Dear Dr. Debbie,
Our fourteen-year-old is scheduled to have two teeth removed in advance of getting braces. He tends to keep his emotions under wraps, and although I know he understands that this is part of the process of straightening out his smile I would like to head off any anxiety about the extractions.
Bracing for Braces
Dear B.f.B.,
Anxiety can be caused by lack of information, lack of trust, lack of control, and anticipation of pain. Let’s aim to reduce all of these potential causes of pre-surgery anxiety.
Information
A good source of information about what’s going to happen (and why) is the orthodontist’s office and or the oral surgeon. In addition to an in-person conversation you may receive a brochure or link to a video that explains the procedure as well as outlines the protocol for the patient.
There’s a big difference between getting a local anesthetic and getting a sedative. Find out the surgeon’s intended plan since this will impact restrictions about eating beforehand (generally no food or drink 12 hours prior to being sedated). It’s also good to know when and what the patient can eat afterwards. Soft foods may be advised for a period of time. You may be further advised to avoid hot, spicy, or crunchy foods for a few days after the extraction since these can irritate the extraction site. The patient may be told to use a warm salt water rinse at intervals for a period of time starting the day after the surgery to soothe the site and to decrease the chances of infection.
Trust
Optimally, your child trusts his health care providers. The best providers, especially those who work with children, instill confidence with a self-assured demeanor and a friendly disposition.
A parent’s trust of the medical professionals who care for her child is essential for a good working relationship. Trust might come from seeing how the doctor interacts with her child, and the diplomas and certificates on the wall, but before the first office visit there can be assurances of an outstanding reputation from friends and acquaintances. If child’s orthodontist or dentist provided the referral to the surgeon it was probably based on good outcomes from prior patients. Trust their professional judgment.
An oral surgeon has had years of training before starting a practice, ongoing training to maintain a license, and possibly decades of experience. Your child’s experience is further supported by an office team starting with the receptionist. When you return her welcoming smile with a trusting smile of your own, your son can see that you are confident that this team can take excellent care of him.
Convey to your child your certainty that although it is his first extraction, this is not a first for the oral surgery office.
Control
It’s natural to feel vulnerable when undergoing a medical procedure. Help your son feel more in control with some choices beforehand. Based on the guidelines given about eating before and after, have your son make decisions in the days before the surgery about foods to purchase and prepare. Emphasize the drink, snack, or meal that he can look forward to as soon as it’s allowed.
It may take a couple of days before he can resume his normal foods, so work with him to plan out what will be in the house ready for him to consume as he recuperates. (I recall my older sister forecasting that I’d be chewing cream cheese sandwiches with my tongue for a couple of days. She was right.)
Pain Management
Besides appropriate choices with food and drink, the post-surgery guidelines will include what to expect and how to manage discomfort as the patient recovers. This may include cooling foods and compresses. If your child knows of any friends who have had dental extractions, or even adults who have had oral surgery recently, he can get plenty of reassurance that proper follow up care includes any medication that may be needed, as long as it’s needed, for dulling the sensation of pain. You will follow the recommendations to use the proper amount of medication for the briefest period to avoid developing a dependency.
The oral surgeon’s office is a ready resource for checking in should any challenges occur in the recovery period. Don’t wait for the follow up appointment to report significant pain and or swelling. Ask about after hours phone calls, just in case. They are there to help.
Plan ahead to have some distractions ready at home to minimize pain. Some well-loved (and not too dramatic) movies can ease the patient through a couple of hours of taking it easy at home.
Looking Forward to a Stunning Smile
Reduce anxiety for this and other necessary ordeals in life by: filling in missing information, trusting the professionals, taking control where you can, and planning ahead to manage anticipated challenges.
Write your question to Dr. Debbie! Please include age(s) of your child(ren) and other details about the situation or concern.
Deborah Wood, Ph.D. is a child development specialist and founding director of Chesapeake Children’s Museum, located at 25 Silopanna Road in Annapolis.
CCM is open from 10 am to 4 pm daily. Online reservations are available or call: 410-990-1993. Walk-ins are welcome. Art and Story Time with Mrs. Spears and Puppy the Puppet is on Monday mornings at 10:30 am. Each Thursday there is a Nature Walk at 10:30 am. As part of Anne Arundel County’s Walktober, all nature walks this month are FREE!
