21 month old needs extensive dental work - help!

[spiraldancer]

our older 2 kids also had early cavities and required similar work (dentists blamed long term breastfeeding, esp. at night, but I don't believe it. . .). I had enamel problems as a baby, as well, so it could well be genetic I suppose. I REALLY didn't want to go through this again, tried to be really conscious about brushing, no sippy cups, little juice, no dried fruit, etc., but w/in months of the teeth coming in, they were turning brown and beginning to crumble. so sad and frustrating!

I am resigned to going through with the recommended treatment - GA and caps/extractions by a pediatric dentist at a hospital, but I'm still very nervous because ds won't even be 2 yet (nearly 23 months by then, though) (the other kids were quite a bit older when they had it done). I think waiting until he's older might just make matters worse, in that the teeth might abscess, and he's likely in pain already (he's still non verbal). he is a strong, healthy little boy, but very emotional and clingy. what I'm most worried about and would love some advice about are:

1. not being able to nurse him from midnight until after the surgery the next morning (he's never been that long w/o nursing and is still VERY attached, has huge tantrums that just don't stop. . . ). he's allowed clear fluids (water and apple juice) up until 6 that morning, so I guess we'll try that, but I have a feeling it won't be very popular. I know we'll survive, and night weaning might be for the best at this point anyway, but should I try to night wean before the surgery date so it's not so connected emotionally/psychologically? or should we just deal with it the best we can that night and figure out what feels right after that?

2. the hospital separation: pre-op. he hates talking to people he doesn't know, he's very shy, he's super clingy to me. I know they deal with toddlers alot, but he's often beyond what I'm used to in terms of extreme emotional responses - this kid gets really worked up when he's sad/mad/scared! I don't want this to be a horrible ordeal for either of us, but unless they let me accompany him into the OR while he goes under (unlikely) it's going to mean him getting dragged away from me kicking and screaming and crying until he throws up . anyone btdt with a lo this young? reassurance? advice? survival tips?

3. we are planning a short family holiday right before the surgery - anyone know if flying (5 hour trip) might be painful for his cavities? don't know why it would - the air pressure maybe - just wondering, worrying. . .

thanks so much for any help or input!

[neetling]

My 3 year old had his dental work done under GA earlier this month. He's still nursing, though not during the night anymore. He is used to nursing first thing in the AM so I let him sleep as long as possible in the morning.

I was very nervous about this. I got a few rude comments "if you don't like this, why don't you brush his teeth" Uh, I do thanks.

In the end it did suck a bit. He is super shy with new people and cannot stand doctors. So he was very unhappy with being in the hospital. He refused to be weighed, so I had to hold him and get weighed, peel him off and get weighed again before he climbed me.

We sat and watched TV for a while. They came and gave him some tylenol and versed. The versed made him calmer. I am fairly sure he hallucinated, which was sort of funny in the moment. "Mama, do you see that pink floaty thing?" as he tried to grab it. So that was a little weird, but it did make it so he didn't freak out when they took him back for the procedure.

He is fine. He was super crabby and clingy when they brought him back to me and he couldn't get out of there fast enough.

While it's certainly not something I want to repeat, I'm glad the work got done. There's no way at all he would have sat still in the dentist's office for the work. He had 3 decent sized cavities, a small one in front and they repaired 2 teeth he broke when he was learning to walk.

[ANewDoula]

