Tooth extraction: 9 tips to prepare your child
We were camping in Pembrokeshire earlier this year when I noticed Libby had an abscess on her gum. It was caused by a bump she’d had a couple of years before that led to the teeth becoming infected. Several dental appointments and one more abscess later, she needed to have both of her top, front teeth removed. Mercifully, the dentist was amazing and it all went swimmingly well. These are our tips for preparing a child for tooth extraction.
1. Which anaesthetic is the best option for tooth extraction?
When we took Libby to our local dentist, he referred her straight to Birmingham Children’s Hospital to have the teeth removed under a general anaesthetic. Libby had an eye operation under a general anaesthetic years ago. So, I know she recovers well from it. But I also know that it is a pretty horrendous experience for all concerned.
Some weeks after seeing the dentist, I received a letter from the local NHS dental clinic. We use the NHS dentist for Libby, but the dental clinic is a larger facility that is presumably more able to cope with extractions for children. At our appointment with them, we discussed the options.
Sedation is an option for most children. But strangely, it wasn’t thought to be appropriate for Libby due to her eye operation. The other suggestion was to wait for a general anaesthetic. At the time, we thought she only needed one tooth removed so the dentist said it would be better to try to do it under local anaesthetic at the clinic. She said that if Libby needed two teeth removed, she would have suggested waiting for a general anaesthetic but that she’d try doing one under a local.
Our decision to have two teeth removed under local anaesthetic
Fast forward a few weeks, and an abscess appeared on the other tooth. Naturally, I thought she would need a general anaesthetic, so I phoned the dentist and started looking into paying for it to be done privately. But the dentist said that she’d try to do both at the same time, under a local anaesthetic.
This was a huge decision for me. Was it the right thing to do to put her through this when I could pay for her to have a general anaesthetic if we did it privately? But then I thought of how poorly a general can make you. I remembered how kind the dentist had been and that she’d said if Libby couldn’t cope with it, she’d stop. Add to that the fact that they were able to bring her appointment forward, and I knew we had to go with the dentist’s advice.
Whilst this was the right decision for us, only you know your child and how resilient they are. Had it been Lia, I may have made a different decision. She gets upset a lot more easily and may not have coped with what Libby went through.
2. Involve your child in the decision
I appreciate that at six, Libby doesn’t have the capacity or the knowledge to make a decision like this herself. But, she is capable of having some input. If she had been horrified at the idea of having her teeth out while she was awake, I would have been much more inclined to go for the general anaesthetic.
Remember that it is your child’s body and they may have strong feelings on what happens. They may worry about their big teeth being damaged and want to get the operation out of the way. Or, they may have the option of waiting for the teeth to fall out naturally. Without having that conversation with them, you won’t know their preference or be able to take their wishes into account.
3. Tooth extraction: focus on the positive
It may seem like there aren’t many positives to someone pulling your teeth out when you’re awake. But in the mind of a six year old, there’s one very big consideration – the tooth fairy.
Whilst Libby was nervous about the extraction, she was also excited at the prospect of the tooth fairy bringing her a coin. So when a second tooth had to come out, her thoughts on the matter involved another coin from the tooth fairy. Right up until we went into the dentist’s room, we were chatting about the tooth fairy and how lucky she was that she’d get two coins on the same night. It meant that was her focus, rather than the horror of having her teeth out.
4. Give your child information about tooth extraction
Before the extraction, Libby was really excited at the prospect of being able to put her teeth under her pillow for the tooth fairy. She has only lost one tooth naturally, and she swallowed it. We wrote a note to explain her predicament, but she was still disappointed.
Unfortunately, it wasn’t until after the teeth had been pulled out that I realised Libby wasn’t allowed to keep them. The dentist started explaining that it’s due to ‘cross-contamination’ but I cut across her and told Lib that they had to give the teeth straight to the tooth fairy to make sure she got them. The dentist gave her a special tooth fairy envelope which was a nice touch. Libby was fine with the explanation, but I wished I’d been able to tell her beforehand what would happen.
5. Take a favourite toy with you
As we left the house to go to the dentist, I had a somewhat inspired idea. When Libby had her general anaesthetic, they’d told us to take a favourite toy that could be there when she woke up. It seemed to work really well, because she wasn’t at all distressed when she came round. So this time, I knew it was sensible to take the toy again. She held it throughout the procedure. At the end, Libby told me that she was glad the toy had been there with her.
6. Listen to some music during tooth removal
We were really lucky that the dentist and dental nurse did everything they could to put Libby at ease. This included putting on some music to distract her slightly from the noisy instruments. When I mentioned about Libby’s tooth extraction last week, my friend Mel commented that she’d listened to music when she had teeth out. It’s not something I’d thought of, but it does seem a sensible option to take the child’s favourite soundtrack.
