Each patient is scheduled for at least two appointments. The first visit is a consultation to review health history, determine the need for general anesthesia and to order the appropriate pre-operative tests. The second visit is for comprehensive oral rehabilitation. Additional visits may be needed if the patient requires a significant amount of dentistry.

Although the focus is to provide comprehensive dental treatment, it is important to understand that general anesthesia has an effect on the entire body and our goal is to provide SAFE quality care under a strictly controlled environment. We only request documents or tests we feel will properly prepare us to meet the needs of the patient. All consents must be signed by a legal guardian.

We take several precautions to ensure each visit is a success. Each patient is provided with an instruction packet to help them in preparing for the appointment.

Most importantly are the NPO (nothing by mouth) instructions. Patients may not have anything to eat or drink after midnight the night before the appointment and nothing to eat or drink on the day of surgery. These restrictions are to ensure the patient does not inhale food into their lungs during surgery. If this occurs, the patient is at risk for developing pneumonia which could be life threatening. If NPO instructions are not followed the appointment will be rescheduled.

For patients who are taking medication(s), our staff nurses will tell the caregivers which medication(s) may be taken at any time before surgery with a sip of water or an equivalent amount of Jell-O. Absolutely NO PUDDING, APPLESAUCE, THICKENERS OR ORANGE JUICE are to be administered to the patient prior to their dental visit.

It is also important to ensure that the patient is accompanied by a responsible adult on the day of surgery. The accompanying adult will be required to stay in our office for the duration of the visit. This allows the doctor to discuss any unexpected changes in the dental surgery and/or the patient's medical status.

Please see the "Instructions for Dental Treatment under General Anesthesia" form for additional instructions.

Individuals with special needs often have trouble in the dental office due to physical limitations or aggressive behavior. We use pre-sedation and general anesthesia to manage disruptive behavior and to protect our clients from injuring themselves or the staff. At Special Smiles, Ltd our attending dentist and anesthesiologist will determine the patient's need for pre-sedation based on medical and behavioral history.

There are several different types of anesthesia used in dental treatment. The most common types used at Special Smiles, Ltd are local anesthesia, general anesthesia and pre-sedation.

Local Anesthesia provides numbness to a small area of the body and it is often used at Special Smiles, Ltd to numb the areas surrounding the tooth prior to an extraction or other invasive procedure.

General Anesthesia involves a loss of awareness and it helps to reduce pain sensation. It is used most often at Special Smiles, Ltd for dental treatment and is only administered by an anesthesiologist or a certified registered nurse anesthetist.

Pre-sedation is used to aid in calming patients who become anxious at the dentist. Often times it is prescribed by the patient's primary physician but it may also be given by our anesthesiologist prior to dental treatment.

In the operating room, each patient's respiratory and cardiovascular function is monitored using standard monitoring equipment and their clinical condition is continuously assessed by our anesthesia team. Following the completion of surgery, the patient is safely transported to the post anesthesia care room for recovery. While in the recovery room, the patient's vital signs are monitored and recorded by the recovery room nurse.

All types of anesthesia and surgeries have some risks. The risks are usually determined by the patient's health history and the difficulty of the procedure. Fortunately, serious complications are rare and obtaining a complete medical history in advance helps us to lower your risks. In the rare instances when complications arise we are fully equipped with emergency monitoring devices including a defibrillator and emergency drugs. Our clinical staff is trained in advance and basic life support. Our office staff is trained in basic life support. We also have the support of Temple University's Health System - Episcopal Division emergency department as well as their emergency preparedness team.

*Special Smiles, Ltd is a licensed tenant at Temple University Hospital – Episcopal Division and no services are being provided by Temple University Hospital - Episcopal Division.

Following dental surgery each patient is transported to the recovery area where they are monitored by our nursing staff. We provide one-on-one nursing care for the duration of recovery which lasts approximately 30 minutes or until the patient returns to their baseline. Once the patient is stable, instructions are given and the patient is discharged home.

Anesthetic drugs affect each patient differently. It is not unusual for stable patients to experience behavioral changes following general anesthesia. The most common after effects include nausea, vomiting, dizziness, drowsiness and a loss of coordination that may last up to 24 hours following the procedure. It is important to ensure each patient is accompanied by a responsible adult during this time frame and that the proper safety precautions are followed.

If there are any questions or concerns about dental treatment or post-operative care you may contact our office or the on-call service for assistance.

Special Smiles, Ltd participates with insurance companies in Pennsylvania and New Jersey, as follows. PENNSYLVANIA: Access, United Healthcare Community Plan, Keystone First, Keystone CHC, Amerihealth Caritas, and UPMC CHC. NEW JERSEY: NJ Medicaid insurance plans including Horizon NJ, United HealthCare, New Jersey FamilyCare, and Liberty Dental. Providing us with the most up to date insurance information will ensure the patient receives treatment without any delays. For your convenience, our office will file all claims with all insurance providers listed above. Special Smiles, Ltd does not participate with any other insurance providers but we will be happy to assist you in filing a claim with a secondary plan or to assist you in seeking authorization for treatment from a non-participating insurance provider.

For patients who have little or no insurance coverage, payment arrangements can be made.