I have 3 kids. 2 with perfect teeth and 1 who needed 8 filings! All 3 were nursed past the age of two. We did nothing different when it came to feeding, cleaning, etc. I was very upset and felt like I had failed my lil guy
My amazing wonderful pediatric dentist told me that tooth buds start forming btw 5-8 wks in utero. Different things can cause each child's teeth to form differently and not to blame myself.
He was 3 when we discovered the cavities and she wanted to wait 6 mths until he was a bit more "mature". It actually was a year we waited ( with 2 checks ups) before the surgery. I was a nervous wreck the day of. But I have to say it really wasn't bad at all. The surgery was in the dentist's office and they had a pediatric anesthesiologist there for the day. My son was with me the whole time, sitting on my lap while the dr gave him the "sleepy" shot. He was out of it in a matter of seconds. Like the other poster mentioned, it was kinda funny holding him. He was laughing and smiling. Then they carried him back and we waited......and waited.
Once he was done we sat with him in the recovery room with a nice warm blanket. He was really out of it for a while. Once we got home he was very upset that he couldn't walk straight. I tried to get him to sleep or be still on the couch but he wouldn't. But within a few hours he was back to normal. No pain, no complaints.

In your situation, I would get a second opinion. Especially on the extractions. I would make sure you feel comfortable with the situation because that will make it easier on him. You should be able to comfort him and make this as easy as possible. If the Dr or hospital has issues with this, I would be concerned about that as well.
As for night weaning, that is a personal decision and shouldn't be based on anything to do with the dental issues. Do what your Mom gut tells you. If you feel ready to night wean because you're ready, then by all means.

I know the concern. It can be very tough. Good luck.

Jes

Originally Posted by spiraldancer

our older 2 kids also had early cavities and required similar work (dentists blamed long term breastfeeding, esp. at night, but I don't believe it. . .). I had enamel problems as a baby, as well, so it could well be genetic I suppose. I REALLY didn't want to go through this again, tried to be really conscious about brushing, no sippy cups, little juice, no dried fruit, etc., but w/in months of the teeth coming in, they were turning brown and beginning to crumble. so sad and frustrating!

I am resigned to going through with the recommended treatment - GA and caps/extractions by a pediatric dentist at a hospital, but I'm still very nervous because ds won't even be 2 yet (nearly 23 months by then, though) (the other kids were quite a bit older when they had it done). I think waiting until he's older might just make matters worse, in that the teeth might abscess, and he's likely in pain already (he's still non verbal). he is a strong, healthy little boy, but very emotional and clingy. what I'm most worried about and would love some advice about are:

1. not being able to nurse him from midnight until after the surgery the next morning (he's never been that long w/o nursing and is still VERY attached, has huge tantrums that just don't stop. . . ). he's allowed clear fluids (water and apple juice) up until 6 that morning, so I guess we'll try that, but I have a feeling it won't be very popular. I know we'll survive, and night weaning might be for the best at this point anyway, but should I try to night wean before the surgery date so it's not so connected emotionally/psychologically? or should we just deal with it the best we can that night and figure out what feels right after that?

2. the hospital separation: pre-op. he hates talking to people he doesn't know, he's very shy, he's super clingy to me. I know they deal with toddlers alot, but he's often beyond what I'm used to in terms of extreme emotional responses - this kid gets really worked up when he's sad/mad/scared! I don't want this to be a horrible ordeal for either of us, but unless they let me accompany him into the OR while he goes under (unlikely) it's going to mean him getting dragged away from me kicking and screaming and crying until he throws up . anyone btdt with a lo this young? reassurance? advice? survival tips?

3. we are planning a short family holiday right before the surgery - anyone know if flying (5 hour trip) might be painful for his cavities? don't know why it would - the air pressure maybe - just wondering, worrying. . .

thanks so much for any help or input!

[earthmama369]

Genetics plays a HUGE part in tooth development and structure. DD got the bum end of a double genetic whammy and ended up having a 4-hour dental surgery at 4, and had her first eight fillings at about 21 months. Definitely work with your dentist and the hospital to be allowed to walk your kiddo back to the OR. That made a big difference for both of us. I advocated for it ahead of time with our dentist, and he helped me work with the hospital. I couldn't stay for the surgery, but I walked/carried her to the OR, tucked her into bed, and helped her with the mask. I stayed until she fell asleep and then had to leave. If you search my name and any kind of "dental" keyword in this forum, you can get the long version. But the short version is that for us, the surgery was necessary and ultimately benefited dd. But we also did a lot of in-office dental work first, and she was older when she had her surgery. If in-office treatment wouldn't traumatize your kiddo, I'd explore those options first.

