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Original poster

Tooth extraction in a child : local or general?

48 replies

lulumama · 10/04/2008 17:56

DS , 8.6 , has an abcess am a bit gutted .

dentist recommends the tooth is extracted, he can do it under local as it is a bit wobbly anyway.or he can refer us to the hospital for a general. i think local is ok? general has more risks surely....

has given me a letter for doctors to get antibiotics

DS not in pain, (yet) face not swollen or anything

am blaming myself

OP posts:
MamaG · 10/04/2008 17:59

Firstly: please don't blame yourself. These things happen and I doubt you could have prevented it.

How is DS with the dentist generally? AS a child I had dreadful experiences with extractions under a local, because I ahve long twisty roots and the anaesthetic took a while to work, longer than usual.

Had an extraction as an adult last year = absolutely fine

Original poster
lulumama · 10/04/2008 18:02

he is fine with the dentist. dentist is lovely, husband and wife team, she is good at hand holding ( when i had a filling at 38 weeks pregnant, wimp!!) and they are lovely. private surgery in their home, so not a big scary clinical place

OP posts:
Original poster
lulumama · 10/04/2008 19:09

anyone else ?

OP posts:
Swaliswan · 10/04/2008 19:28

Could you ask if they could use the anaesthetic cream they have at the dentist for more minor things on the area that they are going to inject? It might not help loads but psychologically it might help your DS to know that he has had some numbing cream so that the injection isn't going to hurt. You could always ask your DS which he thinks that he would prefer. The thought of going to hospital and being put to sleep may be more scary than an injection at the friendly dentist's house.

You are right that GA carries more risks as you have to ensure that the patient's airway is maintained and this is potentially a bit more fiddly when operating on the mouth. I'm not sure that they could put a guedel airway in during an exctraction as per normal for a GA.

numptysmummy · 10/04/2008 19:30

Dd1 had 7 taken out under ga on monday and is fine. Was discharged 30 mins after coming round. Much rather a ga than a bad experience under local.

madamy · 10/04/2008 19:31

I wouldn't worry about airway management with a GA - they would use a nasopharangeal (ie up the nose and sits at back of throat) airway to keep it open - goes in once he's asleep of course!!
I'd go for the local in friendly environment rather than clinical hospital environment tbh.

hertsnessex · 10/04/2008 19:32

i had one removed with local, it wasnt as bad as i thought. what does he want to do?

fairylights · 10/04/2008 19:36

this probably might not make you feel any better (sorry!) but i had to have 4 teeth extracted aged about 8/9 and just had a local anaesthetic, but i think it was just some spray or cream, no injection.. anyway lets just say that i remember it very vividly, it was extremely painful.
But if your dentist if offering a local with an injection then i am sure that would be very effective, of course momentarily uncomfortable but certainly a general is supposed to be a lot bigger deal to recover from..i think?
Anyway, hope your ds (and you!) recovers v quickly whatever happens.
Don't blame yourself, you are the invicible and wonderful lulumama after all

spiderbabymum · 10/04/2008 19:44

OK . A lot depends on whether you think your DS will be able for it . However a dentist would NOT suggest doing it under local unless he felt it was appropriate and he was CONFIDENT that he wasnt going to put your ds thru too much suffering .

My PERSONAL opinion is go with Local . What clinches it here is is that the tooth is a bit loose .
You are correct . the risks of GA are Much higher than a simple Local .

I had to have an impacted wisdom tooth extracted aged 30 . Ok different kettle of fish ....but I chose to have it done under Local . The injection is the worst part ....no different to having a filling . The pulling bit was pain free ..............ie NOT sore ....just pressure .

iS HE TOO YOUNG TO LET HIM DECIDE .?

lOOK WHAT IM REALLY TRYING TO say here is that you can be confident that the local option is Reasonable and safer .

GOOD LUCK .

Original poster
lulumama · 10/04/2008 20:16

thanlk you all especially the invincible bit !!

i thik i am more upset that i have somehow put him in this position by not doing something ..

dunno, am just being silly

DS wanted a GA in hospital as he wants a day off school! he also not keen on needles, but i explained he will have a needle if he has a GA. and he could have the day off if he has tooth out at dentists.

i think the possible risks of GA< and that hospitals are rife with infection more often than not! i will go for local with the dentist for him

OP posts:
jasper · 10/04/2008 20:26

Would not DREAM of sending a cooperative child for a general anaesthetic for a tooth extaction.Def not an 8 year old.

