Is it necessary to fix/fill cavities in "baby" teeth? - Page 3

[sarahariz]

Originally Posted by Plummeting

If nursing was the problem, then prehistoric infant and toddler skulls would have decay. It could be that our own diets degrade our milk to the point that it isn't as easy on the teeth, but even that would just mean we need to change our own diets, not stop night nursing.

I looked at Brian's website (great photos) and his research. I certainly believe that in prehistoric times, nursing did not cause tooth decay. It usually doesn't now, either. But, it seems that, in children who are somehow predisposed to it, that night nursing if the teeth are not properly brushed ahead of time anyway, does contribute to it. At least I know it has in my 28 mo old dd. If it isn't related to night nursing, then why is the pattern of decay as it is (4 front, upper first molars)?

Also, in prehistoric times, processed sugar and carbs as we have today were essentially unknown. The quality of the bm is influenced by what we eat... and I think in my case that has contributed too.

I read some great articles on the LLL site today-- wish I had seen these earlier. Here is the link:http://www.lalecheleague.org/NB/NBdental.html
especially check out "coping with dental caries."

[sarahariz]

Originally Posted by PhoebeBeeBerBee

The two treatment options we have for the four cavities are a) no sedative and strapped to a restraining board and b) GA in the hospital.
I have been restling with this for months now and am not able to come to a decision. The risk of complications while under GA, coupled with the no food or nursing the night before surgery (I would have to sleep away from ds - in another house - for this to work and then likely not see him before the surgery as I don't think he could see me and not nurse if he wasn't allowed to eat etc) vs the obvious trauma of being strapped to a board for 40 minutes while the dentist goes about his work. I just don't know. My little boy is now 28 months old and is a very sensitive and cautious kid. I am very concerned about the short and longterm effects the restraint board experience would have on him. Not just in terms of his feellings about the dentist but the overall trauma of the experience. As an example - ds frequently play acts a game where his toy animals run and hide only to be found "crying" because they have to go to the dentist. He has only been twice and both times he sat on my lap crying and screaming while the dentist talked to me and hardly went near his mouth other than a brief 20 second overview... I just don't know what to do. Typing this out I am leaning towards the restraint board because with that option I can be there with him and the situation does not have the scary possible complications of GA... I just don't know. And I would welcome any friendly and respectful input/discussion.

Thanks

I've been wrestling with it too... we have a 28 mo old dd. Dentist #1 was going to do conscious sedation/papoose board and extract 2, maybe 4 front teeth. Dentist #2 recommended GA and caps for those front 4. We have elected to go with #2 and it is scheduled for next MOnday, Dec 4. Am still agonizing if it is the right thing... if anything "goes wrong" I can't imagine being able to even go on living! It sounds extreme but I so wanted to avoid trauma happening to my little one, even though I know that is an impossible task in this world... just was so hoping it wouldn't happen this soon, with something that seems like it would have been preventable if I had been more willing to brush her teeth despite her crying when she was little. The no nursing before hand will be the hardest part. I don't know how that will go, but I think I am going to start night weaning tomorrow so maybe I will have more of a handle on being able to say no to her and not crumble myself. With the GA, we can be with her as she falls asleep and as she wakes up... with the other, they were going to take her from us and there would be no way to know how out of it she would be with the CS. Plus they were going to use a papoose board. Dentist #2 said she stopped treating children that way because she felt like it was just too traumatic for them.

It is such a hard decision...!!! something I wish none of us had to go through.

[Earth Angel]

Ack, I didn't mean you!! I meant dentists who didn't treat advanced decay!

Thank you so much nancy926 for your explanation. I appreciate the clarification s

Plus they were going to use a papoose board. Dentist #2 said she stopped treating children that way because she felt like it was just too traumatic for them

I was kinda happy to read in some literature that we received today, that the dentist my son will see in March (she's on maternity leave now, and he's OK, and there isn't anyone else.....so we are waiting) doesn't use restraints of any kind either. I guess that it made me feel a bit better in that they are trying to do the best they can to do this work in the least restrictive way possible.

I do think processed junk food is that bad for us. They find trans-fats in the milk of mothers who eat them and we all know how bad those are for us. God only knows what other crud that we eat passes through our milk. DD's dentist also said that toxins in the environment and poor diet can make our milk more acidic, which can have negative effects on the teeth. (She's a really pro-extended nursing dentist who is just finishing her PhD in holistic nutrition.)