[mama1803]

I'm pretty sure that I've read here several times in the past that breastmilk is considered to be a "clear" liquid in terms of what is allowed before surgery. I can't imagine why apple juice would be allowed and breast milk would not.

Can any clarify this?

[sapphire_chan]

Originally Posted by mama1803

I'm pretty sure that I've read here several times in the past that breastmilk is considered to be a "clear" liquid in terms of what is allowed before surgery. I can't imagine why apple juice would be allowed and breast milk would not.

Can any clarify this?

: Why on earth would pure fructose be allowed and not breastmilk?

[Wilbur]

My DS (26 months) is in the same boat, we've got his surgery scheduled for the end of this month and I'm nervous about the same things.
Where he's having his procedure, they require that he have no liquids, including clear liquids (ie breastmilk) after midnight the night before. I pushed on it a little bit and they said that their actual policy is for the six hours preceding the surgery, which means 3 am for a 9 am appointment. And this is the part I'm dreading... because DS is a very "well adjusted", flexible, reasonable little guy... until he is refused milk. And then he is inconsolable. Especially in the wee hours of the morning. It just seems like setting him up for having a bad outlook on the morning of something that will already be challenging... I think he'd do fine with the whole situation, if he could nurse whenever he felt nervous! Just like your son, I think that when he's not allowed, he'll know something is fishy and freak out.
However, after much consideration, I don't think that this one rough morning is enough justification for nightweaning. This isn't the only big thing happening in his life, and I think his ability to nurse is really helping him cope with the different changes. I think we can just get through this one day... also, though, my ds is very verbal, and I'm hoping (wishful thinking?) that we'll be able to talk the day before about how tomorrow morning, we won't be able to have any milk, but that I can hold you, etc....
Anyway, you're not the only one with this whole thing looming... good luck making the right decisions!!

[spiraldancer]

Surgery tomorrow - good thoughts please!

Thanks for all your thoughtful responses! I've got a big nervous pit in my belly, we're scheduled for a 9 am surgery tomorrow. I'm having major last-minute doubts about whether this is the "right" thing to do but I feel like we're committed and need to just follow through. Ds is still night nursing alot so the no milk after midnight thing is going to be weird and sad for him (and me). I know one night is not huge in the scheme of things and we'll make it, but it just intensifies the whole thing quite a bit. I just keep thinking, by this time tomorrow it'll be over. . .

I really hope they don't have to pull the top front teeth - the dentist said he'd have to see how bad they are once he's in surgery. The top laterals definitely will be extracted, but pulling all 4 seems so extreme.

Wilbur, sorry to hear you're in the same boat. It is strangely comforting to know we're not alone in this. Hope all goes well with your lo's surgery!

I'll post later to let you know how it goes. . . Wish us luck!

[organicmidwestmama]

my son went through this at age 3 and was still nursing. i was w/him until he was given the GA, i actually held him in my lap while they administered the GA through his breathing mask. it was super scary feeling him go limp, but the nurse-anesthetist looked me in the eye w/this look of total confidence and peace and i knew my kid would be ok. i cried of course, but he was ok. he was sad when he woke up, and probably in pain, but he got chocolate pudding and movies and then we left after an hour or so.

honestly, to other parents considering this type of surgery, i would suggest a second, or even third opinion and definitly would ask a more holistic dentist for thier suggestions. after the fact, from doing much more research and reading of studies that found treating early childhood carries w/GA surgery and caps and all that NOT having more favorable outcomes vs. waiting to treat, im not at all sure id ever do it again. i suggest reading Cure Tooth Decay by Rami Nigel for a different perspective on treating children's cavities. it really opened up my mind to some other ideas about the cause and treatment of cavities. i personally don't believe our dental health has to be determined by genetics, though our parents nutrition does have a lot to do w/our tooth formation.