Local everytime. Have extracted teeth under local on kids as young as 3 many times

PS I am a dentist

Katisha · 10/04/2008 20:28

DS1 (8) had a tooth out recently and was given the numbing cream first, then the local injection, then the extraction. He was highly interested throughout.

jasper · 10/04/2008 20:29

Re read your post.
I am confused.

Why did the dentist suggest the possibility of GA if your son is not bothered by the dentist?

Why were antibiotics prescribed if no pain or swelling?

If antibiotics deemed necessary why did the dentist not prescribe them?

And purely out of curiosity do you pay privately for your child's dental treatment and how much would they charge for an extraction?

WatsTheStory · 10/04/2008 20:30

This reply has been deleted

Message withdrawn

Original poster
lulumama · 10/04/2008 20:33

Re read your post.
I am confused.

Why did the dentist suggest the possibility of GA if your son is not bothered by the dentist?

Why were antibiotics prescribed if no pain or swelling?

If antibiotics deemed necessary why did the dentist not prescribe them?

And purely out of curiosity do you pay privately for your child's dental treatment and how much would they charge for an extraction?

-----------

He suggested it as an alternative for DS. choice is ours.

there is swelling, not of his face, but on his gum, above the tooth, a large pea sized lump. his face is not swollen and he is not in pain but there is a lump on his gum

i don;t know why the dentist did not prescribe them. i have never needed ABs from a dentist before

i do pay, it is a private dentist, and he will charge £25 or so for the extraction

OP posts:
yummymummymybum · 10/04/2008 20:55

yes i agree local every time. i ama a dental nurse with 17 yrs experience. he will be fine definately, it is usually just the thought of treat that winds them up and once its done they always say 'is that it!'

jasper · 11/04/2008 18:24

lulumama thanks for clarification.

Still amazed GA was offered as a viable alternative, and surprised
antibiotics were suggested going by your description.Completely head scratching about why GP had to prescribe.

Let us know how things turn out..

PS I think 25 pounds is a very reasonable fee.

margosbeenplayingwithmynoonoo · 11/04/2008 18:33

I had a tooth abcess when I was the same age, and one about a year later. I had a GA both times. Once with gas (horribly sick afterwards) and the other with injection (no side effects that I can remeber). I also had a local a few years later when they removed a couple of stubborn milk teeth.

Bridie3 · 11/04/2008 18:36

My son had a tooth out with a local and was absolutely fine. Good experience.

LaComtesse · 11/04/2008 18:47

I had a tooth out in the dental surgery about the same age as your dc is and I swear to this day that he didn't give me anything . I bled for hours afterwards - it was like being attacked by an octopus, sat there in the chair. School dentist - need I say more .

I had another, perfectly healthy, tooth extracted when I was 15 in the London Dental Hospital under a GA and it all went swimmingly (bar my bed being given away before I got there!).

I think it depends how much you like and trust your dentist. My daughter bounces into our surgery and can't wait to show her fangs off but then she's not had to have much done (fingers crossed that she never will). I'd be happy for him to do most things in the surgery as long as he does them. If you're not happy or are still unsure ask for a second opinin.

Original poster
lulumama · 11/04/2008 18:51

jasper, i got the prescription today from the dentist, apparently, i he was only writing to the doc to let them know he had prescribed them , so i got my wires crossed !!

i thought £25 reasonable too, very reasonable.

thank you all for the advice and experiences, i will let you know how it goes

OP posts:
ProfessorGrammaticus · 11/04/2008 18:51

DS1 (9 two weeks ago) had a tooth out under local anaesthetic yesterday. No problems at all.

It was a very tiny one (next to the big front top ones) and the tooth coming through had pushed through the gum just above the baby tooth, rather than pushing it out. It was a bit wobbly though.

The dentist gave him the choice of anaesthetic injection or spray and explained the pros and cons so he (with DH) could decide. He went for the spray, apparently it tasted nice. He said to our lovely dentist "Tell me when you're going to do it" and she replied "I've done it, look"!

Bridie3 · 11/04/2008 19:00

The quality of children's dentistry is so much better than I remember as a child. I was phobic (bad experiences) my children don't blink an eyelid. I'm sooooo grateful.

pistachio · 11/04/2008 19:01

This reply has been deleted

Message withdrawn at poster's request.

TaLcY · 11/04/2008 19:06

Hi lulu

Sounds like you've made up your mind....

dd1 had a general for an extraction a couple of years ago, as they said it would be too traumatic for local.

She's 9 now and had to have another extraction, like your ds, because of infection. [this time under local]
The dentist was fab with her, she was tres brave. I, however was a little nauseous.

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