Often for young people undergoing orthodontic treatment, there is a request by the orthodontist to remove either adult teeth or deciduous (baby) teeth to provide sufficient space for correction of crowded teeth or a malocclusion (bad bite relationship). This often precedes either removable (a plate) or fixed (braces) appliance therapy. This is a daunting prospect for a young person who may never have experienced any form of invasive dental treatment and we recommend that this should be carried out either in hospital with a general anaesthetic or in our rooms using behaviour modification and
sedative techniques.
Certainly a loose deciduous tooth can be removed with local anaesthetic only in the co-operative child, but fully formed deciduous teeth requiring removal for orthodontic reasons can be difficult and emotionally traumatising for patient, parent and the dentist. Most paediatric dentists provide some form of sedation along with techniques in behaviour modification to permit extractions to be carried out in their rooms and not in a hospital setting. Especially in the younger child, extractions may be perceived as body amputations and this may not always be soothed over by a visit from “the tooth fairy”. Multiple orthodontic extractions
are always best performed in the child or young adult with techniques that will reassure them
before they attend, that they will not have any conscious awareness of the treatment when it is carried out, i.e. “you will be asleep”.
Future visits to the dentist should not be compromised by a bad experience and loss of trust. If your child or teenager requires orthodontic extractions talk to your dentist about the different ways of going about it and if necessary
ask for a referral to a specialised dental practitioner not only experienced in removing teeth but also in the use of both psychological and pharmaceutical behaviour modification techniques. This will ensure that the extraction experience is sufficiently positive to maintain your child’s motivation to regularly attend for future dental care. Our practice specifically caters for young patients requiring orthodontic extractions.
