In-Office Treatment

High House Pediatric Dentistry is proud to be West Cary’s only pediatric dentistry specialty practice offering in-office general anesthesia services. As a parent, Dr. Ray knows the difficult decision you may face if your child needs to have treatment under general anesthesia.

Our office and team members are here to walk you through all aspects of the process to make sure that everyone understands what to expect. HHPD is dedicated to providing your child with the best experience possible, so that they will have a positive and enjoyable experience with dentistry for years to come. You probably have questions, so let’s get started.

Why is general anesthesia (GA) recommended for certain children?

For some children, dental treatment under general anesthesia is necessary to provide the best possible experience while still completing all necessary treatment. GA is recommended for several different reasons including:

  • Children with high anxiety or fear of the dentist;
  • Children who have had a traumatic experience with a previous dentist;
  • Very young children (3 and over) with moderate treatment needs;
  • Children with extensive treatment needs;
  • Children with special healthcare needs that would otherwise not be able to sit for dental treatment in other settings.

At High House, the most common reason that we recommend GA is usually for a child that is having their first dental experience, and has a LOT of treatment needs that would be too overwhelming for them to handle, or a child that has had a bad/traumatic experience previously with a dentist, that is now in our office and needs some teeth repaired.

Kids are amazing- but sometimes the number of appointments needed is just too much for them. GA allows us to fix everything in 1 visit (usually around 2 hours), so that we can focus on fun, positive, and easy experiences during dental cleanings and exams. In this way, children get the treatment they need to prevent pain, while still allowing them to naturally grow their comfort with the dentists through subsequent positive appointments.

As stated above, GA is recommended for apprehensive children, very young children, children with extensive treatment needs, or children with special needs that would not work well in other settings. If we’ve recommended GA as an option for your child, we have already considered all the other possible options, and have presented other options as alternatives to GA, along with the pros and cons of each choice.

I’m scared of the risks of General Anesthesia. Can you tell me more?

Sure. Your child’s safety is our number one priority. For that reason, in-office treatment is reserved for children who are 3 or older, and must weigh at least 30 pounds. Our anesthesiologist, Dr. Charles Cangemi, is an experienced clinician who consults for the State Dental Board. At High House Pediatric Dentistry, we do not “cut corners” and Dr. Cangemi is no exception to this rule. Strict guidelines for anesthesia are followed, so that your child’s risk is the lowest achievable.

Parents (Dr. Ray included) may worry that their child may suffer harm during general anesthesia, or even worse, that they may not wake up from GA. But GA is quite safe for virtually all of our patients, as long as they don’t suffer from chronic diseases like cancer or heart disease, and they don’t have problems with their heart, lungs, brain, or blood. For patients that have any chronic or questionable health issues, Dr. Ray will take these patients to Wakemed Hospital. To put the risk of death during general anesthesia in perspective – the pediatric medical literature suggests the risk of death is far less than that the risk of death from an accident while driving with your child in the car. That risk is so small, that we do not even think about it as we put our child into their carseat. Remember, the risk for a problem during GA is far smaller – about 1 in 300,000. In all of Dr. Ray’s time in treating children under general anesthesia, there has never been a child with an adverse event. Other risks are that a short-term low grade fever, sore throat, and general malaise for the day of surgery.

I have never heard of putting a child to sleep for dental work – why would parents choose that for their children?

Did you know that Wakemed Raleigh has one room dedicated to dental surgeries, and that this room is used 5 days per week, every week during the year by Dr. Ray and other pediatric dentists in Wake County?

As a pediatric dentist, Dr. Ray is responsible for making sure that a child gets to adulthood with all of their permanent teeth. Along the way, we sometimes have to face difficult decisions about how to fix baby teeth that may not fall out until 13 years of age! For children that need these teeth to be fixed, it may be too emotionally difficult to insure that the child will have experiences that they can conquer. Thus for these children, the benefits of GA definitely outweigh the risks. In suggesting general anesthesia for your child, Dr. Ray has already considered the risks of treating your child using other methods which may include:

  • An overwhelming negative experience (or multiple awful experiences) previously with a dentist;
  • Significant dental treatment that requires an impossible amount of cooperation from your child;
  • Possible emotional and/or physical injury to your child in order to complete their dental treatment;
  • Negative thoughts/memories of dentistry resulting in dental fear into adulthood.

The risks of NO treatment at all includes:

  • Tooth pain;
  • Infection or swelling;
  • Spread of new decay;
  • Damage to their developing adult teeth;
  • Possible life-threatening hospitalization from a dental infection.

Asking why parents would choose this is also a question we’ve thought about before. We know why we recommend it, but sometimes it’s useful for parents to hear from other parents who have been through this with us. We’ve got you covered! When we polled parents who experienced GA for their children at High House, these points were cited as reasons why they chose to have treatment under GA for their children:

  • All treatment is completed at one visit, usually around 2 hours, with full cooperation of the child;
  • Upfront and accurate pricing- unlike the hospital, where [we] were unsure of what we would owe later;
  • In-network dental treatment lets us take full advantage of our dental insurance with the advantages of general anesthesia
  • A more personal experience, and we can be there when our child is waking up- rather than in the hospital when we have to wait to go back to recovery;
  • A concierge dental assistant there to help from check-in all the way to check-out and beyond.

