Sedation

[Cynthia Mosher]

supermom
Member posted 01-12-2001 08:34 AM
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I am overjoyed to find a place where breastfeeding is supported in the light of dental problems. I have a 2 1/2 year old son who has cavities in five teeth. I first became aware of this about a year ago and I was heartbroken. We have been to see 4 dentists and all have placed the blame exclusively on b.f. My son is an extemely active child and getting him to sit in his chair through dinner is difficult. For this reason we have been told that sedating him is the only option for the repair of his teeth. In visits to dentists we have tried different measures to calm my son enough to fill the cavities. He was given laughing gas which didn't seem to affect him at all. He was given Demoral which he promply threw up, and finally, he was given a sedative which he had an adverse reaction to. It was terrible, he was like an angry drunk, unable to walk, but he didn't want to be held. I had to hold him against me as he screamed and hit me and arched his back. All we could do was wait two hours for the medication to wear off. And in the end no dental work had been done. After this last attempt 6 months ago, we have been seeing a naturopathic doctor in an attempt to remineralize his teeth and avoid dental work altogether. It has not worked however, and he has recently been experiencing pain when eating certain things. At the end of this month he has an appointment at a children's hospital in a town an hour away. I know they will want to put him to sleep and do all the dental work in one shot. I have serious misgivings about this in light of his previous severe reations to sedatives, but I don't know of any other options at this point. I have searched and searched for a dentist who will work with him without using sedatives, but have found no one. I feel so helpless and have been treated with nothing short of disgust at every dentist we have been to. If you have any suggestions or know of web sites where I could get more information I would be very grateful.
Thanks,
Kelly


megerina
Member posted 01-12-2001 09:17 AM
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Kelly,
Make sur the PD you go to is aware fo the sedative reactions your son has had in the past. Not all sedatives are the same, sjust as no two people will have the same reactions to some. Get the records from the dentists that have tried to work on your son, so they have an accurate knowlege of what drugs were used and the amounts.

don't beat yourself up. I have one child who was breastfed, but her mouth was wiped out after every feeding in her sleep who still has caries problems now in her twenties, despite an almost anal dental hygeine regimen. My next duaghter we were looser with, figuring we would just have the same problems no matter what, and she is now 15 with NO cavities. The next has a "million dollar mouth," despite careful attention to her teeth and limiting sweets. She also won't deal with the dentist unless sedated. Don't know about DS, but am hoping he gets the 50% shot at inheriting my teeth, rather than Frank's.

As far as your son, it will probably be less trauma in the long run if they do all the work while they have him under. Why put him through more anesthesia than necessary? My DH can tell you from experience, there is nothing worse than bad, untreated teeth for pain.

Get him fixed up and you and he will be much happier people. You might also want to see about sealing his adult teeth as they come in if he is cavity prone. This can be done without the trauma of crilling and drugs.

Good luck

[Kellypdx]

safety of sedation cocktail?

The dentist who will be working on my almost 4 yo's teeth (possible pulpotomy which I asked about in an earlier post) says she will be using the following medications:

chloral hydrate, vistaril, demerol

Does anyone know anything about the safety of these? Or the necessity?

Thx,

Kelly

[rachel]

my teeth chipped along the gumline

I recently had some wisdom teeth pulled and then shortly after pieces of my two molars, on one side, chipped off (on the outside along the gumline). I'm assuming that perhaps the Dr. accidentally tapped those teeth while extracting my tooth ( I was awake for the extraction, due to the fact that I'm still nursing my daughter, but my entire jaw was numb, so I'm not sure if he accidently tapped the other teeth or not).

My teeth are sensitive, so I already don't like going for cleanings (there's usually not much for her to pick anyway) and the place where they chipped is certainly more sensitve now.

So my question is this: Do I need to do something about this (have them sealed or something)? Or can I just leave it (would that be a bad idea?) Is it bad that they chipped along the gumline where plaque and tartar can build up? Is it enough that I brush and floss regularly?

Anyone else ever had this happen to them? Please, let me know if you had any work done to fix it, or just left the chipped teeth alone!

Thanks!
Rachel

[rachel]

Okay, got it!! NO Nitrous Oxide!! (took a pg test today and am definitely prego!!) I will postpone any work until the 2nd trimester as you advise and will check out the thread you mentioned!! Thanks so much again!!

