Causes of Decay and Prevention - Page 5

[sozobe]

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.

[Smilemomma]

Thank you, sozobe, for the kind compliments. I can see that you are not only a very devoted and concerned mom, but a well-read one, too. (and no, not just 'cause you read the archives! ) Congratulations to you on trusting your instincts and getting the second opinion; you probably know by now my opinion of most pediatricians' dental skills.

I must say, your well-thought out and articulate post is certainly keeping me on my toes! And to think it's 2 am here!

I think you have found a gem! Her sitting on his lap, her obvious comfort with the staff, that is all just fantastic, and worth more than gold right now, and bodes well for her future in dental care! Only one eyebrow raised about you not being able to go back, but clearly they work very well that way, and your sweet girl was very comfortable with that. Good for her! Lots of children really rise to the occasion and take pride in being "big girls/boys".

If I must interject, it sounds a bit like you are projecting some of your own dental fear onto your daughter here. "More immediate and horrifying" ? A "bad dream" ? Those are not your only options. I think this dentist sounds terrific, and he is obviously doing a great job to ensure that she has only a good experience. Believe it or not, it can be done so that she feels proud to have cooperated in getting rid of that bad old cavity bug, proud of her new, strong white teeth and her role in getting them there. It can be a very positive experience, truly, and it sounds like he is well prepared to make it so for her. Only address it in a positive light, and that is all you need do to make this a good thing for her, and for you.

I can see that you have evaluated the most important thing, the *cause* of the cavities, and have quite thoroughly eliminated them. I would be very surprised if your daughter had any further decay at all.

I thought the Mothering article was quite good, and certainly timely. What recommendations in particular were you considering?

I think that once the decay is eliminated, this will be a distant memory for both you and your daughter. Congratulations!

[sozobe]

Oh boy! (Trumpets, confetti ) I got an answer! Thanks so much!

I was surprised to see no mention of the papoose board in your response, and then more surprised to see I hadn't mentioned it in my question. : My question was actually a great deal longer at first, (if you can believe that), and underwent some rigorous editing -- I must have edited that out. That was the single aspect I was most worried about, the fact that this dentist uses a papoose board, which I saw in the archives that you were very opposed to. However, he didn't offer an option -- it was papoose board or nothing.

The procedure happened last Monday (8/19), and was a mixed bag. My daughter went willingly with the assistant, the staff was good about giving us updates, but we weren't allowed back. The uh-oh tooth did not require a cap, just a filling. There were no complications.

The first heart-in-throat moment happened when I first saw her afterwards. I was expecting her to be groggy and out of it, but then I saw lots of little red speckles around her eyes and temples. I tried to clean them off, thinking they were some sort of spatters, but they didn't come off -- the dentist said she had burst some blood vessels while struggling at the beginning, in the papoose board. That was an absolutely horrible moment.

However, I have spoken to her about what happened a lot since. She seems to have processed it pretty well. Her story (which she has told several times) is that a lady came and picked her up, and brushed her teeth, and she liked the lady, and then the lady put her down (here her expression becomes more grave) and put a hat on her (the head restraint part of the papoose board) and she (dd) cried and cried, and then Mama picked her up. Putting that together with what the dentist said, I think she was given the sedation shortly after she was put in the papoose board, and then doesn't remember anything until I was holding her. The dentist said that the struggling part was very short.

Still.

The second bad part is that the dentist says there were already some (more?) white lesions on her front teeth. I have started with flouride, and am brushing her teeth after absolutely every meal, with the notable exception of nursing her to sleep/ naps. I have opened a thread on the extended breastfeeding board for advice on how to nightwean dd. I hope to keep nursing her when I can brush her teeth afterwards, but when I try to clean her teeth after nursing her to sleep, she wakes up. We have a follow-up appointment this Wednesday, so I will ask more about the white lesions/ progress/ lack thereof then. I had so been looking forward to a clean slate.

The last bad part is that my daughter has been less secure since the whole experience. Two days ago, I had a monthly meeting that I go to, and my dh came home early to watch dd; he came home before her nap, I got her down, then I left. That's the usual routine, due to the time of day of the meeting. But when she woke up, she was absolutely hysterical. Dh had a hard time reaching me, and she stayed hysterical for half an hour before falling asleep from exhaustion. Heartbreaking.

The main question I had about the Mothering article was the emphasis on diet rather than use of flouride. The epilogue states that the author has been using a nonflouride toothpaste, herbal preparation of white oak bark, daily supplement of Cacarea phos., rinsing with Natural Dentist's Herbal Mouthwash for Kids, avoiding sugary foods, and loading up on foods rich in Vitamin D. Do you think all of that is necessary? Some of it? If so, which parts? I don't know if that entire regimen is realistic for us, so I want to identify the most crucial aspects.

