DS frightened of dentist after difficult extraction - has to have nother one out - how can I help him?

[Katisha]

DS (8) has overcrowded teeth and had a molar extracted recently which turned out to be a bugger with huge roots and it hurt a lot. He now has to have another one out week after next - how can I help him not get into a tizzy about it?

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Is there a dentist who offers iv sedation near you?

Hmm not sure I fancy that? Does it have to be iv? How sedated? Still conscious?

Oh, poor child, and poor you.

It shouldn't have hurt - dentists should be able to pout in enough anaesthetic to stop any sensation as the tooth comes out, shouldn't they? It's very horrible, with the pushing, and the npoise, though, even without pain.

I think I would call and ask about sedation.

What sort of encouragement does he respnd to best? DS (now 9) has to have a lot of painful procedures (not dental related) and we have always been v matter of fact about it: 'yes, it will be uncomfortable, painful, even, for a while, but it won't last. It will stop.'. We talk about thinking about the fact that however horrible it is it isn't dangerous or bad for him, and it will be for a short time. And concentrate on keeping his hands and ankles relaxed, focus on far away parts of the body, and try and keep them relaxed. But I think it depends very much on the individual child.

I wouldn't worry about sedation. They can give oral sedation - DS had that to lie v v still fro an MRI. I'm not aware of any real risk.

Thanks. Yes the last procedure did hurt despite the anaesthetic - the roots on the tooth were enormous and splayed outwards. It's possible the next one will be similar.

Good idea to be matter of fact and realistic about it - I had assured him last time that the anaesthetic meant it wouldn't hurt, but it did. So I have nothing particularly reassuring to say this time!

I had a horrible extraction last week with a v compilicated root that menat that the dentist had to get it out in several pieces, but the dentist had put big injections in on the outside and inside gum, and I couldn't feel anything, bbut the noise and general grappling were still horrible...many sympathies for your son.

Was the dentist aware that it had not been fully anaesthetised? It may be worth reminding him and asking if there is anything he can do to improve the level of anaesthetic effect.

Also, I wonder if you can give him a good dose of paracetamol and nurofen before he arrives at the dentist so he is 'painkillered up' for when the anaesthetic wears off.

If it was really bad for him, I would consider asking about a GA.

I usually say to DS about any procedure 'the Dr / dentist / physio / nurse will do all they can to make it more comfortable, I don't know what it will feel like, but if it does hurt, it will be over very quickly'. Also get your DS on board that he wants it done for the long-term benefits, and fully understands what those are - IME children who feel less 'victiised' feel less vulnerable, less afraid and therefore less panicked by pain.

(this is based on DS having had much bone surgery AND a blimmin dental surgery!!)

Good luck - this sort of thing is agonising for parents, but the calmer you can force yourself to be, the better.

Thanks Blu - that's all really helpful and I'm sorry to hear how much you and your son have had to put up with. Knocks a few visits to the dentist into a cocked hat!

So it's OK to take painkillers beforehand then - it won't adversely affect the anaesthetic or anything?

WE're Ok, thank you . Tough it has been, and will be again, but I have noticed that the experience that he can survive something unpleasant has actually made Ds very resilient and philosophical, whereas I think our natural instinct is to try and sheild chldren from pain rather than let them fnd ways to manage it themselves, iyswim.

I can't say for sure about painkillers and anaesthetic - except no aspirin related products because aspirin encourages bleeding. But DS was on paracetamol and nurofen for 6 months and we were never warned about local anaesthetics - not that he had any - but he had GAs and morhine-based products and other sedatives while on paracetamol and nurofen.

I have no idea what temporary and local pain management might be available to dentists, but it might be worth calling the dentists beforehand, out of earshot of your Ds, and asking if there are other options - doctors in fracture clinics use morhine-based nose drops or tiny lollipops for children having fractures set, very fast acting but also v quick to wear off. But I guess Drs are allowed to authorise this whereas dentists might not. I just have no knowledge.

It's very upsetting that he has had such a painful experience, poor boy, and hopefully the dentist will agree that anything to help stop the pain will make hima lifelng better dental patient!

Thanks again. Yes we will have a manly chat about how sometimes things have to hurt.