Will my child remember anything after surgery?

Your child’s experience is designed to be as positive as possible. On the morning of surgery, your child will drink a little medicine, which will cause them to relax, and potentially may make them more tired. An important feature of this medication is that there is a slight amnesic effect, which will make your child more forgetful temporarily. The last thing your child will remember is breathing some nitrous oxide through a mask, and then drifting off to sleep. The next thing they will remember is waking up as if they’ve been asleep, in our recovery area with their parents. Post-op instructions are given to the parents, but the experience for children is similar to just falling asleep.

High House Pediatric Dentistry offers 24h call services for our young patients who undergo dental treatment under general anesthesia, so answers to your questions are just a phone call away.

Questions? Call High House Pediatric Dentistry at 919.267.4211 to talk to us today about pediatric dental treatment under general anesthesia.

Our Anesthesiologists

Benjamin Pritts, DMD

Dentist Anesthesiologist

Dr. Benjamin Pritts is a Board-Certified Diplomate of the American Dental Board of Anesthesiology. This credential is the highest level of anesthesia training that can be achieved in dentistry.

Dr. Pritts grew up in rural southwestern Pennsylvania where he began working at his family’s feed mill business and small farm at an early age. Following high school, Dr. Pritts decided to attend the University of Pittsburgh where he obtained a degree in Neuroscience. Dr. Pritts learned about the field of Dental Anesthesiology the first time he shadowed at a dental office and realized how anesthesia can improve the access to care for dental patients.

Dr. Pritts attended dental school at the University of Pittsburgh where he became an award-winning dental student, graduated at the top 5% of his class, and was inducted into the prestigious national honor society, Omicron Kappa Upsilon (OKU). Dr. Pritts first met Dr. Henderson during this time.

Upon graduating dental school, Dr. Pritts immediately began his specialty training in a 3-year Dental Anesthesiology residency at the University of Pittsburgh Medical Center (UPMC). In addition to the extensive anesthesia training specifically for patients undergoing oral and maxillofacial procedures, he trained with his medical colleagues at two Level 1 trauma hospitals (UPMC Presbyterian and Mercy), UPMC Children’s Hospital, UPMC Magee Women’s Hospital, UPMC St. Margaret, as well as clinical rotations with: Pediatric Emergency Medicine, Neurotrauma ICU, Internal Medicine, and Cardiology. The most rewarding experience during residency was providing anesthesia for hundreds of patients living with special needs at The Center for Patients with Special Needs located within the University of Pittsburgh School of Dental Medicine. Additionally, Dr. Pritts provided general anesthesia for pediatric patients throughout his entire 3-year residency.

Dr. Pritts is has a passion for learning and holds an adjunct assistant clinical professor position with the University of Pittsburgh Department of Dental Anesthesiology. He maintains current certifications in Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), and Basic Life Support (BLS). He is licensed and holds a current General Anesthesia permit by the North Carolina State Board of Dental Examiners.

Dr. Pritts, along with his wife and two daughters now call North Carolina their home. They have visited NC their entire lives, and the state always felt like home. Dr. Pritts and his wife actually got married at Cape Hatteras. In his spare time, Dr. Pritts enjoys snowboarding, relaxing at the beach, hiking, and enjoying life with his family.

Braxton Henderson, DMD

Dentist Anesthesiologist

Dr. Braxton M. Henderson is a Board-Certified Diplomate of the American Dental Board of Anesthesiology. This credential is the highest level of anesthesia training that can be achieved in dentistry.

Dr. Henderson is a native of Covington, TN, a small town north of Memphis. Having spent many years living in Memphis and Covington, respectfully, he became familiar with the nuances of both city and small-town living. He received his bachelor’s degree from the University of Pittsburgh with a major in Biological Sciences.

He earned his Doctor of Dental Medicine degree from the University of Pittsburgh and completed extensive training in a three-year postdoctoral dental anesthesiology residency program at the University of Pittsburgh.

Dr. Henderson founded Southern Office-Based Anesthesia to increase access to high quality and comfortable dental care for all patients. Dr. Henderson is exceptionally well-trained at providing all levels of anesthesia so that dental professionals can fully focus on the dental surgical procedure.

Dr. Henderson’s passion is to increase the safety of anesthesia in the field of dentistry.  He enjoys educating dental students, residents, and dental providers on all subjects related to sedation and anesthesia.  Dr. Henderson has lectured extensively to many dental societies and national organizations on topics such as conscious sedation, medical emergencies, office-based anesthesia, management of the medically complex dental patient, and more. He holds an adjunct assistant clinical professor position with the University of Pittsburgh Department of Dental Anesthesiology. He is also an Oral Board examiner for the American Dental Board of Anesthesiology.

He maintains current certifications in Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), and Basic Life Support (BLS). He is licensed and holds a current General Anesthesia permit by the North Carolina State Board of Dental Examiners.

Dr. Henderson and his wife, Chalis, are happily married and have three sons named Silas, Aldon, and Owen. In his free time, Dr. Henderson enjoys exercising, reading, traveling, and smoking meats.

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