My baby has 11 rotting teeth and it's all my fault!

[jillywilson]

Or at least that's what the denist thinks.

Here's the back story: DD2 is very shy. Doesn't do well at the doctors, getting her picture taken, or pretty much anywhere else where strangers might talk to her or, heaven forbid, touch her. When she was around 20 months, one of her front top teeth chipped. Gradually, there was more chipping and discoloration on those top front teeth. I had our family dentist take a peek (while I held her down) and he said that it looked like she was born with weak or missing enamel, but he didn't think it was worth the trauma to her to do anything about it at that point. Fast forward to her 3rd birthday last September. I made an appointment for her with the same dentist because that's when they officially start seeing patients. Well, she stuck both fists in her mouth and nobody could get a peek in there. We rescheduled for February. By that time, I could see some spots on a couple of her top back molars so I really wanted her to be seen. This time, she let the hygenist look, but not clean. This was a huge accomplishment for her! Unfortunately the dentist was out of the office that day so she didn't see him. He called me and said he looked at her chart and thought it would be best for her to be seen by a pediatric dentist and gave us a name of someone he likes.

That brings me to today. The visit went VERY well on Hannah's part. The dentist came out to the waiting room and played with her for a while and got her talking. We went back to the exam room where she showed Hannah pics of her dog and they talked some more. I was very happy with how she related to Hannah and that they welcomed both dh and I to come back with her. Hannah let her "count" her teeth AND clean them. Woo-hoo!! I was so happy that Hannah was cooperating so well.

After all of that and Hannah was picking out a sticker came the verdict. She has decay on 11 of her 20 teeth. Then came the kick in the stomach. She asked if she ever took a bottle to bed. I said no. She asked when she stopped. I said "She never did. I nurse her." Still? "Yes." Her eyes got big and she looked at Hannah and said "Oh honey, this is not your fault." She went into a lecture about how breastmilk is so full of sugar and basically I've created a breeding ground for bacteria by letting her nurse to sleep. DH popped up with "Our older dd nursed this long and has perfect teeth." She just shook her head and said something about how that was lucky for the older dd, but Hannah wasn't so lucky. She said some other stuff, but I wasn't listening by then. I did mention how our family doc said she was born with weak enamel and she just smiled politely and shook her head in disagreement.

So now we have decisions to make but I'm feeling so sick about it all that I'm not thinking straight. We can either take her to a hospital and have them all done at once under general anesthesia or do it in the office over the course of six visits. Each visit would be with just a local anesthesia and she said she would need my help to hold her still. It was a miracle that she did so well today I don't know how I would get her to be still after getting a shot in her mouth!! Even if I get her to do it once I don't know how I would trick her into going back 5 more times. That seems very traumatic for her. On the other hand, the general anesthesia is scary and the dentist said she wouldn't be surprised if our insurance would not cover that.

Any words of wisdom? Comfort? Just please don't scold me anymore for the night nursing.

[Past_VNE]

Mama, I don't advice you about her teeth, but let me tell you this:

YOU WILL NOT GET ANY SCOLDING HERE. We know that it's not your fault. We know that nursing does not cause rot, bad teeth and bad care cause rot. Sometimes, teeth will have caries no matter how good the care is. In your daughter's case, I would have to say that nothing you could have done would have prevented it. Bad care makes for a bad tooth now and again. 11 bad teeth is just not likely.

Hugs, Mama.....to you and your daughter. It's NOT your fault.

[peilover010202]

Oh, I agree with pp. No scolding here. I'm just not sold on breastmilk causing decay. There are far too many children with perfect teeth after night nursing.

This will really be up to you and dh - but given your explanation, I would be *very* inclined to go the general anethesia route. And, why does she think insurance won't pay for that type of sedation? I would definitely call them and get all billing codes and call your insurance company (or have them do it.) I don't know exactly what treatment they are offering - but I'm really surprised they don't think insurance will pay for the general anethesia.

Gl mama - I hope everything goes smoothly.

[LavenderMae]

I had a dentist say the same kind of things to me about my ds's teeth (bad decay too). He also told me to wean him right away (my ds was 1 at the time). We never went back to that dentist.
My ds's teeth started to decay almost as soon as he got them in (he started getting teeth at 4mths). It has to me due to bad tooth enamal formation inutero (in my opinion anyway).
Breast milk DOES NOT CAUSE TOOTH DECAY, even if you night nurse. Now if there is food matter in the child's mouth and breastmilk then decay can happen.
Because of a couple of tramatic experiences with capping some of my ds's teeth he refuses to allow a dentist even look in his mouth and since his decay is not getting worse (or at least very slowly) we are just leaving it alone (keeping his teeth as clean as we can). He is 4 1/2 now and should start losing baby teeth relativley soon.
Good luck mama and don't let that dentist's ignorance make you feel too bad!!

