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Original poster

Dentist wants to take 2 teeth out of ds

32 replies

PeppaIsBack · 04/04/2012 16:03

ds, who is 6yo, never had any issue with his teeth. This week he developped a tooth infection on one his baby teeth.
Obvioulsy he is now on Antibiotics but the dentist said he will need to have that tooth out as it is now dead. He is also talking about taking the same one on the other side as it has 'some decay' (filling has been put on). The idea is that, if they take a tooth out just on one side, because the space his new teeth will have will be different on both sides, the teeth will grow with an 'irregular spacing'.
He asked me if I though ds would be able to cope to have his teeth removed under local anestetic without sedation Confused.

So my questions are:

  • is it really necessary to have both teeth out (one of which is 'healthy').
  • is it necessary to have any of the teeth out?

Apparently, his adult teeth will grow afterwards so I am wondering if it is really necessary to go such a procedure....

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Bonsoir · 04/04/2012 16:05

It sounds like a good idea to take those teeth out as the adult teeth will grow in straighter. Go for it.

Original poster
PeppaIsBack · 04/04/2012 16:12

Except that I am pretty sure he will need some brace for the bottom anyway (just looking at the way the first teeth have come out at the bottom).
And the adult teeth will still grow afterwards. So there will not be 'more' space for the other surely?

And he is just 6yo. If he was 15yo, I would leave entirely the choice to him as whether he is happy to have some teeth taken out or not. It feels wrong to do that if there isn't a strong medical reason for it.

OP posts:
NatashaBee · 04/04/2012 16:15

This reply has been deleted

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Original poster
PeppaIsBack · 04/04/2012 16:19

Yep agree on that. I had one removed, I was said it would be 'easy' and the dentist ended up in such a struggle that he nearly didn't managed to do it!

I don't know what is the issue with the tooth which has the infection staying.

OP posts:
ragged · 04/04/2012 16:27

Go see 2 other dentists privately & get their opinions. That's what I would do.

Original poster
PeppaIsBack · 04/04/2012 16:36

I've done some search on google.
Apparently, on an adult, you do a root canal treatment to remove the pus. You can't do that on a child with baby teeth. So tooth is taken out...

Might go and ask for private pov from another dentist...

OP posts:
CPtart · 04/04/2012 16:51

My 9 year old DS is facing the same problem with one of his (previously filled) decaying baby teeth. Our dentist has referred him for an assessment to a specialist clinic where, if it is deemed necessary, the tooth will be taken out under sedation. He has an appointment next week. I am dreading it tbh, but trying to stay calm and reassuring. Although a course of antibiotics has cleared the infection, his tooth causes very little pain now and I wish it would would just become loose and come out on its own. I too wonder, why it cant just be left in, is it causing more problems while its in there.? Maybe someone qualified to advise us will come along..........

Bonsoir · 04/04/2012 16:51

My DD is 7 and is about to have two perfectly healthy baby teeth out to make space for her adult teeth. And she will need a brace as well.

Grumpystiltskin · 04/04/2012 19:22

If it's infected, even after taking antibiotics, the infection is still there. I have probably one child aged 7-8 in my OOH clinic each month with exactly this problem. Tooth was sore, dentist gave antibiotics & said it needs to come out, pain went, mum didn't want tooth out & now dc hasn't eaten or slept since Friday, it's now Sunday & you have to find a dentist you have never met before to fix the problem.

It is possible to do a "pulpotomy" on deciduous teeth but if the decay is/was extensive this might not be possible.

Taking out teeth on opposite side is called balancing, there are other options such as fitting a space maintainer but these aren't widely used. If the other tooth is ropey then that may be what has tipped the balance.

DS should now be getting his first adult molars. These teeth are for life so it's important to pinpoint exactly what caused the decay in the baby teeth to prevent him needing a lifetime of treatment on the permanent ones.

