Help my dd (3.5 yrs) has 4 cavities! What to do?

[Pam_and_Abigail]

We just got back from dd's second dental checkup. Her first was a year ago. At that one, I had mentionned a spot on her tooth that concerned me, but the dentist simply told me that it was a soft spot with some staining. He didn't tell me that it could develop into a cavity, or give me any ideas on how I might prevent it from becoming one. Well, today, guess what. It's developed into a cavity, plus there are three more on other teeth!

On top of that, he said he might not be able to do non-mercury fillings, depending on "moisture levels" at the site, which he says is harder to control in kids.

Worse yet, our government medical covers the fillings, but not the nitrous recommended to allow the procedure to occur. Next option to that is the hospital, which they had no info on (I guess they assume we'll be shelling out min. $54 for the nitrous), but I had to go to a hospital for dental work when I was young, and it was day surgery involving general anasthesia.

We don't eat a lot of sweets, and since Yule/Christmas have almost completely cut out sugar and chocolate from her diet, for behavioural reasons. We do eat honey, maple syrup,. dried fruit, fruit leather, though.

I don't know what to do. Has anyone had similar situations? What have you done? Have you had success getting non mercury fillings in young kids? What are the alternatives made of, anyway? There's one I've seen that is ceramic.
I'm thinking the dentist is either incomptenet or malicious for the way he's dealt with these 'spots' (as we brought it up a year ago, and it was 'nothing to worry about' then).
What is the best way to prevent further decay? I know dh and I both have unfilled decay, and are both overdue for dentist visits ourselves, but we're not covered, and we can't afford the hundreds of dollars each for it. I've heard decay is partly caused by genetics (ie some teeth are more inclined to decay, and composition is determined by your genes).

I feel like I've failed in taking good care of her teeth. I'm feeling pretty bad. But I'll feel worse worse if I put mercury in her mouth. Like I told the dentist, we don't vax so as to avoid mercury. His comeback was that it's less mercury than eating seafood, but I was under the impresion that only things like tuna are high in mercury, not all fish, and so I avoid tuna.

I'm hoping so more dental-savvy moms can weigh in on this for us.

Thanks so much!

[MizLiz]

Hi Pam,

I think you might be the same Pam who used to attend LLL meetings here in Dartmouth...

My ds has had lots of dental carries and these first appeared when he was around 2 yrs. old. His top four front teeth were totally rotten (I first noticed that one of them had chipped but couldn't figure out how it had happened). The rest of his teeth were filled with soft spots and other caveties. We went to a pediatric (sp?) dentist who was a complete a**hole ("You rotted your kid's teeth!"). He had my son sedated with some sort of schizophrenia medication and did all of the dental work in about 20 minutes in his office. Poor Zack needed the four teeth pulled out (he had no front teeth until he was almost 9!), two other teeth were crowned, and eight more were filled. I really regret how the procedure went and how I went along with the doctor against my better judgement for what was best for my ds. I do think that he needed all of the fillings, etc., but I would have prefered to have him put under a general anesthetic (sp again!) and had the work done at the hospital. I say this because the sedation that was used didn't really work and I know he was screaming throughout the whole procedure because the music in the waiting room was cranked up loudly while Zack was in with the dentist (I wasn't allowed in with him). I felt so bad and somehow responsible for letting his teeth get to such a state. Zack is now 10 and still has bad memories from the experience.

We now have a new dentist who would have Zack come in every three months to keep on top of soft spots (she'd fill them right away) and seeing the new (and very kind) dentist helped Zack to get over his dentist phobia that resulted from his bad experience. Neither she or the original dentist ever used mercury fillings for him (I'm not sure of the name of what they do use but it's some sort of plastic-type based compound). He has had lots more fillings in his baby teeth but none so far in his adult teeth . She used to also apply a concentrated flouride treatment on his teeth (I wasn't completely happy with this but it helped to save him from more heavy duty dental work so I consented.)

Since then I have met MANY parents whose kids have had mouths filled with caveties. Some of these parents were chastized by thier dentists for nursing at night or for not brushing their kids teeth often enough. These are unfair accusations, though - some children have very soft enamel and very acidic saliva, apparently, and this is a major contributor to dental carries. Don't blame yourself for this! Different dentists seem to have very different approaches to how to handle the caveties, depending on the extent of the damage and the age and capabilities of the child. I'd get at least a couple of opinions before going along with something for your dd that you aren't comfortable with. And I'm sure that mercury fillings aren't the only way to go for a child as young as yours (and her teeth don't sound half as bad as some other kids with similar problems I've met).