7. Keep them away from drama llamas
Tooth extraction isn’t a nice experience and there will be a lot of people who had it done and hated it. But the last thing you want is for a child to hear that before it happens. It will frighten them and make the whole ordeal more traumatic. If you know a drama llama who had their teeth extracted and it was the worst experience of their lives and they’d rather die than go through it again, steer clear until it’s over.
8. Talk to people who have been through tooth extraction
Contrary to the above, it’s useful to talk to people who aren’t drama llamas. I mentioned to my sister that Libby was having teeth out, and she breezily mentioned that she’d had four teeth taken out. It wasn’t an issue, she didn’t make it out to be an ordeal and told Libby she’d be fine. Naturally, this was a lot more reassuring that talking to me as I’ve never had a tooth removed.
I didn’t find a lot of advice out there about tooth extractions beyond what the dentist could tell us. My experience of this is limited to a local anaesthetic for a very confident child. It would be great if you could leave any tips you have if you’ve supported a child through this or been through it yourself. Hopefully, your experience will help someone else. Feel free to ask questions too, I’ll answer if it’s something I can help with or if not, I can share it on social media to see if anyone else has experience.
My five year old is waiting for her tooth removed. She too had an abscess while on holiday in May caused by her grinding her teeth, she got referred to the the dental hospital who wanted to remove under general but we refused as she is high risk. We are waiting for an appointment for removal under local so this is so reassuring as I was a bit worried about it. Xx
Oh I’m so glad you found it helpful. It’s such a worry for us as parents isn’t it? I was so impressed with how she took it in her stride. I do hope things go well for your little one.
Nat.x
Our eldest had to have 10 taken out a little while back due to mum having taken antibiotics whilst pregnant which affected the teeth growing – She was such a little trooper throughout the whole process but both her mum and me found the whole thing utterly grim.
Oh my goodness what a traumatic experience for her. And I had no idea that antibiotics during pregnancy could cause an issue with teeth. My littlest has a problem with one of her teeth where the enamel hasn’t developed properly and it makes me wonder what caused it. Well done to your daughter for being such a star. I agree with you though, it’s horrible to see them going through that.
Nat.x
Hi Nat – its surprising how brave kids can be eh – Now she has a broken arm from PE…first week of big school and hey presto – off to the fracture clinic….again
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Oh no! I hope she recovers quickly.
Nat.x
What a fantastic post and I agree with a lot of it. When I had my wisdom teeth removed, I clearly remember Katy Perry’s Roar on the radio, which is a song which is particularly special to me. It was a coincidence that it was on, but it helped!
Two of my kids have had teeth extractions, but both were emergencies, so we didn’t have time to prepare. My son had his taken out under general anaesthetic at the hospital as they were half hanging out and had to be removed. My daughter had hers done under local anaesthetic at the dentist as she had a big tooth growing over a baby tooth. We’d expected that we would have to return at a later date for the extraction, but had it done there and then! She hated the whole experience, but bizarrely said that the dentist who did it was her favourite dentist because he was so nice to her when he did it!
Ahh bless, lovely that the dentist was so nice about the extraction that she still liked him even though he did it! I sort of wished they’d just done Lib’s tooth then and there at the dentist because it wouldn’t have time to build up in her mind.
Nat.x
Oh my goodness you poor things. You must’ve been so worried. I had one out not long ago and it was so bad I think I’d have a GA next time. What a little trouper she is
Oh gosh I’m sorry you had a bad experience. Libby coped well with it but I do hope it doesn’t put her off the dentist.
Nat.x
Thank you so much for the advice… it is calming my mama nerves as we get ready for our appointment in an hour! We have done GA for other surgeries and that didn’t scare me like this… anyways back to strong and clam mom duty!
Oh gosh I really feel for you, I’m sure it’s much tougher on us than them, they seem to bounce back so quickly! I do hope all went well.
Nat.x
It’s not just the noise of the dental instruments that can be unsettling for the kids, it’s also the vibration and having new sensations in their mouth that they aren’t accustomed to (and add to that any additional pain/sensitivity from the abscess). Finding a paediatric dentist who takes their time and speaks both to you and directly to your child is key. My child’s first dentist wasn’t a paediatric dentist and was always, always in a rush so that was a terrible experience. I think the anxiety is definitely worse for us parents (kids live in the moment) so I’ve had to be mindful of my anxiety level in the days preceding my child’s dental appointments when we had to have one of his teeth extracted, a filling done and silver caps put on. If I didn’t process that anxiety beforehand I wouldn’t have been able to support my child and project any calm or confidence which would have sent him into a cloud of worry.
Lots of good advice, thank you. I don’t think the one that did Libby’s was a paediatric dentist but she was actually really fabulous with Lib so we definitely lucked in!
Nat.x
I hope all went well! x
Thank you, we were lucky and it really did go well.
