Should I lie to my kid about the dentist?

[CaseyCassum]

Don't eat me alive, please. I just have a question.
My son is 14 and deathly afraid of the dentist. Always has been.
Whenever he was younger, the methods the dentist used to force compliance of children in the denstist's chair were (by today's standards) pretty barbaric.
If a child would fight the dentist and refuse to settle, it was standard practice to strap the child down using a weighted blanket and straps, and then usher the parents out of the room to do the dental work... This happened to my son and I went along with it because I knew no better at the time.

Of course these days I'd never go along with something like that and I'm pretty sure dentists don't even do that sort of thing anymore but that's beside the point.

Well, now my son's capped baby tooth is retained and needs to come out. It's not unusual that baby teeth that are capped in silver need to be extracted, the only problem is my son is beside himself at the thought of the dentist's needle.
A few days ago the dentist told him to wiggle wiggle wiggle! That the tooth needed to be out by his next visit in 6 weeks, or she would have to pull it.

My son is so desperately afraid of the dental needle to numb the gum he is digging and gouging at his baby tooth and it is not budging.
The gum is becoming infected because he is scraping and tearing at it, and his bathroom sink is looking like something from a horror movie.

IV sedation (where an oral surgeon and an anesthesiologist put a patient under) is not possible because he had it two years ago to remove another retained baby tooth and he had a bad reaction necessitating the assistance of paramedics because the anesthesiologist couldn't roust him after he went under... Not doing that again.

I've tried explaining to him that the pain he is causing his mouth right now is alot worse than what the needle stick will feel like but he is having none of it.

For two days he's come to me crying and shaking for hours on end. He's digging in his mouth and gums because he is terrified of the dental needle and I just don't know what to do.

My son has special educational needs and is just about on par with his peers, but while he is 14, he is about as mature as an 11-12 year old developmentally.

He sees a psychiatrist for his ADHD so I was considering asking her what she thinks?

I knew this sounds so trivial but I honestly don't know what to do to help him.

Would I be unreasonable to lie to him and tell him the destist said to stop wiggling the tooth and that it can fall out naturally, only to take him in 6 weeks and hope and PRAY talking him through the oral anesthesia will be possible?

I love this. Like the 80s was the pinnacle of child abuse 😆

Could he have a different sedative first? DS needed a tooth to be extracted when he was 6 and they just gave him a little drink to have before they used the GA. He was really tipsy and tired on the way to surgery and didn't even notice being put under. (We are in Germany. They recommend GA for younger kids here to avoid them getting scared.)
DS goes to a specialist pediatric dentist. They are really good with kids and he usually likes going because he gets to watch cartoons during any procedure.

Certainly never had anyone strapped down. That's insane.

Is the tooth actually capped in silver or is it an amalgam filling?
If former - why not a normal (tooth) coloured cap?

Op I have a ADHD and ASD DD14.
I have been there.

Firstly, listen, sedation clinics don't always use IV there is one I use that specifically focus on kids, sedation is through a small breathing tube over the nose. No IV. Hunt one down. They even have them with different fruit flavour smells they can chose that go over the nose like a face mask.

Secondly phone around and find a dentist who understands how to deal with ND kids. Many of them get it.

In the U.K., they would be able to take it out in hospital. I wouldn’t force it. It will likely come out eventually on its own.

Your poor son! I have a 14 year old and nothing like that happened in their lifetime. I can’t believe you allowed someone to do that to your child. He’s now traumatised, and needs support with that. If you lie to him, you might never get him near a dentist again.

My dd spent ages in the surgery just practising sitting in the chair, before she’d even let the dentist look in her mouth, let alone touch her. And she hasn’t had previous trauma.

the previous poster who called this pandering is just cruel.

I'm 69 and it has never happened to me, my child, my grandchildren or anyone I know. My mother stayed with me at the dentist even in the 1960s.

Where did this barbarity take place? It is not normal.

