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Child requires several teeth extracted -what are the options?

aliasojo
Posts: 23,053 Forumite


Dentist referred child (9) to hospital, hospital recommend several teeth to be extracted and say own dentist will do this and the hospital will see again afterwards in a few months time, to fit a type of brace.
Child is terrified at the thought of extraction, but hospital just say a type of gas will be used (child will be awake but 'floating') along with numbing gum injection.
What are the alternatives these days?
Child is terrified at the thought of extraction, but hospital just say a type of gas will be used (child will be awake but 'floating') along with numbing gum injection.
What are the alternatives these days?
Herman - MP for all!

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Comments
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Woa the alternative is to make sure the teeth are cared for in the first place, then there would be no need for extractions.0
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the_devil_made_me_do_it wrote: »Woa the alternative is to make sure the teeth are cared for in the first place, then there would be no need for extractions.
Some of us have medical conditions which cause the teeth to crumble and get infected. You have no idea of the misery involved.
An option is to ask your dentist about is a referral to a specialist dentist dealing with the utterly terrified. My cousin got a referral to one of these NHS specialists and swore by him. They can give special sedation not allowed to be administered by a normal dentist. Personally my dentist teaches at the dental hospital so I wasn't bothered by the pain and just got a special prescription from the doctor for a tranquillizer to be taken on the night before and the morning of the extractions. But then my jaw was broken and extractions on an already broken jaw aren't pleasant.
As to the gas or other sedation. Well the problem is that you don't know how you are going to respond until you've had it once. My mother goes out like a light. I get very relaxed and happy but couldn't have it with all of my extractions due to other medications I was on. Some people however fight it and then it's not effective. Is your dentist a good one? For children they will sometimes take the teeth one or two at a time? It's worth finding out the policy in your practice as dental care varies hugely from area to area.
Personally I would do some research because there are a lot of options out there which just didn't exist even a decade ago. Also if there is an infection involved they sometimes now like to begin treating that even before they do the extractions. Not only is it safer for infection spread it makes it less painful to work on the mouth.
Good luck and keep in mind that once the healing is over with any amount of pain is worth it. I speak here as a woman whose dentist finally agreed to extract all of her remaining teeth as a health hazard. That man made me so darned happy even having to re-break my jaw in three places due to complications. It's really worth while to keep on stressing the end of the pain once the teeth are gone and any infection is dealt with.
Forgot to say. If the 9 year old has ever had any previous sedation or anaesthetic then that will help predict their reaction to the gas. Whether they might be frightened and fight it or have any good memories of other hospital staff putting them under too make it less scary. If there is a history of problems with sedation and that is medically supported then you might find your dentist more than willing to make a re-refferral to a specialist rather than taking a risk with a potentially problematic extraction. It's worth asking your dentist if there are any relevant factors which determine their choice of treatment. So that you can have the information to hand before they see your 9 year old.0 -
Hi aliasojo, it really depends on the reasons for the extractions. If it is for orthodontic reasons then there prob isnt any other option other than what has already been recommended by the hospital. If the teeth require removal due to infection or decay I would have thought that there should be an option for GA extractions. This is certainly the case in Northern Ireland.
Why did your dentist refer to the hospital initially?
The gas you mention is the laughing gas or nitrous oxide which is useful in many circumstances but I find not terribly good if the patient is extremely anxious. Oral sedation is not recommended for children as it can be counterproductive. You need to go back and discuss it with your own dentist as they will know best what services are available in your area.0 -
are these orthodontic extractions? the relative analgesia (i think that's what you mean by the gas) is very effective in this age range of children, it makes you feel like you've had a few pints! It means that the child would be awake and able to communicate with the dentist but care a lot less about what is going on.
IV sedation is not relly used for children this age and the only other alternative is a general anaesthetic which carries it's own risks.