[peilover010202]

"In a study done by Dr. Torney, no correlation was found between early onset (< 2 yrs) dental caries and breastfeeding patterns such as frequent night feeds, feeding to sleep, etc. He is convinced that under normal circumstances, the antibodies in breastmilk counteract the bacteria in the mouth that cause decay. However, if there are small defects in the enamel, the teeth become more vulnerable and the protective effect of breastmilk is not enough to counteract the combined effect of the bacteria and the sugars in the milk.[stress mine] Enamel defects occur when the first teeth are forming in utero. His explanation is based on quite a large study of long-term breastfed children with and without caries.

According to this research, a baby who is exclusively breastfed (no supplemental bottles, juice, or solids) will not have decay unless he is genetically predisposed, i.e.. soft or no enamel. In a baby who does have a genetic problem, weaning will not slow down the rate of decay and may speed it up due to lack of lactoferrin."
Source: http://www.kellymom.com/bf/older-baby/tooth-decay.html



I found this info in another post here...HTH

[Devaskyla]

big hugs. It is not your fault, or night nursing. The dentist may be good with kids, but she's clearly under-educated on this topic.

http://www.swedish.org/111715.cfm

[bluets]

I'd get a new dentist too, or educate this one with material from kellymom.com (Docs and dentists are big into patient education - I'm even more into practitioner education and provide my caregivers with material that I find relevant to my health issues)

If you haven't yet done so, I suggest you read JaneS' thread on Curing Cavities through Nutrition (http://www.mothering.com/discussions...d.php?t=399989) - a lot of good material there, and you may even decide to NOT follow up with dentist-recommended care.

Good luck.

[tmareeh]

How did the dentist come to the conclusion of 11 cavities? Did she do x-rays or just look at the teeth?

I would definitely get another opinion. That is a lot of trauma to put your child through. I also want to share my personal experience with you. I'll try to make it brief.

I was 20 years old before I had a cavity. I went to a new dentist for a routine checkup. He told me I had 8 cavities and the beginning of periodontal disease. I didn't have any fillings and didn't go back to that dentist. A few months later I went to a different dentist. He told me I had 6 cavities (no periodontal disease). I went ahead and had 3 of the cavities filled. (Even with insurance, it was costly to have the fillings.) About a year later I went to a 3rd dentist. This dentist came highly recommended. He said I had 1 small cavity. I relayed my previous experiences to him and even brought him the x-rays taken by the 2nd dentist. I didn't understand all of these discrepancies in diagnosis. He told me that cavity identifying is somewhat subjective. One dentist might just watch a cavity that another one would choose to fill.

I would really urge you to get another opinion for your child.

Good luck!

Taryn

[Chele]

as someone who has dealt with the exact same senerio, get another opinion. Even if they say the same thing about your daughters teeth make sure you like them and that they don't just point the blame finger at you. I had a horrible experience with a ped. dentist so I just starting seeing one of the other dentists in the same practice, it was like night and day. The first was so rude and condesending (I know for a fact that he has refused to treat kids unless they are weaned right away....what a bastard) the second dentist I saw acknowledged the defects in my sons teeth and said nothing about nursing. No matter what they may say to you, don't ever think it was breastfeeding. We are scheduled for a procedure at the hospital next month, I tried desperately to avoid this trying to delay any work until my son was older but his teeth are just deteriorating so rapidly that we simply can't wait any longer. I am sad and overhwelmed with this situation. Good luck to you.

[SolsticeMama]

We did do the general anesthesia when my son was 16 months old. Now those caps are broken and one dentist says extract them all now (ds is 2 1/2 now) We're seeking another opinion and have had lots of phone consults...not sure what we'll do yet.
BUT, our insurance did not pay for the GA for dental work. The total cost to us ended up being $7500. We appealed for months, to no avail, but got lucky. The hospital had a program that we inquired about (they didn't tell us about it) where they write so much off for charity each year. So, we had to submit lots of financial info and even though we didn't think we'd qualify, it was all paid for! Maybe this will be helpful to someone else too.......
It is just so nice to be in good company here. Each of the 3 pediatric dentists we've seen has been so condescending and SURE that we have caused our son's decay with breastfeeding. I am thankful for all of the great information and sharing here.

[Plummeting]

Breastfeeding does NOT cause tooth decay. Please see:

http://www.brianpalmerdds.com

for more information. He has a section on infant caries or something like that. It explains how night nursing does not cause tooth decay. He is an expert and knows what he's talking about.

Most dental insurance will not cover the hospital costs associated with general anesthesia. However, it is often much, much less expensive to tell the hospital you have no insurance. They usually have a flat fee they charge, which is MUCH less than you'd have to pay if you tried to use your insurance. For instance, in our area, the children's hospital will charge a flat fee of $900 for this procedure if you tell them you aren't filing with insurance. However, if we tried to use our insurance for it, we would pay about $3000 to $4000 out of pocket. Your dentist can still bill his/her portion to the insurance company, because the dentist's bill is completely separate from the hospital bill.