Anyway, I'm happy that the worst of it seems to be over, and I will continue to do everything in my power to keep the cavities from recurring.

Thanks again.

[gypsimama]

I love my dd's dentist and a question for Smilemomma

My 15 mo dd had her first visit with her dentist today and he was amazing! I was soooo nervous and scared that he was going to tell me to stop nursing her because she has a small cavity and lots of white marks on her front teeth. He was awesome and gave me so much info (alsmost as much as I've read in the dental archives .

So here is his plan, Smilemomma I was hoping you could add your .02 cents here:
1. try to cut back on the night nursing to 2-3x's per night.
2. 0.12 % Chlorhexidine Gel 2X's per day for two weeks
3. After Chlorhexidine Gel is finished start Prevident 1x per day for 3 months and avoid all other forms of flouride (ie water, toothpaste) and only brushing with water the second brushing of the day.

We go back in two months for a follow up and to "dig out the little spot" on her tooth and he said he could fill it with something that will fall out eventually and that may be okay until she gets her adult teeth.

I got such a great vibe from him and he was extremely gently and patient with dd. We used Roman Chamomile (sp?) right before we went in along with four drops of RR for me the combination seemed to work really well. Dr. Gary asked if she was always this laid back, there were no tears and she blew him a kiss when we left. I take that as a good sign.

So, Smilemomma, what do you think of this plan? I haven't taken the scripts to the pharmacist yet because I wanted to bounce this off of you first.

Thanks in advance and I'm sorry this is so long.

Kaight

Edited to add: found info in the archives re: Prevident, so now I'm just wondering about the Chlorhexidine Gel.

[Smilemomma]

Oh, Kristi, I'm looking forward to the updates!

Don't they just make you speechless sometimes? It's amazing how something so simple turns the corner for them! "I brushin, mama..." that is soooo cute! Give her a big hug from me!

[Smilemomma]

Wow, that's so great! Give that cool dentist a hug from me! She blew him a kiss, that is so sweet! And great news for him, too. He must be good.

As for the night nursing, as you probably saw from the archives, I believe that it is not at all necessary to night wean even partially for dental reasons.

I too use a material like that to restore these teeth. It goes in really quickly and easily, it just doesn't last as long as the more permanent stuff. Sometimes it lasts until the tooth is lost naturally, and sometimes we have to replace it. We can either use the same stuff again, or go to the more permanent stuff, depending on the cooperation level of the child. Sometimes just a few months makes all the difference.

Isn't it amazing how well the oils can work? I love, love, love the Roman Chamomile. Glad it worked out so well for you!

And hurray for this dentist. Between you and him, you are making this as easy as possible on your daughter, which will not only get her healthy now, but will help her actually enjoy the dentist throughout her lifetime. What a precious gift! Kudos to you, mama!

[sozobe]

Hi there,

Thanks again for your thorough reply. I know there's a lot of us rapping on your window and pressing our noses up against it and waving and saying "Hello!!!" when you've got plenty to deal with as it is.

The central equation with the papoose board was accept it and go forward, or reject it and go back to square one. It had already been such a delay-ridden trip, and such a quickly-progressing case, and what evidence we had gathered indicated that nobody our insurance covers in Illinois would do it without the papoose board. I was virulently against it (I, ahem, am also a mother), but I was dead set against having to stay in the waiting room when dd was initially checked out, too, and she was just fine with that. My question (and may have been Freudian that I edited it out, since I was very concerned about the answer) was whether the undoubtedly disturbing aspects of the papoose board were bad enough to delay treatment by several more months, or pay the full fee ourselves (which we absolutely can't afford), etc.

Dd went back for a check-up last week, just to make sure that the fillings are fine and to have a non-equipment visit. She was utterly unperturbed in the waiting room, playing with other kids and toys and having a nice time. When we took her back to see the dentist (his consultation room, not a "real" exam room), she was fine until we laid her on my lap for him to check out her teeth -- she didn't like that, but wasn't hysterical or anything. Just complainy. He was done quickly, and she recovered immediately, and waved bye-bye and smiled.

As for breastfeeding, no, I haven't begun weaning yet. I felt that was the last thing she needed as things have been stressful lately. I also like to think about things thoroughly before beginning any project of this type, so I can be consistent and confident in whatever road I've chosen. I haven't completely decided about nightweaning yet. I definitely don't want to wean her entirely, no matter what. Nursing when I can brush her teeth afterwards is not an issue at all. But even you say, "and taking away the bacteria's food supply (lightening up on the night nursing)..." I am going to great lengths to do everything to keep the white lesions she has from advancing, and it just seems odd to me to have such a glaring exception. She sleeps about 12 hours a day, and nurses to sleep all the time, and 2-3 times overnight. So that is half the day that I'm brushing her teeth as soon as a non-water particle has been ingested, and half the day that bacteria-food is happily hanging around? That just doesn't seem like a good idea.

