Months ago, our son, during a blissful moment of childhood enthusiasm, was dancing around in circles. He had just figured out he could make his little body move around-and-around-and-around–and then he fell. He smacked his face solidly on our new laminate flooring and chipped his front tooth. After a visit to the pediatric dentist, where his tooth got filed smooth again, we were warned to watch out for an abscess from the trauma–which could occur after months. Of course, it occurred, and we found ourselves contemplating the route to take for extracting this tooth.
The first dental surgeon’s office I called was very blunt: “We only do IV anesthesia.” This would mean my 20-month old would be put completely under, for a procedure that takes less than 15 minutes. “Why don’t you bring him in tomorrow and we may or may not be able to do the extraction then?” Hm.
The next office I called assured me that they wished to reduce stress to the child, so they use an oral versed anesthesia to put him in an unconscious state, then they take him back for the procedure (which I could not attend). Their next open appointment was a month away. Hmm.
I called the pediatric dentist again and that office took the liberty of contacting two more surgeons, both of whom did tooth extractions as outpatient procedures in a hospital setting, with IV anesthesia. And they were both booked for over a month. Hmmm.
This tooth had to come out, or else it would keep getting infected. (Which would mean extended antibiotics and possible damage to the adult tooth in its formation stage.) Frustration!
Finally, the pediatric dentist offered to do the extraction. He told us that it would require a papoose-style restraint, a quick topical numbing agent, local anesthesia, and he would then extract the tooth. We decided that the in-office procedure, without general anesthesia, was the best option for our little boy. We wanted to reduce the amount of harsh drugs he is exposed to, and we’re not really keen on the idea of the kiddo being unconscious unless absolutely necessary.
We took little Bear in for the procedure and it went much better than this worrying mama expected. Sure, it was hard to see him so upset at being put in a restraint (which he, um, broke out of…), it was heartbreaking that he didn’t really understand what was going on (even though we “practiced” what might happen multiple times), and I hated to see his mouth propped open with a vise-like device for a few minutes. But the extraction took literally minutes. Our appointment was at 10:30 and we were back in the car before 11:00. Bear was back to normal as soon as he realized it was all over.
Which brought me to the question: why were the other surgeons so intent on general anesthesia? If we hadn’t read, researched, and taken our time making a decision, things could have gone completely differently.
Additionally, in doing more research, I came across this article (and other supporting documents HERE and HERE) which point to the idea that pediatric anesthesia could be harmful to cognitive development. According to preliminary research, anesthesia caused significant deficits in lab animals (chimpanzees) when administered at an early age. To date, the FDA has not released further statements nor research on this subject.
Clearly, in the event of an injury, one has to weigh the pros and cons of treatment for her child. However, in our case, it deeply disturbed me that the risks of anesthesia were not even considered by the surgeons. General anesthesia was the ONLY choice for this procedure, despite the fact that it is a common and quick one. And while there is no definitive answer about whether anesthesia causes brain damage, the research is indicating that it does, so isn’t that worth a mention or a consideration by the surgeon?
I can only assume two things: 1) the general anesthesia for this procedure is for the sake of ease for the doctor and 2)the surgeons either aren’t keeping up on current research or they don’t think it is important to mention to parents. Or both.
I am, yet again, reminded of the importance of taking responsibility for one’s health–and not relying solely on the advice of the medical community.
Have you experienced a situation similar to mine? Have your children ever had to undergo anesthesia? What are your thoughts?
In your case, I’m so glad you were able to avoid stronger anesthesia but in many cases as far as childhood dental issues the procedure takes much longer and I feel the anesthesia can be a necessary evil in not traumatizing your child. Of course every child is different as is every pediatric dentist but I know the anesthesia for our case was not due to our dentist’s lack of knowledge or for his own ease…it was for the comfort of my child and for his health. He needed hours of work done and being restrained for that amount of time would have just been cruel. Every situation is different.