Your dentist should be able to help you here.

mercibucket · 04/04/2012 19:29

Ds is 9 and had a tooth removed after it had an abcess. It was easy, no sedation just la, most of root gone already and adult tooth soon grew to fill the gap. We didn't get the opposite tooth removed as I didn't see the point - he's 9, teeth don't come out naturally in matching pairs at exactly the same time, the other one will come out soon enough anyway
As your ds is 6, some of that doesn't apply of course but it was an easy procedure and easy recovery. I wouldn't recommend struggling on with antibiotics if they're not shifting it easily.
Ask about space maintainers. We just measured the gap with a view to using them but there was no change

mercibucket · 04/04/2012 19:29

Ds is 9 and had a tooth removed after it had an abcess. It was easy, no sedation just la, most of root gone already and adult tooth soon grew to fill the gap. We didn't get the opposite tooth removed as I didn't see the point - he's 9, teeth don't come out naturally in matching pairs at exactly the same time, the other one will come out soon enough anyway
As your ds is 6, some of that doesn't apply of course but it was an easy procedure and easy recovery. I wouldn't recommend struggling on with antibiotics if they're not shifting it easily.
Ask about space maintainers. We just measured the gap with a view to using them but there was no change

magso · 04/04/2012 19:47

Ds had a baby tooth removed after it broke at about age 7. He was in pain so was able to tolerate removal with a local ( injection). It seemed very quick. The injection was the worst bit. However ds ( who has both LD and ASD so not usually tolerant of misfunction) had already lost a few baby teeth (naturally) so was used to the concept of very wobly nuisance teeth needing a quick yank to finish the job! He now(at 12) needs an adult tooth removed for overcrowding and having failed with sedation ( was very sick) it looks like a GA may be required.

birdsofshoreandsea · 04/04/2012 19:51

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Message withdrawn at poster's request.

Original poster
PeppaIsBack · 04/04/2012 21:48

Thank you for the explaination.

I do get the thing about clearing the infection. I suppose my point is more that, if the ABs do clear the infection, is there any point in taking the tooth out? Or are you saying that even if the pain has gone the infection hasn't?

I suppose that what confused me is that she said the tooth was dead as the nerve had been damaged by the infection and that's why it has to come out. Which is vey different from what you are saying.

OP posts:
mercibucket · 04/04/2012 21:51

hmm not sure about that - maybe ask another dentist at the practice? it's not what I was told, in fact I had to push a bit about the infection as the dentist was sure the abs had cleared it up and no further action was required.

Grumpystiltskin · 05/04/2012 06:58

The dead tooth is like a splinter, taking antibiotics will temporarily relieve the symptoms of the "splinter" but won't remove the cause of the problem. The tooth is dead because the nerve became necrotic & died, there will be infection around the base of the tooth which will continue to flare up until the source of the problem (the dead tooth) is gone.

A pulpotomy involves putting medicaments inside the tooth to kill the infection. Similar to root canal treatment in an adult but not quite the same.

ripsishere · 05/04/2012 07:06

My DD had four teeth out a year or so ago. This was to pave the way for orthodontic treatment to start.
We moved from Belgium so the treatment won't begin for another year or so.
Her extractions were pain and trauma free.

supernannyisace · 05/04/2012 07:14

Which tooth is it? Is it one which is likely to fall out shortly anyway?

I haven't had a tooth out by LA, but did have some reluctant baby teeth removed by GA as a child. I don't know how a young child will take to having an injection in the gums - I have to now and again as have crowns at the front, its a bit ouchie.

Although the babyteeth don't have big roots like adult teeth so shouldn't be too much tugging iykwim.

Hope he is okay.

Original poster
PeppaIsBack · 05/04/2012 07:29

Oh ds is absolutely fine. Despite having an obvious infection, he was still eating etc..., complained about his tooth only when brushing them and went into meltdown because going to the dentist meant not going to football Hmm.
So I can't say the experience has affected him that much lol.

