How to explain to a 2 year old that we have to pull out her 4 front teeth??

[carmen358]

After much, much research, getting second opinions, (and many tears) we've decided we need to get DD's 4 front teeth pulled (2 and a half are pretty much gone already anyway). We're scheduled at the hospital for GA on May 17. We're trying to figure out how to explain to her what is going to happen. She's very bright and verbal and I want to show her respect by telling her what we're going to do before it happens. We have a plan for after the surgery (we're going to ask for the teeth and put them under her pillow, etc.) but I'm wondering if anyone has suggestions for how to explain to her *why* we have to pull out her teeth.

So far, all we can come up with is something along the lines of "all little kids lose their baby teeth and then they grow big teeth! sometimes kids need a little help with losing their teeth so their big teeth can grow in big and strong." Does that sound lame?

[choochootwo]

I don't think it sounds lame at all. I think it sounds just right.

I don't have any advice, just wanted to let you know I'm really sorry. Our son as ECC too and I know how heart-wrenching these decisions can be. **super big hugs**

[seraf]

Carmen, that is no fun at all! My oldest had is top 4 filled at 13 months and pulled at 31(?) months. A few falls broke 3 of the 4 teeth in half so they were pretty funky. We told him that the his teeth needed to come out to make it easier to eat, to help keep his other teeth healthy and so his mouth wouldn't hurt. We told him that he might feel a pinch with the shot (in his arm) but he wouldn't feel the teeth come out.

The procedure was a breeze. He was angry about the shot for about 10 seconds before he fell asleep. The procedure was over very quickly and he was barely concous when we took him home. He was hyper and uncoordinated as he came out at home (couldn't stand but trying to jump on the bed). His mouth healed quickly. He never complained of pain while the gums healed. He began eating much more. He made a bigger mess with food because he did all his biting with his eye teeth and molars. His permanent teeth came in later and really pushed to get through the callouses that formed on his gums. He is still not used to biting with the front of his mouth, but he is getting better about it.

I know this is more than you asked for, but these are things that surprised me so I thought I would give you a heads up. We were offered caps but once they pulled the teeth we saw infection on the roots and were glad they were pulled instead.

[1love4ever]

I'm really sorry you have to go through this, I cant imagine.

I'm not good at explaining things for toddlers, I can never come up with the right things to say, so with DD who is 2 and 2 months, I am pretty much just honest with her.  In a case like this I would just tell her that she has to get her teeth pulled because (and then say the real reason, I dont know what that is in your case).  but, what you said sounds great.  I just never would have come up with it on my own, so I would have just told her the reason as if I was speaking to an older child.

[carmen358]

Thanks for the feedback everyone. It *is* so hard and we're just devastated. I really appreciate the support and understanding.

And I also agree to tell her the truth - she deserves that. But I also feel like she will understand the truth better in simpler terms. The dentists can't tell us why this has happened - she had no sugar until 1 year, brushed teeth, never had a bottle, no juice at all (except a bit of prune juice with meals for constipation sometimes) and was breastfed until 25 months! The best they can come up with is "you shouldn't have nursed her so long" (which just drove me up the wall) and that it's genetic and she doesn't have great enamel for whatever reason. I don't think DD would understand either of those reasons so I think I'll stick with the simpler version.

[seraf]

There are many theories. My kids have seen 8 pediatric dentists between them and each gave a different reason. I switched DD to a normal adult dentist after the last one said that one treat a week was probably just too much for her, when I pointed out that her treats were still fruit he said, when she probably shouldn't eat fruit. Lol, I'm being polite. He didn't say probably.

I personally think its a particularly aggressive bacteria. My current dentist thinks its weak enamel due to genetics. In either case, if your DD is like my kids the cavities will continue but at a much slower rate. You will develop a thick skin and she will be fine. My dd, at about your daughter's age, sat still in my lap for an hours worth of fillings totally awake. She has always been patient with dental work and that's why we switched to a regular dentist at 2.5.

Feel free to PM if you like.

[soymilk]

I very much sympathize.  My 2 year is going through the same.  The cost is nearly $3,000 (we have to pay $1,700 out of pocket).  She will have to get 4 front teeth capped / or removed, 2 cavities filled on the bottom molars and caps on 2 other molars.  we are scheduling it to be done in May 2012.

Please let us know how it goes.

[choochootwo]

Carmen : 

 I agree, simpler is better with Little Ones. 

