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Toddler dentistry questions...fillings, papoose board, etc. - Page 2

post #21 of 45
I think they say chewable vit C is bad for tooth enamel; I haven't tried it so don't know much about it. I use Emergen-C sometimes (almost any grocery store, health store, & general store, like Wal-Mart or drug stores, carry it now; vitacost.com is a super affordable source) and SAP for acute infections.

Em-C has 1000mg C per packet, but also has some sweetener, so isn't my favorite way, but is very easy to get down most kids if you find a flavor they like. Mine love Super Orange, Tangerine, Pink Lemonade, & Lemon-Lime the best, and hate the berry flavors. They like it as a drink and they like to stir it into their unsweetened whole yogurt.

SAP is just a powder, and you should take it with bioflavonoids. I buy it from Bronson, and also their bioflavonoids tablets - you take one tablet with every 5000mg of SAP (which is a buffered vitamin C). For little ones, I crush the tablet in a mortar & pestle (simple & inexpensive, really pretty marble decor for the counter!), then mix the SAP w/ the powder & mix it all into a little OJ or cran & OJ, maybe watered down a bit. I think I've also mixed it into the yogurt with a packet of Em-C (Em-C has the biofl. already mixed in).

This is a very distilled version of things you can do with vit C, lol; there is a sodium ascorbate mega-thread somewhere on MDC that is FULL of info!

Megadosing means taking it until you get loose bowels (b/c it's water-soluble, you just excrete any excess). I give a little one 2-3gm (2000-3000mg) the first hour, then 2-3gm more every 2-3hrs until we reach "bubbly tummy" stage, then hold steady or slightly back off the amount for the next dose.
post #22 of 45
Quote:
Originally Posted by Slingin'Momto4 View Post
Thanks for this post! I am in the "wait and see" approach w/my 30mth old DD, she has severe ECC on her 4 top front teeth and her to way back top molars. I found the post on what to watch for very informative, thanks SOOO much! How do you get your 2 yr old to take Vit C? Is there a chewable form of good vit C or is it liquid? Thanks so much!!
what is ECC?
post #23 of 45
I didn't get a chance to read through all of the replies so I hope I am not repeating too much, I just wanted to share a few thoughts since my I had a similar experience.

I think it is pretty crazy that dentists act so casual about strapping down a kid for dental work. There is so much that the 2 yo will be freaked out by because they don't understand. When I asked about the office sedation offered at my dentist office they explained that the child somehow won't remember even though they will likely scream and struggle throughout the procedure. My dentist that I finally settled on actually said that she thought it was unethical to perform in office procedures on kids 3 and under because the risk of complication from the sedation, injury from the child's struggle, and poor quality/incomplete work is too high. I would totally seek out a second opinion. I had a similar situation where the dentists covered under our insurance plan were part of a chain, but that meant that we had several offices within an hour or so from home that we could choose from and each office housed different dentists. You can still run into blanket protocol issues I suppose, but we actually ended up finding a good fit for us just by trying out the different offices.

I would make it a point to ask the dentist what kind of timeline you are under because you may be able to delay the work being done with some home treatments or it may be accelerated decay in which case you could be saving your child from having extractions by doing simple fillings sooner. In our situation waiting was not beneficial beyond us finding the dentist we liked. My son went from having minor decay on the front four and some in the back to having serious decay within a matter of six months. I think it is good to be choosy but aggressive in dental treatments with toddlers.
post #24 of 45
Quote:
Originally Posted by eternamariposa View Post
I think it is pretty crazy that dentists act so casual about strapping down a kid for dental work. There is so much that the 2 yo will be freaked out by because they don't understand. When I asked about the office sedation offered at my dentist office they explained that the child somehow won't remember even though they will likely scream and struggle throughout the procedure.
My dentist said pretty much the same thing today. They usually let the parents help hold the kid down, but he said "we also have a board to help if necessary" (which I told him I didn't like )
He also said that due to the drugs he uses for "conscious sedation", the kids won't remember at all afterwards. But it's hard for me to believe that struggling for an hour won't traumatize them in some way

