Namine had two teeth on the right side of her mouth extracted.

In the first step to make room for her existing adult teeth, Namine had an adult tooth and a baby tooth removed. It was an outpatient procedure, and we made it back home from the hospital the same day, none the worse for wear. Well, maybe a little worse for wear. But I’m getting ahead of myself, so let me back up a bit.

Namine was born with a condition called Pierre Robin (pronounced “ro-BAN”) Sequence, or PRS for short. This condition was the reason Namine had a tracheostomy breathing tube until she was two years old. It caused her to have an undersized and regressed lower jaw, known medically as micrognathia. This smaller jaw caused her teeth to become impacted, rubbing up against each other.

The solution to Namine’s impacted teeth is simple: four teeth in total will be removed. Today’s appointment was the first of two, each of which planned to remove two teeth. This will allow her to get braces next February, which will help to realign her teeth into proper position, with enough room to grow.

Prior to the appointment, we didn’t know how well Namine would cope with having even one tooth removed, much less two. For that reason, we would play it by ear and stop the procedure after the first tooth was removed, if necessary.

As it turned out, it wasn’t necessary. Namine did exceedingly well, despite being nervous beforehand. The only part she had trouble with was during the numbing injection, but I’ll get there in a moment.

The dentist’s assistant actually scolded me during Namine’s first extraction. Dr. Michels and her staff at Children’s Hospital of Wisconsin change the terminology around a bit in front of children. Let me explain. So in order to properly numb a child’s mouth prior to a tooth extraction, there are several steps:

The first step is to swab the area with a numbing gel. This they call what it is; cotton swabs, after all, are not scary.

The second step is to inject Novocaine into the gums, palate, and the floor of the mouth. (I’m sure there’s a proper term for that, but I don’t know it.) The words “needle” and “inject,” however, are taboo. The staff refer to this step as “numbing spray” so as not to freak children out.

It was during this step when I got myself in trouble. As I was watching the dentist injecting Namine’s gums, I commented out loud on how surprised I was that the needle was so flexible, and the nurse gave me a dirty look. She explained that they don’t use that n-word. Namine knew all about the steps leading up to a tooth extraction — she wanted to know, preferring to be well-informed — although I’m sure that’s not the case for every child.

Jessica and I have always been as honest as possible with Namine, especially regarding all the medical procedures she’s needed. If she’s going to be her own advocate — and at ten years old, she ought to know enough to be — then she needs to be knowledgeable. She agrees with that point, so even when it’s scary, she still prefers to know.

But it was during this step — the gum injections — that Namine had the most trouble. Even with the numbing gel having been applied, the injection is enormously painful. Namine knew this beforehand, but knowing is not the same as experiencing. So it was here that I proved useful, providing a hand for Namine to squeeze. And I was happy — although maybe that isn’t quite the correct word — to be there as a stress ball for Namine.

The third step, of course, is extracting the tooth. They never used the word “extract” in front of Namine, preferring the word “remove,” but she knew they meant the same thing. I suppose there’s no gentler language for this, although I doubt they offer every child the opportunity to see their removed teeth, as they did for Namine.

And let there be no doubt, she definitely wanted to see the removed teeth. She was iffy at first about holding them, but even that didn’t bother her for long. Before we left the hospital, the dental assistant put them in a small envelope for us to take home.

Namine showing off her extracted teeth

Once we arrived home, Namine decided to leave her two forcibly removed teeth for the Tooth Fairy. She wrote on the envelope “For: Tooth Fairy, from: Namine Eiche.” She also illustrated it with a picture of herself sleeping in bed, with the Tooth Fairy looking on. (In this drawing, the Tooth Fairy carries a scepter with a tooth at the top.)

Before the evening’s end, Namine’s mouth was starting to regain some of its feeling, and with it came the pain from the trauma her mouth had suffered. She received some pain medicine — nothing substantial — and seemed content, if tired and ready for an early bedtime.

All told, this appointment went far better than expected. We have no reason at present to believe the next appointment later this month should go any different. This will leave Namine the whole month of January to heal, and then she’ll get braces in February.

This post is part of the timeline: Growing dental issues – an ongoing story on this site. View the timeline for more context on this post.

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