Your child may have recently complained of tooth pain caused by decay. Perhaps during his or her last check-up, the dentist or orthodontist recommended extraction of a primary (baby) or adult tooth for orthodontic reasons. Or, your child may have suffered trauma to his or her teeth during a fall. These are all common reasons for teeth extractions in children.
We have performed thousands of children’s teeth extractions over the years. A child’s experience during extraction or any dental treatment greatly affects his or her perspective on dentistry as adults. So, we perform extractions in children in ways that create a positive experience. Pediatric dentists are also greatly qualified for providing general dental care and selected extractions in children as they truly understand their needs. Here are some approaches that we have found to be very effective in transforming a potentially scary experience into one that is gentle and non-traumatic:
- Preparation by parents – Children largely form their expectations from their parents. What is said and how it is said by parents can make a child relaxed, trusting, and ready, or create a deep sense of fear even before walking into the office. We discourage parents from making statements such as, “Don’t worry, they won’t hurt you” or “It won’t be painful,” or other statements that suggest the possibility of such experiences. Instead, we ask parents to tell stories about “happy teeth” and “a friendly dentist who will make you feel better.” This type of communication helps to build trust and reduces much of a child’s anxiety.
- Develop a dialogue – Whether a child is seen for a consultation first or the procedure is performed on the first visit, it is crucial for the oral surgeon to spend some time developing a dialogue with them. Simply talking and asking questions about things such as school, favorite sports, hobbies, likes, etc. helps to ease the child’s anxiety. They become comfortable and begin to view the oral surgeon as a friendly and safe person. A 5-10 minute friendly conversation goes a long way in calming a child and promoting their confidence and trust.
- Give them the control – We play a little game that really makes children feel in control and, hence, less anxious. I tell them that they are the captain of the ship or spaceship, and I must follow their orders. I let them know that because they are the captain, I have to ask for permission for everything I do. They must say “yes” before I proceed with the next thing. For example, I ask them if may raise their chair? May I put a towel on them? May I put a mask on their nose? I wait for them to say “yes” before I proceed. If they hesitate, I let them know that is fine and tell them that I will just wait until they let me know that they are ready. In this way, nothing is done without their approval. This simple technique makes them feel engaged in the process and greatly increases their cooperation.
- Anesthesia – IV sedation or nitrous oxide are great anesthesia options to ensure a positive experience for children when undergoing teeth extractions or other oral surgery procedures. These are safe and routine options offered by most oral surgery practices. The recovery is quick, allowing patients to return to school or normal activities within 24 hours. Anesthesia not only helps patients be more comfortable and reduce anxiety, but is also very helpful when removing baby teeth that can be quite complex. In an earlier blog, “There is Nothing Baby About Removing Baby Teeth,” I discussed why such extractions can be difficult.
We have come a long way in how we take care of children’s dental needs. With good anesthesia, patience, and intentional dialogue, we can truly make a child’s experience a positive one and set them on a lifetime course of good oral health.