4 year old tooth extraction advice - Mothering Forums

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#1 of 25 Old 07-24-2008, 11:23 PM - Thread Starter
 
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My daughter has to get a tooth extracted next week and it's going to be awful. We don't want to have her sedated. We have found a wonderful dentist who is a homeschooling mother of six and very good with children, but that don't make it a walk in the park!

She said my dd (almost 4 years old) will get wrapped in a papoose thing that holds her arms against her body, and I am supposed to be there to hold her head still for an anticipated twenty minutes of her screaming agonizing screams (this is what the dentist told me to expect). Her mouth will be numb so she won't be in pain, it will just be a traumatic experience. If I can't hold her head still, it will take longer.

So is there anything that will make this better? Or just anyone who survived having their little one go through this?

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#2 of 25 Old 07-25-2008, 01:45 AM
 
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My daughter has to get a tooth extracted next week and it's going to be awful. We don't want to have her sedated. We have found a wonderful dentist who is a homeschooling mother of six and very good with children, but that don't make it a walk in the park!

She said my dd (almost 4 years old) will get wrapped in a papoose thing that holds her arms against her body, and I am supposed to be there to hold her head still for an anticipated twenty minutes of her screaming agonizing screams (this is what the dentist told me to expect). Her mouth will be numb so she won't be in pain, it will just be a traumatic experience. If I can't hold her head still, it will take longer.

So is there anything that will make this better? Or just anyone who survived having their little one go through this?
I hate to say this but thats sounds AWFUL and I would seek a new ped dentist or ask for other options. That will make her have a horrible dental phobia if you do what is said above.

What tooth is this and why is it needed to be pulled?
Can she get nitrous oxide "laughing gas" and her mouth numbed?
My son got pretty looped on the nitrous oxide when he had it.

My son had to get a crown down a few months back and we had about 4 dental visits prior called the "anxiety reduction program" that helped quite a bit. He did not have a local, but did have nitrous oxide. He cried and held my hand, but I never would have held him down and the dentist would have never asked me too.
Bribing him with a trip to the store for a toy after helped. Also, you can tell her the tooth fairy will come that night?
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#3 of 25 Old 07-25-2008, 01:45 AM
 
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Oh goodness- we just went through this today, and while my dd (age 5) is fine and dancing around and just a little sore, I am traumatized. I wish you love and strength to hold her hand lovingly through it and let your child know it will be ok (then quietly freak out on your own later if necessary!).

I am a bit-shellshocked tonight...wish I had more encouragement.
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#4 of 25 Old 07-25-2008, 07:37 AM
 
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She said my dd (almost 4 years old) will get wrapped in a papoose thing that holds her arms against her body, and I am supposed to be there to hold her head still for an anticipated twenty minutes of her screaming agonizing screams (this is what the dentist told me to expect). Her mouth will be numb so she won't be in pain, it will just be a traumatic experience. If I can't hold her head still, it will take longer.
No way. I couldn't do this to my child. A child can remember early experiences and this sounds like enough to scar her for life against wanting to go to a dentist. I just don't agree with it. My children have had various procedures done at the dentist but nothing has ever been put on their body to hold them down or anything.

I can deal with the crying or them getting upset and helping in that manner but I wouldn't allow them to be placed in a jacket to hold their arms like that.

Why is the tooth being removed? Is it something that can wait another year or two? Is this a pediatric dentist? I just removed my children from a pedia dentist last year and moved them to my family dentist when I was told my youngest had 6 cavities!! I took her to our dentist and he said she had zero cavities and her teeth have been fine ever since. Some of these pediatric dentist can go overboard and diagnose things that aren't there.

I'd get a second (or even a third) opinion first if I were you.

I also agree with doing the nitrous oxide as the only option if you do go through with it.

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#5 of 25 Old 07-25-2008, 09:42 AM
 
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You might consider getting a second opinion. My 3 yo son just had his front tooth pulled two weeks ago. He was given the laughing gas and literally laughed throughout the procedure. He had zero pain, zero trauma. I cried, he didn't. We drive two hours to the children's hospital for his dental work. It's worth it.
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#6 of 25 Old 07-27-2008, 11:06 AM - Thread Starter
 
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Thanks for the replies. I need more input on what the alternative is to restraint. I cannot see my dd letting the dentist work in her mouth without interfering, and I don't want her jerking or pulling where there are sharp instruments!!! Also, the dentist said it would take twenty minutes if she was perfectly still but could take longer if she wasn't able to work steadily in her mouth. So, how has it worked for those of you whose little children had work done without restraint?

