Pediatric (Childrens) Dentistry
The following information is provided to answer some of the most common questions asked by our patients and their families.
About 2032 Dentistry
2032 Dentistry is a family dental office with a special interest in providing pediatric dental care. Many offices in the area refer their pediatric patients to us. Our caring team will do our best to make their dental visits a positive experience, after all, an enjoyable appointment is better for your child and us. Once treatment is complete, your child will return to the referring dental office.
We offer nitrous oxide/oxygen sedation, full GA sedation and televisions with Netflix with children's shows as part of our in-office sedation technique.
About Dr. Kathryn Moore
Dr. Moore graduated with a Bachelor of Science Degree from Trent University Peterborough 1985 and a Doctor of Dental Surgery degree from the University of Toronto 1989. She earned a dental internship position 1989/1990 at Mount Sinai Hospital in Toronto, where Dr. Moore had the opportunity to work with leaders in Special Care dentistry; she was excited to continue this work at Peterborough Regional Health Centre.
As a general dentist, Dr. Moore has developed a special interest in treating children.
Dr. Moore has been on staff at Peterborough Regional Health Centre for over 30 years, where she provides care to young patients and those patients with special needs under general anesthesia.
About Dr. Sarah Trotter
Dr. Trotter attended the University of Western Ontario in London. She graduated with an honours Bachelor of Science Degree in 2006 and a Doctor of Dental Surgery Degree in 2010. During her education, Dr. Trotter was recognized for her work in the Pediatric Dental Clinic at Western.
After graduation, Dr. Trotter worked with Dr. Bruce Gibson for 7 years in Lakefield, Ontario.
Dr. Trotter was excited to partner with Dr. Kathryn Moore in 2017 and create 2032 Dentistry for Life. Dr. Trotter has a special interest in treating children. Along with Dr. Moore, Dr. Trotter strives to provide the best in pediatric care to their pediatric patients and is on the staff at Peterborough Regional Health Center, providing care to young patients under general anesthesia.
At our practice we offer several management techniques to enable safe, appropriate, and quality dental care to your child. The treatment of choice will depend on your child’s age, the amount of treatment that is required, and behaviour management challenges specific to your child.
1. In Office
Many children find that with a little tender loving care, patience, Show-Tell-Do and TV-Netflix-Headphone distraction they can comfortably undergo treatment here at the office. This may also be combined with local anesthesia (freezing) and/or Nitrous Oxide/Oxygen sedation, or full GA sedation (below).
2. Nitrous Oxide/Oxygen Sedation in Office
Nitrous Oxide is a mild sedative and mild pain reliever used to manage special needs or anxiety while your child receives dental care. It may be used when several procedures need to be done at the same time, when the safety of a child may be compromised, or if your child has a strong “gag” reflex.
Often called “laughing gas,” nitrous oxide is a very safe, mild sedative that will help your child remain relaxed during dental procedures. We will give the sedation with the use of a soft mask (your child can choose from several scented nasal masks) that will carry air (oxygen) mixed with the medication. Your child will be asked to breathe through the nose, not the mouth, and will sense a faint, sweet smell. The sedation will take effect in about 5 minutes. The mask will remain in place on the nose until the procedure is done. Your child will be awake during the entire procedure and may have a “happy” feeling. When the procedure is complete, the nitrous oxide will be turned off and your child will breathe in pure oxygen for about 5 minutes to clear out any remaining gas. You should limit your child to a very light meal before this procedure, such as toast or a bagel.
3. General Anesthesia at Peterborough Regional Health Centre or at 2032 Dentistry Office
We will recommend general anesthesia to perform dental treatments
Your child will sleep through the procedure and have no memory of it.
When anesthesia is needed, there are special rules for eating and drinking at home before the procedure.
Your child will have some restrictions after the procedure.
You should plan to stay at the hospital or 2032 Dentistry office for most of the day until the anesthesia has completely worn off and it is safe for your child to go home.
To keep your child safe and comfortable during a dental procedure, we might decide with you to use general anesthesia in the operating room. General anesthesia also may be used if your child needs extensive or complicated procedures that will take a long time to complete, or needs several procedures done all at the same time. An anesthesiologist — a doctor who specializes in anesthesia — will give your child the medications that will make him or her sleep soundly during the procedure.
General anesthesia makes your child’s whole body go to sleep. It is needed for certain dental procedures and treatments so that his or her reflexes will be completely relaxed. Your child will feel no pain during the procedure, nor have any memory of it.
General Anesthesia at 2032 Dentistry
For children without additional health issues we offer GA in our office. Your child will receive anaesthetic care from a team that includes a medical anaesthetist and registered nurses. The office environment provides a more comfortable setting and avoids the delaying your child's treatment due to OR availability and wait lists at PRHC. Our facility is designed for pediatric care only - which means it is perfect for those children of a certain age and size - your child may be too large!
Every effort has been made to ensure the process is safe, efficient and of the highest standard. Our facility has undergone inspection by the Royal College of Dental Surgeons and found to meet the rigorous standards required for certification as an approved general anesthesia clinic.
The cost of the anesthesia and Oral Sedation Facility is in addition to the fees for the dental services. Not all dental insurance plans provide coverage. We will submit a pre-determination so you should have a good idea on the coverage prior to proceeding. You are responsible for any fees not covered by your insurance - this includes patients with Healthy Smiles (HSO). If you have multiple insurance plans we will submit both primary and secondary insurance claims. We will take assignment for your insurance – this means they pay us directly and you are responsible for any difference between the cost and their coverage.
General Anesthesia at PRHC
For children that are not treatable at 2032 Dentistry we have OR privileges at PRHC, which is of course provides an excellent team and environment for treatment.