Nat.x
My son (5) has weak teeth and we don’t know why. He has a cap on one, and has done for 1.5 years. Yesterday an abscess developed on it and he now has to have it removed under GA. I’m nervous about GA as I’ve been fortunate to never have one and neither has he. I wish it could be done before school starts (Scotland) but it seems unlikely. Do you have any advice regarding GA and how long he will be off for, if as I expect he is at school.
Oh bless him, I do home they manage to fit him in quickly. We thought Lib would have to be done under GA but we were lucky that they were able to fit her in quicker under local and she was fine with it. Lib had a GA for something else when she’d only just turned two. She had an operation to correct a squint in both eyes so I would imagine that would take as long if not a little longer than a tooth removal. She went in first thing in the morning and we were home by lunchtime. She didn’t really seem to have an adverse reaction to the anaesthetic at all. If she’d been at school back then, she would have been back the next day because she bounced back really quickly. I know others struggle a little more with it though, some are very upset when they come round. We were warned that she could be angry and screaming when she came round because of the effect of the GA. Actually she was the opposite. A little sleepy and but not upset at all. The only time she cried was when she was told she couldn’t have another yoghurt because she’d been nil by mouth before the op and was hungry! I certainly wouldn’t worry about your little boy missing too much school, he will be fine after a day or two. I do hope all goes well.
Nat.x
Thank you for that. I think I’m most worried about the GA and just want it to be done quick as I get awful anxiety if it’s a drawn out process. One of the P1 mums is a nurse at the children’s ward and said tooth extraction is done on a Friday so that’s made me feel happier if it’s after school starts as he should only miss the one day to have the procedure. We just found out on Friday he has an astigmatism right eye with a “twitch” (lazy eye) and his eyesight is very poor. He’s never complained of anything, obviously that’s his normal. The orthoptists here go to the local pre-schools to test children and that’s how it was caught – not been a good few days. The dentist yesterday advised me to call consistently to ask for a cancellation so fingers crossed I’m successful. Thank you again for replying to me. X
Oh bless him, sounds like you’re going through very similar things to what we went through. If it’s any comfort with the eyesight, I noticed a HUGE improvement in Lib’s schoolwork when she ended up with the correct prescription. Her reading suddenly just clicked, it’s a real game changer. With the operation, the worst time is when they’re actually under GA and you’re waiting for them to come round. Just be aware it can take a while for them to actually come round and don’t panic. I do hope all goes well.
Nat.x
Watching him get so frustrated at not being able to see during the test clicked with me. It seemed to explain quite a lot of the more challenging times we’ve had recently. I definitely think this will be the best for him and couldn’t have come at a better time, so he’s used to his glasses ready to start P1. Thanks for you help and reassurance. X
Bless him, it’s frustrating for us as parents too isn’t it? I do hope things fall into place for him now.
Nat.x
My 6 yo needs 2 or 3 of his teeth extracted. He is so scared- our family NHS dentist just showed a needle once to put on a cap. He refused. We found a great private paediatric dentist, but she can’t do extraction.
GA at hospital is our only option. Any advice how we can talk him through it, what happens, how he will feel. He says he doesn’t want to be ‚put to sleep‘. I fear that once we get appt, he won’t allow GA to happen.
Oh bless him, it’s so difficult when they’re little isn’t it? My daughter had GA when she was 2 and it was completely fine, it was like blowing into a balloon to initially get her to fall asleep. It may well be worth you chatting to the department that will be doing it and explaining his worries, they’ll probably tell you what will happen and it might make him feel a bit better. I wonder whether ‘helping you to go to sleep’ may be a better way to word it rather than being ‘put to sleep’? I know my girls associate being ‘put to sleep’ with sick pets being put to sleep when they die so that could cause some confusion? I hope you manage to allay his fears.
Nat.x
I am glad to see that you are still responding to this post. My 4 year old will be having a procedure in 2weeks to remove a molar and 4 top front teeth. I know this isn’t going to go well and I am at a loss as to how to explain this to him.
Oh bless him, it’s so difficult when they’re little isn’t it? On the plus side, they heal so quickly and for us, it really wasn’t as bad as I thought it would be. We just explained that it needed to be done and having it done would make her big teeth nicer which she understood. She coped so well with the whole thing. She still fondly remembers being allowed scrambled egg to eat without any bread or toast but doesn’t seem at all traumatised by the memory of the teeth being removed! She also has beautiful, straight big teeth now and I’m sure it has something to do with the fact that her baby teeth were out of the way before the big teeth had to try to push past them. I do hope it all goes well for your little one too.
Nat.x
Hello, I am ready your article, and by the way is so helpful. My 8 year old need to have two tooth removed, and I am worry; I will opt for local anesthesia for sure and I hope in YHWH my LORD everything goes well in Jesus Christ name .Thank you for the information . I Glad everything went well with your Beautiful daughter. Blessings!!
Thank you, I do hope all goes well for your daughter.