anxiety over dental restoration

[crawdad]

(first post, hello all)

daughter, six years old. she has a tiny cavity that we are dealing with at home and one that must be cleaned out and filled. ive read quite a bit on here about raw food, natural alternatives, etc. our regular diet now includes raw dairy and near zero sugar. using xylitol based products such as sweetener and tooth paste and brushing habits are quite regular. i appreciate the information posted, both in research and opinions.

moving on to the issue. said daughter has high anxiety with anything medical. she has never been able to drink medicine, gets very anxious and eventually vomits it, needles and suppositories are the only solution when needed. any doctor visit is usually an ordeal. she behaves normally in just about any other situation, no idea what sparked it but now we have it to deal with and have been trying our best to remain calm and search for the best solution.

first and second attempt to clean cavity out for a filling was a failure, she could only take it so far and then broke down and was nearly inconsolable until we left. the only child dentist in town that does both conscious and unconscious sedation refuses either parent to remain in the room and im afraid i was unable to just go with that, so we are moving on looking for another out of town.

curious what others have done when dealing with an over anxious child for something such as a tooth filling. the sedation we are considering is midazolam (nasal spray) and a study on the oral form is shown below, we figured the nasal spray would be easier for her to take than drinking some grapefruit juice solution. id prefer not to put her totally out of it.

A pilot study of the efficacy of oral midazolam for sedation in pediatric dental patients

thanks in advance.

[mysticmomma]

I'd do GA over versed any day. Naking now, but bbl later with details.

[crawdad]

appreciate your time when you get a chance. thanks.

[mysticmomma]

Sorry, totally forgot to come back! Anyway, my experience with versed and my daughter was a disaster. She was more anxious with the versed than if she had nothing. She hated the "out of control" feeling, and it took forever to get her to drink the medicine. While general anesthesia has risks, the studies shown involve kids that are already dealing with severe medical problems. In addition, while under GA, the dentist could fully examine, x-ray and clean her teeth, and fill any other teeth that have issues before becoming full blown cavaties. My DD just had dental surgery as well (she is 5). She did great. No pain afterwards at all. She had to have a tooth pulled, several caps placed, and it healed fine. She remembers nothing from the surgery.

[crawdad]

id prefer no sedation at all if i can help it, which is what we have scheduled for right now for middle of next week. the main issue we have is being told we cannot be in the room at all during the procedure and apparently this is quite the norm for pediatric dentists but not for general. finding a pediatric dentist with some sedation options (nitrous, etc) and willing to allow a parent in the room seems incredibly rare.

i read a report on the efficacy of midazolam vs chloral hydrate and the numbers were very clear in favor of chloral hydrate. unfortunately with continued exposure to it in lab rats tumors appeared, how nice. again, id rather not use anything at all with perhaps the nitrous only if needed.

[mysticmomma]

the nitrous mask itself can be quite anxiety provoking. good luck. I never leave my kids side. It's MY policy. even when she was sedated I was there. When she went into the OR, I accompanied her until she was asleep. She had 4 teeth pulled with no sedation and if I could go back, I would have done GA and had everything done at once.

[crawdad]

well, just thought to update. after exhausting all of the options in my area i opted for the twilight sedation at a local pediatric dentist and none was covered in my plan so it was pricey. we were unable to stay in the room with her but the work simply had to be done. all the work need to be done was done and no complications have been noticed. we are quite religious with the teeth cleaning now hoping to prevent another cavity visit for our overly anxious (high anxiety) daughter.

and now, a couple months later i read about a 5 year old who just died at an office i called who is in my area and decided not to go since they used chloral hydrate. so sad.

http://www.gainesville.com/apps/pbcs...te=printpicart

reinforces my justification in being paranoid and wanting the best for my kids.

[LDSmomma]

Originally Posted by mysticmomma

. I never leave my kids side. It's MY policy. even when she was sedated I was there. When she went into the OR, I accompanied her until she was asleep.

Please share some of your confidence & persistence on this one! I'm in the market for a new ped dentist who is more agreeable about this, but I worry that DS's current dentist will just refuse to see us if I don't let them take him back alone. Were the docs nice about this to you?