The Dental Visit

We'd known for a while that Elizabeth would have to have some teeth pulled. Her mouth is very small, and once she began losing baby teeth, there wasn't room for all her teeth to grow back in since her permanent teeth are so much bigger than the baby teeth they are replacing.

Last week was the time we'd scheduled an appointment to have some of her baby teeth pulled. We weren't looking forward to it at all. This is the child who has had uneventful teeth cleanings for only the past 18 months or so. Before that time, she would cry and scream when she first entered the torture chamber (i.e., the room where she lies, complete with headphones, on a comfy, padded bench and watches cartoons on the TV screen directly above her on the ceiling). The first two times we took her (she was 4), the dentist and hygienist were barely able to look in her mouth, much less clean her teeth or get x-rays. But after she turned 5, she would cry and scream for a few minutes, and would then settle in for 20 minutes or so of Dora the Explorer as the hygienist worked on her teeth with strawberry-flavored toothpaste. Once she turned 6, she would go right in, lie down, put the headphones on herself, and settle in for a few minutes of entertainment. We were hopeful that the disastrous office visits were behind us.

Then, as she began to lose baby teeth and her permanent ones began to appear, it became obvious: her mouth was way too small for all of her permanent teeth to come in straight. Our pediatric dentist advised us to visit an orthodontist and get his opinion of the situation. And his advice was the same as the dentist's: some teeth had to come out. Four teeth, in fact. Two on top and two on bottom. Two on the left and two on the right.

Ugh. How in the world could this child lie still while the dentist numbed her gums in four places, then ripped out four teeth by the roots?? It didn't seem likely to happen.

How should Joe and I, as responsible parents, respond? How could we guide our daughter through this procedure without it causing her to be scarred for life? After much thought and discussion, we hit upon what seemed to be the perfect solution: she needed medication. I called the dentist's office, and asked about our options. And our dentist, who has been present at each of Elizabeth's dental visits, readily agreed that she was a prime candidate for conscious sedation. He wrote a couple of prescriptions which we had filled before the big day.

We also went about preparing Elizabeth in another way. We bribed her. We promised that after her teeth were pulled, she could have all the ice cream she wanted. We would also buy her tacos from Taco Bell for lunch, or whenever she felt up to eating them that day. She wouldn't have to do any school work, and she would get an extra hour of game time. As she pointed out, she was getting four nice treats: one for each of the teeth she was having pulled. The day before our dental visit, she told me she was looking forward to the next day because of all the fun things she would get to do. (A definite answer to prayer!)

This is Elizabeth a few days before her dental visit to have her teeth pulled.

On the morning of the procedure Joe, Elizabeth, and I arrived at the dental office an hour early. (You didn't think I was going to do this by myself, did you??) An office nurse administered the medication to her, and we were sent back to the waiting room. At the appointed hour, we were called back to the torture chamber. By this time, Elizabeth was a little groggy, but insisted on walking back to the room herself. She settled in on the bench and got her headphones.

The nurse immediately outfitted Elizabeth with the mask which would deliver the (strawberry-scented) nitrous oxide. She prepared four swabs with topical numbing medication, and inserted them into Elizabeth's mouth, one each on the gum areas immediately below or above the four teeth to be pulled.

Here she is in the dentist's office, completely accessorized with protective eyewear, headphones, and a nitrous oxide mask.

After 15 minutes, the dentist came in to inject anesthesia into the gum areas. I was sitting on the bench, with Elizabeth's legs across my lap. The child never even twitched as he injected tubes of medication into her gums. Her eyes were open during part of this time, and she responded to the nurse and dentist when they asked her if she was doing OK. (She would later tell me that she didn't even know that she had received shots in her mouth.)

After allowing 15 or 20 minutes for the anesthesia to take full effect, the dentist came back in and began to pull her teeth. Again, she never twitched. While he was pulling the four teeth, he mentioned that two of her front bottom teeth were loose, and that he could go ahead and take those out if it was OK with us. So Elizabeth ended up getting six teeth pulled that day. (For the price of four!)

Here are the six teeth that were pulled. Who knew that canines had such long roots?

We received instructions on how she might be nauseous for the first hour or two after we got home, and that she couldn't drink any carbonated beverages or use a straw for the first 48 hours in order to prevent the blood clots from dislodging from her gums.

Joe carried her to the van while I paid.

We had laid in a supply of ice cream in preparation for her return home, and she immediately asked for a couple of scoops once we had her settled in on the couch. Then she asked for a couple more scoops. She had gone to the dentist that morning without any food or drink, and she was hungry! After four bowls of ice cream, she told me she was starving, and asked me to go to Taco Bell and get her a couple of soft tacos. She immediately devoured those, and within 15 minutes of eating them, was on the floor wrestling with Catherine. We declared her completely over the effects of her morning.

Here's Elizabeth's beautiful smile after having the teeth pulled.

We are very thankful that everything went smoothly, and that the medication worked just as it should have. Elizabeth will go through this same procedure again in a few more years after most of her permanent teeth have come in. We're hoping that will go just as nicely as this time did.