[sahamama]

Nitrous Oxide Use in Child Dental Care

Hi! My four-year-old daughter is scheduled to have a filling put in for the third time on Tuesday. The previous two fillings have fallen out. Each was noticed missing about six months after being put in. Two different dentists think that the composite fillings are falling out because they are not setting up properly. They feel that my daughter probably placed her wet tongue on them before they were set so that they did not cure properly. This time they want to give her nitrous oxide to help prevent that from happening again. I am afraid of even more tooth being lost if the filling should need to be replaced a fourth time, so I want to ensure that it works this time. However, I am worried about them using nitrous oxide on her. I have never had it myself, but my sister had it as an adult and became rather wild and uncontrollable. Any drug that alters the brain concerns me -even if just temorarily. The only drug she has ever had her entire life including child birth is novicaine for the filling. I am very, very grateful for that and would like to keep it that way if possible. I plan to try the Roman Camomile and Young Living's Peace & Calming Oil that I read about on this site and hopefully that will work instead. However, if the dentist insists on nitrous oxide should I worry? I haven't been able to find out much about the down side to nitrous oxide. My holistic dentist is giving her oral methionine prior, during, and after the nitrous oxide to help replace the methionine that is lost from her system during the administration of nitrous oxide. I would appreciate any suggestions or knowledge on the subject. Thank you.

[khrisday]

My son had Versed before a minor surgery (due to his extreme anxiety we felt the Versed before hand was better for him). He is extremely hyper, and the Versed worked just fine. He went off to surgery as happy as a lark and has no bad memories of it (whereas he had horrible memories of having blood drawn years later).

[simonee]

Thanks khrisday. That's just what I needed to hear! Nothing like knowing that other people have been there with success!

[sahamama]

Thank you for all the info. I did go ahead and let them give her the nitrous oxide. Everything went fine. The dentist told me that by giving her nitrous oxide she wouldn't need any novicaine. That surprised me. I thought she would need both, but he said that with baby teeth nitrous oxide acts as a pain killer as well. It seemed to work. She enjoyed it so much, that she didn't want to stop. The whole way home she fussed that she wanted a gas mask to use at home! I thought, "Great! Now she's adicted!". OK, sometimes I worry too much. She did get a little raised red spot on her cheek the next day, but it didn't last long. I think it may have been her body detoxing through her skin, or it may have been unrelated. Thanks for your help!

Sahamama

[MamaInHarmony]

question about sedation

My 3 1/2 yo dd is scheduled for a dentist appointment on June 7, and I am really stressing out about it. She has cavities and they want to use a combination of vistiril and chloral hydrate which she will take by mouth. Smilemomma, what do you know about these drugs? I feel like this is our only route. We have known that she had cavities for over a year now. I had consultations with four different dentist before finding one that would try treatment without sedation and over the course of a few visits. It turned out horribly, mainly because of the dentist who should really just retire. He is supposedly a pediatric dentist but is in no way gentle in any sense of the word, and would not even look me in the eye let alone look up at me to discuss anything. After that, we had a long brushing, brushing, brushing only break and then saw a dentist who I really liked. Dd let her do a cleaning and exam wonderfully, but then when we came back for the fillings she really couldn't bring herself to do it. Dd was trying so hard to work with the dentist and do what she was asking of her (in between crying) And in the end the dentist could not do it. She does not have in office nitrous and does not feel comfortable with the papoose which I find as a plus. But this, leaving us with having to find yet another dentist. I am feeling torn. I am really ready to get it taken care of and have a fresh slate to work with so to speak, because dd is really wonderful about brushing now. She was not at all at the beginning , that along with extended (still) BF and genes I attribute to her cavities. They want to do the sedation and I cannot be in the room, which just kills me. I know smilemomma, you say don't go anywhere where they don't let you in, but because of our insurance we have limitations to which dentists we can see. I just want it to be over with, I have been stressing over this for so long. Any advice would be great. thank you

[Debbiemom]

I know this is not really what you're asking about, but I just want to say I *really* regret not staying with my son during his dental procedure. The only way I'd ever leave one of my children for a dental procedure again would be if they were under general anesthesia.

A friend of mine took her daughter to a dentist out of town; it was a two-hour drive and they made a day-trip of it. Could you do something like this? Is there a dentist in another town that your insurance would cover?

Would the other dentist who tried to take care of her teeth that you really liked be willing to try again with sedation and letting you stay?

[MamaInHarmony]

Thank you for your reply. Specifically why do you really regret not staying with your son? Was he extremely traumatized by the whole thing? Did he not really "go to sleep"? I know that they're not supposed to go to sleep, the dentist wants the child to be able to understand what they're saying to them. Even getting to the "sleep" state that they want seems unrealistic when they schedule the appt. for 9:00 in the morning after a full nights sleep. I know it is a huge thing to ask of a parent to leave the room, my heart literally sank to my toes when they told me that. That is originally why we've waited so long to do it. I am really bummed about this whole thing. I swear my next child I am brushing her teeth from the get go. I do not want to go through this again. I will see if the woman dentist that I liked will be willing to try again. I'll keep you posted here. Thank you again.

