Extracting teeth under local anaesthetic

[ToothlessTerror]

DS is 12. He has to have 5 baby teeth out (canines and molars). This is for orthodontic reasons - there is no decay and they are not wobbly. I stupidly assumed that this would be done under sedation, but the dentist just announced that it will be done under local in two sessions. Aside from the fact that DS is very squeamish, I can't help thinking this will be quite traumatic. (I'm not usually worried about dental work.) We can opt for sedation but there might be a wait of several months.

Has anyone got any experience of their DC having multiple teeth out with local? How did it go?

Dd had 2 out under local when she was 14. She was fine but it did look a bit brutal to me as a spectator

Hers were adult teeth though so had bigger roots

I'm a dental nurse and have seen hundreds of teeth being extracted by local.
The experience in general isn't traumatic as long as the patient is calm.
We don't like to refer for sedation unless we really really have to.
Most children we have in for orthodontic extractions are surprised how quickly it can be done and how they didn't feel any pain. They might feel a tugging which is normal.
You can ask the dentist if it will help your DC to see the instruments they will use before hand. We've had a few ask but the dentist I work with generally shows the kids the tools anyway.

You can ask for sedation but it can take weeks for the wait what is your son saying about it. Years ago my eldest got them taken out with a general our dentist didn't take out kids teeth

Jesus, seeing the tools would have me running for the door!

Thanks for the replies. My only experience is of other people's DC having sedation or GA for several teeth, so it is good to know that local is usually alright.

DS has had local for single tooth extractions and hated it, so it might be hard to keep him calm. He has difficulty keeping still anyway (for medical reasons), so I guess we'll have to see how it goes.

@WentToMarket - I think DS would be the same! He feels faint in biology classes.

When I had my teeth extracted as a teen, I had 6 out!

Eye mask and headphones playing heavy metal were the only thing that got me through. (Pick a song you don't like!!)

If he is fidgety because a medical condition maybe ask about sedation and get them all out at once.

No no no no no

Take it from a nurse and someone who's child had 4 teeth removed under GA

go for the GA every time

I work in an operating theatre where we do tooth extractions (because of decay) under general anaesthetic in young children or children with additional needs.

We also do some orthodontic work under general anaesthetic but not usually for straight forward extractions. Baby teeth should come out without too much effort.

He may still need to have a cannula inserted to be given sedation so bear that in mind if he is squeamish.

I had multiple teeth removed when I was a young teen for orthodontic reasons under local anaesthetic. It’s never going to be pleasant but only you and him can judge what is going to be the right thing for him.

Both my older two had two removed on two visits two weeks apart for their four removals pre orthodontics. Once the anaesthetic is in, getting two out didn’t seem much worse than getting one to them. One child was offered some gas and air up her nose but opted not to try that.
A GA is a risk that I wouldn’t take lightly if at all avoidable and having 5 teeth out at once would be horrible too.

Orthodontic extractions are done under local.

I don't actually know of anyone having sedation for ortho extractions. Occasionally if there's either severe SN or buried teeth a GA is given, but I don't think we would accept referrals for sedation for ortho extractions, especially not for baby teeth.

They are baby teeth so they will be very quick and simple, generally extractions on teenagers are easier than adults because their bone is softer. He will be fine. Most teenagers cope very well, once the injections are in it is painless and you can use numbing gel so that they barely feel it.

You won't get a GA for removal of baby teeth for orthodontic reasons. That's not an option.

Generally sedation on 12 year olds would be inhalation sedation, and he would still need 2 visits.

Honestly local is the safest, and easiest method.

I think I'll have to have a chat with DS and see what he thinks (don't want to make too big a deal of it just in case that worries him more though). Rock music might help, although I'm not sure our dentist is the kind of guy who will sympathise.

Of course, if DS is really twitchy on the day, the dentist might not want to do it anyway and might refer. He's got to have GA next week anyway for something else he couldn't keep still for, so I'd rather avoid another if I can. And I'd rather get it done with than wait for months.

I had 8 teeth removed when I was his age under local in two separate visits and I was fine, they were healthy teeth, I just had too many of them. I don’t think sedation is required tbh as it takes barely any time to remove them and the worst part is the anaesthetic going in, I’m not traumatised at all.

Thanks for the new replies. It's good to have inside information (as we were led to believe sedation would be on offer).

I had my milk canines and a back milk tooth removed under local at 12. The most memorable but was the numb face on bonfire night . I was fine though...didn't hurt.

Happy to hear stories with no trauma.

My 13 year old had 2 milk teeth out last month - looked quite an effort to me, but was no bother at all to dd. No worse than normal teeth falling out on their own. Honestly, no drama, and fine in a couple of minutes.

I'm a dentist. Please do not worry. The teeth will all be straightforward under la. It can be staged and done gradually. Topical gel can be used, and most local anaesthetic techniques nowadays are virtually painless.
Removal of the baby teeth will be straightforward as there won't be any roots, so they will just pop out.
General anaesthetic is hugely expensive and comes with a higher morbidity rate than local. This will be avoided in all but the most extreme cases.
In Scotland as orthodontics is classed as cosmetic nowadays, GA isn't allowed anymore if this is the reason for extraction in first place.
sedation may be an option, but I'd try the la first.

We were offered a choice of local in two sessions, sedation in two sessions or GA when ds had eight back baby teeth removed aged nine. He was asked what he wanted as well as me. I'm so glad it was done under general. The recovery was horrendous and there's no way I'd have persuaded him to go back for round two.