Nikki–Absolutely. Had this been a longer or more difficult procedure, I wouldn’t have been able to argue against anesthesia, though I might have asked for an attempt at something other than IV general anesthesia, depending on what needed to be done. However, I do wonder about how pediatric procedures will be handled when/if the FDA finds that anesthesia can cause permanent damage. Will doctors approach situations differently?
I feel so bad that you were Made to go through all that by the medical community…this reminds me of other things done out of convenience, like pushing untested vaccines, rushing a mom into a c section bc delivery is just taking too long for the drs convenience, or suddenly requiring all these tests for moms who get pregnant after thirty five, just because the insurance companies are playing some numbers game…it would be so much better if drs were able to base their care on a deep knowledge of facts AND their patient…I think those days are over though… I am pleased to see you pushed to get the info and care you felt best for your child!! It is always good to read these types of posts bc it gives me more confidence too!
Thanks, Julie! I completely agree. So much of our “health”care is decided based on convenience or insurance factors. The pediatric dentist’s job would have been much less stressful for him to complete if my kiddo hadn’t been conscious–but who are we working to make most comfortable? Thankfully, he recognized that full anesthesia just wasn’t the best option for this procedure. I’ll never forget a sociology professor I had in college who went on a rant about how so many medical practices are done for the convenience of the doctor. He threw in the subject of childbirthing positions (lying in a hospital bed versus standing/squatting/kneeling), thank goodness, and that point has always stuck with me! I often wonder how much of my current thinking is based off of one man’s rant in 1998.
I’m so happy I found this. We actually were told NOT to come back to the dentist office if we did not sedate our son for one cavity. They said he was too squirmy. Parents can make any decision they want for their child, but mine was to have him NOT sedated. I did research, and they actually banned this in the U.K. due to dental deaths. Some occuring right here in the United States. I would rather my son experience 15 minutes of anxiety than take ANY chance on his life. We will be finding a new dentist who respects our wishes.
Glad my experience could be of some help! I hope you find some luck in finding a dentist who will offer you some options. You may want to research cavities a bit further. I haven’t read much about it lately, but I have come across articles discussing natural methods of “healing” cavities. If your son is very young, it might be worth an investigation…
I was so relieved to read this. I just found out that my 21 month old’s four top front teeth are all rotting and basically disintegrating. Her dentist have me the option of going to the hospital to have the work done under ga or in the office in the papoose. I decided to do it without the ga. The dentist told me she could do it in 15 minutes, and it would be more traumatic to me than the baby. I’m happy to see that your experience was similar to what she described. Thank you!
Aw, poor kiddo 🙁
Glad you went with your gut and everything turned out well!
Julie Cattabiani says
Thank you. I have people telling me left and right to do conscious sedation to pull two of my sons teeth. He’s almost 5. I am going to another dentist today to see if they will do it with just numbing. I am sick of hearing how traumatized he is going to be. I feel otherwise and it’s nice to see I am not the only one.
Question, we have a procedure to do and they are using Versed. Oral conscious sedation. this seems like a much better option than General, and I can’t imagine her doing it with nothing since she is so fearful already. they have to extract a tooth.
Hi Hannah–I am in no way qualified to give any kind of advice on this. I think your phrase “I can’t imagine doing it with nothing…” points to your answer 🙂 My post was written from the point of view of a mother of a 20 month old; had this incident occurred when my son was older, more developed, and more aware, I would have responded differently.
I have a one year old little girl who is absolutely terrified at the dentist. She has to have her top four teeth extracted and they are doing the papoose. The thought terrifies me .. As I’m sure it must it diffinently will my little girl. .. I’ve been reading so many different reviews on ga and the papoose.. Is the psychological damage reversible.. I worry maybe it’s my own fear coming through. And they said I don’t have to be in there with her .. But I feel like I should,but at the same time I find myself feeling panicy at the thought.. They say it will take a few minutes.. Uggh she gets so upset and over heats. That scares me.. As well as throws up when she is so upset.. Any advice.. Please
This post is many years old but gave me much relief! I stumbled upon it trying to find something to make me feel better. My 18 month old is having a tooth extraction on Tuesday. I’m to hold him down while its preformed. His dentist didn’t even consider GA as an option which now, after reading this, I’m in full support of. Thank you for sharing!