Really a child who is about to undergo orthodontic work should be able to accept simple extractions under local anaesthesia or relative analgesia. If your dentist doesn't offer this then they can be referred to somewhere such as a community dental service who can provide this. Only complex extractions should really be undertaken under a general anaesthetic or at least the child to have tried to have the teeth extracted ubde local/relative analgesia.
hope this helps0 -
oops crossed posts, too slow at typing!!!!!0
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Orthodontic extractions will never be done under a general anaesthetic.
Putting a child to sleep to have teeth out has risks - as mentioned above.
This is acceptable if the teeth are diseased, and the child is in pain, but it is not an acceptable risk just to straighten a kids teeth up a bit.
Local anaesthetic and happy gas should do the job fine, but if it doesn't, then nothing will be lost by waiting for the child to grow up a bit and doing the treatment when they're a bit older.How to find a dentist.
1. Get recommendations from friends/family/neighbours/etc.
2. Once you have a short-list, VISIT the practices - dont just phone. Go on the pretext of getting a Practice Leaflet.
3. Assess the helpfulness of the staff and the level of the facilities.
4. Only book initial appointment when you find a place you are happy with.0 -
the_devil_made_me_do_it wrote: »Woa the alternative is to make sure the teeth are cared for in the first place, then there would be no need for extractions.
Your comment made me angry and I was about to post a reply based on that anger. Fortunately my good common sense kicked in and I will only ask that since you obviously base your advice on kneejerk assumptions, then please dont post on this thread, your advice is embarrassing.Herman - MP for all!0 -
the_devil_made_me_do_it wrote: »Woa the alternative is to make sure the teeth are cared for in the first place, then there would be no need for extractions.
My 13yo daughter has to have teeth removed before she gets her permanant brace. At the moment she has a temporary, removable brace for 9 months to widen her palate, as it's kind of narrow. She has too much teeth for the size of her mouth. Please think before you post.
She was told that normally they don't do extractions under general anaesthetic for cosmetic work, but as she had a fear of the dentist (she used to be terrified, but we now have a super dentist who explains what she's doing - she's even had a small filling without any pain relief! ) we were told she might get them out under general aneasthetic. It depends on how she's feeling. Personally, I think she might manage to get them extracted with local anaesthesia. Her new dentist is that good with her. Our last dentist was horrible with her. He froze her mouth but he called her a big baby for crying, and said she was too old for that, and then refused to finish the job.0 -
Toothsmith wrote: »Orthodontic extractions will never be done under a general anaesthetic.
Putting a child to sleep to have teeth out has risks - as mentioned above.
This is acceptable if the teeth are diseased, and the child is in pain, but it is not an acceptable risk just to straighten a kids teeth up a bit.
Local anaesthetic and happy gas should do the job fine, but if it doesn't, then nothing will be lost by waiting for the child to grow up a bit and doing the treatment when they're a bit older.
Toothsmith, I've quoted you as there are a couple of points I'd like to reply to.
Both my eldest 2 (now 26 and 19) had teeth out for the same reason, under general anaesthetic at the hospital years ago when they were around a similar age. Which is why I was surprised the hospital didn't mention it for the youngest.
Youngest has a double row of front teeth both top and bottom. Her baby teeth show no sign of falling out naturally (although she has lost a couple, it's not enough), her mouth is very small and her second teeth are coming in far too far back behind the front ones and also are coming in very squint as there is just no room for them. She is getting a hard time at school from the other kids because of the state of her mouth and the hospital say it would be better for her to have several removed at this age to make space so that a few years of growth might help before the serious orthodontic work has to start. She wil have to have a type of brace now and also the train track type at around age 13.
Thank you to all for the helpful advice btw.Herman - MP for all!0 -
Chances are the rules probably weren't as strictly adhered to 14ish yrs ago when eldest had it done - also in 1994, GAs were still done in dental practices, so there wasn't as much of a backlog of 'emergency' GAs in the system as there is today, now that they're only allowed in a hospital setting.
Probably the same reason for your 19yr old getting away with it - but that one does surprise me a bit.
Was the necessary orthodontic work quite extreme?? I can't see how just a bog standard 4 adult premolars out would have justified a GA.How to find a dentist.
1. Get recommendations from friends/family/neighbours/etc.
2. Once you have a short-list, VISIT the practices - dont just phone. Go on the pretext of getting a Practice Leaflet.
3. Assess the helpfulness of the staff and the level of the facilities.
4. Only book initial appointment when you find a place you are happy with.0
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