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Extraction for 3 yo?

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mommy24

Junior member
Joined
Sep 6, 2010
Messages
4
My 3 year old son will need to have 2 teeth extracted. I have a feeling that the dentist is going to try to push complete IV sedation and I am not comfortable with that at all. My older son (8) had 2 extracted with nitrous oxide and did great. Do you think this is ok for a 3 year old?
 
Hi mommy24,

I am not a dentist but I just thought I would put my 2 cents in. When I, myself, was 3 years old I had 4 teeth extracted with local anesthetic (novocaine) and nitrous oxide and did just fine, I barely remember any of it. I struggle with dental anxiety now, but I assure you that experience has nothing do with it...my fears are contributed to other things. I think IV sedation would be a bit extreme for a 3 year old but everybody's case is different and not being an expert I can't really comment on the appropriateness of this method. I will tell you don't feel pressured to do anything you aren't comfortable with. If the dentist wants IV sedation for your child and you don't, I would ask him why it is necessary and express your concerns to him and I'm sure a compromise can be reached.

Best,
Kitkat
 
My nearly 4 year old had a single tooth extraction with just local anaesthetic. The local was delivered painlessly - I was in the room - and it was all over and done very quickly. He didn't like having blood in his mouth but was otherwise fine with it. I suspect he's the type of child who would have hated nitrous but doubt it was available anyway.

I think to do it with just local at that age, you need to be able to guarantee a comfortable injection (numbing gel plus slow delivery or TheWand).

I/V sedation is unpredictable in such young kids and there have been a spate of pediatric dental deaths in USA recently so I understand your concerns...nitrous is a much safer option and therefore probably worth a try even if you have to do 2 separate appointments.

Hard being a 'Mom'...:grouphug:
PS If in USA I think you may meet resistance given your child's age, so I would ask how urgent is the extraction...can it wait until the child matures a bit....can anything simple be done in the meantime?
I'm of the view that a full hospital GA is safer for young children than i/v sedation in a dental office but that may be because in UK GA is the preferred route and i/v is pretty much contraindicated for kids. I understand they do sometimes do local and nitrous though, so again worth a try.
 
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Nitrous is tricky for a 3 yr old, it depends on how mature they are, some can co-operate for it, some can't so it's very much up to the child.

It would certainly be my preferred option for treating a 3 yr old rather than IV.
 
I have performed IV sedation for years on little kids and I liked it as it was far more predictable than oral drugs.
Having said that and even though I never had a problem I did quit that practice some years ago as I was concerned for safety reasons.
Today how would I handle a child similar to yours?
Anterior extractions are very easy and fast to perform once the patient is numb.
If the parent was comfortable with the following I would give the child a high level of Nitrous oxide and very gently give local anesthesia realizing there is a good chance she would cry loudly then after a couple of minutes when I was sure she was completely numb I would use a 4x4 large gauze to protect her airway and quickly remove the teeth.
If the parent wasn't happy with that I would offer oral midazolam at 2mg/kg or less dose and still use the nitrous. It is still a good chance that she would cry but a better chance at amnesia.
If that wasn't good for the parents then we go to the hospital.
I hope this helps.
 
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