Important Details to Know Before Pediatric Dental Surgery

I recently found out that my 6 year old daughter has a condition called "Shark Teeth."

As you can see from the picture above, Sharks are known for having more than one row of teeth.  When this occurs in humans, it is usually because adult teeth are growing in behind baby teeth and the baby teeth are not getting loose on their own. (I later found out that this is pretty common in children who experience special needs)

To make a long story short, my daughter had to have her 4 front bottom teeth extracted all at once.  THAT was her first "losing a tooth" experience!!

This mama was no less than DEVASTATED!!!  I had spent months planning how our family would welcome the Tooth Fairy and all of the precious traditions that we would start in order to ease the trauma of having wiggly teeth and then losing them. (Especially for a child who experiences sensory issues).

So, to be consistent with all the other things that are "A-typical" of our life, my daughter ended up having  major surgery at our local hospital and all four teeth were extracted (though she now insists she lost "a tooth"...and we allow her to believe that! ha!).

I learned a few things that day (and how to prepare for that day):

1.) Schedule your child's procedure to be the first procedure of the day.

• The reason for this is the child cannot have food or drink after midnight.  When kids first get up in the morning, they want to eat or drink.  If you are the first procedure, you can tell your child they can have breakfast after seeing the dentist.  (Or, as we communicated... "First see the dentist, THEN eat breakfast")

• The second reason is to avoid delays in the procedure.  If others are scheduled ahead of you, it is possible that due to unforeseen complications in their procedures, your child's surgery might be delayed (meaning a longer time for anxiety to build up, longer time to wait to eat/drink)

• Also, it will help if your child is relaxed from just waking from a full night's sleep.

• This (lack of delays in scheduling) also ensures you will get the anesthesiologist you were originally assigned.

2.) Talk with your doctor and anesthesiologist about the drug "Versed" to see if it would be an option for your child.

• This is the same drug that they often give to patients who will go through a colonoscopy.

• This drug calmed my daughter right down before surgery (making it so much easier to administer anesthesia).

• FYI--The drug is a liquid and it must not taste that great, because after they gave it to my daughter, she kept asking for water.  

• This drug is a quick acting drug. 

• The drug also helps with the recovery process.  My daughter was so calm in the recovery room and when we took her home. My child, who NEVER sleeps on her own, actually found her blanket and napped for 2 hours.

3.) Advocate to be assigned to an anesthesiologist who will allow you to remain with your child until your child is asleep. 

• In our hospital, there were over 30 anesthesiologists, but only 4-5 that allow parents to stay with children until they are asleep.

• My husband was allowed to suit up (in a paper suit), carry my daughter to the operating room and hold her while she "blew up the purple balloon" (they put a mask over her mouth and nose and when she breathed a purple balloon looking device inflated and deflated. This sedated her so they could then start the anesthesia via IV and she didn't feel a thing)

4.) Try to distract or re-direct your child from looking in the mirror for at least 24 hours after the procedure.

• Day one is rather a disturbing sight.  The "holes" are really red and sometimes blood filled.

• Day two is so much better, the redness and swelling have decreased significantly, and it is much less scary to look at.

5.) The night before surgery, dress your child in what they are going to wear to the hospital the next morning.   

• You can take your child straight from their bed to the car and avoid a lot of questions. 

• Doing so also gets you away from the refrigerator quicker.

6.) Pack a cup (no straws or sippy cups) and your child's favorite beverage in a thermos. Put them in the trunk or back of your vehicle (out of reach of your child).  Keep it in the vehicle until your child is in surgery.  

• Once your child is in surgery, go get the beverage and cup and have it ready for your child for when they wake up in the recovery room.  

• The hospital will have options to offer you, but your child will desire and feel so much better if they have their comfort beverage available to them.

7.) Be honest with your child, but DO NOT give your child too much information.

• My daughter is always asking "What's next?" she wants details.  So, what we told her was that we were going to see our friend, the Dentist, because he was going to help us make sure there would be enough room for her pretty big girl teeth to come in.  That information was just enough.

• DO NOT give the gory details of surgery, or a play by play of medical equipment, stitches and etc.

• DO tell children that medical professionals care about them and want to keep them safe.

8.) Present your Medical Professional in a positive light.

• We constantly tell our daughter that our medical professionals are our friends.  

• We always point out fun things about them.  "Our dentist is so nice, he sings to your teeth" (and we are fortunate, because he does sing to her teeth.  Our daughter is really big into numbers and counting, so he also will count her teeth to help calm her.)

• Also, when entering a strange room with lots of equipment and antiseptic smells, be sure to comment about how "cool" all that neat stuff is!

9.) Make sure mom and dad are at their best

• Line up support from family and friends to have a meal or two delivered so that you can focus on your child once you arrive home and even the night before (gift cards for ordering in work great too).  (It was hard and humbling, but I emailed my friends/family and flat out ASKED if any were available to provide a meal or gift card.  I am so thankful I did!!)

• Consider setting up a "Caring Bridge" site so you can keep all family and friends updated with one message (vs. sending 25)

• Pack a breakfast for you to eat after your child is in surgery (An amazing friend made us mini muffins to take with us. We kept them in the trunk with our daughter's drink and once she was in surgery, we retrieved them and renewed our energy.)

• Wear soft comfortable clothing that your child will want to cuddle against.

• If you normally wear perfume or cologne, wear it, but keep it light.  Your child will be able to recognize you by your scent before they are awake enough to see you.

• Bring a blanket from home (your child can use it before and after surgery and you can use it while they are IN surgery)

• Get a good night's sleep the night before.

10.) If your child experiences sensory issues (sensitivity to light or sound) you might choose to bring your child's sunglasses and ear muffs with you.  These came in very handy for us with my daughter- especially in the recovery room.

And a couple of bonus suggestions: 

** If your child experiences any allergies or sensitivities to anything, be sure to discuss this with your anesthesiologist and medical professional and make a plan in advance of anything happening.  For example: my daughter is terribly allergic to all adhesives - even if they are latex free.  The adhesive literally burns her skin and also makes her break out in a terrible rash.  We made an advanced plan that included what medications/creams to put on them and when to call the hospital if something serious were to occur.

**Be prepared for your child to come out of anesthesia in a very emotional way - usually, either angry or sad (crying).  (a friend of mine joked that how your child wakes up from anesthesia tells you what kind of drunk they will be someday- ha!).  In our case, because of the "Versed" calming drug, our daughter woke up and was just very quiet and calm.  However, many children around us were crying.  We actually had to leave early because all the crying was bothering our daughter.

**Know your hospital's policy and state law regarding extracted teeth.  In our case and in our state, the law considers teeth to be a "body part".  Every body part that is removed during surgery must go to the pathology lab.  However, if there is no decay/infection in the teeth, we may pick the teeth up once the lab has completed their tests/review.  (If there were to be decay in the teeth, they are then classified as a bio-hazard and cannot be returned to you.  In that case, have some white tic-tacs on hand to leave for the tooth fairy)  =0)

**If you are especially sentimental (like me) you might consider having your child's photo taken before their procedure (we did this the night before at our local photo center). Be sure to take your camera with you to your child's surgery. We captured many "fun"/memorable experiences (my husband sporting his paper outfit, pictures of doctor/anesthesiologist, how our daughter looked after surgery and in recovery, etc, etc)

I hope your child will never have to experience dental surgery, but I found that it was much easier once I knew what to expect. 

If your child has experienced dental surgery or other procedures, I'd love to know what other tips you have for parents or what policies your hospital or state implemented. I firmly believe that knowledge is information!!