2.5yo "needs" multiple crowns

[meg-momto2]

i took DD to her first dental appointment today. she's deathly afraid of doctors offices, hospitals and the staff. we had to restrain her just to examine her teeth. she has decay along the gum line on her 5 front upper teeth front and back. two upper molars are quickly crumbling and she has a few minor spots on two lower teeth. according to our dentist she needs her two upper molars and 5 front teeth crowned. she also needs a few small fillings on the bottom and one on top. i told her we don't do metal but they said they do stainless steel crowns for molars but resin for the front teeth. they want to sedate her with Versed, laughing gas and use the papoose board. no mention of pain medication. there will also be x-rays while under sedation. this will be broken up into two sessions months apart.

while i do agree that her teeth look terrible she's not complaining. she doesn't care for really cold liquids but that's about the only thing i've noticed. i asked about pulling the teeth but the dentist doesn't like to do it on such young children. i don't think her front teeth are in need of urgent work. they're easy to keep clean and will be the first ones to fall out. i do want to do something about the molars. i think i'd be o.k. with crowns if i could get them in resin and she was given pain medication in addition to the sedative. i'm going to look for a second opinion.

has anyone had to deal with a similar situation? should i push for general anesthesia? i can be with her if we use the sedative and i could maybe talk them out of restraining her if she cooperates.

[Denali]

I feel for you

I'm in a similar situation right now, and I'm still in the middle of doing research, so this isn't advice, just for comparison:

DS is the same age as your DD, his top 4 front teeth are decayed, plus some spots on molars etc.

Our dentist wants to extract the top 4, put some crowns on molars and do a couple of fillings for smaller cavities. He'd prefer stainless steel crowns because they're more durable, but would do others if I really wanted.

He gave me a choice between in-office conscious sedation (he'll drink a mix of midazolam and Hydroxi-something...I posted it in another thread, but forgot now), the work would take about an hour, and I would be able to be with him and help hold him.... or it would be general anesthesia at the hospital. He recommends the conscious sedation, because "it has less risks".

I am still a bit undecided, but am leaning towards the sedation as well, just have to do some more research (such as: what about pain medication, and does the dentist have nitrous oxide for backup, just in case).

I'm not sure I like your dentist's standpoint on a few issues (seems pretty inflexible to me), so if I were you, I'd definitely get a second opinion

Good luck to you and DD,

Charlie

[gbailey]

Sorry you mamas and your babies have to deal with this. Did the dentist say whether or not there is a way to prevent the decay? DD hasn't been to a dentist yet and I wondered if they offered any future tips? TIA.

[MCatLvrMom2A&X]

For me GA and the risk of death is not something I would do. I would go with in office sedation. That is what we are doing with ds and he dosnt even remember the dentist visit. They give him the meds to drink, wait and hour till he is asleep then use the numbing shot along with nitrus.

You are very lucky to have a dentist willing to do in office sedation and that will allow you back there during it. The dentist I am using for the work on ds has a no parent policy which I loath but I cant handle the thought of GA so this is the way it has to be He is the only dentist anywhere around me who will do in office.

He has one more visit for the remaining 8-9 teeth then I wont be seeing this dentist any more and will go back to my family one.

[The Duchess]

My youngest child aged three had all these issues. He had a lot of decay and then fell twice, once off our deck and then when he was climbing on a barrier in the ice-cream parlor and fell head first. As a result one of his front teeth was pushed back into his gum. It gradually started to come back down again and our dentist said she would not try to pull it or do anything as this could damage his growing permanent teeth.

Anywhoo I could tell something was wrong because he was very moody and sure enough he had developed an abcess/infection at the front of his mouth due to the trauma. We decided to get everything taken care of as we were leaving the states for Europe and wanted to be sure he had good care.

Therefore we went to a pediatric dentist specialist. DS was sedated by a professional anesthesiologist there and all the work was done in the one visit.

His upper four front teeth were removed. They said they could save one but said it would look unsightly and also be much more likely to catch while playing so I said go ahead and take it out. He had some white fillings put in about 7-8 teeth and one has a steel cap.

He was 2.5 at the time of all this work and is now 3.5. First thing we noticed was a massive improvement in mood even tho he still had to take antibiotics to kill the infection. He was calm and easy-going again, it was amazing. Poor baby had been obviously very uncomfortable.

Since then he has had check-ups and all has been fine. He was seen by an American dentist here in Germany just yesterday and DH told her that the decay was due to nursing. I was never told that in the US but the dentist told me that DS should stop nursing now.

I know there is a long running debate about nursing caries but my eldest child nursed for 5 years and she has the healthiest teeth of our three kids. I think it's more likely just neglect with DS as we were under tremendous stress for the first two years of his life and I also had post-natal depression. The result was I think a less balanced diet and not enough preventative dental hygiene by mom and dad .

Anyway the good news is we are all much, much less stressed - no stress virtually now. The whole family is much happier and relaxed and I am healthy again and working at improving the children's diet all the time. They get excellent meals at their local schools too.

[lava]

another opinion?

My 2nd child, now 4.5, had a "sippy cup addiction" after self-weaning from EBF at 10 months. I didn't take him to the dentist until he was 3.5 and by then it was almost too late. His "two front teeth" in particular were visibly affected, but he has iffy spots on his molars too.

BUT he has no pain, they don't bother him at all, so the (pediatric) dentist said basically "we can fix them if you want or if the appearance bothers you enough or certainly if he has pain, but otherwise, he's going to lose these teeth soon enough and get his permanent ones in, so why put him through all that and spend your money." I totally agree with him.

We weaned the sippy, brush more frequently, and take him every 3 months for fluoride treatments (to help keep them in as good a shape as possible until they fall out--even though the fluoride makes him wacky for a few days it's worth it IMHO to try to save his teeth).

So...you might consider a second opinion (or just asking this dentist if you could just wait for her big teeth?). Obviously some kids may have extensive enough damage that they need them fixed, but...?

-lava