Experiences with inhalation sedation tooth extraction

[Tumty]

My child had a bad experience trying to extract tooth under only local anesthetic. She has now been referred for sedation. She needs adult molars removed so it’s not an easy job. Just wondered if she is prone to panicking how much does the sedation help? I am feeling quite apprehensive about the procedure

My son (nearly 10) just had this.

the sedation itself was fine - worked well, he was nervous but once it kicked in he seemed relaxed and didn’t feel anything during the procedure; so highly recommend serration especially as it’s makes them feel all relaxed so great for anxious kids.
word of warning for afterwards which I wish I’d had though- when we left I didn’t realise he was still a bit out of it and he nearly veered into the road before I could stop him ☹️He was then nauseous, sore and very irritable until home and cuddled up with painkillers.
That night he woke crying at 2am needing more painkillers and was really irrational, thinking his friend was in the bathroom and that there were spiders in the room, took ages to calm him down.
im not sure if this is normal post-sedation or a random reaction but wish someone had advised me in advance it could happen as I really hadn’t expected it.
wish you lots of luck for your ds
procedure 💞

• sedation not serration!

Ok that’s good to know. I have another child who managed extractions under only local anesthetic and I wish we could just do this. But I don’t think she could cope the same way. Well we already tried and she couldn’t. But the recovery on only local anesthetic is so so quick. What are they like when under inhalation sedation? Completely spaced out but still awake?

Also I assume his reaction that night was a one off and he was ok by the next day?

Sorry another question . Was it adult teeth your ds had extracted ?

He was just relaxed - smiled, could
answer
questions / follow
direction (open wider, turn your head etc) so sedation itself was good.
yes- he was fine the next day (sore where the tooth had been root canalled) but not at all out of it or odd- so it was just that first night and I’ve no idea if it’s just a rare reaction that happened with him as our dentist didn’t warn it might happen.

No need to be sorry! Happy to help.

yes was an adult
tooth. He was under sedation for 1 hour + due to some complications with the nerve so maybe the length affects them too? Just a guess.

Ah ok thank you so much. We have four teeth needing to be taken out so two in one session. Then back again for another two. So really need the first experience to go well. We have discussed with the dentist the option of referring for a general anesthetic instead but I am also worried about doing that

I have terrible teeth and have needed a lot of treatment. I've been to a few different dentists and have had tooth extraction and lots of other treatment, with and without sedation.

Sedation definitely helps but I think the biggest difference is how the dentist administers the local anaesthetic. Some manage to do this almost painlessly, injecting a bit at a time with a tiny needle at lots of different points around the tooth. Others seem to ram it in all at once in one or two spots with what feels like a huge needle and it's the worst bit of the whole procedure.

If you get a 'rammer' then sedation at least blunts the memory but if you can find a more skilled dentist then I think that's better.

If your child has sedation then expect them to not be properly with it for up to 24 hours.

Are the extractions for orthodontic purposes?

Not entirely for orthodontics. The teeth have hypoplasia and a poor prognosis that they will last many more years. But removing them will allow space for orthodontics too

Sounds like it's all four 6s that need to come out in that case. How old is your child?

13

My 7 year old DS had this a couple of months ago. He wouldn't let the dentist anywhere near his mouth before and eventually needed a molar removed as he wouldn't allow any fillings.

The sedation relaxed him so much he actually fell asleep! The procedure was completely successful and no effects afterwards at all.

Thanks that’s so reassuring

Presumably your DC has been referred to your local Community Dental Service, if GA has also been discussed. (Or a dental hospital). Very Unlikely that a private dentist that offers inhalation sedation can also provide the extractions under GA.
Many, many 13 year olds that get referred into our service, have this treatment without issue over 2/3/4 visits; sometimes they need a trial of inhalation sedation alone so they get the feel of what it feels like and how the breathing technique feels like-in and out through the nose alone with the mouth wide open. For the vast majority of 13 year olds, Local anaesthesia and inhalation sedation works very well in the hands of an experienced Community dentist. If it proves unsuitable, your child probably will be listed for GA instead; hypoplastic 6s usually fit the remit for GA but orthodontic extractions of 6s don't IFYSWIM. There are some dental schools that also paeds IV sedation -which is much more profound- but they're a bit few and far between.
The inhalation sedation -Nitrous oxide /oxygen titrates mix -once the procedure is complete- is followed by 3 mins on 100% oxygen before the nasal hood is removed. This is usually followed by 10mins approx ambient room air before your child is ready to be discharged home. 99% of the inhalation sedation is removed during that post op period; the other 1% is expelled from the lungs over the next 24 hours; so usually advise patients to refrain from any sporting activities etc the rest of the day and to rest up quietly at home. It's not the inhalation sedation that makes this successful, there is an awful lot of hypnosuggestion from the treating dentist and behaviour management+
Good luck; hope this is helpful. I have done about 8000 -10000 inhalation sedation appointments over the course of my career-mostly extractions-and vast majority go well. Try not to worry. Good luck 🤞

I had my wisdom teeth under sedation as a teenager. I bit the dentist

Sorry missed a few words out there; should read:
It's not just the inhalation sedation, there is an awful lot of hypnosuggestion from the treating dentist and behaviour management. You may be lucky enough to be sent to a Community trust that has the Wand STA system for local anaesthetic. This is fabulous !!! This is my favourite dental gadget of all time -still a needle- but local anaesthetic is deposited via the computer system-below the pain threshold.

DD had a front baby tooth that she had knocked on the edge of a table out under nasal sedation when she was 5. She went to our local NHS paediatric dental service for the procedure. They explained what would happen and let her try the mask on her first visit. Think they also mimicked injections with a needle-less syringe. It was quickly apparent that she wouldn’t be calm enough to have the procedure on that occasion so they sent us away with a mask to play/practise with (it is still in her toy medical kit) and we went back about a week later.

She was still nervous that time, but they took things slowly and got her to have a good few breaths before they started. She wasn’t drowsy, but got very irritated, in quite an amusing, dreamy way, by the bright lamp and tried to kick it. She still complains about me holding her legs down three years later. They were able to extract the tooth quite easily and she was more or less back to her normal self by the time we got home, we just had a quiet afternoon. She was very pleased with her £5 from the tooth fairy and more so when her dad (my ex) decided he needed to outdo me and gave her another £10.

Thank you Birminghamnewstreet. That is very helpful. Yes have been referred to local community dental service. We waited 9 months for the referral to come through. The first thing they offer is extraction under sedation. The problem that is worrying us a little is that under only local she said she wasn’t numb and could feel when the dentist started the pulling. But we don’t know if this was psychological iyswim. or if the dentist made some error when injecting. She actually coped no problem with the injections.

extraction under general has been discussed but referal for that takes a further 9 months. And we would have to go through another appointment to discuss whether or not she the criteria.as it’s a whole different department. And I am concerned that they won’t be happy that we haven’t yet tried inhalation sedation and may say we need to do that first. so I think it’s better to do this first really.