My son is in the same boat. No sugar, no juice, no soda. There are several different factors that can contribute to ECC. C-section birth is one, as is lip and tongue tie. Leaky gut, high fevers in infancy. Celiac Disease. The list goes on and on. I blamed myself for a long time. I picked through every thing I did, wondered what I could have done better. Sometimes it just happens the way it does.

Here's what we have going on with our son that I firmly believe play a contributing factor in his ECC. Sometimes they just end up with the entire deck stacked up against them : Antibiotic use during my pregnancy, C-Section birth ( led to reflux and gut imbalance, and leaky gut ), the leaky gut lead to autoimmune responses to foods leading to viral infections and high-fevers from ages 10 months to 14 months old, lip tie, I think I and my son are carriers of forms of the MTHFR gene and this resulted in me being deficient in folate and b12 during pregnancy and can result in poorly formed enamel in babies. Our son cannot properly digest many foods, including grains and possible gluten, celiac disease is not an absolute, but it has not been ruled out. 

If you see anything on the list that sounds like your daughter, I would encourage you to do some research to help with future dental issues as they may continue after surgery. I'm happy to help with any suggestions. We're just walking down this journey ourselves. 

You're a wonderful mama who obviously loves her daughter to the moon and back. Hang in there. 

[carmen358]

Thanks so much for your reply, choochoo!

I had a very normal, healthy pregnancy and a home birth so I can rule out that and no lip or tongue tie. We do suspect a gluten intolerance...but they won't test her yet. I have a gluten allergy (I haven't had the test either so not confirmed celiac). I just recently learned of the link between celiac and ecc....it's interesting.

And thank to you too, seraf! DD is much the same in terms of being able to sit/lay there for quite some time while they examine her. She was even able to have x-rays and sat completely still - the nurses were all whispering behind us that they'd never seen a 2 year old sit still for so long. We thought about going with in-office care but it would take 3-4 appointments at about 45min - 1 hour each. We ended up feeling like the more compassionate way was to do the the GA.
 

[choochootwo]

If you're noticing decalcification or enamel loss in addition to cavities, you may want to give cell salts, fermented cod liver oil, butter oil, and transdermal magnesium a shot to help her existing teeth. Our son is all of the above and we'll be adding zinc and digestive enzymes. 

I her stool frequently contains undigested food or is soft and yellow I would recommend an enzyme. Oftentimes celiac babies do have some sort of leaky gut from being exposed to gluten and I believe about 30 % ( I'm sorry, I don't have a source and the percentage is probably off ) are also sensitive to grains. 

I wish you all the best! 

[carmen358]

We have been doing cell salts for about a year now along with xylitol and high vitamin cod liver oil and ghee sometimes. We also give her a calcium/magnesium supplement every night before bed. We were doing probiotics but haven't for awhile...thanks for the reminder!

[carmen358]

I just wanted to update this thread for anyone who might find the information useful.

Our DD had her surgery yesterday morning. It went completely fine. After she "came to" from the GA she was awake for a few minutes and then back asleep hard for another 4 hours when we got home. She seemed fine when she woke up but then the additional freezing they had put in where the extractions were done wore off and she's been in terrible pain since about 5pm yesterday. We've had to alternate tylenol and advil to try and keep it manageable. I called the dentist/surgeon today and she said what is happening is very normal and that to just ride it out with the pain meds and lots of TLC. She seems a bit better tonight so I hope the night goes better.

She ended up having the 4 front top teeth removed, stainless steel caps on all 4 first molars and sealants put on the back molars. The dentist was finally able to see what the problem is and why this has happened in the first place. She was able to identify that DD has a very obvious, severe enamel defect which causes a whole bunch of issues and looks like white splotches all over her teeth. Something to do with hypercalcification - there was a flurry of info after the surgery and we're not 100% sure on the details but will get more info at the follow up appointment. In addition to that she also has deep crevices in all her molars which of course makes them even more vulnerable. She said the defect happens in utero - when the teeth first develop. So, as least we know what we're up against and I can stop driving myself crazy with blame and trying to figure out what went wrong. There is still a chance her adult teeth may not have the problem.

Thanks to everyone who posted with their support.

[1love4ever]

O my goodness!  I am glad everything went ok but am very sorry that your family had to go through all of this.  I would love to hear about her progress.  Thanks for the update.