Thank you for your question.
I suppose the dentist who is attending to your child recommended the extractions based on the fact that the breakdown on the teeth is severe (as you have also described), which may cause more problems for your child in the long run.
They probably timed the extraction of the 1st molar with the growth sequence of the 2nd molar in the hope that the 2nd molar would be able to drift into and occupy the space left behind after extraction.
Is it a must to extract all the 4 at the same time since the 2nd molar is ready under GA? Any painless way to extract one at a time?
It is definitely not a must to extract all 4 under GA at one time. You can do it chairside, however local anasthetic is required (i.e. injection). If your child is able to cope with the numbing jabs and extractions whilst fully conscious and aware, then that is of course a viable alternative.
However more often than not, dental extraction is a traumatic experience, even to adults. Thus if you think that your child may not be able to cope with chairside extractions (bearing in mind he probably needs to return on 4 separate visits for each tooth extraction), then I would suggest GA to extract all 4 at once.
Hope this helps!