Babe, how was the procedure done with your dd, if you don't mind going into it. I'm hoping you're feeling much better now that a few days have passed and hope your dd is

My dd has very visible, obvious cavities. I thought I would just scrub her teeth very well twice a day and they wouldn't get worse, then they'd eventually drop out. So I think this is my fault for not getting it taken care of earlier. She is experiencing pain due to an infection due to the extremely rotten state of her molar. I don't remember the official terms. I think she has an abscess in her mouth that we are giving her antibiotics for prior to having the tooth pulled. The other cavities are not so extreme and will be filled.

I am strongly against putting drugs in dd's body, so it is hard for me to weigh the trauma of restraint against the trauma of sedation, which is the other option we are considering.

And since the dentist said there would not be pain after the local anesthetic, I keep hoping that I'll just explain to dd that she'll be wrapped up in this blanket to keep her still, that I'll be holding her head still so the dentist can work, and that it will be over soon and it wont be a big deal. But, since the dentist promised me that she would scream anyway, I'm guessing the dentist is right. I hate this!

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#7 of 25 Old 07-27-2008, 12:03 PM
 
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Seems to me it just takes a minute to pop out a tooth, after the novacaine kicks in (basing this on having my wisdom teeth out). My ds would be screaming because he was confined as much as anything else. He'd likely be more traumatized from being held down than anything else. I RAN from the dentist that was going to do ds' 10 fillings in a papoose.

I found a good pediatric dentist who tried doing them one section of his mouth at a time with an oral sedative. Now fillings take a lot longer than a simple extraction. We did end up doing the work under GA because the oral sedative made ds cranky and he was only 3. The oral sedative basically had the effect of making ds feel drunk, plus it tasted extremely bitter. I actually think he would probably have done better without it.

If the dentist just gets in your dd's mouth long enough to give her novocaine and if your dd lets her back in after feeling that "pinch", it should just be a minute or two to get the tooth out. The risk is that your dd won't open her mouth again after the novacaine. Sounds like your dentist is planning on keeping her papoosed the entire time it takes for the novacaine to take effect, not just the couple minutes when she actually has to do something to her. Neither ds nor I have had "laughing" gas but if that makes her relaxed, it could be a good option.

Ds' dentist's office has video games in the waiting room and tvs in the exam rooms which help keep the kids distracted. That can help a lot, too. The dentist also had a jocular manner and joked with ds and put him at ease.

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#8 of 25 Old 07-27-2008, 12:31 PM
 
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Thanks for the replies. I need more input on what the alternative is to restraint. I cannot see my dd letting the dentist work in her mouth without interfering, and I don't want her jerking or pulling where there are sharp instruments!!! Also, the dentist said it would take twenty minutes if she was perfectly still but could take longer if she wasn't able to work steadily in her mouth. So, how has it worked for those of you whose little children had work done without restraint?
Where my son goes the child either has to agree (be compliant) to have the work done or they will not do it. They have a "no fear" practice.
To me this ped dentist you are seeing is old school, and this is why so many adults are afraid of the dentist. If she has more procedures needing done, I do not think you will EVER be able to get her back in the dentist chair.. Would you?



I am so sorry you are going through this. But, I would get a second opinion or tell your DD dentist you do not want to use the restraints. At my son's dentist I can lie down with him, or sit with him. You could always "help" her keep her hands down?
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#9 of 25 Old 07-27-2008, 01:01 PM
 
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My son had to have cavities filled and a tooth pulled at 18 months.
We chose the oral sedation and it was the right choice for us.
(we were told that a child has to be somewhat compliant for the gas to work, if he was fighting it or not breathing through his nose it would not be effective.)

He was given a small amount of liquid about a half hour before the work. When we got back they put him in the papoose and put the gas on him also.

I understand a lot of the comments about the papoose and I agree to an extent. Yes, it's horrible and any mother is tortured by the thought of strapping down a child and traumatizing them but, you have to know that those of us that did use it weighed the risks and benefits and know that the procedures our children had to endure were unfortunately very neccesary and I agree that for his saftey he had to be restrained while they were working in his mouth with dangerous instruments.

All of the work took about 40 minutes and he was very out of it. he moaned a little but did not freak out at all. After the work was finished he nursed to sleep and woke up 2 hours later (normal nap for him) perfectly fine. I believe he does not have memories of the procedure. (part of the sedation medication is a retro-active amenesiac.)

I know you said sedation was not a route you wanted to go with, but you may want to look into the conscious sedation we used. I believe it made all the difference for us. It's so hard to make the best choices for their health while knowing it's going to hurt them too.

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#10 of 25 Old 07-27-2008, 06:27 PM
 
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I know you said sedation was not a route you wanted to go with, but you may want to look into the conscious sedation we used. I believe it made all the difference for us. It's so hard to make the best choices for their health while knowing it's going to hurt them too.
When I had my wisdom teeth out, sedation helped so much. Before I took the medication I was pretty scared, and after it took effect I was calm and totally fine with what was happening. I can't imagine having had it done without it. Not using anything could be very traumatic for your kid.

