Please could you

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Please could you help me…
Should a young child of 5 years old be given an injection for a filling? I have been seriously distraught by the extreme pain by 5 year old son experienced yesterday. He was given two fillings without any pain relief. As soon as he was in the dentists seat the dentist started drilling the cavities. My son was so brave but was screaming in pain for about fifteen minutes.  I asked the dentist why he wasn’t giving an injection and he said the pain would be just as bad. My son’s body was shaking all over, he was sweating and was in shock. All I felt I could do was hold his hand, reassure him, but I was so unprepared for the level of pain he was put through. Is this right?
Should a dentist discuss the treatment with the parent first and give a choice for an injection or not?


I feel my son has had such a traumatic introduction to the care of a dentist. He didn’t talk for two hours afterwards, which is completeley unlike him. I spent the afternoon cuddling him and comforting him, but I can’t forget the level of pain he went through and have been really tearful myself. Please could you give me some advice. Thank you.
 

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Asked on 10/05/2006 12:00 am
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Oh dear! What an unfortunate and unpleasant introduction to dental care. I can appreciate your distress, and the difficulty you face in undoing that experience for your son. The best advice I can offer is to ask your friends with similar aged children for a recommendation of a dentist who is good with children, and who works in a system that gives them time to rebuild your son's trust. Personally I find that sedation can be a big help when treating young children, and it may be worth asking if this is available. Hopefully limiting your son to food and drinks only at mealtimes will prevent him needing any more fillings, and going to the dentist will be a fear-free experience for him in the years to come.
Nigel Jones

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Posted by Dental Professional (Questions: 0, Answers: 1475)
Answered on 22/05/2006 12:00 am
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I am very sorry to hear about your son's experiences.  One always has to way up the benefits of an injection v's the trauma of feeling treatment. There is no minimum age for injections and whilst it could be entirely appropriate to start treatment with no anaesthetic, I feel most dentists would have stopped treatment once they knew your son was experiencing more than mild discomfort. Usually, if delivered correctly a local anaesthetic need not be traumatic.
 
Perhaps consider finding a dentist who is going to give your son more time.  This could be his existing dentist once you have discussed this matter with them or it could be a new dentist. However it is also important to consider what has caused the decay and so a preventative approach is most important

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Posted by Dental Professional (Questions: 0, Answers: 1475)
Answered on 10/05/2006 12:00 am
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Thank You for your question.  I feel it is important to discuss the various treatment options with the parent, and with the child, so that everyone understands what is happening.  Sometimes a deciduous (baby) tooth which has a small area of tooth decay can be treated without local anaesthetic. This depends on the child. Some people feel that the injection of the local anaesthetic is more distressing for a young child.  Judgement of the nature of the personality of the child and the treatment needed is paramount.

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Posted by Dental Professional (Questions: 0, Answers: 1475)
Answered on 10/05/2006 12:00 am
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Children's dentistry is very different to adult dentistry. Although the actual treatment is relatively easy from a technical point of view, children need to be handled extremely carefully.  This means that they need time to understand the procedure and to be introduced to each part of the treatment. Sometimes treatment has to be done over a number of appointments. This depends on each individual child, and requires dental professionals who are sympathetic to the needs of children.
 
There are many different ways of diagnosing and treating dental decay, and preventive dentistry means that by working with the dental team, your son's confidence can be restored. I would advise finding a practice where you can discuss your child's experience and find our about why he is getting decay, and how to stop it, hopefully preventing the need for any further fillings.
 
Our practice has a special children's unit called Future Smiles, and our staff will be happy to give you advice by phone

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Posted by Dental Professional (Questions: 0, Answers: 1475)
Answered on 10/05/2006 12:00 am
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I am so sorry to read your question which greatly saddens me as a member of the dental profession. Your son's experience is of course inappropriate, dental treatment on young children is sometimes very difficult to achieve a satisfactory result for all sorts of different reasons but there is never any merit in distressing a child 'to get the job done'.  To answer your questions:-
Local anaesthetic is appropriate for most dental procedures be they on adults or children and if explained properly to the patient, is readily accepted by most. It does however take time and, although not an excuse, the time constraints on some dentists may encourage them to complete the treatment in the swiftest but not necessarily the kindest way. Baby teeth can sometimes be treated with no anaesthetic, particularly with the help of a little sedation, very successfully but it is always important to stop treatment if it is painful or difficult.


Your options for the future are to consider discussing your son's treatment with the dentist who carried it out, seek a more sympathetic approach from a different practitioner or even consider referral to a secondary care facility although the latter option is unlikely to be necessary. The advent of the new NHS contract is likely to make dentists practicing within the health service poorer financially and therefore your son's experience may sadly become more commonplace.

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Posted by Dental Professional (Questions: 0, Answers: 1475)
Answered on 10/05/2006 12:00 am