DS2 has to have up to 8 teeth removed under GA

[sphil]

...and I am feeling devastated. We knew that he had some spots of decay on his milk teeth (a legacy of poor diet when younger) but now his adult molars are showing a condition called hyperplasia/hyperplasty? where the enamel is almost non-existent. The dentist said it's often linked with severe childhood illness and AB use in early infancy, both of which DS2 had at 10 days old. These teeth now have cavities and the dentist says that extraction is the best option. Because they don'y like giving GAs more than once, they will take out the less affected teeth at the same time.

I am going to ring the hospital and find out exactly what will happen so I can do DS a photo story. But other than that, does anyone on here have experience, reassurance etc? I am panicking about lots of things - he's not allowed to eat before the procedure, his mouth may be numb and painful, he is supposed to 'refrain from exploring the sockets with fingers or tongue' fgs - we haven't got a hope in hell of preventing that, as he does it all the time anyway.

poor ds
No advice just good vibes. I had I think 4 out at the same time as a child. The worse bit was going home on the bus I think.

oh poor lad and you, sorry no advice, but I hope it goes well.

oh, sphil, sorry to hear this.

No advice (I counted it as a huge bonus that dd1 even went inot the dentist's earlier while I had some stiches removed (painful implant process going on)) but lots of sympathy.

FWIW, my recent patient advice leaflets (following said implant last week) mention possibilities of surgical bandage etc - worth asking abuot? I didn't have any,a s had stitches instead, but even if it's not something "normally" doen for extractions, maybe they'd consider?

how on-side is the dentist? woudl they consider "alternative" treatments to stop him exploring post-op? (it really is quite important, i think, as otherwise the clot doesn't form, and you get "dry socket" - VERY painful)

SF - does your leaflet say how long it takes for the clot to form? We could probably distract him for a while, but not for 24 hours, say. Where does the surgical bandage go?
It's being done in hospital, but I've been given a number to ring if I've got any questions, so will ask.
Riven - apparently 'reconstruction' is out of the question - I didn't ask why, but perhaps should have. The teeth are equally balanced both sides, so shouldn't affect his jaw growth - but will ask about this too.

I've just been trawling other threads and they talk about having to have leads to the chest, blood pressure cuff and possibly cannula. I have absolutely no idea how we will prevent DS pulling these out.

Bad news, i'm afraid.

Leaflet says:

during the first 24 hours, avoid uisng straws, rinsing vigorously (smoking and alcohol - shouldn't be a problem ). these actions, and others such as probing with your tongue, could disturb or dislodge the protective blood clot form the surgical site. Loss of clot (dry socket) may cause uncomfortable delayed healing, and require additional treatment"

about the bandage it says:

"you will probably leave the office with a wet gauze pad covering the surgical site (I didn't, I had stitches instead. Not sure what the criteria are for either option). Under this gauze may be a putty-like surgical bandage, which may stay inplace for 10-14 days"

hth

My kids all have hyperplasia to some degree. DS1 had some baby teeth out under general (his adult ones are not as badly effected)the other 2 don't yet have enough adult teeth to tell how bad theirs is. Not sure I have much advise to offer, the procedure was fairly short and he didn't have to starve that long, from after breakfast to early afternoon (this was better than other ops he has had which were 12 hours). DS is deaf but does not have other SEN all the other children on the list had significant SEN so the dentists and anesthetists doing the op were used to the problems you talk about I would definitely phone for a chat beforehand so you know what to expect.

Hi Sphil, my ds had 12 teeth out by ga last year. They also don't like to use ga much with him due to his heart condition. He never had any checks..blood pressure ect before they knocked him out as they couldn't get near him. They had to waft the mask closer and closer until they were able to cover his face. The op was nearly 4 hours. We had to be there as soon as he came out before he came round for his aggression. The canula they put in had a triple bandage round and covered with a glove and sling. The stitches he got in his mouth were out within hours. My son was in a few days on the heart ward for this. HTH..anything else just ask. Take care x

Thanks both. Dentist did talk about possibility of stitches - it depends how deep the roots are and how much bleeding there is apparently.
Geogteach - it's good to know that your DS1's adult teeth aren't as badly affected - this is something that really worries me. DS2's procedure is at 8am (or that's the time we have to be at hospital, so I guess it'll be much later than that) but breakfast is the meal he asks for most insistently. He will just be saying 'toast...toast...toast..' at three second intervals, I can guarantee it!
Can I ask - do you use the strong prescription fluoride toothpaste on your DCs teeth?

No we just use kids toothpaste (my kids don't like mint which is a bit of a handicap when choosing toothpaste! How old is he? They usually work through the list youngest to oldest which should give you some idea how long you will wait. For me starving him is the worst aspect of all the ops DS has had. Hope it goes ok.

Hi sphil we use the sodium flouride tablets crushed in his food. Sensory issues stop him using a toothbrush and paste.

He's 7. I may talk to the hospital about how long he's likely to have to wait - if I know I can be more prepared. I think it may well be the worst aspect for us too - DS2 is very insistent about food!

