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.