From: advax@reg.triumf.ca (A.Daviel)
Subject: Re: Extraction of baby teeth
Followup-To: misc.kids
News-Software: VAX/VMS VNEWS 1.41    
Keywords: 5 year old, anaesthetic
Organization: TRIUMF: Tri-University Meson Facility
Distribution: usa
Date: Tue, 7 Apr 1992 22:25:00 GMT

In article <43098@as0c.sei.cmu.edu>, bjz@sei.cmu.edu (Barbara Zayas) writes...
> 
>My 5.5 year old son, Jeff sustained trauma to one of his front
>teeth.  An absess is forming in the space between the traumatized
>baby tooth and the permanent tooth above it.  Since Jeff's permanent
>tooth is compromised by the absess, the dentist recommended
>extracting both of Jeff's front teeth.  (He recommended extracting
>BOTH teeth as it is likely that if one of the baby teeth remains in
>place, the permanent tooth (the one above the absess) will come in
>at an undesirable angle).)

My 4yr old had a similar experience, knocking both front teeth.
One tooth initially became discolored, then turned white again some weeks
later, but the other seemed unaffected.
We took her to the dentist who said that the discolored one was bruised.
They took some X-rays and watched them for a few months, as it was not 
conclusive whether there was an abscess or not, and we didn't really
want her to have a gap in her teeth for years. It seemed from the X-Rays
that the one that discolored was probably OK, but that in the other one
the nerve had died. Anyway, they decided it was
best to extract the dead one, for the reasons you mention, so we agreed. 
In the event, there was an abscess so we did the right thing. There is some
possibility of a 'spacer', a prosthesis that would be inserted to keep
the other teeth straight (besides the aesthetic effect). We have to keep
watching the one that bruised to see if that also develops problems.

>My question is about anaesthetics.  The dentist scheduled Jeff for a
>local. There are two reasons for why I'd want to consider something
>a little stronger.  The first is obvious: I want to cause Jeff as
>little anxiety and pain as possible.  This is his first major
>experience with the dentist and I'd like him to remember it without
>pain and fear.  The second reason is that I think that it would be
>nearly impossible to keep Jeff still throughout the procedure.  He
>has difficulty staying still for an x-ray and keeping the aparatus
>in his mouth let alone sitting through something as unpleasant as an
>extraction and the work that they'd have to do to rid him of the
>absess.

We go to a paediatric dentist, who charges a bit more than our plan
covers, but specializes in kids and has a lot of toys, videos, music,
etc. Our daughter actually looks forward to going. She just had a local,
and I think probably a novocaine swab before the injection. She actually wanted
grandma to take her, so we weren't there. When I asked the dentist beforehand,
he said that it was quite an easy extraction and a local would be routine,
but if she was 'difficult', a general might be necessary in which case
it would be done in the hospital (I presume he doesn't have an anaesthetist).
She kept the tooth, and we said if she put it under her pillow the tooth fairy
would swap it for a present, so she did. She doesn't seem any worse for 
the experience.

>Anyway, I don't know the technical term for the alternative, but we
>always called it "laughing gas."  Is this a viable alternative in
>general?  Is it viable considering Jeff's age (5.5 years)?

When I was a kid in Britain I had laughing gas (Nitrous Oxide) for extractions,
which I didn't mind too much. But my dentist didn't use locals for fillings,
and I was terrified of going to see him, finally avoiding dentists for 17 years
until I needed a root canal, so I am quite pleased that my daughter is on good
terms with her dentist.

Andrew

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