He said he'd still prefer in office sedation to general anesthesia in the hospital since there are fewer risks involved.....and I don't know what to think or to decide
post #25 of 45
Quote:
Originally Posted by Denali View Post
He said he'd still prefer in office sedation to general anesthesia in the hospital since there are fewer risks involved.....and I don't know what to think or to decide
This is SO hard. With our situation my son needed pretty extensive work to be done, four extractions, four pulpectomies with crowns, etc. and he fights SO hard that we couldn't even get really complete x-rays in the office so we ended up going with general. Hardest decision/experience of my life without a doubt. I totally sympathize with your struggle s
post #26 of 45
Quote:
Originally Posted by eternamariposa View Post
we couldn't even get really complete x-rays in the office so we ended up going with general. Hardest decision/experience of my life without a doubt. I totally sympathize with your struggle s
We couldn't get xrays either...but then, they were ok with that....they said, they didn't really expect a kid his age to cooperate with xrays

The dentist feels completely confident that he'll be able to get the work done by using conscious sedation......but I still don't know what to do

I really don't like the idea of restraining him, especially for that long, but on the other hand, shouldn't I choose that method just because it has a slightly lower risk of complications....?

I know what you mean about hard decisions
post #27 of 45
we have a similar situation here. the dentist is recommending GA rather than sedation and strapping down for my 2.5 year old, he has 8 cavities, one in each molar. the dentist doesn't think she can do it in office as my son wasn't cooperative today when she just tried to do an exam. any advice?
post #28 of 45
No REAL advice, just an update to my thoughts from before Christmas:

I have done some more research and found out that there are not so little risks involved with in-office conscious sedation as well, especially when a combination of drugs is used. Also, since our son has to have quite some work done, I don't even know if the sedation would last long enough. And my Ds is not very cooperative either.

So I'm almost to the point where I think that having GA in a hospital setting is safer than conscious sedation in an office setting, due to the monitoring and emergency response possibilities, even if GA in general has bigger risks than sedation.

I would like to talk to the dentist again to get a few last questions answered, and - even though this is not really the deciding factor - I would like to get an estimate for the costs for doing the GA in a hospital. We don't have dental insurance, and the estimate for the in-office treatment is 3000$. I read somewhere on here that somene else was quoted 20,000 $ for the GA procedure in a hospital and sincerely hope that that's untrue

But all in all, it looks like we will be going the GA route.
post #29 of 45
We had our medical insurance cover all of the hospital costs and worked seperately for the dental for what the dentist did specifically. In other words, the room, GA, nurses, recovery was medical but the fillings, crowns, etc came under dental. Without dental coverage it was $4000 for us.
post #30 of 45
$4000 isn't too bad, that would only be $1000 more than the in-office sedation. Thanks for letting me know...I checked our insurance policy, and they do cover the general anaesthesia costs (same as with you, not dental fees, just the hospital stuff), but only IF the patient is under 7 (which he is) AND if he "can't be treated effectively and safely" in the dentist's office.

Since the dentist recommended the in-office sedation, the latter might be difficult to prove...I guess I'll really have to talk to him again
post #31 of 45
I took my DD in to the dentist with already-pretty-bad cavities just before her 2nd birthday. We had to do another "initial visit" with that dentist at a second office, where our insurance would cover the work (it didn't at the first place, so we paid out of pocket for that). He seemed OK, and competent enough... except that he didn't remember us from one visit to the next, and recommended getting the teeth filled/pulled/etc ASAP under sedation, but couldn't give us an appointment to have it done locally.

Anyway, today we're off to a third initial appointment, at Children's Hospital, which takes half a day to get to, but at least I know they have the facility to treat her. It's so stressful!
post #32 of 45
Just discovered tht there was a new posting......so what happened at the children's hospital?

Anyone else have any updates, new discoveries, new thoughts, etc.?

I am ashamed to admit, this whole thing has stressed me out so badly that I just "put my head in the sand" and did nothing for a few weeks. Procrastinating at its best

I still don't know what to decide. Right now my problem is that the dentist had recommended the work should be done very soon, but we're going out of country for a month in April. So now I'm wondering whether to squeeze the surgery in BEFORE the trip (if yes, what kind...sedation or GA)...or just wait and see until afterwards (especially since I'm still not 100% comfortable with the extent of work he recommended).

I'm tentatively leaning towards waiting, but I'm also afraid something might happen during the trip, maybe triggered by the flying etc.?

So....even if no one has any new insight, just share where you're at in your struggles and commiserate
post #33 of 45
I think it is really important to act cautiously but quickly, I know what the heck does that mean right? For us we got multiple opinions to make sure that the diagnosis and treatment plan were accurate and to make sure we felt totally comfortable with our dentist. We chose GA because our son was only 2 and there was NO WAY the work would have been done well under the in office, plus they don't have the kind of things on hand the hospital would if he did have a reaction to the sedative, also I don't really go for the idea of concious sedation that will allow for such thrashing and screaming that he would need to be strapped down but somehow he wouldn't remember. It was all scarey, really scarey.

