Hospital treatment: questions parents ask

Two reasons, usually together: the amount of treatment, and your child’s age. A three-year-old with several teeth needing crowns cannot sit through that awake, and trying is unkind to them and to the work. Doing it all in one session while they are asleep is safer and gentler than several long visits in the chair.

Baby teeth matter because of what they do: chew, hold space for the adult teeth, and stay comfortable. Decay in them moves quickly and can reach the nerve. If you would like to talk through the alternatives — happy gas in the chair for smaller amounts of treatment, or simply waiting and watching — ask us. Some plans can be made smaller; your clinician will tell you honestly what can and cannot wait.

Your child is looked after by a specialist paediatric anaesthetist — a doctor whose whole job is anaesthetising children — in a hospital, with the hospital’s theatre and recovery staff. Modern anaesthesia for healthy children is very safe. The anaesthetist assesses your child before the day, calls you (usually the day before) and will answer any question you have about the anaesthetic itself; that is their expertise and we would rather you hear it from them.

If your child has a medical condition, tell us early so the anaesthetist can plan for it.

A specialist paediatric dentist from Tooth Town, on a theatre list at Herston Private Hospital or St Andrew’s War Memorial Hospital. It may not be the same specialist who saw your child at the consultation — that depends on which list and date you choose. All of our paediatric dentists work from the same plan and the same standards, and your consulting clinician’s recommendation is what gets carried out.

Of course. We would rather you were sure. Your plan and x-rays belong to you and we will send them to whoever you choose. If the second opinion suggests something different, tell us — it is a conversation, not a contest.

Talk to us before you decide anything. Sometimes the plan can be staged or simplified. Payment plans are available for the dental fee. If your child is eligible for the Child Dental Benefits Schedule, the plan shows what it covers. And a referral to the public hospital dental service is always an option — your clinician will write it, and there is no awkwardness in asking.

Because three separate parties look after your child. Tooth Town charges the dental fee (the treatment itself plus our fee for operating in the hospital theatre). The hospital charges for the theatre, the bed and the nursing staff. The anaesthetist charges for the anaesthetic. The hospital and the anaesthetist invoice you directly; we do not handle their fees and cannot quote them.

Only the Tooth Town dental fee is paid to us before surgery. The consent form’s wording about “fees” refers to ours.

Both will contact you in the week before surgery, and both will give you a quote if you ask. The hospital’s and the anaesthetist’s rooms are the right people to ask about their fees, and about what your health fund will pay towards them — they deal with the funds every day. We send you their contact details with your booking.

It depends on your policy, and on which of the three bills you are asking about. Hospital cover usually helps with the hospital and anaesthetist accounts (there may be a gap). The dental fee comes under “extras” or dental cover, not hospital cover, and some funds do not cover dental treatment done in hospital at all. The reliable way to find out is to give your fund the item numbers on your treatment plan and ask what they will pay — we are happy to provide the numbers in whatever form your fund wants.

Medicare does not cover the dental fee. The Child Dental Benefits Schedule can cover some items for eligible children; your plan shows which.

A deposit within 24 hours of choosing your date, to hold the theatre place — it comes off the total, it is not extra. The balance of the dental fee by 4:00 pm two weeks before surgery, along with the signed consent (or at booking if you book inside two weeks). If a date is going to be difficult, ring us: we would much rather agree a date than lose the place.

It is the paediatric dentist’s fee for treating your child in an operating theatre rather than in our chair: the extra equipment, materials and staff that involves. It is part of the dental fee, paid to Tooth Town. It is not the anaesthetist’s fee and not the hospital’s — they bill separately.

It happens, and it is why the plan says “or may require” against some items: good x-rays are often only possible once your child is asleep, and they can show a tooth needs more, or less, than planned. If something significant changes — for example removing a tooth rather than saving it — we call you from theatre before proceeding, so please keep your phone on. The final account reflects what was actually done: we invoice the difference if it is more, and refund with a corrected receipt if it is less.

Yes. You receive a receipt within one to two business days of surgery, itemised with the item numbers your fund needs. A tax invoice before the day can be provided on request, but funds generally will not pay a claim until treatment is complete.

It transfers to a new date, and is refunded if the surgery is cancelled altogether. Cancelling within 48 hours of surgery may mean it is forfeited, because the hospital and anaesthetist have held that time for your child. If surgery is postponed because your child is unwell, the deposit simply moves to the new date.

Ours: a booking and medical form when you choose a date, and the consent form about three weeks before surgery (signed online). The hospital’s: an online admission form, which the hospital sends you — if it asks for item numbers, they are on your treatment plan, and we can read them out. The anaesthetist’s rooms will also contact you with their own form and fee information.