The state of Tx requires the child to be a certain age or they will not do the procedure without GA where can I go to get this procedure done without GA
If a child gets upset and creates copious amounts of secretions and/or worse — vomits, this is a set up for a life threatening disaster called ASPIRATION. A screaming child who is restrained could EASILY suck fluid into their lungs causing an immediate life threatening laryngospasm where the secretions actually cause the vocal cords to snap shut and the child is unable to breath but still using their chest wall muscles to try and pull air through a closed hole. This leads to “negative pressure pulmonary edema”. Or the child could gasp those secretions into the lungs causing aspiration pneumonia.
If either of the above situations were to occur, a dentist and his hygienist would have absolutely NO CLUE how to manage the crisis. Their protocol is to call 911 while your child is now in respiratory arrest. Anesthesia professionals are not JUST trained to do general anesthesia. Our JOB, Our #1 priority is to PROTECT THE AIRWAY. The reason children die in dentists offices isn’t Bc they received sedation. It’s Bc they received sedation by unqualified medical personnel. In a hospital or outpatient surgery center A CRNA (certified registered nurse anesthetist) would be present even if only light sedation were to be used. The CRNA is there to do something called Monitored Anesthesia Care – giving light to moderate sedation and being present to intervene if an airway crisis were to occur. He/she sould quickly take over the airway and break the spasm in ways that only anesthesia is trained to do. Or they could quickly get an airway in place and prevent any permanent hypoxic (lack of oxygen) injury to the brain.
I agree every situation is different. One tooth in a calm child…..sure, that can be done. But full dental rehab….no way. Im not sure of your source about general anesthesia causing permanent brain damage (which is ABSOLUTELY false), but I can assure you that hypoxic brain injuries DO OCCUR everyday in dentists offices. I am a parent and I fully understand all of you just want what’s best for your child. I hope this helps some of you to better understand thst while general anesthesia may not always be required, it is imperative that an anesthesia/airway professional be present for extensive procedures. Don’t let a dentist talk you into doing it in the office so that all the money stays in his pocket. Ask him if a CRNA will be present. If he says No…….. well, it’s your call. But you absolutely have the right to ask for it to be done in an outpatient facility where a CRNA is on site.
Last word of advice, when multiple people tell you it needs to be done with anesthesia and you have to search to find one who will do it without…… Maybe the others did have your child’s best interests in mind and you found the one who didn’t. Be careful. Be educated.
And healthful mama, I hope you do not take offense. As I said, each situation is different and you ARE CORRECT that an abscess cannot wait a month to be treated. That is insane. Dental infections can go bad quickly. Over the course of a month, that small access could spread into the jaw bone causing osteomyelitis and sepsis. In your situation I think you made the right call. That’s my humble opinion. Remember we know our children best. That’s why you have to do your research and be an advocate for your child.
My four year old daughter had six cavities filled due to Enamel hypoplasia. We opted for NO sedation. The risks of laughing gas, conscious sedation, and certainly IV sedation are just that… Risks, or otherwise known as dangers. We found a pediatric dentist (one of few) in our town that practices non-sedation dentistry and my daughter had an AWESOME experience. I was able to go back with her, the dentist was amazing, and so was the staff. We are very happy with our choice, but it was ours. Each child, and parent for that matter, is different.
Whereabouts do you live? I haven’t found ANY in this town! 🙁
So happy I found this post! We are in the same situation this week, front took damaged and 6 months later causing abscess, etc. I’ve been so worried. Thankfully the pediatric dentist suggested exactly what you went with off the bat. It would’ve been a red flag if they wanted to be a 20lb 18 month old under hard meds. So I’m glad that’s not the case.
Now I’m worrying about the recovery? And how has it been since your little one had the tooth removed? Because I believe this post is 2 years old…..