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Old 12-10-2008, 06:14 PM
16 posts, read 421,603 times
Reputation: 35


Hi I was wondering if anyone knows if it's normal practise for a dentist to extract an abscessed tooth? My 7yr old daughter needed her tooth removing and was to frightened to have it done by her normal dentist so he sent her to a dentist who specialised in phobic children... My daughter was to scared for her to do it too so we were told she was being placed on a waiting list for it to be done in hospital whilst under. In the meantime however it became abscessed and after the dentist saw it she decided to pull it... when she did my daughter sceamed in agony she was begging the dentist to help her but she just replied it couldn't hurt as it was numbed first (I'm not sure how she knew how much of the injection went into her gum as it was going everywhere) My daughter continued to scream it hurts help me, as she was holding on to me I noticed it didn't smell nice. I was in tears by then and the dentist asked us to leave through the back door so she wouldn't disturb the other patients. I had to drive home with my daughter curled in a ball shaking and crying to me to help her, blood everywhere. It eventually stopped bleeding after about a half hour and she calmed down and said it didn't hurt anymore just at the same time as this smell went, I assume it was the infection draining. She is now still upset by it, I had to take her for a hearing test the other day and she was really scared. She constantly bursts into tears when she remembers about it, she tells me it's the most painful thing she had ever experienced ( even worse than when she broke her arm). I don't know how I am ever going to get her to not be phobic of the dentist.
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Old 12-10-2008, 08:33 PM
Location: Fredericksburg, Va
5,354 posts, read 14,410,452 times
Reputation: 7790
That's terrible! Why wasn't a root canal suggested? Was the tooth too far decayed to be saved? Or was it just a "baby" tooth?
At any rate, I think you need to find a more empathatic dentist! While having a tooth pulled can be traumatic, it shouldn't be painful!
(I can't imagine how a 7 year old got an abcess!)
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Old 12-10-2008, 08:37 PM
Location: Moon Over Palmettos
5,978 posts, read 18,343,110 times
Reputation: 5066
From what I know, if they find it to be abscessed, they would have put her on a regimen of antibiotics first before they extracted the tooth and given her something palliative in the meantime. That is really strange. I hope our resident forum dentist Elipar jumps in here. I am so sorry for your child's experience!
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Old 12-10-2008, 09:13 PM
Location: Summerset, SD
325 posts, read 2,884,069 times
Reputation: 565
Whether an adult or child, an abscessed tooth has the same treatment goal---remove the infection. A lot of practitioners choose to put patients on antibiotics and wait for swelling to go down, but that's the wrong thing to do. The fastest and most reliable method of reducing infection is to hit it at the source. In your case, it's to remove the tooth and/or drain it. It's possible to do a "baby" root canal, but not as predictable and not as important since they are baby teeth. That doesn't mean to say that all baby teeth aren't important, they are. But there are other ways of dealing with baby teeth than trying to save them at all costs.

The dentist was stuck between a rock and a hard place. Your child was probably extremely phobic to begin with, which is why she was recommended to have sedation for her dental work. Yet the abscess requires immediate care. What to do??? It's a dilemma, and not a fun one at that. First, you and the dentist must decide if your daughter is really experiencing pain. I can't speak specifically about your situation, but there are a fair number of children who pretend to be in pain so they can get out. This needs to be discerned. Second, if the child is truly in pain, then the dentist needs to stop. Unless something is life-threatening, there doesn't seem to be a good rationale for subjecting someone to torture. At this point, it might have been best to be sent to an oral surgeon to have the tooth removed with some method of sedation.

It has been clearly shown in research literature that anesthetics are not 100% successful, especially in cases of abscess and chronic pain. There are a number of mechanisms which mediate this. Suffice it to say that if the patient claims the tooth hurts, and the patient is a reliable source of information, then it is true, regardless of how much anesthetic was already given.

Now you've got a child with white coat syndrome. What now? I wish I knew, because I could relieve the anxiety of 20% of the population. I'd imagine systematic desensitization and/or anti-anxiety medications work best. It's a tought situation but you've got to work through it. Avoiding problems just make them worse.

Hope your daughter is well.
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Old 12-11-2008, 04:54 AM
16 posts, read 421,603 times
Reputation: 35
Thanx for all your replys... yes it was a baby tooth and I have no doubt that it needed to be pulled some way. She absolutley did feel it.. I have a lot of past experience of her faking it so I've got wize to it but she was screaming uncontrollably even the assistant with her was looking mortified! I think like you say she should of been antibiotics first. Can I ask is the injection they give you is a measured dose? I ask this because when she was injecting her there was loads of it just squirting in her mouth and on her face. I affraid that not enough was administered but I can hardly bare to think about it. Thanx again
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Old 12-11-2008, 06:17 AM
Location: Summerset, SD
325 posts, read 2,884,069 times
Reputation: 565
Woops, I need to clarify a point. Anesthetics can get you 100% numb, but not every single time.

If there's an abscess, DO NOT TAKE ANTIBIOTICS AND WAIT. Antibiotics do not generally have good bone penetration, which is where the abscess is located. It also likely has an epithelial lining with poor blood flow, so antibiotics aren't very effective. However unpleasant it may be, the SOURCE has to be addressed.

Each carpule (cartridge) of the typical anesthetic (2% lidocaine with 1:100,000 epinephrine) contains 36mg of active ingredient. The maximum dosage is 7mg/kg. You have to factor for how much was injected versus how much suirted out.

In my practice, if I can't deliver anesthetic safely, then the patient is getting a referral to someone who can sedate the patient. It's safer for both of us.
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Old 12-11-2008, 06:21 AM
7,079 posts, read 35,829,360 times
Reputation: 4073
That tooth ABSOLUTELY had to come out. A root canal will do nothing for an abscess. And, since it's a deciduous (baby) tooth, there shouldn't even be any second thoughts about this.
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Old 12-11-2008, 11:39 AM
10,864 posts, read 12,342,101 times
Reputation: 15405
Why was a young child sent home with a tooth area still bleeding??
Why would a practitioner think that a child/person was "pretending to be in pain"?? I wouldn't want to go to any practitioner who didn't take symptoms seriously. If x-rays, clinical exam, etc. back up the fact of a problem, why would a practitioner think otherwise?
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Old 12-11-2008, 11:50 AM
Location: Mid-Atlantic
1,820 posts, read 4,163,373 times
Reputation: 1911
My daughter also had an abscessed tooth (6yr) and it was a baby tooth as well. The dentist did put her on a small dose of antibiotics ,but only because we were leaving to go on a vacation. They pulled the tooth immediately upon our return.
It sounds as though the OP's daughter wasn't given a strong enough injection of novicaine (sp?), as my daughter obviously was feeling no pain during her extraction-thankfully!
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Old 12-11-2008, 12:18 PM
16 posts, read 421,603 times
Reputation: 35
I know the tooth had to come out...it's the manner in which it was done with an already scared child by a dentist who "specialised with phobic children" I suppose whats done is done but I can't stop thinking about it, I can't understand how it decayed so quickly! I always look after my kids teeth... their not aloud much sugar and always opt for chocolate rather than sweets that stick to their teeth, she mainly drinks milk, absolutley no fizzy drinks and she had a check up in May and they were fine but by August it was abscessed and needed pulling... she was then put on antibiotics and sent to this other dentist but by the time she got appointment through it was abscessed again. I thought she damaged it when she had a fall off a swing (which is when she broke her arm) but the dentist said no. Poor girl has been in the wars! I suppose just carry on as normal take her for her 6 month checks and she'll regain that trust with white coats and me. Thanx all
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