Two business days before surgery we email your child’s admission time and the fasting instructions for that list, and text you to say the email has been sent. Until then the time is provisional, because the hospital and the anaesthetist set the order of the list.

We understand — a hungry five-year-old is nobody’s idea of a good morning. The order of a list is set by the hospital and the anaesthetist, mostly by age and medical complexity, and the youngest children generally do go first. We cannot promise a particular slot, but tell us your child’s age and any special needs and we will ask. Morning lists and afternoon lists both exist; if the fasting matters more to you than the date, we can look for a morning list.

They come from the anaesthetist for your specific list and we send them with the admission time — please follow those rather than anything general. As a rough guide, no food for six hours before, and clear fluids until about an hour before. If your child is breastfed, or has a condition that affects fasting (diabetes, reflux), ask the anaesthetist directly; the contact details are in your booking email.

Yes, usually the day before surgery, to check your child’s health, confirm fasting, and answer your questions. If your child is anxious, has had a bad experience with an anaesthetic before, or has medical needs, this is the call to say so — they can plan a calmer induction, and premedication if it will help.

Ring us and ring the anaesthetist’s rooms as soon as you notice. A cough with phlegm, heavy nasal congestion, fever, vomiting or diarrhoea in the days before surgery can make an anaesthetic unsafe, and only the anaesthetist can make that call. If they postpone, your deposit moves to the new date and we will find you the next available list. Please do not decide on your own that it is “probably fine” — let them decide.

Often, yes, and it saves your child a separate experience. It has to be organised in advance: tell us as early as you can and give us the pathology request form from your GP or specialist before the surgery date, with any special collection requirements. It cannot be added on the day without the paperwork and the right tubes. The results go to the doctor who requested them, not to us.

Tell us, and tell the anaesthetist when they call. There is a great deal that can be done: a calm, unhurried induction, premedication, a parent present until your child is asleep (the hospital will explain what is possible), and a note on the list so every person that day knows. Our anaesthetists are very gentle with children; it is what they do all day.

It is day surgery, so most families go home the same day. If you are coming from a distance, both hospitals have accommodation nearby; ask us and we will point you to what other families have used.

Plan for a morning or an afternoon. You arrive about an hour before the procedure. The treatment itself is usually one to two hours depending on how much is being done, and recovery is around two hours. It is day surgery: you go home together the same day. Occasionally, for a medically complex child, the anaesthetist recommends an overnight stay — they will tell you in advance if so.

Once your child is asleep and good-quality x-rays are taken, we sometimes find that a tooth needs a different treatment from the plan. If a decision is needed — especially one about removing a tooth — we ring you from theatre before going ahead. If we cannot reach you, we follow the choice you made on the consent form about additional treatment found on the day.

Your Medicare card, health fund card if you have one, any medication your child takes, the pathology form if a blood test has been arranged, and something comforting for the recovery room. The hospital’s admission email lists anything else they need.

Yes. When the treatment is finished the paediatric dentist comes to tell you what was done, what was found, and anything to watch for. If you would rather a partner takes that call because you cannot be there, tell us beforehand and we will ring them.

Sleepy, clingy or teary for the rest of the day — that is the anaesthetic wearing off. A sore mouth, especially where teeth were removed. A little bleeding or pink saliva. Some children have a slightly bloody nose for a few days from the breathing tube; that settles on its own. A small amount of bruising near the mouth is not unusual. Most children are back to themselves within a day or two.

Start with fluids, then soft food for the first day or two: yoghurt, mashed potato, scrambled egg, pasta. Thin drinks through a straw are fine straight away; thick drinks like smoothies are better left for a few days if teeth were removed. If your child had white (composite) crowns on front teeth, avoid biting into hard things with them — apples and carrots cut up, not bitten. Silver crowns can be eaten on normally once the numbness has gone.

Children’s paracetamol (Panadol) and ibuprofen (Nurofen) at the doses on the packet, given before the numbness wears off and then as needed. Most children need little or none after the first day. If pain is getting worse rather than better after two or three days, or there is swelling, ring us.

Usually the day after, if they feel up to it. The day of surgery itself is a quiet day at home with an adult.

Yes. We ring you on the next business day to see how your child is going. You also get a complimentary review appointment, ideally within a month, so we can check the work and answer anything that has come up. You do not have to take it if all is well, but it is there.

Brush them like any other tooth, twice a day with a smear of fluoride toothpaste, and floss between the back teeth once the mouth is comfortable. Crowns on baby molars are designed to stay until the tooth falls out naturally, usually around ten to twelve. If a crown ever feels loose, ring us; it is a quick fix.