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#11 of 25 Old 07-27-2008, 07:15 PM
 
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I understand a lot of the comments about the papoose and I agree to an extent. Yes, it's horrible and any mother is tortured by the thought of strapping down a child and traumatizing them but, you have to know that those of us that did use it weighed the risks and benefits and know that the procedures our children had to endure were unfortunately very neccesary and I agree that for his saftey he had to be restrained while they were working in his mouth with dangerous instruments.

.
I agree that a restraining a child may be okay under sedation.
But I do not think it is at all okay when they are not. I can not imagine what they child would be thinking about the dentist or there parents "watching" them be in there minds "tortured". I think my son would lose trust with me and he would never walk back in the dentist again.

I think the OP needs to think about the dentist long term, not just now. I know meds are not what you want to do, I completely understand that, but your child is going to be very stressed and her thoughts of the dentist will be of this visit forever. Kids do not just forget.
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#12 of 25 Old 07-27-2008, 07:22 PM
 
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I am sorry she has to go through this. If it were my child I would sedate her. Just because I had a extremely traumatic dentist experience when I was a kid and now just thinking about the dentist puts me into a panic attack. I would rather go in for surgery,having millions of babies, anything but ever go to the dentist.

Sorry that is all i have to offer I hope you can cope with the situation no matter what you do.

Good luck.

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#13 of 25 Old 07-27-2008, 07:24 PM
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Please consider some type of sedation for this procedure. Nitrous Oxide wears off really quickly and makes these uncomfortable trips really easy on the child. I would do that a million times before "papoosing" a child while they screamed through a procedure.
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#14 of 25 Old 07-27-2008, 07:48 PM
 
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All of the work took about 40 minutes and he was very out of it. he moaned a little but did not freak out at all. After the work was finished he nursed to sleep and woke up 2 hours later (normal nap for him) perfectly fine. I believe he does not have memories of the procedure. (part of the sedation medication is a retro-active amenesiac.)
Boy am I jealous. My daughter had a badly damaged tooth pulled at 16 months, and while the oral sedative did make her dopey and goofy initially, so she thought getting strapped into the papoose board was funny, as soon as the dentist gave her the novocane shot she started screaming (I guess she feels needles the way I do). She didn't stop screaming until a while after the dentist was done, when she fell asleep. And the "amnesia" effect was highly over-rated judging by her reaction the next time she woke up in a carseat (a month later). In retrospect I think she would have been better off skipping the sedative, since it required fasting, and the low blood sugar made everything so much worse, and being hungry and feeling really weird from the sedative did a lot to upset her. Unfortunately there's no way to know how a kid will react until it's all done. The children's hospital where she had the work done is rather insistent that you drive the kid home afterwards, not take the bus. I ignored that rule, strapped her to my chest and took the bus home anyway, it's the one descision that I wouldn't change if I could do it again.
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#15 of 25 Old 07-29-2008, 12:55 PM
 
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Did you get a second opinion?
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#16 of 25 Old 07-30-2008, 02:55 AM
 
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IMO, you are doing the right thing by going ahead with the extraction.
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Please consider some type of sedation for this procedure. Nitrous Oxide wears off really quickly and makes these uncomfortable trips really easy on the child. I would do that a million times before "papoosing" a child while they screamed through a procedure.
: I would tend to agree with the above. Also, really, really try to control your own anxiety before going. Experienced dentists constantly see that the parents' fear sets the child up for a difficult experience. IMO, the papoose does have a place to ensure that the child does not hurt himself or the dentist, but it's not the ideal option for a child of that age.

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#17 of 25 Old 08-02-2008, 10:10 AM - Thread Starter
 
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Thanks for all the replies, experiences, insight and support, all!

We are going for the extraction next Thursday. DD and I have decided on the papoose route and have been practicing rolling each other up in a sheet with our arms pinned down. She knows what the papoose is for. I told her that the Novocaine shot will hurt but then it will make it so her mouth doesn't feel anything so it wont hurt anymore. I don't think I've given her the impression that she should be scared or worried and she does not seem scared or worried. She knows the tooth is going to be pulled out so it wont ever hurt her again and she is glad.

I am feeling much more peaceful about this now. I'll plan to post an update after it happens so anyone else who might have to do it can benefit from my experience just as I have all of yours.

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#18 of 25 Old 08-07-2008, 09:23 PM - Thread Starter
 
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We got the tooth extracted today and I'm so glad it's over! DD is totally recovered. She was very willing and eager to go, but when things started getting stuck into her mouth she started resisting and resisted to the end. Luckily it did not take long.

The one thing I would do differently is make sure she got to see all the tools and tell her what they are for ahead of time while things are still fun and pleasant! She was freaked out by the vacuum one, for example.

