After the dentist had informed us that our two and a half year old would need her abscessed tooth pulled, we had some decisions to make. We had to think long and hard about how to handle a toddler tooth extraction.
So, let me get this straight. We welcomed our third baby, discovered a dental abscess on our daughter’s front tooth, and will need to nurse her through an extraction? All of this in the span of three weeks? Sheesh!
WHICH METHOD TO CHOOSE?
Neither of our two options was ideal:
We could either:
- Use nitrous oxide, “laughing gas,” to relax her before the pull. Then, they would numb the gum, inject it with novocaine, and pull the tooth.
- Use anesthesia and put her under completely.
I instantly thought anesthesia would be too drastic and dangerous. Then again, our little Violet, who we also dubbed “Violet Monster” since she was one year old, may be too erratic to handle the extraction. We had this vision of her flailing and not sitting still.
We called the anesthesiologist, and he graciously answered many questions for us. He was on vacation with his family and still picked up his phone! We were obviously nervous about the procedures in place, in case something went wrong. The extraction happens in the pediatric dental office. As concerned parents, this is not a hospital, so we were concerned about what they would do if an emergency situation occurred with the anesthesia. The anesthesiologist reassured us that he has done this for a decade and worked with thousands of toddlers. Not once had he experienced an emergency.
That said, we were also concerned about the effects of anesthesia on someone so young. That is when the anesthesiologist explained to us that he uses what is called Monitored Anesthesia Care (MAC). Basically, with a toddler, they use the least amount necessary to keep them under, and it is monitored continuously throughout the procedure by the anesthesiologist.
STILL NOT SOLD
The unnerving part would be that we would not be able to be with her. If we used the anesthesia, parents are not allowed to be in the room. I understand this completely, but I still did not like the idea of having to wait for her to wake up before I could be by her side again. In the end, the price tag was the determining factor. We were on the fence anyway about anesthesia, but with an $800 price tag, this was not going to be the route we were able to take.
NITROUS OXIDE IT IS
So, bring on the nitrous oxide. The pediatric dentist office gave us a little mask to practice with at home. This practice session at home would allow Violet to get used to having the mask on her nose since she would need to be breathing into it throughout the entire procedure. The masks were different colors with a matching smell. Violet chose the pink bubble gum scented mask to take home with us. This seemed like a good start on how to handle a toddler tooth extraction.
PREPARING FOR THE PULL AT HOME
We did not start prepping for the pull until a couple of days before the extraction. We did not want to put those thoughts in Violet’s mind too far in advance. However, she probably knew something was up since we kept examining the injured tooth!
I bought a couple of cute tooth fairy tokens as a new incentive. Violet loves Peppa Pig, so I purchased a Peppa Pig book about losing a tooth. It was fantastic because Peppa loses a front tooth, just like Violet was about to lose.
I also bought a tooth fairy souvenir box. It is super cute and stores all of your baby teeth in a sweet little memory album.
We kept explaining to Violet that the dentist was going to make her tooth feel better. The dentist was going to take the tooth out like Peppa’s and that the tooth fairy would pay her a very special visit. She seemed receptive to this information, but at this young age, we were not certain how much she was fully grasping.
The day came, and I was probably more nervous than Violet! Emilia did not sleep hardly at all the night before, so my husband and I were “running on fumes” as my parents used to say. That morning, she was not to eat anything two hours before receiving the nitrous oxide. Well, that is super hard for my toddler with the insatiable appetite and her appointment was not until 11 a.m. She managed well when I told her we would get a scrumptious treat to devour after the dentist.
My husband and I both went to the appointment with her. We wanted as much moral support as possible, as we did not know how she would handle this event. They allowed both of us to stay in the room with her during the extraction.
As they walked us back into the room, Violet started to tense up a little bit. At first, she did not want to sit in the chair, even though there was a giant plush zebra sprawled on top. I offered up my phone because she loves to watch nursery rhymes on YouTube kids. That instantly relaxed her, and I was able to coax her onto the examination chair.
Today’s pediatric dentists provide all of the bells and whistles. As a second mode of distraction, they played Frozen on the television suspended from the ceiling.
PICK YOUR POISON
Next, she picked her nitrous oxide mask of choice. This time she selected the red cherry scented mask. She had to breathe the nitrous oxide for about five to seven minutes before she began to relax and they could start.
She was very cooperative, to our relief. The dental hygienist and the dentist were beyond amazing. They were extremely patient and spoke to her in the most gentle of voices. As Violet began to get a little silly from the gas, she looked up at the hygienist and said, “I seeeeee you.” We all chuckled at her cute happy little voice.
NUMB THE GUM
The next step was numbing the area. They put little sunglasses on her eyes for protection. By this time she had lost interest in the YouTube videos on my phone and was only focused on the television above her, entranced by Elsa’s magic. My husband was gently holding her hands by her side. It was not necessary to restrain Violet because she was incredibly cooperative.
They placed numbing gel on her tooth, then injected her with “sleepy juice,” their kid-friendly term for novocaine. The staff is cautious not to show the needle to the child, phew! That thing was massive. She tolerated it no problem; did not feel a thing.
Then, there was the pull. I could not look. My husband watched, I turned my head. Before I knew it, the tooth was out. It only took a few minutes, as it was already pretty loose. Once the tooth was out, the rest of the bacteria from the abscess drained, ensuring the elimination of the infection.
They cleaned off her tooth and put it into a tiny decorative box for her to take home. While doing this, Violet had to keep breathing into her mask for another five minutes. They pumped pure oxygen through the mask to get rid of the remaining nitrous oxide.
My Violet was a real champ! When all was said and done, she walked out of the examination room waving to everyone with a huge smile on her face. “BYE BYE! SEE YA LATER!” she shouted gleefully. It was like nothing happened. They let her pick two trinkets from the toy box this time around. By the way, now at the kid’s dentist, you get some legit toys. I remember getting a bouncy ball or something similar. This contemporary toy box offers princess crowns, decks of cards, stuffed animals, puzzles, play doh, the works!
Probably the most challenging part was the remaining numbness. It takes an hour or so to wear off. I could tell Violet was slightly uncomfortable. Other than that, she did not have residual bleeding (which they said could happen, especially because she is a thumb sucker). She also did not get nausea or throw up, which can also be a side effect of the nitrous oxide.
We ended the experience with a well-deserved trip to Baskin Robbins. Violet requested “geeeen” ice cream. So, by golly, green ice cream is what she got! A healthy scoop of delicious mint chip!
To sum up, the day could not have gone smoother. She was excited to go home and show her sisters her missing tooth.
THE FIRST VISIT FROM THE TOOTH FAIRY
As promised there was a monetary prize waiting for her the next morning under her pillow. I don’t know what the going rate is, but the “tooth fairy” left her five dollars for her troubles.
How to handle a toddler tooth extraction will be different depending on your child. This strategy is what worked for us. The main thing I would stress to all parents is to find a pediatric dentist that fits ALL of your needs. If you are not entirely comfortable with their style, keep looking. It makes a world of difference in your child’s dental care.
What tips and tricks work for your child and their dental visits?
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