This whole post is barbaric. Your poor son. There are dentists in UK that specialise in phobia patients and also SEN children. They are cared for quite differently. Also, there is no need for your son to have such pain etc. there are other options for sedation, deep ( semi-GA) or light (conscious). I would question the dosages used previously and the experience of dentist using them. There should be a second airway responsible clinician present during sedation and they should be able to reverse the drugs if required etc. However, failing all that. I would have your child seen at a dental hospital/acute provider where he could go to theatre and be listed on a dental operating list in a paediatric hospital. Because you are US this will be something you can pay for and have partly covered by insurance and no waiting list. In UK the waiting list for hospital dental lists are years long. You could avoid that. Essentially though there is no need for your poor son to be in such pain and distress. Stop him gouging at his mouth and seek an alternative way to have his treatment completed.

Oh man that's really hard. I used to have a really bad needle phobia acquired in a similar way, when I was v young. As an adult I did CBT/exposure therapy and it helped hugely. I wish I had done it sooner. I imagine there's some sort of therapy that could be done at that young age, though it takes time.

In the meantime, has the dentist suggested any methods besides anesthetic for numbing the pain?

Not sure if this works for dentistry, or if there's something similar
https://www.buzzy4shots.co.uk/

When I was young bribery also helped a bit.

Definitely don't lie. My mum lied whenever she'd take us to get injections, and even got the doctor to come to our house once without telling us, and it gave me all kinds of trust issues..!

For all those commenting
papoose boards and restraint are common and normal practice in the US for paediatric dentistry , that's not saying it's right but it is normal practice and many/most paediatric dentists would refuse treatment without their use in certain cases

ops son has had iv sedation in the past , it did not go well, many adhd drugs interact with sedatives , iv sedation can be very unpredictable in younger children anyway

at 14 the tooth should have come out by now, the dentist has said it needs to come out

nitrous oxide is used in the states very commonly (happy gas) and may be a possibility

op is going to talk to the psychiatrist about possible pre med

it is a stainless steel crown because it is a baby tooth, you don't put white crowns on baby teeth.

you will not/should not give a full general anaesthetic for a wobbly baby tooth.

Hi everyone! Thank you all for the added suggestions.
I am going to talk with his Dr about something for anxiety, Even if it's just therapy. We have about 6 weeks til tooth day, so can get a few good sessions in before hand.
We're not in the UK, and oral surgery here is typically done in the oral surgeon's office.
The tooth is capped in silver because it was a baby tooth. It is retained now and needs to come out but it simply will not budge.
My younger son has the same issue with all of his teeth, and none were capped. He has NEVER lost a tooth naturally, they all are removed by the dentist whenever the adult teeth started pushing through the gum behind or in front of the baby teeth. My younger son didn't even "lose" his first tooth til he was 9 years old, and even then it was cus the dentist pulled it out after the adult tooth erupted behind it. At one point my younger son had 2 rows of teeth after 4 of his adult teeth erupted behind his babies and he had to have them all removed. So I've always trusted the advice of this dentist and didn't really question her whenever she said my older son's tooth needed to come out.
I'm not going to lie to him because those of you who advised against it are right. I don't want him to have trust issues, pretty sure that's from where his anxiety stems - being forced into the chair and strapped down while I was kicked out of the room.
So I'm going to talk to him and his psychiatrist together and see what we can come up with and HOPEFULLY a few therapy sessions and maybe something for anxiety on the day.
I'll also talk to his dentist today and touch base with her to make sure the tooth absolutely needs to come out but, from what i saw on the xray, it needs to come out; the adult tooth is pushing sideways and if it erupts in that position he will have need more dental work to straighten it out.
I will also get the information for what sedative the oral surgeon used exactly and what was used when he had his appendix out and maybe we can find a sedative he can use, but I still need to help him find a way to manage his anxiety so will work on that as well.
Thanks again everyone if there's any new info ill post an update.
PS. I also survived the 80s, it was rough going but I made it😂

One of my kids met with a dentist with a terrible bedside manner when he was 10 and needed a filling. He got up and walked out.
It took 6 months to find him another dentist I was happy with.