It happened at 4 this afternoon and by the time we got home she was speaking happily about the dentist pulling her tooth out, and the fact that she has nineteen teeth in her mouth now and she has put the extracted tooth under her pillow. She plans to make a wish but hasn't yet.

Thanks, all.

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#19 of 25 Old 08-07-2008, 09:44 PM
 
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Wow, I am glad it went okay for your daughter.
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#20 of 25 Old 08-08-2008, 05:15 PM
 
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My doctor never did that. There are other options, such as IV sedation. Ask for a second opinion, that sounds awful. Also, read "Cure Tooth Decay" for an alternative.

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#21 of 25 Old 08-08-2008, 05:28 PM
 
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Thanks from me, for this thread. My baby is going to need work done, esp on a back baby molar. I'm terrified. It all happens in September. It doesn't help that I'm certifiably phobic....sigh.

Our plan for now for him is the N2O. I hope he doesn't need full on sedation, as my next immediate fear will be, and is, that he is a red head (read up on red heads and sedation of you don't "get" my sentence there).

I don't want this for him. I'm pissed at myself for nursing him til almost age three, as his low tone and milk mouth (not the good, white teeth milk mouth, but the acutual pooling of milk sitting on the gumline for hours milk mouth) is the reason.

I always thought breast was best. Now I still believe that, but w/a caveat.

**sigh**
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#22 of 25 Old 08-09-2008, 08:07 AM
 
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First off, I am glad your daughter is doing well.

For you, Sojourn, please don't beat yourself up about your baby's teeth.
My husband is a maxillary surgeon so he sees kids from time to time, although not often for "routine" issues. What they do at his hospital is that they show the kids and their parents around to give them a semblance of familiarity. The kids may hold a few instruments (nothing sharp, of course) and skip the light on and off a few times, hold the vacuum in mama's mouth etc. If the kid is very afraid of being restrained (or if it is not a necessity), they let the father or mother lay down on the dentists chair and hold the kid in their lap. (With one hand you hold your baby's head). This works great not only for examination but also for small procedures, or so he tells me.

Extracting a molar should only take a few minutes/seconds and if you are lucky there will be next to no bleeding. The problem is that you have to apply a little pressure to get it out in one smooth move, this works better if the child's head doesn't move.
Talk to your dentist about all the possibilities and different kinds of anaesthetics, this will hopefully put your mind more at ease. As a previous poster said, if the mother is calm and confident about the procedure (as much as this is possible- I feel you there) this will transfere to the child.
I wish you all the best!
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#23 of 25 Old 08-09-2008, 12:47 PM
 
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Adasmommy, I'm glad it went well and that it's done.

Sojourn, don't blame yourself, breast is best for his over-all health. Bad teeth are as much a result of genetics, and luck (which strain of bacteria you get colonised with) as diet, and breastmilk is a lot less cavity promoting than most things you could give him.
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#24 of 25 Old 09-03-2008, 05:20 PM
 
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I'm glad I found this thread! Not that I want any of our kiddies to have dental issues, but it's nice to know it can work out. Due to a med I took during pregnancy for a UTI dd's teeth have some issues. We've been "waiting and seeing", but over the weekend she began comlaining of pain and after a visit to our ped dentist this morning she had an infection. She has some antibiotics to take this week and the molar will come out next wed. She is 4.5yrs. The plan is to do gas (she took home a little nose cup to practice breathing through it) and then novicaine and she said the extraction will take 5min once all is set up. I am such a freak about anything entering my child's system, and I have this irrational fear that she will have a bad reaction. However, that's "my thing" and I am really trying not to pass that along to her. I'm sure tons of kids get the gas and local every day and are fine! Thankfully, dh is on this one and he will take her next week.

I'm hoping it goes well b/c there's more work to be done.

To the op, I'm really glad it went well for your child!

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#25 of 25 Old 09-05-2008, 05:23 PM
 
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OP, so did it actually take the 20 minutes they estimated????


leafwood, FWIW, my son had two teeth extracted when he was about 2.5, and it was a walk in the park. He had seen the dentist two times before (one to meet, one to have a cavity drilled and filled with NO medication), and liked him so much it wasn't a problem. They even have TVs in the ceiling, and play movies all day (Finding Nemo was what DS watched for about 10 minutes). There was no papoose, no sedation, no nothing but a little bit of lidocaine, and the pulling, and it was done. They weren't molars, but they were crumbly and disintegrating, so not "easy" for the dentist to do.

DS's dentist starts off with nothing (no medication or restraints), and they will escalate slowly as each child and each situation needs. So I just don't see the need to start with thoughts like the sedation and such!

DS continues to see the same dentist, and absolutely loves being there....asks every time we drive by if he can have an appointment, and he's over 4 now...
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