It took us 6 mos to find the dentist and cycle through opinions and in that time the decay went from being white spots that looked like small pieces of food I had missed to being big-almost over the whole tooth, brown grooves. Toddler tooth decay can progress very quickly and infections are very dangerous and can threaten adult teeth as well as causing pain. Take the time you need to make the best choice for your family but keep in mind that as time goes by things will get worse so don't just try to ignore it or hope somehow your lo will be ready to start loosing teeth naturally before treatment would be necessary-btdt.
post #34 of 45
Thanks for sharing your experience

I am also leaning toward GA because of all the things you mentioned. I'm just not at the point where I can fully commit to it (also I have to do some more research about the financing.....will have to see whether this dentist will classify the GA as "necessary", so that our health insurance will help with the hospital costs )

I wish we had another ped dentist around here so I could get a second opinion. There's one I've heard of in the next "big city" but he has an 8 month waiting list for new patients so that's out of the question. There's no one else out here.

We have been working on halting his decay ever since he was about 9 months old (he'll turn 3 in May). So his decay is already in the brown/black stage. In that light, would you try to get things done before our out-of-country trip in April, or would you wait until we get back in May and set it all up for then?
post #35 of 45
If he is in the brown/black stage I would get it done ASAP to minimize the chance of infection from abcesses that can travel up the vulnerable root of the tooth and present complications in their extraction as well as pain for the little guy.

I sympathize with you so much and I am so sorry that you are going through this.

Some things that might help you emotionally s...

My son was up and running around the house the same night of the procedure and eating way too many popcicles and jello cups. He also had homemade chicken soup-with everything cooked a little extra- that same night and thought it was funny when chicken kept falling out if he smiled. Within the week he wanted to get back to the park.

I played up that it was so totally awesome that he was already making room for his big boy teeth to come in when most kids have to wait unitl they are way older like one of his older cousins, he said he felt like a big man.

He eats whole apples, corn on the cob, and subs. I don't know how but he does it.

They don't make you change out gauze all the time, they use a foam and there was no need for pain relievers which is a relief from what I expected.

It will be hard to loose the smile you are used to but they still smile and its goofy and cute. Making sure that we kept all of the scarey feelings to our selves kept him positive too. Kids don't really seem to care, its mostly adults that freak out and we stay cool about it and he says "don't worry look [points at his bottom teeth] i still have teeth, its ok" lol. He has actually had a couple of occasions when a kid will FREAK OUT excited because they had the same work done and think its awesome to have silver teeth(stainless steel not mercury).

If its a children's hospital they are also willing to flex to best accomodate your child. When mine screamed "i want my mommy!!!" and no one could hold him still and got his pulse ready to exit the 190s they brought me into recovery and when his pulse dropped below 150 within a minute of hitting my arms, they disconnected all the crap that was bothering him and sat with us. I sang to him and he fell asleep.

He was not nursing anymore-very newly weaned at a little over two. But I know some mothers who were still nursing pumped before hand so that after the procedure they could offer it in a cup until the lo would be ready to nurse.

I hope that is helpful, sorry if its too long.

His procedure took 4+ hours. I used that time to cry A LOT. But when he came out all of the decay was gone. We didn't have to think about it anymore, the other teeth were safe. And, happily, a year later his cleaning went great and no cavities, yay! So it did work, it did address the problem.
post #36 of 45
When you say it's i the brown/black stage, do you mean it was white denting and has progressed to brown grooves, or do you mean it was decayed, and now the decay is covering over with the (increasingly) black & glossy sealing stuff that Nagel mentions in CUre Tooth Decay (that is a sign of healing)?

If I saw it continuing to decay, but slowly, I might put it off some more. If it was continuing to decay rapidly and I was about to go out of the country for a month, I'd lean strongly towards getting the work done before leaving. If it was not continuing to decay, and/or was healing, I would not get it done now, although I'd be fastidious about continuing to eat real, whole, nourishing foods while away, and make that an important part of my trip planning.

I'd also get really familiar with the C protocol - vitamin C & restoring nutritious eating has taken care of our abscesses (which, again, are not a danger in themselves, they are only the body's response to a growing infection and when properly done, they contain it beautifully & without pain) every time, whether with teeth or an infected bite on ds' leg or an infected wart on a girly toe. And pack my SAP & bioflavonoids, for sure.