We actually didn't go that route, instead choosing sedation in the office. I wouldn't use ANY ped dentist who insisted on doing the work with no sedation whatsoever, for a child who is already afraid of strangers like that. Our dd took 4 Vistaril capsules before her procedure. It's an antihistamine that makes you very drowsy. Then, once we got there she was given nitrous. It went very, very smoothly and DD doesn't seem at all traumatized by it. However, if you DD really does require that much work, I might opt for the anesthesia, because it might be too traumatic to have that much done under sedation only.

Either way, I absolutely would not use the dentist you saw. It's not so much that she blamed nursing - most of them do - it's just that she was so disrespectful to you and she's obviously unconcerned about your daughter if she wouldn't even offer sedation to do the procedure in the office. The dentist we chose did tell us he thought night nursing contributed to caries, but he also said that he would never recommend weaning a child, because that wasn't his area of expertise. He was respectful about our decision to nurse and caring towards DD. Therefore, his particular beliefs about nursing didn't bother me at all. I can deal with a difference of opinion if someone will treat me and my child with respect.

[veganf]

Sounds like that dentist's office needs some educating. Hopefully you can provide them with some literature and straighten them out before they insult anyone else.

I'd go with the general. Maybe you can get free care from the hospital?
I'm curious though, how many of the decayed teeth are baby teeth? Aren't they just going to fall out in 2-3 years? Are they that badly decayed that they need all that work done?
Also, I know after having wisdom teeth pulled and a cavity filled that they very strictly told me NO sucking on anything for a few days (ie. straws, lollipops, etc.) because that can damage the work done and hurt me (I have no idea if it's true or not, obviously I didn't test it.) But I'm wondering if they'll instruct you the same way and get all bent out of shape about the nursing. Just thought I'd mention it to be prepared.
I'll be interested to see how this turns out. Good luck, and good job mama.

- krista

[Ragana]

I also have 1 BF kid with good teeth and 1 with bad. Our dentist told us that this problem is mostly hereditary. From what I've read, unless your DD is pooling the milk in her mouth at night, BF isn't what causes tooth decay, as the above posters have said. We were also told to avoid any sticky or very hard candies, as well as sticky fruits, such as raisins and fruit leather, which we had been giving her in lieu of candy. Also no juice.

We found an excellent pediatric dentist who was able to fill 4 cavities and do one root canal/cap with just local anesthesia, because we did not want general. Our daughter was about your daughter's age when that happened. We kept telling her that it was OK to be scared, but that it was something that needed to be done and she was capable of being brave & we would help her. Of course, she also got special treats after it was done - she was a trooper. And she's great about brushing her teeth now, and although like anyone she doesn't love going to the dentist, she does fine with it.

About the not doing anything because the teeth will fall out anyway. We were told that by some people, but our dentist told us that if the decay goes too far, it can affect the permanent teeth. Also, our daughter is now almost 6 1/2 and showing no signs yet of losing any teeth, so we're glad we did it.

[beanma]

so sorry! there's a wealth of info in the dental archives. not sure if SmileMomma still lurks, but you might PM her. she's an AP mama dentist and sweet and smart. to lose her as the dental moderator was a big blow. take care and a second opinion might be in order. my oldest sounds a lot like your little one personality wise. easily traumatized, especially by invasions of personal space. i know some dentist will allow the child to sit in your lap in the big chair while they do the exam. maybe that would help?

good luck to you...

[jillywilson]

Thank you so much for all of the responses. I'm still reading through all of the links and great info. I think I'll be sending a packet of info to the dentist about breastfeeding.

We still don't know what we are going to do. IRL, I'm getting so many varying opinions about what to do next that my head is spinning. Second opinion? Third opinion? In office? In hospital? Do nothing? $$$$$?

So, thank you again for all of the great support and info.

[jenP]

to you!
BTDT, will post my story when I have a bit more time. Just wanted to add real quick, re: weaning... telling you to wean the child makes as much sense as telling you to not give her food ever again. Sure, carbs in milk can feed the bacteria in the mouth. So do carbs in food. Do we stop eating? NO! we just brush our teeth after eating. So why would weaning help? She would still have to eat, anyway.

good luck!

Jen

[paquerette]

One of the more recent issues of Mothering had an article about dental benefits of bf'ing. Maybe you should order a copy sent to that dentist.

[Pookietooth]

Oh, to you mama! Your dentist told you right in front of your dd that nursing was the problem. That must have been painful. It's hard when someone tells you something that you know is emotionally good for your child is harmful physically, particularly when it's something that is so taboo like nursing.
Just wanted to say, my ds is exactly like your dd, including the super-shyness, right down to the age when his teeth first started chipping. He's had his four front teeth pulled, and five other fillings. He still nurses to sleep at three, and you know, I think that that's at least part of it. For most kids, it doesn't matter, but I think if a kid has the tendency, it might worsen it. Especially with a high needs kid who nurses often throughout the night.
But really, blaming you now doesn't really help things, does it? The reasons are no doubt complex, including nutrition and constitution.