Grumpy, would you mind explaining a bit more about that 'dead' tooth?
dc1 had 2 baby teeth that died following a fall. The advice at the time was to leave them as they would not be an issue + as they were front teeth, he would have had a gap for a very long time (I think he was about 3yo at the time). These have never been an issue.
On the other side, I am struggling to see why having an abscess means that the tooth is dead? In that case, I would expect the tooth to change colour and become yellowy/grey?

Could you also clarify somethingelse? if the child is taking ABs for the infection, is it not fair to think that the infection is gone if there is no pain/no reoccurrence ? I am struggling with the idea that if there has been an infection then there will always be, even after the ABs. I would have though that the body would have been able to fight off the infection as it does for any other part of the body (unless overwhelmed in which case I would look at the child himself and try to understand why they are run down).
unless of course the issue is the 'splinter' in which case that amke sense

OP posts:
Grumpystiltskin · 05/04/2012 08:07

Did you read my comment about splinter? The tooth is now a source of infection. It will continue to be unless it's treated. It should be there until ds is 12ish, a front tooth that dies as a result of trauma firstly doesn't have to last as long and secondly hasn't died because of dental decay caused by the effects of bacteria on sugar in the diet. The nerve inside a decayed tooth will die if the decay is deep enough. It just happens and is due to inflammation that can't heal itself.

The mechanisms are different. If you has a big infected splinter in your hand & took antibiotics for it, would you think it a good idea to leave the splinter in situ once the infection had gone or would you rather have the splinter removed to prevent the infection recurring?

Original poster
PeppaIsBack · 05/04/2012 08:46

Yes I have !

I really do understand your analogy with the splinter but I don't understand how you can say that the tooth is dead? How would the dentist know if the decay is deep enough just by looking at the gum? (no Xrays, or even touching the tooth)

So if I understand well the mechanism is:

  • decay leads to infection of the side tissues of the tooth (in children. Different in adults where the roots are affected)
  • ABs to help and clear the infection but tooth removal is advised to be sure that there is no infection left at all (similar to root canal treatment in adults)
-IF you could be sure that the infection is gone wo the tooth removal, you coud keep your tooth (as with adults) but I am guessing this is difficult to confirm.
  • The problem is that the infection will be under/inside/around (?) the tooth so it isn't easy to see and infection can get trapped, hence your splinter analogy.
  • Death of the tooth might a side issue as a dead tooth doesn't cause an issue as such (like in the case of a knock). The infection is.

Is that about right?

OP posts:
Grumpystiltskin · 05/04/2012 09:03

Pretty much. If the tooth has had an abscess, we know all of the tissue around where the nerve enters the tooth is dead so there is no way that the nerve & blood vessels (the pulp) can still be alive so the tooth is dead or what we call non vital. You've explained it pretty well tho!!!

Original poster
PeppaIsBack · 05/04/2012 09:11

Thanks! I was getting completely muddled up with what I thought was different information/different pov lol.

So I am right in saying that, with adults and with children, once you've had an abscess the tooth is dead? And it might not change colour like dc1's teeth did.

In your experience, have you ever seen children who had infection, kept their tooth and were OK? Or it is always a question or how long/when' until they get another infection?

OP posts:
Grumpystiltskin · 05/04/2012 09:22

I haven't treated children routinely for about five years so I really couldn't say. The only ones I see are in pain at an OOH session!! Sorry, your dentist would be able to give you a prognosis though.

Oblomov · 05/04/2012 09:33

Ds1(8) had a tooth removed last week. 2 weeks ago, he had very sore tooth. went to dentist, she tried to take it out, with an injection, but the injection did not work. she said this was becasue the infection inside was preventing it working. so we took antibiotics for a week. and then went back. quick injection. which obviously he didn't like. but then , it literally popped out. the injection was obviously the worst bit.
I can't understand why you are objecting so much. there obviously is a problem, because he needs filling on one side and there is already infection on the other.
I would have them both out asap.

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