The tea tree oil thing is interesting, but I'm not sure how it would work for night time. I might try it for naps and go from there.

She has also just started indicating that she wants to sleep in her own bed, so that is something I'm going with and might lead to nightweaning. She has really wanted to sleep on the floor lately, so I went and got the mattress out of her (never-used) crib and put that on the floor. She loves it!! Took her nap there yesterday, and we (ouch) slept there last night. I'm not at the point where I want to leave her there by herself yet, but I can see that happening.

Thanks again.

[gypsimama]

Thank you so much, Smilemomma. You ROCK!! Your reply was reaffirming and personal and I just can't tell you how much I value your input here.

I'm glad to know that you think his plan is a good one, I'll fill the scripts on Tues. I would be interested to learn more about your essential oil solution, but only if or when you have time. Is there anything about it in the archives?

Thanks again, for making this mama feel at ease and for empowering me before we even made it to the dentist.

[pattigirlny]

4 yr old has cavities!

i am so upset and worried because i was just told by a ped.dentist that my son has at least 3 cavities(1 pretty bad) all in his upper and lower molars! 4 months ago my husband took him to his dentist for a check up and the dentist recommended sealants due to deep pits/fissures....son refused to go back there(not very kid friendly) and when we took him to a great pediatric dentist yesterday...they saw all of those cavities!i never thought a 4 year old could could have such bad teeth! of course now i am feeling guilty because.....i shouldve brought him to a dentist last year...i should have brushed his teeth 2x's daily religiously...maybe i shouldve given him flouride vitamins.... or used flouridated toothpaste...i should have noticed the cavity...i dont know...(he breastfed for 3 years...not a candy eater or juice drinker)i am just so worried now on how or if they can be filled? what if they are worse....i cringe at the thought of torturing him with alot of dental work......my poor 4 year old! we took xrays and have to go back in 2 weeks to discuss our options...right now i am just feeling so extremely worried about the future...is he just prone to cavities? will his secondary teeth be poor as well? he has a secondary molar coming in the back sorta behind his present molar...maybe then he'll lose that decayed molar? i dont know how long that takes....for a tooth to come out.....i am just worrying sooo much...especially since my son was so proud that he got his teeth checked by the 'cool' dentist...i dont know how i will be able to tell him his shiny clean teeth has holes in them and need to be fixed? ugh! plus now i also worry for my lil 17 month old...i dont know what a cavity looks like? when should she get a checkup? and how fast can a cavity form? should i give a flouride vitamin? i am sorry for going on and on.....as you all can see i am a big worry wart!......i guess any advice or thoughts would help me feel not so all alone on this.....thanks so very much!..patti

[chumani]

I know exactly how you feel when my oldest dd was 4 I noticed 2 spots that looked like cavities. We took her to our dentist, who is really great btw, and after the x-ray he showed us how 6 of her molars were actually decaying under the gumline in the roots. He sent us to a ped dentist she ended up having 6 pulpotomies and all 8 of her molars were capped. She never complained of her teeth hurting before or after the procedure. Her saliva was cultured and came back positive for bacteria which was the most likely reason for the decay. Best wishes to you and your son!

Sarah

[simonee]

Hi you're NOT the only one!!!!!!

Check out the archives (somewhere at the top of the dental entry screen) ~ there's a lot of threads on exactly this problem, including lots of support and info on what to do.

Don't blame yourself, and don't worry too much quite yet. There's not much chance that his permanent teeth will be affected yet, I think, and there are actually several child-friendly, non-traumatic options for helping him.

Good luck, and tell us what happens next.

simonee your self-appointed dental assistant

[Greaseball]

Quick tooth decay

Does anyone know what some causes of quick tooth decay are, aside from not brushing and too much candy and all the usual stuff?

I'm asking for me, although this could become a problem for dd someday (she's just now getting her 2nd tooth! ) because I hear it can be hereditary.

At the beginning of the year, I had a molar with no problems at all, and then 6 mo later there were large visible holes in it. And this is with regular dental care, brushing, etc. It had to be pulled. I have another molar with the same problem, although the dentist said it could be saved with root canal treatment. But just a few months ago, it didn't have problems.

