A 3-Year-Old with Severe Tooth Pain: Full-Mouth Dental Treatment Under General Anesthesia
Severe Tooth Pain — And Multiple Hospitals Unable to Treat Him
Leo was 3 and a half years old, lively, active, and very expressive for his age. But for the past week, tooth pain had kept him from sleeping at night.
Every night, he cried from the pain while lying in his grandmother's arms. His grandmother was exhausted from holding him through the night.
His parents took him to several hospitals, both public and private. But as soon as Leo kicked, cried, and refused to open his mouth, most places politely said they could not handle the case.
For the family, being turned away again and again felt almost as painful as the toothache itself.
3.5 years old · Unable to cooperate · Several decayed baby teeth · Family exhausted by pain and anxiety
The First Evaluation — Even One Hour of Comforting Was Not Enough
Dr. Sun from Pediatric Dentistry tried to help Leo cooperate through games, stories, and gentle communication. Leo was outgoing and smart, but the moment anyone mentioned opening his mouth for a dental exam, he completely resisted.
After more than an hour of effort, the team could only perform limited pain-relief treatment with his grandmother helping to hold him.
The examination still showed a serious problem: several baby teeth had decayed deeply, and three of them required root canal treatment.
"For a 3-year-old child, completing root canal treatment while fully awake and uncooperative is almost impossible."
The Team Decision — General Anesthesia Was the Safest Practical Choice
Dr. Sun, Dr. Li from Pediatric Dentistry, and Dr. Xu from Anesthesiology evaluated the options together.
- Behavior guidance had already failed
- Nitrous oxide or sedation required some cooperation
- Leo was too young to stay still reliably
- Forcing treatment could create lasting trauma
- Incomplete treatment would not solve the pain
- General anesthesia
- Nasal intubation for dental access
- Eye protection during the procedure
- Rubber dam isolation for dental safety
- Complete treatment in one session
When Leo's parents heard the words "general anesthesia," their first concern was whether it could affect the brain. Dr. Li did not avoid the question. Instead, the team explained the safety measures step by step, showing tools such as eye protection, nasal intubation equipment, and rubber dam isolation.
Dr. Xu from Anesthesiology also provided a personalized fasting plan: no solid food for six hours, no milk for four hours, and no water for two hours before surgery. To prevent excessive hunger and discomfort, Leo could drink a small amount of electrolyte beverage two hours before the procedure.
"For this case, the long-term pain and repeated traumatic dental visits could be more harmful than a short, carefully managed anesthetic procedure."
The Result — 3 Root Canals, 2 Fillings, 4 Sealants, and Home in Two Hours
On the day of treatment, Leo first drank strawberry-flavored sedative medication while sitting in his mother's arms. About 20 minutes later, he became sleepy and calmly received an IV line without crying.
Because the dentists needed full access to the mouth and needed to check the bite, Dr. Xu performed nasal tracheal intubation. The dental team then completed the entire treatment in one session: 3 root canal treatments for baby teeth with stainless steel crowns, 2 fillings, and 4 fissure sealants.
After the procedure, Leo woke up within 3 to 5 minutes. He was still a little drowsy and said, "I haven't played enough yet." Half an hour later, he saw his new little stainless steel crowns in the mirror. Instead of crying, he seemed curious.
The hospital prepared ice cream for him after surgery to help soothe throat discomfort and provide sugar. Two hours later, Leo went home with his parents without needing hospitalization.
Severe tooth pain woke Leo every night, and several hospitals could not treat him because of poor cooperation.
Under general anesthesia, the team completed root canals, fillings, and fissure sealants in one session.
Leo was back to playing and eating normally, and his grandmother no longer had to hold him through the night.
"I used to think general anesthesia was a huge thing. Later I realized that letting my child cry from tooth pain every night was the real disaster."
— Leo's mother
Leo's case reminds parents that baby teeth still need proper treatment. Severe infection in baby teeth can cause real pain and may affect the developing permanent teeth. For very young children who cannot cooperate, a professional pediatric dental and anesthesia team can help complete treatment safely and reduce repeated medical trauma.