If you child is outside of our facility capabilities we will recommend the PRHC. These reasons include age, size, and any other health issues your child may have. Unfortunately the wait time may be longer at PRHC due to OR availability. We will work hard to ensure the wait is reasonable for the treatment your child needs.
At PRHC, the cost of the OR (anaesthetist, registered nurses, GA, supplies) is covered by OHIP, but the dental treatment and administration is not covered and your responsibility. We will submit a pre-determination to your insurance so you should have a good idea on the coverage prior to proceeding. You are responsible for any fees not covered by your insurance - this includes patients with Healthy Smiles (HSO). If you have multiple insurance plans we will submit both primary and secondary insurance claims. We will take assignment for your insurance – this means they pay us directly and you are responsible for any difference between the cost and their coverage.
When general anesthesia is needed, there are important rules for eating and drinking that must be followed in the hours before the procedure. One business day before your child’s procedure, you will receive a phone call from our treatment coordinator. Calls are not made on weekends or holidays.
Following are the usual instructions for eating and drinking.
For infants under 12 months:
Up to 6 hours before the scheduled arrival time, formula-fed babies may be given formula.
Up to 4 hours before the scheduled arrival time, breastfed babies may nurse.
For all children:
After midnight the night before the procedure, do not give any solid food or non-clear liquids. That includes milk, formula, juices with pulp, coffee, and chewing gum or candy (do not give any of these).
Up to 4 hours before the scheduled arrival time, give only clear liquids. Clear liquids include water, Pedialyte®, Kool-Aid®, and juices you can see through, such as apple or white grape juice.
If your child takes daily medication, you may give it unless specifically told not to do so by your child’s doctor or the scheduling nurse.
Going to Sleep
Once your child has been registered for the procedure, a member of the staff will meet with you to take your child’s vital signs, weight, and medical history. As the parent or legal guardian, you will sign a consent form before the anesthesia is given which outlines the treatment to be performed.
The anesthesiologist will meet with you and your child to review your child’s medical information.
Dr. Moore/Dr. Trotter will meet with you to review the proposed treatment plan
If your child is very scared or upset, the doctor may give a special medication to help him or her relax. This medication is flavored and takes effect in about 10 to 15 minutes.
Once your child has been taken to the operating room, a small mask will be placed over your child’s nose and mouth. The medicine that is directed into the mask —will help your child relax and will make your child sleep.
Once your child is asleep an intravenous (IV) line will be started so that medication can be given throughout the procedure as needed. This IV requires a needle to be inserted into your child’s vein, usually in the arm or hand.
A tube will be inserted through the nose and into the lungs to maintain the child’s airway
During the procedure, your child’s heart rate, blood pressure, and other vital functions will be closely monitored.
How to Comfort Your Child On the Day of Surgery
As a parent, watching your child undergo anesthesia may be a very uncomfortable experience for you. Children can sense a parent’s concern — so for your presence to be helpful to your child, you must try to be as calm and encouraging as possible while you are with your child at the hospital. There are ways you can help your child, even if you feel uncomfortable.
You can bring along a “comfort” item — such as a favorite toy, stuffed animal or “blankie”— for your child to hold during the induction.
Bring any favorite computer games for them to play on your tablet while waiting for their treatment
Bring a change of clothing – it is not uncommon for patients to urinate during anesthesia
Following General Anesthesia
Once the procedures have been completed, your child will be taken to the recovery room where nurses will carefully check his or her vital signs. The effects of general anesthesia can last for many hours.
Your child’s nose, mouth, and throat may remain numb for 30 to 45 minutes after the procedure.
Your child’s throat may remain slightly sore for 1 to 2 days after general anesthesia.
Your child’s gums and mouth may be sore for several days afterward, depending on the dental procedure.
Use caution when your child eats and drinks for about 30 to 40 minutes after the procedure.
Your child may feel dizzy or feel like vomiting.
Give your child only soft foods for the first few hours after undergoing anesthesia.
At-Home Care and Follow-Up Visits
Your child is not to return to school or day care that day, and you may need to see how he or she feels the next day. Sometimes the effects from general anesthesia — usually tiredness — can last into the next day. Your child will need to remain at home where an adult can monitor him or her.
Upon returning home, your child may only have minimal activity for the remainder of the day.
Our office will tell you when you should schedule a follow-up visit.
When to Call the Dentist
If your child’s gums are sensitive, Tylenol® or Motrin® will help with any discomfort. If your child experiences the following for more than 24 hours following dental surgery done with anesthesia in the operating room, you should call the dentist:
Severe bleeding of the gums
Severe vomiting or dizziness
If your child has any of these symptoms, call or text the office at 705-743-5924. You will have been provided the dentist cell number for emergency (with the above symptoms please call).
If unable to reach Dr. Moore/Dr. Trotter, please leave a message for her. If you feel that you need urgent attention during the day between 8 am and 8 pm please contact the Dentist on call.
Dentist on Call: 705-748-8500
If you are calling in the evening between 8 pm and 8 am, please call the hospital emergency department:
Peterborough Regional Health Centre 705-743-2121
Illness and Special Needs
If your child has any special needs or health issues that you feel the dentist and anesthesiologist need to know about, please call our hospital coordinator at our office 705-743-5924.
During the two weeks prior to your scheduled hospital visit if your child has developed a cold, stuffy nose, cough, flu or other illness, you will need to call us and the procedure will be rescheduled as soon as possible. Please do not leave it to the day of the surgery. The anaesthetist will cancel if they is any indication of illness, which results wasted OR time and puts your child into a much longer wait. It is important to notify us in advance about any special needs your child might have.