[MamaInHarmony]

Smilemomma, just so you don't have to repeat yourself, I just looked in the archives!! Aren't you proud of me! I posted anyway earlier without looking because I did a search for the drugs listed above and came up with nothing, so therefore I thought it wouldn't be in the archives either. But indeed it is. So, thank you for doing all that work to organize it so nicely for all of us here. Lots of love, Harmony

[SquirelNutkin]

Hypnotist for Dental Fillings-Anyhone?

Hi-
So, has anyone ever used a Hypnotist during the dentist or other medical times?

Has anyone used a Hypnotist for any problems?

I am actually considering using a Hypnotist for my daughters dentist appt. to get some fillings finally filled- but wanted to get the range of expereince from the mothering community before I made a decision.

thanks
b

[Debbiemom]

I don't know for sure whether my son was traumatized or not. He is only 4 and not all that communicative so it's hard to say. He was given an amnesia drug called Versed and presumably doesn't remember anything although I have my doubts sometimes. He has had some night terrors since his procedure and an extreme refusal to allow us to even LOOK at any "owies" he gets, but we also moved to a new state right after this so it's hard to say what is caused by that stress.

He was not asleep when I was told to leave the room, in spite of what I was told (that I would stay until he was asleep). I don't think my son being able to talk to them was a priority; he was having extractions and the entire procedure took about 4 minutes. He screamed the entire time so I know the dentist wasn't concerned about my son's opinion of what they were doing; as far as the dentist is concerned because he was "asleep" (which is apparantly what they call being under the influence of the Versed in their office), then it didn't matter. He was also sedated with other drugs and he was given a local anesthetic. I assume he was screaming in fear, not pain, but since I wasn't in the room, it's hard to say.

Anyway, to answer your question, I wish that I had insisted on staying with him because that would have ensured that I found a different dentist. The reason they had me leave so was that I would not know that my son was not truly asleep as they had promised and that they had misled me about how the procedure would go. I have no doubt that there are dentists out there who have what they feel are valid reasons for the parents not to be present and who do only what they've promised during their procedures, but as far as I'm concerned, there is no way for me to know for sure what they are doing to my child if I'm not there.

[Smilemomma]

Oh, Harmony, THANK YOU! I'm glad it's working!

Good luck to you and your sweet girl, let us know how it goes!

[Smilemomma]

Thanks, y'all!

Hypnosis has worked well for several of my patients; enough that I will continue my studies to incorporate it (and acupuncture) into my practice when babes are bigger.

You could ask around to find a dentist who does it; but in my experience, they're pretty few. Now, good dentists in general DO use a hypnotic technique with voice (me, too) that works pretty well, but I don't think that's quite what you mean.

Another, possibly better approach is to find a board certified hypnotist. They can induce a trance like state in their office, and give you instructions on how to duplicate it in the dental office. (this is what some patients have done to good success; one mom actually brought her hypnotist with her, but the others were able to do it just fine on their own). One woman used hypnosis for her childbirth, too.

Good luck, let us know how you do!

[gilnikche]

Anesthesia + Sedative = Mommy Anxiety

We have just has yet another dental visit for my 4 y.o. son.

Nitrous Oxide did not appear to do any good at the other dentist's office in 2/02. This dentist wants to have him take Valium 45 minutes before his next appointment, then use N.O. during the procedure. This makes me extremely anxious! Where can I find the information to make an informed decision? I need to know if:

-How these react together?
-Is this more dangerous than doing a general?

[gauge14iv]

Im not sure NO3 is so great for a four year old for several reasons - It is not effective when you breathe through your mouth rather than the nose mask - and 4 yo with mouth open is going to breathe through his mouth so how much NO3 is he going to get? Bascially little to none...Secondly, the nose mask SCARES some kids making them hyperventilate and again making the NO3 inneffective. I'd probably forego the NO3 on a kiddo who was not old enough to understand how to breathe through his mouth and who had a hard time being comfortable with the nose mask.

The Valium on the other hand - may knock him out completely or just make him very very groggy. And no, that is absolutely not as risky as general anesthesia, in fact it isn't anesthesia at all, only "knock em down" drugs - but it is less predictable as far as how effective it will be.

That said - there are several things you will want to consider - is your 4 yo at all cooperative? What is the procedure and how critical is it? How traumatic is this going to be for your son if he were to be aware of it happening? It's rough I know - our 8 mo old DS had general anesthesia last week to have a tongue tie altered. There were a lot of factors behind chioosing general, but all things considered we felt it was the safest, least traumatic way to handle it.

[gilnikche]

Thanks gauge14iv. He really does need to get this work done soon. I used to work as a nurse & am familiar with Valium & general anesthesia. Knowing too much makes you very cautious. I swear I may start looking into acupuncture as an alternative!

Smilemomma, Any input?

[Smilemomma]

You betcha, baby!

Check out the dental archives under both "sedation/nitrous oxide" (N2O2-O2, btw ) and "general anesthesia for dentistry".

I can help if you have anything left over after all that!

Good luck!