterwards, your child recovers in your arms when they first wake up. We will contact you the same day and again the following day to make sure recovery is on track.

What emergency protocols are in place?
Anesthesia today is safer than it has ever been, and emergencies are extremely rare. I carry multiple pieces of backup equipment and emergency medications to resolve issues if they arise. I hold current Basic Life Support, Advanced Cardiovascular Life Support and Pediatric Advanced Life Support certification, and have emergency protocols if needed.
Do you meet all licensing requirements?
Yes. I hold a physician licence from the Medical Board of California, board certification from the American Board of Anesthesiology, and a General Anesthesia permit with Pediatric Endorsement from the Dental Board of California. I also hold current BLS, ACLS and PALS certification from the American Heart Association. The Dental Board has additionally appointed me as an evaluator, which means I am one of the people who inspects and evaluates other practitioners against these same requirements.
What training and experience do you have, and what standards do you meet?
See my about section for an in-depth answer.
Do you give my child opioids like fentanyl?
No. I use an opioid-free anesthetic for all pediatric cases. Their pain is controlled with local anesthetics during and shortly after the procedure, and you may give them over-the-counter pain medication at home.
How long before the procedure should my child avoid food or drink?
  • No solid food for 8 hours before the appointment.
  • No dairy products for 6 hours before the appointment.
  • No breast milk for 4 hours before the appointment.
  • Water, apple juice without pulp and Pedialyte are okay until 2 hours before the appointment. No orange juice.
  • Nothing to eat or drink for the last 2 hours before the appointment.

If these times are not met, the case may be postponed for the safety of your child.

Who will evaluate my child beforehand?
Both my nurse and I will contact you before the procedure. First, my nurse completes a thorough medical questionnaire with you over the phone. I then review your child's medical information personally, and we obtain medical records from their doctor if their medical history necessitates it. Before the treatment date, you and I speak directly, and together we formulate the anesthetic plan best for your child.
What happens if my child becomes ill before the procedure?
Please call us immediately so we can talk it through together. If your child has a cough, cold, flu or fever, or if they accidentally ate — then most likely we will be rescheduling the procedure for their safety.
Should my child take their medications that morning?
It depends on the medication, so we will go through this with you specifically during the pre-op conversation. Do not stop, start or give any medication on the morning of the appointment without checking with us first.
Is there anything I need to do before and after?

We will thoroughly discuss the pre-op and post-op care with you before the appointment and send you written instructions as well. If you ever have further questions, you can call us and we will discuss it over the phone.

We will also go over everything in person with you on the day of the appointment to answer any last second questions you may have.

Will I get written instructions?
Yes, you will have written instructions sent to you before the procedure.
My child has a medical condition. Can they still be treated in a dental office?
Maybe. We will ask you questions over the phone, obtain medical records if needed, and I will speak to your child's doctor directly if needed before making a decision on whether it's safe to administer anesthesia.
Will my child get poked or have a needle placed while they're awake?
No. Your child breathes in anesthesia gas through a soft mask and falls asleep. Only after they are asleep, an IV is placed to administer fluid or medications.
Can I stay with my child while they fall asleep?
Yes. One or two parents, depending on the size of the treatment room, may be next to the child while they fall asleep. After they are asleep, you must go to the waiting area while I focus on keeping them safe during the dental work.
How much medication will you give my child?
The least amount of anesthesia possible to make sure your child is asleep and comfortable, and not overly sedated. There is no fixed dose — it is based on a combination of factors including your child's age, weight and medical conditions.
How long are dental treatments?
Duration may vary depending on how much work your child may need. Typically, treatments are around 1–2 hours if only a few teeth need attention, however they can be as long as 3–4 hours if more extensive dental work is needed.
How long does it take for anesthesia to wear off?
Your child will be groggy for a few hours after the procedure. They may want to take a nap when they get home. Typically, after their nap they are much more awake. Eating and drinking is highly encouraged after anesthesia to stay hydrated and keep up with their nutritional needs.
How soon after anesthesia can my child eat or drink?
As soon as they are opening their eyes and asking to eat or drink, you can start to give them small sips of water to make sure they are swallowing safely. After a few small sips, you can give larger sips, followed by progressively thicker food and finally solids. Always encourage them to eat, but never force them.
Can my child go to school the next day?
Probably. Most children feel well enough to go to school the following day, however some may opt to stay home to allow additional time to recover. Every child is different, and their safety always comes first.

Contact

Ask your dentist, or start here.

Does your child need anesthesia for dental work? Let’s talk through it.

Call directly (310) 990-3102

If your child's appointment is approaching, or you would rather just talk it through, call me.

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Privacy

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Important notices about anesthesia for minors

Anesthesia Is Voluntary; Alternatives Are Available: Sedation and general anesthesia for dental treatment are almost never medically required; they are provided primarily for your child’s comfort and to allow dental treatment to be completed safely. Anesthesia is voluntary. Alternatives including treatment with local anesthesia only, lighter (minimal) sedation, or no sedation are available and can be discussed with the Anesthesiologist and your dentist. You may ask questions and may decline anesthesia.

Important Notice Regarding Anesthesia for Minors: The administration and monitoring of deep sedation or general anesthesia may vary depending on the type of procedure, the type of practitioner, the age and health of the patient, and the setting in which anesthesia is provided. Risks may vary with each specific situation. You are encouraged to explore all the options available for your child’s anesthesia for their dental treatment, and consult with your dentist, family physician, or pediatrician as needed.