You could explain to your child that he can have as many appointments as he wants just for a look with as many different dentists as he needs, until he finds one who makes him comfortable. Tell him you won't allow anything to happen that he doesn't consent to.

Just a word of warning - I did take my child to a dentist who claimed to specialise in anxious patients but his approach was to drug them up to the eyeballs and on speaking to a pharmacist friend we weren't going down that route.
In the end we found someone with a lovely bedside manner and he had a few little 5 minute checkups before going back for any treatment. He's ok with the dentist now.

To add to my previous post, it wasn't down to him to manage his anxiety, it was down to the dentist to earn his trust. Some (like ours now) thrive on helping out anxious children in this way.

What would really help if a new dentist that is able to acknowledge the harm done by his previous one and promise wheel take things at his pace. However it needs to be someone that can transmit a level of confidence to him.

If a child would fight the dentist and refuse to settle, it was standard practice to strap the child down using a weighted blanket and straps, and then usher the parents out of the room to do the dental work... This happened to my son and I went along with it because I knew no better at the time.

Far from ‘standard practice’ OP, this was assault. Why on earth would you let someone do that to your child, it’s unimaginably appalling?

Because in America , where the op is , this is standard practice in many paediatric dentists , particularly for young and uncooperative children.

The use of papoose boards and restraints is standard in many practices and many dentists will refuse to work without them. https://www.rdhmag.com/patient-care/pediatrics/article/14301164/papoose-board-in-dentistry-purpose-and-considerations-of-use

It is not the way we work in the U.K. but then there are practices in the way we treat children that equally paediatric dentists in America would disapprove of.

Probably won't help him this time but may do in the future. I've never known the injection take more than 20 secs. So count slowly to 20, and it'll all be over before then. You can bear quite a bit of pain if you know it's going to stop.

Pretty much what lollygaggle said.
It's still standard practice here. Not assault.
He's too old for the technique now anyway but, knowing about him what I know now, I would not use a dentist who insisted on it anyway so it's moot point now.
His psychiatrist has an appointment for him to see her next week and talk about this and the possibility of a single dose of something for anxiety on the day of so hopefully that'll help in the short term and hopefully next week his Dr. will tell me if there is any therapy we can do for him long term, in addition to the therapy he has already in place.

Dress it up all you like @CaseyCassum it’s very definitely assault. I’m sure if someone did that to you, you would rightfully call the Police.

Can the dentist give midazolam? It has short term memory loss as a side effect so is used for less pleasant procedures.

I would not lie to him but I would be trying to help him get over his fear.

Numbing gel before the needle, and no one likes a dentist's needle.

I would also be prepared to bribe him.

And I would consider something like valium.

Obviously you know your son better than strangers on the internet.

In the UK they cannot give a GA in a dentists you have to be in hospital but they can give sedation which is basically carbon dioxide.

I took a friend to have a tooth removed with sedation. She is someone who went about 6 years without seeing a dentist because she hates it so much.

During the procedure she just giggled.

Just to reassure people Carbon dioxide is NOT used in sedation

Op has already said that child has had iv sedation which did not go well. Midazolam is used in IV sedation. Also many ADHD drugs interact with midozalam.

carbon dioxide would kill you, nitrous oxide is used in RA and op said their dentist is going to use it.

You cannot blame op when this is a commonly used method in the US where they are. It is also used in Canada and Norway as well as several other countries.
https://www.caringtreechildrensdentistry.com/blog/use-physical-restraints/

It sounds like your children have “shark teeth” which is how my DS’s teeth also grow. The adult tooth grows in either under or alongside the baby tooth and for a while they coexist but then eventually the baby tooth will fall out. Our dentist is happy with this.