I have been taking calcium supplements. I drink one or two cups of coffee a day; could this be bad for the teeth? I also have not had a regular teeth cleaning in several years; I decided to get all the major cavities taken care of first and I'm going to get the cleaning probably in a month. Maybe then the decay will stop.

What do you think? Is it some kind of nutritional problem, or is it hereditary?

[AdinaL]

I also have this. Curse of soda drinkers everywhere. I drink a ton of milk and have enver had any problem with my calcium intake and still get it. My dentist put me on a prescription toothpaste that had mondo flouride in it and that helped for a while - but ran out of insurance and toothpaste.
I was told I just have weak teeth..so does my dad.
Cleanings will help. Brushing with flouride toothpaste helps. Drinking anything that has sugar in it through a straw helps. Having water on hadn to rinse out your mouth after you drink anything helps.
I am dreading my next dentist visit....many many cavities to fill....ick.

[Greaseball]

I don't drink much soda.

I have thought about extra fluoride. I can ask my dentist about prescription toothpaste. Once I was prescribed this mouthwash, and I forget what it was for, but I didn't use it because everyone I knew who used it developed brown teeth. It was listed as a side effect. Do those OTC mouthwashes help at all?

[sozobe]

On continuing night nursing -- bad news

I have been keeping a very close eye on my daughter's front teeth, where the white lesions were, to make sure they don't progress. They don't appear to. But I just decided to do a more thorough exam of her whole mouth, and am almost certain I have found two more cavities (in the very early stages) on the outside surface of her top molars, near the gumline. (The previous ones that were fixed on the molars were in the creases.)

I will have this checked out by the dentist, of course, to be sure. But if that is in fact the case, I just don't see how I can possibly wait until my daughter decides to stop night nursing. I have been brushing her teeth after every meal, twice a day with flouride, her diet is excellent, and night nursing seems to be the only remaining variable. I understand that night nursing does not CAUSE cavities, but given the extensive problems that my daughter has had, it seems irresponsible to continue.

Nightweaning is the last thing I would like to do, all things being equal, and if there is any science out there showing that it will not have an effect, in terms of continuing tooth decay issues, I would love to see it.

Thanks.

[Smilemomma]

Woo hoo, sozobe, just saw your update on the other thread, that's great that they're just demineralization!

I have every confidence that they will not be permitted to progress .... weaning or not.

Hurray!

[Smilemomma]

Willibug, I'm so sorry I haven't replied before now! It's probably all over and done with by now ... I hope it all went well!

I was archiving threads and was just about to send this one to the encyclopedia in the sky when I saw you had another question!

Of course you don't have to wean unless you're both ready! Check out "told to wean?" in the archives for more info. It's best, of course, to brush after nursing, but as a mom I know how impractical that can be, especially at 3 am!

You are so welcome, thank you for all your kind words. It makes my day! Especially tonight, when I'm spending so much time archiving, it's nice to know I'm doing some good!

[Smilemomma]

Thank you so much, gypsimama! Your reply is *exactly* why I'm spending so much time here -- I think it is so cool to hear when moms feel like they have some information to go with, and that it helps with the overwhelmed feeling, at least a little bit. I'm especially psyched when I hear how the dentists are amazed at their knowledge ...

Thank you for saying so, you made my day!

The essential oil rinse is in the archives under "mouthrinses", but it is the Dental Herb Company's Tooth and Gum Tonic. It is fantastic. The only drawback is that it is only available through a dentist's office. There might be more info on the gum disease thread, too. It kills bacteria and viruses, with no chemicals, no alcohol ... I love it!

Good luck to you, I hope all went well!

[willibug]

Thanks again, Smilemomma! Yes, it's all done and over with now! All went really well. The dentist and hospital were wonderful--couldn't have been a better experience--considering! However, DS ended up having SIX fillings rather than the 3 or 4 we expected . And we did go ahead with the fluoride treatment while he was there. So, all's well, and baby is none the wiser about his ordeal ! And we are still nursing away, but I haven't been able to curtail his nighttime appetite. But I do brush as soon as he gets up, and I try to make it 3 times a day at least. And I plan to take him for his next checkup in 3 months time rather than 6 as I do with my other kids, at least until I feel a bit better about his oral health. I've decided to say no to the fluoride drops because, like you said, I know he swallows some of his fluoride toothpaste. One thing I haven't been able to do that the dentist recommends is swabbing on a little ACT rinse with a q-tip each night and then wiping it off. It's enough of a struggle just getting the brushing done. But maybe I should make more of an effort. What do you think? I'd like to try the tea-tree rinse for both DS and me, since we are now BOTH cavity-free(HOORAY!!!) I'll go look up that thread now.

Thanks again, Smilemomma!

[Smilemomma]

Hurray for you both!

Blessings!