So, my 6 yo and I walked into a pediatric dentist office yesterday after a lovely consult last week that I felt so positive about. He was to get this pulpotomy procedure on his upper right molar and a small cavity filled on the one behind it. Two weeks ago, he got 6 cavities filled at our regular dentist and although it took forever (nearly two hrs in the chair) and it felt traumatic b/c of the length of keeping his mouth open, he didn't cry but a tear. He walked into this new office yesterday totally fine, not worried or complaining at all. Well, it ended in disaster and major trauma. They did some procedural stuff differently from the get go which I wasn't sure would be more helpful or not - such as using nitrous mask and keeping his mouth open VERY WIDE with a metal crank thing. He started looking nervous, chest rising quickly just from those things, then a little tear from the needles, but kept it in check. Then when she started drilling into the badly decayed hole in his molar needing the pulp, he basically started moaning and wailing loudly. I asked her to stop b/c within maybe 20 seconds, he was screaming 'it hurts!' She gave him another shot and a min to try to calm down/let it take more effect. He couldn't calm down. "I wanna go home, mommy!" Screaming hysterical. I asked her, "Is it possible that he WAS feeling it in the nerve?" She said, what I know is that he is profoundly numb in the area (Meds were at max for weight - although I wonder if some more time to let the meds soak in would have been better which is what the other office did) BUT she cont'd to say that the decay is deep and it's possible there is inflammation (like pre-absess) already in the root and that yes, it is possible he is feeling it. So, we agreed on a few min alone and got him distracted with a movie, and tried again although he was already extremely fearful and jumpy bf she even touched him. Same thing. The nurse tried holding his arms down with him screaming and choking on his extra saliva from crying and I said forget it, there is no way to know what he is feeling, and I have to believe him. She said, 'ok, I agree, let's give him the benefit of the doubt." She filled it temporarily with zinc oxide but said we need it fixed very soon and our options are: 1) to be done under GA but it could still absess later and need to be extracted if this is the case, or 2) to just put him through at least 5-10 more min of this 'sensitivity' but yet it could still absess, OR 3) pull the tooth in the office with local still (might cause same reaction to the pain and will be very hard to watch b/c of that and ALOT of blood), or 4) do extraction under GA. So, we're going back on Friday to try and just do the small cavity next to it and see how he reacts to that as a baseline bf trying to go into the pulp of the bad one. So far my other ideas to try again bf jumping to extraction or general anesthesia: ask about other sedation like valium?, NO nitrous (although I understand why its used, it only seemed to make him more nervous and not relaxed), NO clamp or less wide (he said that part hurt his jaw), leave both the gum numbing med on longer and the novacaine soak in longer, bribe him with ice cream before and after?, a promise of a movie out with mom after maybe too?, Please, anything else? I am one stressed mom right now. I do not want to put my child in agony but I also cannot opt risking his life with GA either. I'm scared. I wish I KNEW what he was feeling. He did so well at the other office, this was total opposite. I never saw him this upset except this summer when he was stung multiple times by wasps nest. Taking blood he cried and tried to pull back, but I KNEW what that was like...I don't know if what he's experiencing is normal discomfort or just fear vs. agony, yk? Please help.
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11/6/12 at 7:12am