Good luck with this. It isn't easy to go through.

[lexbeach]

I'm sorry you're having such a hard time with this. I can definitely relate. My 3-year-old ds has 5 cavities right now, and we just had two others filled. I feel pretty guilty about it even though I think it is most likely just the way his enamel is and that there probably wasn't anything we could have done to prevent it (although we don't use flouride, so I don't know if that would have helped).

I will say that dried fruit and fruit leather are two of the absolute worst things for teeth because the sugar sticks onto the teeth for a long time. You may want to eliminate those from dd's diet, or make sure that you do a good brushing right away after she eats them.

I think you should find a different dentist. Ours never mentioned the possibility of having to use mercury fillings. And we didn't medicate ds at all for the fillings. He sat in dw's lap, and the whole thing took less than 10 minutes (for two fillings). They only do two at a time because they think it's too long for kids to sit otherwise. But they said it's really quite painless since they don't use a drill-just this sand-blaster type thing (I've had it done to me too, and it really doesn't hurt), and apparently the nerve endings in kid's teeth are much deeper than adult teeth. Ds said it didn't hurt at all.

Find someone who will definitely do the non-mercury fillings and who will let your dd sit in your lap in the chair.

Good luck!

Lex

[Pam_and_Abigail]

Thanks so much for both of you (Hi Liz yes it's me).
I will look for a new dentist for sure! We also stopped using fluoride toothpaste about a ear and a half ago.
I hope we can find a dentist as good as yours, lex!
Wow, poor Zach!

[JBaxter]

I wanted to say watch the dried fruits and fruit leather they are sticky and have a tendency to say in the grooves of the teeth. Just make sure you brush well after eating them.

[Alison]

Pam, just wondering why you wouldn't use flouride toothpaste? Are there reasons you shouldn't that I haven't heard? My DS has just turned three, and is due for his 3rd dental checkup next month. The last two really weren't much more than the dentist getting him used to having his teeth looked at. I don't think he has any decay, but then I have pretty good teeth, had no childhood fillings, and the dentist told me that decay levels tend to be similar from mother to child, since the child is most likely to get the oral bacteria that cause decay from his mother. But we do use flouride toothpaste, when I'm cleaning his teeth. When he cleans his own, we use non-fluoride, because he tends to swallow the toothpaste if he isn't being watched. Are there other reasons that we shouldn't be using fluoride toothpaste though?

Alison

[MizLiz]

Originally Posted by Alison

I don't think he has any decay, but then I have pretty good teeth, had no childhood fillings, and the dentist told me that decay levels tend to be similar from mother to child, since the child is most likely to get the oral bacteria that cause decay from his mother.
Alison

That's not always true... I've never had any caveties in my life, neither has my brother but poor Zack has enough for all of us! Actually, he has no decay so far in his adult teeth (cross fingers!)... maybe he gets his bad teeth from his father's side of the family

[Alison]

Originally Posted by MizLiz

That's not always true... I've never had any caveties in my life, neither has my brother but poor Zack has enough for all of us! Actually, he has no decay so far in his adult teeth (cross fingers!)... maybe he gets his bad teeth from his father's side of the family

As I said, "most likely" from the mother, but not always. And since Zack's adult teeth are okay, so far, who knows. Can you remember what his dad's teeth were like? Hey, how are Sophie's teeth?

I'm going to look for more info on fluoride to find out why people wouldn't use it.

Alison

[Pam_and_Abigail]

Fluoride is toxic. Harmful if swallowed. A regular tube of it can kill a child if they manage to consumer the whole thing. It must be spit out. Also, I seem to recall from when I was researching it, it may actually weaken your teeth in the long term. Please correct me someone if I'm wrong.
As far as decay, I have heard two parts of getting it from parents. 1. How resistant your teeth are to decay is partly a genetic factor
2. The bacteria that cause decay are contagious, spread through saliva contact.

[Alison]

Originally Posted by Pam_and_Abigail

2. The bacteria that cause decay are contagious, spread through saliva contact.

Yes, that's why my dentist said it was usually the mother that the child would catch it from, since they generally spent more time when very young with the mother.

But don't we have fluoride in our drinking water, here in the city at least?

[mamadege5]

My dd has very soft enamel on her teeth. We use a ped dentist we I would stay away from the nitrous if you can, it makes it easier for the dentist, NOT the child. BTDT

She did recommend a prescription flouride toothpaste because dd's teeth were developing more and more "weak" spots. Always careful to rinse thoroughly and NOT swallow. We've stopped using it now because they seem to have stabilizied. Sugarless gum chewed AFTER meals helps the good bacteria and flushs the gunk off teeth, esp after the fruit leathers or gummy type foods that stick to teeth.
We have an appt tomorrow, if I get any other good ideas, I'll update.

