This is an outpatient surgery center and not a regular dental office. A regular dental office conducts an exam, cleaning and x-rays on a patient. If further treatment is required, they can choose to do it right away or schedule a follow up appointment knowing exactly what treatment options the patient requires and how much time it will take.
Here at SCD we work with the developmentally disabled, handicapped and young children who are unable to see a regular dentist. X-rays and an exam are conducted after the patient is sleeping, therefore, we are unable to know in advance how long each case will take. So that the patient does not have to undergo general anesthesia multiple times, all of the needed dental care will be completed in one appointment. We ask that you be prepared for a long wait.
Yes, general anesthesia has risks associated with it that require our doctors to evaluate the patient very carefully before treatment. A physician and a dental anesthesiologist will evaluate the patient prior to treatment to make sure they are able to go under general anesthesia.
We understand how hard it is for young children and special needs patients to go without food and water, but it is imperative that they remain fasting until they are taken back for treatment to ensure their safety. General anesthesia causes the patient to lose the protective reflexes that guard their lungs and can stimulate nausea and vomiting. If the patient has eaten recently, it is possible that they might vomit during anesthesia and inhale food into their lungs. This may be life threatening so it is important that the patient not eat after the specified time listed on the pre-operative paperwork.
Our waiting room is full of patients who are fasting so we do not allow food or drinks inside. You may bring items to eat or drink outside at our picnic tables (east of our entrance). Food and drink items will need to be left in your vehicle and are not allowed to be brought into the waiting room. There is also a cafeteria in the Loma Linda University Medical Center located south of the School of Dentistry or the Campus Cafeteria located in the Campus Center on Anderson Street in the Loma Linda Market shopping center.
Your appointment here will be very different from an appointment at a regular dental office.
- When you first arrive at your check-in time, you will need to sign-in and fill out paperwork. The front office will process your paperwork, determine your insurance coverage, and collect your co-payment, if applicable. When this process is completed the patient’s chart will be passed onto the preoperative nurse.
- The nurse will prepare preoperative evaluation paperwork for the patient and then they will be called back for a health history and physical exam with our physician. The nurse will weigh the patient, take vital signs, and verify any needed information. The doctor will conduct a brief physical exam to rule out illness or respiratory concerns which is very important for the patient’s safety once they undergo general anesthesia.
- Once the patient is medically cleared, the chart is given to our attending doctor and a dental anesthesia resident will be assigned to the case. The dental anesthesia resident will then meet with you to conduct an evaluation. They will ask questions about the patient’s medical history and discuss with you how general anesthesia works, the risks, and answer any questions you may have. You will then need to sign a consent form for the patient so they can receive general anesthesia.
- Your dental anesthesia resident will obtain approval from the attending dental anesthesiologist and prepare an operating room for treatment as soon as it is available. When the room is ready the dental anesthesia resident will call you into the back with the patient while they are given medications to make them fall asleep. Once the patient is asleep you will need to return to the waiting room until treatment is finished
- While the patient is under general anesthesia, the dentist and dental assistant will take x-rays and conduct an oral exam. The dentist will then come out to meet with you and discuss any dental treatments the patient needs. The dentist will have you sign a consent form for the dental treatment and will then return to the operating room to begin treatment immediately. It is important that this process goes as quickly as possible to reduce the amount of time the patient is under anesthesia.
- After dental treatment is completed the patient will be transferred to the recovery room by the dental anesthesia resident and a nurse will be assigned to monitor the patient’s recovery. The nurse will bring you back to the recovery room when the patient begins to wake up. The nurse will tell you how the treatment went and any care instructions you will need to follow. They will also answer any questions you may have and accompany you to your vehicle to help you safely transfer the patient from the wheelchair.
- A nurse will contact you the next morning to see how the patient is doing and ask if you have any questions.
You will be able to enter the operating room with the patient and be with them while they are placed under anesthesia. However, once the patient is asleep, you will need to return to the waiting area. At the discretion of the recovery room nurse, you may be allowed to go back into the recovery room after their treatment is completed and the patient starts to wake up.
There are three financial components for every patient treated at our facility.
- Professional dental fees
- Anesthesia fees
- Facility fees
We will obtain the patient’s insurance information, both medical and dental, to determine coverage and provide you with financial information before your appointment. We accept most private insurances (PPOs) and Medi-Cal/Medicare. Please be aware that we do not accept HMO medical insurance plans. This does not prevent you from having your dental care at SCD, but it does mean that all services will need to be paid for prior to treatment.
Every patient referred to our clinic is evaluated to see if their health status is appropriate for our outpatient treatment services. Unfortunately, we are unable to treat patients with some severe medical disorders. The decision to refer patients to another facility is usually made by at least two of our attending dental anesthesiologists.
Here are a few examples of health issues that cannot be seen at SCD:
- Severe cardiovascular disease
- Severe asthma
- Conditions requiring supplemental oxygen
- Sickle cell anemia
- Organ failure
- Extreme obesity
- Bleeding disorders
- Latex allergies
Because of the risks associated with general anesthesia, the physician will not clear any patient for treatment if they are sick or have recently been sick. If your child has any symptoms of flu, cold, fever or other sickness and infection, it is important that you call and reschedule your appointment. The patient will need to be healthy for at least two weeks following any illness before they can be scheduled for another appointment. This is for the safety of the patient. If the patient comes in and the doctor determines that they are sick or have recently been sick, the appointment will be cancelled. Please call us to reschedule instead of risking the health of the patient.
We have many patients who come from care homes and we are committed to working with and treating these patients. We know that homecare staff are very dedicated to caring for these special needs individuals and that it can be a very demanding position. If our physician has recommended that the patient be evaluated by their doctor or specialist, the intention is to be comprehensive in assessing any risks to the patient before they are put under general anesthesia.
Please bring the whole patient chart to each appointment. It is incredibly important for the doctor to see everything so they can make a well informed decision regarding the patient’s care. If the patient is brought in without their complete medical chart, their appointment will be rescheduled for another time.
You will receive specific instructions from the recovery nurse on when the patient can eat including other care needs. There will also be typed instructions on the patient’s discharge form. A nurse will call you the day after treatment to see how the patient is doing and answer any questions you may have.
While under general anesthesia, medical tape is used to hold the patient’s mouth open while they receive dental treatment. When the tape is removed it may leave red marks on the skin (usually on the forehead, chin, cheeks, neck or eyelids). These marks should fade within a few days, but if the patient experiences an unusual skin reaction, please contact us at (909) 558-4663.
Usually they will be able to return to school the following day. However, if their dental treatment was more extensive, they may need an extra day to recuperate.