PUNE: Mukul Madhav Foundation and Finolex Industries Ltd. recently aided the Pune Police Hospital by facilitating them with additional medical equipment, to help upgrade their current setup. Conducted in honour of Late Shri Pralhad P Chhabria (Founder- Mukul Madhav Foundation and Finolex Group), the inauguration was held on Wednesday, 21 December 2016, at the hospital premises, at the hands of Commissioner of Police, Rashmi Shukla. Other prominent personnel gracing the occasion were Sheshrao Suryawanshi (Deputy Commissioner of Police), Sunil Ramanand (Joint Commissioner of Police) Girish Bapat (Guardian Minister Pune), Prakash Chhabria, (Executive Chairman, Finolex Industries Ltd.) and Ritu Chhabria (Managing Trustee, Mukul Madhav Foundation) amongst others. On this upgradation by the company and Foundation, Ritu Prakash Chhabria, Director, Finolex Industries Ltd, and Founder/ Managing Trustee Mukul Madhav Foundation said “We are fortunate that the police authorities considered reaching out to us, to help support them, as improving healthcare, sanitation, and education facilities has always been the vision of MMF, since our inception in 1999.
It is our pleasure to associate with the Pune Police force team headed by a dynamic personality, our very own Commissioner, Mrs. Rashmi Shukla. She is truly an inspiration to all women of this city and country.” The Pune Police hospital is regularly visited by several renowned doctors of Pune who volunteer here once a week or once a fortnight, to provide their specialty services. Some of the equipment presented by MMF is a Sonography machine, Dental chair, Digital processor printer for XRAY, ECG Machine, BP apparatus, and an ophthalmic slit lamp. In the month of January 2017, the Police department observes safety week and to mark this occasion, Finolex Industries and their CSR partner Mukul Madhav Foundation will be donating riding helmets and masks to all (over 900) traffic police men and women in the city. Finolex Industries appointed MMF as their CSR partner since 2014, and have since executed several projects in the areas of health, education, social welfare, disability, water, sanitation and environment, together.
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"Is sedation safe for a dental visit? Our 25-year-old son has autism, and it’s so upsetting to see him strapped into a jacket for procedures." This week’s “Got Questions?” answer is from pediatric dentist Elizabeth Shick, director of Pipeline Programs and Global Health Outreach at the University of Colorado's School of Dental Medicine. Dr. Shick co-authored the Autism Speaks ATN/AIR-P Tool Kit for Dental Professionals. (Follow the title link for free download.) Thank you for your question. It’s shared by so many people with loved ones who are affected by autism. Of course dental procedures can be uncomfortable and scary for anyone. This distress is amplified for many children and adults with autism. And I certainly understand that you find it emotionally wrenching to see your son physically restrained – even if it’s for his safety. Fortunately, we have a broad range of treatment options – including conscious sedation. While generally safe when administered by trained experts, sedation comes with risk.
Perhaps you’ve even read the recent tragic news of the young girl who went into cardiac arrest after an apparent overdose of sedative drugs before a root canal. Clearly, risks must be balanced against benefits. It’s also important to know that dentists don’t generally receive training in the use of restraints, sedation or anesthesia during standard dentistry education. So I recommend seeking out a dentist who has completed additional training with a focus on these procedures. Once you have such a dentist whom you trust, I suggest discussing the pros and cons of the following options. Conventional treatment: With patience and understanding, many children and adults with autism can sit through a normal dental visit without restraints or sedation. In my experience, this involves talking the patient through procedures and using positive reinforcement to accomplish appointment goals. In the Autism Speaks tool kit for dental professionals, we discuss helpful techniques such as desensitization, Applied Behavior Analysis and the use of social stories and visual supports.
There are no added health risks with these approaches. However treatment may progress slowly and take multiple appointments. (Also see Autism Speaks Dental Guide for families.) Protective Stabilization: Protective stabilization is an important option when the dental patient can’t be persuaded to sit still in the dental chair. This is to ensure safety for both the patient and the dental staff. This can be as simple as having a parent, caregiver or dental assistant hold the patient’s hands. If this isn’t enough, we might use a wrapping device made from soft cloth to help stabilize the patient’s arms and legs. In our Autism Speaks tool kit for dental professionals, we recommend that dentists get advanced training on how and when to properly and safely apply such restraints. It’s perfectly appropriate for you to ask the staff if they’ve received training in protective stabilization, sometimes called “medical immobilization.” Many dentists feel most comfortable with medical immobilization because it’s the safest way to perform dental procedures when the patient can’t be depended on to hold still.
Nitrous Oxide: Inhaled through a nose mask, nitrous oxide is a generally safe anti-anxiety medicine. Importantly, the patient must continue breathing through the nose until the dental procedure is complete. So it’s not a good option for children younger than four or five or anyone who is crying or otherwise breathing through the mouth. In addition, a small minority of patients simply don’t respond to nitrous oxide. For some, it causes nausea, though this rarely lasts for more than a few hours after the appointment. Conscious Sedation: Conscious sedation involves the use of sedatives to produce a calm, sleepy state without loss of consciousness. Individuals with autism vary widely in how they respond to conscious sedation. And sedatives can have serious side effects. So it’s important to carefully screen patients to rule out respiratory problems, evaluate tonsil size and look for other medical contraindications. If you and your son’s dentist are considering conscious sedation, I recommend having a physician perform a medical exam prior to the dental visit.
You want to ensure that your son is a good candidate. During conscious sedation, an appropriately trained assistant must carefully and continually monitor the patient’s vital signs at all times. Before dental professionals administer sedation, most states require that they complete advanced training and licensing. So ask about your dentist’s qualifications and credentials. Usually the sedative is given as a pill or liquid one hour before the procedure. The most common choices include midazolam (Versed), hydroxyzine pamoate (Vistaril), meperidine (Demerol) or chloral hydrate. In addition, the dentist may want to use stabilization restraints and supplemental oxygen during the procedure. General Anesthesia: General anesthesia, which involves loss of consciousness, is a last choice for those who don’t respond to the above options. It must be administered by a dental or medical anesthesiologist or certified registered nurse anesthetist in a hospital or fully equipped healthcare center.