Quote:
I am ashamed to admit, this whole thing has stressed me out so badly that I just "put my head in the sand" and did nothing for a few weeks.
That has been my response to this dental nightmare more times than I can count, too. s: It's so tough, and it sucks, but one thing that helps me is to keep in mind that they're teeth. TBTG it's not cancer or something equally tragic.
post #37 of 45
Quote:
It will be hard to loose the smile you are used to but they still smile and its goofy and cute. Making sure that we kept all of the scarey feelings to our selves kept him positive too. Kids don't really seem to care, its mostly adults that freak out and we stay cool about it and he says "don't worry look [points at his bottom teeth] i still have teeth, its ok" lol.
So, so true. My son's decay happened so fast (while I was trying to get the dentist to do something about it and she (who was a sub) said he was "too young" and by the next visit, the four front top teeth were GONE to the gumline) that he has an amazing vampire smile, lol. But as much as it makes *me* want to cry, it's important to keep that to myself, and I encourage relatives to, too - he doesn't know, notice, or care at all at age 2, and I doubt he'll care as he gets older as long as no one else makes any kind of deal about it to him.
post #38 of 45
Ds hasnt had his top 4 teeth since he was 2y2m and it has been a non issue for him or anyone else. The other kids just assume that he lost those teeth like they will eventually and adults dont even seem to notice.

His decay started as soon as those teeth came past the gum line and within 8 months they had broken off to the gum and he got abcessed so they where pulled in office with just local and me and the hygenist holding him down. It took less than a minute and I have no regrets about it.

I wasnt willing to risk his life under GA just to have 4 teeth removed.
post #39 of 45
Both of our kids had extensive early decay.

The first one had two fillings and a crown at age two. The second had four fillings by age three.

With DS1, he was going to a ped dentist who used in-office sedation by injection. There were things we didn't like about that practice though...parents were not allowed to stay in the room and the practice was not supportive of breastfeeding - and we left it when I couldn't get DS2 in for an appointment sooner than a month away after I found a large brown hole on the backside of a front tooth.

So now we go to a different ped dentist. I like this practice much better. He does use the papoose board, and does not do in-office sedation (except nitrous oxide) because he does not feel it is safe. He told me that if he needs to do work that is extensive enough for sedation beyond nitrous and novacaine, he wants a real anesthesiologist taking care of the anesthesia and monitoring the patient, so he can focus on the dental work, so he does those cases in a hospital. For quick procedures he uses nitrous and novacaine in his office. He does use the papoose board with a body wrap for very young kids who cannot hold still or who will fight the entire procedure, or who just feel more comfortable wrapped up. At age two, our son fit all three of those. His cavities were wide but shallow - very quick to clean and fill, and we agreed that the risk of general anesthesia was not justified.

Parents are invited to stay through the whole procedure at this practice. Both times (two sets of fillings) I held him in my lap in the chair with a nitrous mask on for a few minutes, then we transferred him to the board and wrap. I was at his feet and talking to him the entire time. He was not happy but I did not expect him to be, and I felt strongly after DS1's crown that I wanted DS2s decay to be addressed ASAP. I was not willing to wait until he was "ready" to be agreeable to having dental work done and have his teeth rot away in that time, or use general anesthesia for such quick fillings.

This dentist is very supportive of breastfeeding, including extended breastfeeding, okay with alternative vax schedules, very thorough in his work, and his office is a very positive place where the whole staff does their best to help the kids be relaxed and have a positive experience. He uses the papoose board for safety and security, and does his best to have the kids calm along with being wrapped. The board worked well for our son, keeping him safe and allowing the dental staff to do their job as quickly as possible. If I had to do it again, I wouldn't change a thing.

I came back to add that GA can also be a bit traumatic. Both of our kids have each had two surgeries under GA and both times they were pretty unhappy for at least 30 minutes after coming out from under. Also from my own experiences I hate the feeling of coming out from under GA. I would look at GA for a very long or involved dental procedure, but other than keeping a kid from having to be awake through a long procedure, I don't see it as less traumatic than using nitrous oxide and a papoose board when necessary for a quick procedure.
post #40 of 45
I wish I could have found a dentist like yours laundrycrisis but I ended up having to use the one who has a no parent in the room policy It was either that or GA and for me GA was not an option.

I talked to every ped practice in my area 6+ of them and every single one that did in office sedation had the no parent policy. Now that ds's work is done I will not go back to that practice again. From here on out our family dentist can do the work with nitrus and novicain.
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