Parents guide: kids tooth removal | Benowa & Gold Coast

In this article, we discuss the tooth extraction procedure itself, with a rundown from our specialist paediatric dentist Dr Michael Chong:

• Ways to extract a child’s tooth
• What to expect – the risks and complications
• The costs

Also see Child tooth extraction, under our services menu where we explain why your child might need their baby or ‘big’ teeth pulled out. It covers the essential facts for parents and our approach to removing teeth for children.

WAYS We EXTRACT A CHILD’S TOOTH

At our dental practice:

• Simple extractions can be done ‘in the chair’.
• Local anaesthetic is administered via needles to numb the treated area.
• We also have ‘happy gas’ (relative analgesia) in our treatment rooms.  
• Your child will be awake.

In hospital:

• Your child may need to go to hospital for kids tooth removal if your dentist has to perform more extensive or complicated procedures.
• A specialist anaesthetist will ‘put them under’ with general anaesthetic.
• Your child will be asleep.

In the chair or hospital – which one will the dentist choose?

Whether your child has their tooth removed in the chair or in hospital depends on:

•     Co-operation of the child
“This plays a big part and has to do with their age and previous dental experiences,” says Dr Chong. “Firstly, we ask ourselves or the parents: will this child be able to handle the needles and sit for the removal? Dental injections take about 40 seconds to administer and, for children, that can be a challenge to sit still for that long while it’s stinging. Also, there are usually two injections required.”

•     Complexity of the removal
“A simple tooth extraction can be done under local anaesthetic and the tooth will come out quite easily once it’s numb. We’ll opt for general anaesthetic when a more difficult, complex case requires several needles and the tooth might come out in several pieces.”  

•     Multiple teeth
“If a child needs more than one tooth taken out, we consider how many times they have to return to get the job done. Will they sit again for a second or third time? If it’s beyond the ability of the patient, we’d discuss doing them all at the same time under general anaesthetic because it’s much easier for the patient.”

•     Overall dental workload
“Sometimes there’s other dental work to complete, such as several complex fillings. So we have to look at whether the child is able to handle these treatments during multiple visits to the dental surgery.”  

•     Dental infection and swelling
In severe cases, the tooth won’t numb up sufficiently with local anaesthesia, so the tooth will need to be removed in hospital where the infection can also be drained.

•     Medical history
“A child’s health status may prevent us from removing a tooth in the dental setting, for example, there may be behavioural factors or inherited bleeding disorders. If a child is under the care of a paediatrician or other medical specialist, we’ll check all relevant factors with them before commencing treatment. Sometimes a specialist might want it done in hospital because there’s more control of their health and fewer variables are left to chance.”

•     Health plan
“Sometimes a child’s medical specialist will ask for an additional, non-dental procedure to be carried out at the same time – perhaps a blood test they’ve been unable to get from a child, or a procedure for a patient with special needs.”

WHAT TO EXPECT – THE RISKS AND COMPLICATIONS

In the chair

The risks are less severe, however they can be more common due to the patient being able to move. “If we’re removing a tooth for a child in the chair, the first risk comes with administering the anaesthetic,” explains Dr Chong. “If a child won’t sit still and they move with the needle in their mouth, they can suffer unwanted injuries (called iatrogenic trauma). It’s dangerous for the patient and this is a risk we think about with every child.”

“A badly broken tooth can be a challenge to remove well, but this can be more challenging in the chair because we’re also managing the patient’s behaviour. Sometimes the tooth can break in half or the roots can be left behind. Some patients present to us with a tooth that’s only half out.”  

“The main complication is having an otherwise good patient turn into a fearful child after their tooth removal. What can seem like an easy process to an adult may be overwhelmingly scary for the child, so they might be fearful or less cooperative at their next dental appointment. Nobody wants that to happen.” Behaviour management skills and the experience of the dentist are vitally important to getting a good result without traumatising the child.

In hospital

“Although more difficult teeth are removed in hospital, complications are extremely uncommon because everything is at our disposal. The risks in performing this type of surgery can be related to the risks of general anaesthesia. Anaesthetic risks are uncommon and can be discussed in detail at your consultation appointment.”

THE COSTS of Kids tooth removal

The costs of having your child's tooth removed depends on their situation. “A simple removal is easy to quote for as it should be straightforward,” assures Dr Chong. “But some cases, like those related to a complex injury, can be more difficult.”

“In many cases, I’d look at the big picture, not just a single decayed or damaged tooth, to get the best outcome for the patient. This can be discussed together at the consultation appointment with the patient and their parents. Then their requests are acknowledged and the quote can be given.”

“There are higher costs involved with general anaesthetic, but at least everything is done once and done properly. Then we, or their family dentist, can concentrate on getting your child confident again.”

Open wide! Let’s look inside!

You don’t need a referral to bring your child to us about kids tooth removal. To make an appointment, just call us now on (07) 5597 2000 or book online.