Smilemomma, so glad to have found you...I have read through the entire dental archives and am feeling enormously better about my own situation. You are exactly the kind of person I have been searching for to talk to; knowledgeable and thoughtful. Thank you.
I understand that you are busy, but I still have some questions, and would really appreciate your take on this. I also haven't gone into this story with anyone IRL yet, so forgive my long-windedness. I will summarize my main questions at the end.
My daughter is now almost 21 months old. She got her teeth very early (~6.5 months), and I rubbed them with gauze occasionally, buying a toothbrush at about 10 months. She played with the toothbrush and I brushed her teeth occasionally, but she _hated_ it. I'd gone through a thing where she could not stand to have her fingernails clipped, and I took it gently, not pushing things, and she eventually became totally fine with it. Because I wanted to encourage good dental hygiene long-term, I adopted a similar model. I'd brush a bit, but when she started to protest, I'd back off.
She hadn't changed her opinion of tooth brushing after she reached a year, and that's when I started to get more serious. Most of the parenting books I have are fairly neutral about brushing up until that point. (They recommend it, but not vociferously.) I would do it on my own, and holding her with one arm while brushing with the other was not very efficient. I used non-flouride, enzyme toothpase, "First Teeth", since she didn't know how to spit yet.
At about 13 months (?), I noticed that her front teeth had some white discoloration near the gumline, which worried me. I asked her pediatrician about it. She (the Dr.) was unconcerned, saying some kids' teeth just developed that way, but that I could take dd to the dentist if I wanted to. The overall tone was "you worry too much."
I set out to make a dental appointment, which took a while. I noticed a brown spot on her left lateral incisor, and I ratcheted up the intensity. About 6 months ago, we took her to the dentist. He proclaimed the spot a chip, nothing to worry about, that all of the rest of her teeth were fine, and that I was doing all the right things. (Wrestling with her to brush her teeth at night, letting her play with the toothbrush in the morning, toothpaste, etc.)
HUGE relief, celebration, etc. Just a chip! Hooray!
I remained concerned, though, and in addition to brushing her teeth more regularly, I checked them often. I found a tiny brown spot on her right lateral incisor, and decided we had to get a second opinion. This, again, took time, and we went to the new pediatric dentist about a month ago. He said that the two brown spots were indeed cavities, plus 5 more, for a total of 7 cavities.
This was, of course, utterly devastating news. In the scheme of things, not too big of a deal, I keep reminding myself, but sure feels like it.
The dentist was nice and very reassuring, and proclaimed the problems (4 front teeth, three molars) "eminently treatable." One might require a cap (the original uh-oh tooth), but the rest will just be filled with composite, plus sealing the cavity-free back molar.
We have an appointment to have that done in less than a week. Ack. It will be conscious sedation, (Chloryl Hydrate? and v------; dh evidently swooped up the paper I had laying here a bit ago which had the specific terms and took it to work with him to haggle with the insurance company) and nitrous oxide. The dentist says it will take up to 2 hours, but he said the exam would take about 20 minutes, and it was 6 minutes. (x-ray, flouride treatment, everything.) And what's more, dd walked out holding the hand of the assistant, smiling, and showing me the bag of stickers etc that she'd been given. This was a huge relief because I had not expected that I wouldn't be allowed in with her, made a big stink about it, and was told (nicely, but still) that if I wanted to go in with her I'd have to make an appointment with another dentist, which was the last thing I wanted after all of the delays. She did climb up on the lap of the dentist when he was talking to us after her exam, though, which impressed me a lot.
SO -- questions:
1.) How traumatic will this be for dd? Will it be like a bad dream, or more immediate and horrifying?
2.) Are there really other viable options for treatment? It's been such a long, hard road to get to this point, and I'm generally very impressed with this dentist, and there is only one other pediatric dentist in Illinois that our insurance covers, who is very far away and less well-recommended. I'm just loath to go back to square one unless I feel it's necessary. If it's necessary, though, I'll do whatever it takes.
3.) What steps should be taken to ensure healthy teeth from now on? The study you cited about not brushing/ brushing without flouride/ brushing with flouride was very interesting. I don't know what combination of factors contributed to my daughter's tooth decay. We co-sleep, she night nurses (less and less, though), she VERY rarely has juice (like a sip if I'm having some 1 -2 x/week), and I didn't brush her teeth optimally for a long time. Since we found out about the cavities, dh has been helping me (finally!), and we do a thorough brushing every night. I then do solo brushings when she wakes up, and after meals -- about 4 times a day, total.
Evidently dh's family is cavity-prone, and there may be genetic predisposition. My mom says that I went to bed with a bottle of whole milk every night, and didn't have a toothbrush in my mouth until I was three, and no cavities. (!) Best as I can tell, dd has a genetic predisposition which was exacerbated by inadequate brushing. Will adequate brushing, no juice, limited sweets, etc., be enough to keep her teeth healthy? What do you think about the recommendations in the current issue of "Mothering" (which brought me to these boards)?
THANKS so much.