decision to fill cavaities in 2yr old

[marshapn]

My DD appears to have rare cavities in her front bottom teeth. Her dentist wants to fill and says given small teeth, she thinks 10secs drilling and 10mins work total--depending on behavior of our DD.

We need to decide on how the procedure should go. We're leaning towards no drugs (novocaine, laughing gas or valium) and just holding her on our lap. And preparing her by talking honestly beforehand that will hurt a little, but we will be there to help her/hold her/take care of her and that we will spend some time with her as a family (rare given crazy work schedules) afterwards.

Reasons we're leaning towards no drugs:

* Dentist said prick from novocaine freaks kids out as much as the drilling and some kids hate the numbness.
* Laughing gas: we don't know how she will react to the relaxant.
* Valium: while idea of possible amnesia seems good, having to put her in a foamboard as a result seems wrong and again, how will she react to the drug?

What are other folks' experiences with any of the above? Which routes did you choose and why?

We are also adapting her diet/increasing xylitol intake and will explore, once these cavities filled, possible underlying reasons for these cavities in hope to prevent more.

Thanks for your advice!

-- Marsha N

[tessie]

I've had a couple of fillings without drugs and as they were small cavities I dealt with the pain. But that was as an adult. Sorry, but I really wouldn't recommend a small child go without pain relief.

[tylerdylan]

I've had many fillings and only one done without anything because I was told it was tiny and not worth the pain from the freezing. WRONG!!!! It was horrible! As bad as the freezing is at least it just hurts for a few seconds instead of several minutes of gripping agony.
For a 2 year old - I wouldn't dream of going without at least the freezing. The reason is that the freezing will hurt and she'll cry and then get over it and relax for the rest because it won't hurt. If there is no freezing and the drilling hurts she will not cooperate and they won't be able to do the filling. I suppose you could start with trying it without anything and if it hurts her then do the freezing and try again? Tough call!!

[1growingsprout]

Id opt for the novicane, the dentist should put numbing gel on the area before the prick so the child really cant feel the prick. IMO having drilling and dental work with out pain relief just seems cruel. I really dont see how you are just 'going to hold her'. Do you know how long 10 mins is for anyone let alone a 2 yr old when someone is working in your mouth and you are in an uncomfortable situation? Thre is enough 'dental trauma' in this world, why purposly create more if it can be avoided? If our dentist even suggest that I would be looking for a new provider.

[deditus]

Boy, I see you are getting all kinds of varying opinions! I personally hate novacaine and I don't think I will ever get it again. It never worked well for me and the last time I had it caused muscle spasms in my jaw for over a week from a poorly aimed shot (probably 20xs more painful than natural childbirth).
My dd had 5 fillings done in January (at age 2.5) with nitrous and she did great. I like nitrous because of it's short half-life, the effects stop very quickly. I think you should try the nitrous and see how she reacts, it is EASY to stop it if she reacts poorly (although I haven't heard of anyone reacting poorly to it, I'm sure it happens). If you try to get them filled with nothing and it doesn't work out, she will definitely be scared of the dentist. And honestly I wonder why it would take 10 mins to fill - dd's dentist had all 5 of hers done in about 5 minutes flat. 3 of them were small but two required quite a bit of scraping. He had 2 assistants helping him so it would go faster.

[zulupetalz]

Is something like Benedryl an option as opposed to Valium or Nitrous? I don't know a ton about it, but I'd definitely give her something prior to, even if you ask the dentist to do a very light block.

[MCatLvrMom2A&X]

At least the numbing shot. Nitrus is gone from the system as soon as the mask comes off so I dont have any issues with it. Both my kids have had the above and did great with it. The stuff they use to numb the spot before the shot they dont even feel the shot.

I would not consider having it done without something. That kind of pain you remember for a lifetime.

[denimtiger]

For tiny cavities in front teeth, you should know that there are dentists out there who have advanced technology that doesn't require drilling.

Some dentists have waterlase lasers, and other dentists have air abrasion technology. Our pediatric dentist has waterlase lasers, and they are comfortable and don't require any pain relief, though I hae no experience.

My own dentist has used air abrasion to remove an old (composite filling) from one of my front teeth to replace it, and it was completely easy and comfortable (and fast!) with no pain medication, even though he was removing an older filling and cleaning out some decay that had developed underneath. He told me that he could remove almost any new cavity or any composite/resin filling with the air abrasion, but needed more traditional tools (and pain relief measures) for removing amalgam fillings.

He's actually done that same filling on me twice, because he didn't think the color was perfect the first time. It was not uncomfortable at all.

The first time I had the tooth filled with the traditional novocaine and drilling, and it was awful. A novocaine shot in the front part of the mouth is not fun.

[Twoplussixis8]

Reasons we're leaning towards no drugs:

* Dentist said prick from novocaine freaks kids out as much as the drilling and some kids hate the numbness.
* Laughing gas: we don't know how she will react to the relaxant.
* Valium: while idea of possible amnesia seems good, having to put her in a foamboard as a result seems wrong and again, how will she react to the drug?

Any update? We had a scary experience on Friday under general using sevoflurane They had to stop. Sons heart rate went in the 30's I now want to talk with parents who used no sedation on a child. My son is 20 months old

[marshapn]

We went twice since original post (I didn't realize this debate had developed and did not see it beforehand, oops). Once to get the two bottom filings done and second time for top one. The drilling was 3 secs or so each time. Ruby cried, but it did not traumatize her because she went back the second time to the dentist and was trusting, even though unhappy. No tantrums, nothing that would indicate trauma. Discomfort yes, of course.

We told her honestly beforehand that it would hurt. We gave her as much control as we could (how she wanted to sit, what music she wanted to listen to while it happened), we let her know that we would spend some fun time with her afterwards. We went to a next door drusgstore and bought her a nice toothbrush that she chose out before the 2nd visit and she showed the dentist her toothbrush. I think we did the right thing for our child--all kids are different of course. Our daughter is very verbal and her comprehension seemed about right for what we felt we wanted her to understand to go this route.

Down side--we need to go back because the 2 of the 3 filings have since fallen out. No doubt about it--drugging her might have allowed dentist to get a longer lasting filling in (she used some white glue stuff because mouth can be wet for application, but they don't always stay in well, esp when teeth so small--and this may be true for the more permanent filings too mind you). So we have to go back and see what dentist says about the fillings. We might reconsider drugs if it allows us to not have to go back frequently to get the fillings redone.

We have been using MI paste, on and off, and it has been helping, seemingly.

PS. So sorry last poster, to read about your child. That is very scary. 20mos seems so hard because for us the fact that our DD was able to talk/understand made the no drug route more conceivable for us. Good luck figuring it out.