Is It Really Necessary for Kids to Go Under for Wisdom Teeth Removal?

Ed Anderson
Sep 4, 2018 · 4 min read

Modern dentistry has made it possible not only to identify growing wisdom teeth in younger patients, but also to remove them safely and with less discomfort than in the past. However, these advances in dental care have also posed some risks.

Wisdom Tooth Removal 101: Understanding the Basics of the Third Molar

The wisdom teeth, also known as the third molars, can be spotted in patients in their mid-teens and are often removed in the late teens or early twenties. Often, removal is required because the person’s mouth is too small to accommodate the additional set of molars, which can be quite large.

Some people find that their wisdom teeth come in with little trouble. Others, however, may experience symptoms like pain, infections, and swelling of the face or the gums in the area of the wisdom teeth. When symptoms occur, dentists or orthodontists may recommend removal of the teeth in order to avoid future problems like infection, cyst or tumor development, or damage to existing molars, according to Stanford Children’s Hospital.

Wisdom tooth extraction is a form of surgery, according to Stanford Children’s Hospital.

During the procedure, the surgeon makes an incision through the gum tissue around the tooth, detaches the connective tissues holding the tooth to the bone of the jaw, removes the tooth, and sutures the opening. In some patients, parts of the bone surrounding the tooth may require removal as well.

Wisdom Tooth Removal and Sedation or Anesthesia: What Options Exist?

When a parent hears that their child will need wisdom tooth removal, safety is their first concern, notes Jenny Green at Colgate. Questions about whether a child will need sedation or anesthesia often come up early in the process.

“Most wisdom teeth extractions are performed in the dentist’s office under local anesthesia,” according to Stanford Children’s Hospital. However, patients who experience significant anxiety about the procedure may be able to talk to their dentist or oral surgeon about alternatives, such as supplemental sedation or other forms of anesthesia.

Parents whose children are facing wisdom tooth removal should start by talking to their children about the procedure. Find out what your child’s comfort level is with being fully alert during the process with a local anesthetic preventing them from experiencing pain during the procedure. Often, a simple local anesthetic is the quickest option for wisdom tooth removal.

However, if the child is nervous or the dentist or oral surgeon recommend it, considering other options may be worthwhile. According to the Children’s Hospital of Pittsburgh of UPMC, the three most common options for patients who don’t want to be fully alert during their wisdom tooth removal are oral sedation, nitrous oxide, and intravenous sedation.

Oral sedation is taken by mouth or through the nose as soon as the patient arrives for their appointment. It typically takes about 20 minutes to reach full effect. The patient remains awake while on oral sedation, but can relax more easily during the procedure.

Nitrous oxide, or so-called “laughing gas,” has been used for many years in dental procedures including oral surgeries. A mixture of nitrous oxide and oxygen is provided through a breathing mask. It can take effect in as little as five minutes, and causes feelings of relaxation and euphoria. Once the procedure is finished, the patient receives pure oxygen through the mask in order to help the body clear out any remaining traces of nitrous oxide, according to Jenny Green at Colgate.

Intravenous sedation is the type most parents mean when they talk about “going to sleep” or “going under” during a wisdom tooth extraction. Typically, nitrous oxide is used first to induce relaxation, so that a needle can be inserted into the patient’s arm or the back of the hand. Sedatives are provided through the needle directly into the bloodstream. Depending on the type and amount of medication used, the patient may remember the procedure only indistinctly or may not remember it at all.

Items to Consider When Choosing Sedation for Your Child’s Wisdom Tooth Extraction

According to the American Academy of Pediatric Dentistry, children do best during a dental procedure if their parents understand what is happening and help them understand and be prepared for it. To make an informed choice, it helps to understand how sedation works and what options are available.

Regardless of the type of sedation used, oral surgeons and their staff monitor patients throughout the procedure. This is particularly true in the case of intravenous sedation, which can pose risks including problems with breathing, heart rate, or blood pressure. When intravenous or general anesthesia are needed, an oral surgeon may even refer you and your child to a dental hospital.

When considering the options that are best for your child, it helps to ask the following questions:

· How anxious is my child about this procedure?

· How anxious am I about this procedure? Why am I anxious, and how can I address it? To what extent is my child’s anxiety a reflection of my own?

· How strong are my child’s self-soothing, self-regulation, and self-monitoring skills? Children with strong skills in these areas are more likely to do well even without sedation.

· What allergies to medication, if any, does my child have? Have I discussed these with my child’s dentist and oral surgeon?

· Does my child’s pediatrician have any input on which would be the best option for my child, and if so, what does the doctor say?

Whichever option you choose with your child, be sure to follow doctor’s instructions carefully before the procedure. These may include instructions to avoid food or drink. Having kids wear loose-fitting clothing can help doctors attach monitors and other devices more easily, and the company of a favorite stuffed toy or blanket can make the procedure simpler as well.

Ed Anderson

Common Name | Uncommon Thoughts

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