Hi Sphil my son was 8 when he had his op. Though because of his SLD he was admitted the day before for the hosp to do his nil by mouth and he was also first down before any of the younger ones. In for 8am. HTH.

I really hope they will take him down early - he'll find the waiting stressful enough, let alone waiting AND hungry.

I suppose the thing that's upsetting me most is the fact that he won't understand what's going on. It's not as if his teeth are hurting him. When he broke his leg we could say 'DS2 went bang, leg broken', tap the cast and say 'this will mend leg'. But I don't have a clue about how to explain he has to have teeth removed or why. Unless I say they're 'broken' I suppose. I hate the fact that he'll be in pain and won't understand why we've allowed it to happen

please be prepared for a long wait,.
I was told that dd would be one of the first to go down, but they left her and the other dc with cp to last.(just wanted to prewarn you)

Probably DS2 won't get any of that because he doesn't have challenging behaviour - he'll just be unhappy and bewildered. I'll take his portable DVD which should keep him occupied. Dh is going with me, so should be OK.

I know we'll probably have an easier time than many people would have - but it's just the lack of comprehension that is upsetting me.

sphil

Ds2 had this.
he had to have a GA about two years ago ( he was 11) . He has severe ASD so I was worried, like you are.

He had to have stiches as one of the teeth was growingthrough the roof of his mouth.

The procedure was brilliant actually.
I went in with him. They had put some numbing cream on his hand and injected him there. I was anxious aboutthe jab and initially they tried to hide what they were doing IYSWIM but DS2 wanted to see and was really cool/fascinated by it. He went out really quickly

I had a post op present agreed with him and he was very focussed on getting his Baloo toy afterwards so he was quite co-operative. They let me in as soon as he was stirring ( I had spoken to the staff about it before hand)
I had toy ready and sat withhim as he came too.

He wanted the injection thing out of his hand asap and they helped with that too.

After that it was just a case of being readyto play with him and distract him. he was sleepy and just wanted hugs really

We never had to tell him not to touch his mouth so can't help there.

We don't think there is much we can do about how weak his teeth are - he struggles with normal flouride toothpastes as he reacts to them but I use a natural toothpaste with low flouride and a flouride mouth wash ( which he is less likely to swallow)

I will post if I think of anything else....

Ds had to have 7 teeth out under GA, I felt like the worst mother ever! The worst bit was the waiting, we were told he would go down first but we ended up further down the list. In the end I was having such a terrible time I burst into tears (very unlike me) and they bumped him back up the list . The main problem was one I hadn't foreseen, ds went in the playroom and the first thing he spotted was a pile of playstation games which he was very excited about. Unfortunately there wasn't a working machine to play them on but I couldn't make ds understand and he got more and more upset and started trying to look at all the tvs next to the beds in the ward! Of course I tried to stop him and everyone was looking...

Anyway, he had the gas after a bit of a struggle and I had to go and wait back in the ward. They called me back in before they woke him up so that he would know I was there. He came round, looked at me and promptly fell asleep again! He then slept for hours, nurses kept coming in and saying "is he still asleep?" to the point where I was starting to get worried and they were talking about the ward closing for the night (day ward only).

When he eventually woke up properly he looked a sight with dried blood that had run down his face but he didn't seem to be in much pain. After about half an hour he happily ate a banana and we were sent home. By the next morning he really seemed fine, although he couldn't tell me of course he was eating normally etc.

They did manage to save one tooth by putting a silver cap on it, he still has it now. I'm hoping he doesn't swallow it when the tooth comes out .

Oh and he had a dental check up just before Christmas and there are no problems with his adult teeth that are coming through, in fact I was complimented on his dental hygiene! (little did dentist know I have to sit on him to clean his teeth!).

The dentist wanted to put fissure sealant on his adult teeth to try and minimise the chances of having a GA in the future but ds struggled so much she only managed to do one tooth. That could be something you might want to enquire about though.

Pagwatch and Pixel - thank you so much! That's very reassuring. I went to my parents' support group yesterday and told them about it, but I just got lots of GA horror stories, so your posts are much appreciated.

We have a portable DVD so will take that in for before and after. DS2 loves DVDs second only to to YouTube .I was worried about what to give him to eat afterwards as his foods of choice are mostly crunchy, but he eats bananas, so will take those too.

He is actually pretty good at having his teeth cleaned, so I'm hoping that we will have the same experience with his adult teeth. The dentist has managed to put some fluoride varnish on his baby teeth - is that the same as the sealant you mentioned Pixel?

Just re reading this and didn't mention the stitches in his mouth were out in hours as he pulled them out.

Oh no, i'm sorry your DS will have to go through this. I hope it goes as well as possible and that the healing part of it is quick.

I don't know if it was the same stuff I'm afraid, just that it protects the teeth. I'm hoping they can do another tooth next time!

I don't remember ds having stitches, I don't think he did. Certainly no one mentioned them if he did!

Oh and ds didn't have the numbing cream on his hand as he'd had it once before for a blood test, and was more upset by the plaster on his hand than anything else.