dental anxiety in a child - advice please

[siiiiiiiiigh]

DD (11) has had problems with two molars since they came through her gum. Same tooth on either side, rubbish enamel, no luck.

The right sided tooth cracked and caused abscesses. So, it had to come out a couple of years ago. She tolerated the jags ok, but, the tooth crumbled when the dentist pulled, and so there were 5 bits to take out. DD tolerated it, but, could feel lots as the anaesthesia wore off during the extraction.

3 years later, the other tooth has to come out. She's properly anxious at the thought, lots of resigned tears but really, really not happy. I had no idea she was upset by the previous extraction, thought she'd just forgotten about it.

I mentioned her fear to the dentist, he said that he'd need to give it a shot, and, if she couldn't tolerate it then he could refer to the anxiety clinic.

Can't find any details of what a paeds anxiety clinic might offer. Anyone got advice/insight?

Thanks.

Dentist here. There is no reason at all why your DD should have to endure the preceding worry, nor the actual experience, of your dentist having a go. Ask for a referral to the local Community Dental Service. Their remit, amongst other things, is management of dentally anxious children. Also their should be, separately, access to NHS sedation services to which she can be referred. What area are you in? PM me if you would prefer to keep it private!

Sorry, paeds / anxiety clinic may offer: 1. What I call "TLC" ie a sensitive patient- centred approach. 2. Nitrous oxide sedation (light, quickly reversible, very safe, very pleasant. 3. IV sedation: move heavy duty, requires a Canula in the hand, careful monitoring and a recovery period. 4. General anaesthetic. In all cases she will have local as well. In 12 year old who is fairly mature and really wants to cooperate options 1/2 are likely tone successful. If she is so anxious that cooperation is difficult then 3 might possibly be suitable. Where she is highly anxious or unable to cooperate, or the extraction looks very difficult then a GA might be offered, for which she would be referred on to a hospital clinic.

Doh! She's 11. It all still applies!

Oh, that's incredibly helpful, thank you.

She's quite mature, as in, accepts that the tooth's a problem and that it needs to come out.

Her preference would be to leave it until it fell out naturally, but, the molar is coming in at an angle and so, the dentist is not confident it'll push out on it's own.

Saw an orthodontist this morning who's referring her for x-ray to see what's going on with the tooth. Her plan would be to fit a brace to keep the gap from the missing tooth in the hope the errant molar (if that's what it is) will come down in the right place.

I was a bit surprised by the "we have to have a go before we can refer you" - she's not, by any means, dramatic (gets it from her dad, obviously) so, if she's saying "I am worried about this" then...she is!

We're in Edinburgh. Been very happy with our new dentist. The tooth crumbling episode wasn't the dentist's fault, but, clearly, the 8 year old DD was upset and refused to go back to that clinic. Parking was blooming awful at it, anyway, so, I agreed.

Thanks, Bonzo. Very helpful to see what the options are, I'm hoping she'll come round and we can nip the anxiety (which isn't unreasonable, I think) in the bud.

We've been through something with dd1 aged 14yo.
She's had a tooth come through with damaged enamel-huge filling, which came out about a year later.
He went to fill it and she was in such a state (which is very unlike her) he ended up putting a temporary filling and saying we'd have to refer her to paeds dentistry, who would either sedate her or give her something to make her relax.
Temporary filling fell out next day (not much tooth left to hold it).
Went back and she refused to let him even get a temporary filling in.

Next day they phoned and asked me to come in to sign the referal. Dd1 then stopped and said "maybe I will have it done at the dentist". I asked them to hold back for a couple of days while we discussed it.
She swang between the "better the devil dentist you know" and being able to choose her appointment time, and going for full sedation, but not knowing when it might happen with unknown person and place.
Eventually she said she'd give it a go at the dentist. He sat her down and said a very mild version of what he wanted to do, and said he'd stop at any time if she asked and just refer her.

And actually she was brilliant. She did shake a bit, and was obviously holding herself together with difficulty, but did manage it, and got the whole filling (and metal bar to hold it in etc) done without the total panic from the previous time.

I think the giving her control helped. Plus that the fear of the unknown (different dentist, sedation, no control on time) made the difference. I was very thankful too, as I knew she would have to face up to it at some point.

Thanks for the advice, chatted to dentist on the phone who said "if she's as anxious as that, then, no, we'll just refer her on to the clinic. No problem"

Phew.

Really appreciate the help, thank you.