[Pam_and_Abigail]

So, I have another question. I'm hoping to call around to some different dentists soon, and I'm wondering what questions I should ask them. I am specifically interested in the techniques used by your dentist, Lexbeach. Do you know what the grinder thing is called? I don't wanna just ask for it that way...

thanks again

[Pam_and_Abigail]

I was gonna start a new thread, but I really just have a continuation of this issue.
I sat down with our phonebook, intending to call every single dentist in the area, ask them about not using mercury and ask about the sanding device. I called a bout 2/3 of them so far, but I will probably stop there. See, in our town, most dentists won't even see kids, and refer them two three main dentists. #1 isn't taking patients (she's booked into the new year) #2 is the guy we already saw #3 is willing to see dd, but msi won't cover another appt, and they'd want to do their own assessment. Also, the 'sanding' device depends on the individual cavaity, how deep it is, etc.
The appt for her fillings is in a week.

We may just go with that, refuse mercury, and shell out the $50 for the nitrous and hope we don't go over half an hour.

[Alison]

Hey Pam. We had Andrew in last night and it turns out he has a cavity! A little one on the biting surface. So I did need all this information after all! Our dentist seems to think she can do it without freezing etc, and she wants to try (I like her, she's good with kids, and she's been conservative with me--ie gave me an onlay when most dentists would have gone whole hog and given me a crown). Anyway, she said if he wouldn't cooperate with her, we could look into sending him to either a dentist in Mic Mac who works just with kids, or else the IWK, where they do a lot with behavioural management techniques and possibly nitrous. Andrew actually managed to have a cleaning yesterday--polishing, flossing etc, and sat well for it. We'll see what happens. I didn't ask about mercury, but will do so before having the filling done. I can't imagine that she'll use mercury--I've never had a mercury based filling there myself. I think my second choice will probably be the IWK (since it's closer to home and they have behavioural techniques they can try first before sedation). However, we are lucky in that we have health insurance through work that will cover anything provincial won't.

Our appointment for our regular dentist to see what she can do is in two weeks as well.

Alison

[Pam_and_Abigail]

I went to the IWK for my wokr when I was about 8, and I am not sure I want to go that route with my kids. It was a big deal - a whole day in. I remember that it was cloudy, and I remember telling my mom that I was afraid if there was a thunder storm and the power went out, that I might not wake up from the anasthesia. I remember being scared that I might die. Granted, I was older than Abby is, but I recall it not being a great time for me. Then again, I also had a fear of dentists anyway.
What's the name of your dentist? Cuz I've already played with the idea of considering looking in the city.

[Alison]

My own dentist is in Fall River, not really in the city--Dr. Jordan. I really like her. Sounds like the dental work you had as a kid was more than just a little filling. There's been no mention of any sedation at all, just nitrous basically. We'll see what happens when we go back in two weeks.

[Pam_and_Abigail]

We've been told mso doesn't cover nitrous. I wonder what the iwk option would be like.
Mine was 14 cavities on 12 teeth and 4 of my teeth were capped.
Thanks!
D and I are going to have to go over all of this

[Alison]

You know, there are things covered when in hospital that aren't covered when done outside hospital. You might want to check with the IWK on that, but I seem to remember that being an issue in the news over the last few years, abouthow if you had treatments in hospital things were covered but if you were given prescription for at home they weren't. Not nitrous specifically, but still maybe worth checking.

[Alison]

Pam, did you have A's cavities done yet? We go in tonight to see about Andrew's cavity. I have my fingers crossed. The good news is that since our last visit, he's fascinated by flossing, and will let me floss his teeth every night! Still fights brushing though.

[Pam_and_Abigail]

We went in lst week, but we only got one done, because it took a while for Abby to warm up to it. Nitrous gas isn't covered at IWK, either, I found out.

The delay kinda sucked because now we'll have to pay for more nitrous in 2 months when we go back. It would have been nice to at least get two done at a time. Part of the reason we ran out of time was the dentist was late getting us in. We were 5 minutes late, but then he didn't take us in until 25 after our appt began. It was 7 mins to the end when we got started. Abby didn't want to lay in the chair. I didn't think to suggest the lap idea, as I was mostly running around after dd2, but DH hinted at it and they ignor4ed whatever he said about it.