I hadn't really thought of this angle as to why my boys have had such different experiences with the strength (or lack there of) of their teeth. But, my diet was much better with my first (he was so sensitive to sugar, it would keep him up all night if I just had a bit of chocolate, and he was a horrid sleeper as it was). With my second, all bets were off. He wasn't sensitive to anything, and chocolate is my best friend when it comes to a hair raising day with my boys. I imagine my diet consisted of much more sugars with my second than my first, thereby making my milk much more sugary with #2 than with #1.
The thing I had been thinking is that I just didn't brush #2's teeth as well, he is so much more willful than #1....so it is probably both these things, along with genetics (Dh and his sis have really soft teeth that decay easily) and whatever else that has created these issues

I just don't know what to do. Typing this out I am leaning towards the restraint board because with that option I can be there with him and the situation does not have the scary possible complications of GA... I just don't know. And I would welcome any friendly and respectful input/discussion

PhoebeBeeBerBee....I just wanted to offer s. It really isn't anything to pick from is it! Either option sucks. For us, we're opting for the most minimal sedation he can have, simply because when I have been sedated for dental work (I had to have a surgical root canal, wisdom teeth out, etc) it was done and over with and I didn't even remember what happened. Sure there was some pain afterward, but I HATE having them poke around in there, looking over you, that sound of the drill and their other tools.....I just can't stand it.
I can't imagine strapping him down, he is so willful (mine is 31 mo), and I think the resulting trauma has the potential to rule out dental visits for quite a long time in his mind....and if he has crappy teeth, I imagine he is going to need to make peace with the dentist unfortunately .
That said, using anesthesia (sp?) of any kind on him makes me sooooo nervous. i haven't read anything on it, and don't really want to, but probably should.....can you guys share what you have been looking at?


s again to all us mammas making these hard decisions.

[Destinye]

Subscribing as am in such a dilemma and really believe and want to do things holistically - where are the dentists though!

[bri276]

as far as anesthesia, maybe ask about propofol? my dd had this for an MRI, put her to sleep very quickly and she also woke up very quickly, with no side effects (though, it CAN have side effects, they are very rare).

I'm getting anxious about dd's teeth. I never really put two and two together about sugars in the diet = sugars in the milk. I brush her teeth but of course, she eats several more times after that, so I've taken to additionally brushing them first thing in the morning, and have been considering adding a third brushing in the afternoon. sigh, one more reason for me to stop baking sweets.

[AngelBee]

:

[momma,mia]

My husband and I have been debating this topic as well. I am scared not to do anything, but more scared of losing my son due to GA. The thought of taking my son to be sedated and then leaving by myself b/c he doesn't wake up is the scariest thing!! We had scheduled getting his teeth done in Aug. when he was 27 months, but we chickened out. He is smaller than a lot of kids his age, so that worried me as well. He is 31 months now and we are still struggling with what to do.

He is also such a beautiful child and I feel guilty letting his teeth get worse. He shows no signs of pain, so this is my only reassurance. I have really felt the guilt as well and know how you all feel. I have played the blame game with myself for months and emotionally it ca)n make me a wreck. I have tried to figure it out or think of alternatives. I have tried calling dentists up to 4 hours away (since we live ina rural area and options are limited). I would totally drive hours away if I could find someone who could offer me a solution that didn't involve physically restraining my son (which I feel is emotionally damaging) or putting them under GA with the risk of death.

I want to have this taken care of but at the same time, risking my son's life seems crazy. It is just so hard. I feel the right thing to do would be to get it taken care of and quit worrying about the rare chance that something could go wrong.

I do think nursing combined with his eating could have caused or at least made it worse. I imagine the reason this happens more now is because of the increase of sugar and processed food in our diets compared with that of our ancestors.

[Destinye]

Originally Posted by momma,mia

My husband and I have been debating this topic as well. I am scared not to do anything, but more scared of losing my son due to GA. The thought of taking my son to be sedated and then leaving by myself b/c he doesn't wake up is the scariest thing!! We had scheduled getting his teeth done in Aug. when he was 27 months, but we chickened out. He is smaller than a lot of kids his age, so that worried me as well. He is 31 months now and we are still struggling with what to do.

Well if it makes you feel any better we are NOT going to do GA on DD 35 mo, I just do not think its worth the risk either. She goes to the pediatric dentist next week and will see what they say otherwise it will be a 70 miles trip and a ferry ride to the nearest recommended Holistic Dentist who will try to work on her, or do caries control, temp fillings at least until she is older for any more extensive work or she loses them naturally. DD had all her teeth by 18 months so am hoping she gets her permanent teeth on an early schedule too, the holistic dentist told us to play dentist at home and get her used to it, and also she would look at the x-rays to see any signs of when her permanent teeth were coming through (now or later obviously for the later erupting teeth) and sounds really nice. I think its possible to avoid the GA and invasive treatment but still take care of their teeth, but there are so few holistic dentists out there.

[momma,mia]

I have looked for a holistic dentist that would help us. I called around the St. Louis, MO area since that is the biggest city (four hours away) from us. We live in southeast mo almost in Arkansas. I just didn't have any luck.

I was so hoping to find someone who had an answer that sounded good to me and something my son could handle. So, now I am doing the waiting game and trying to take care of his teeth and limit sugar contact. I know that once they are 3, dentists seem more inclined to work with children. Maybe I should begin contacting some more Holistic dentists again to schedule an appointment when they are more willing to work with him.

My son does have several that need worked on like 8. The top 4 are the worst but they are holding up better than i thought. I still struggle with feeling like a bad mom, but again the risk of GA is scary .

[Earth Angel]

Can someone point me in the direction of the info describing the risks of GA and also the different options that *should* be available for the little kiddos? We are getting closer to March (his appt is near the end of March), and I want to go in as educated as possible. Also, I didn't realize there were holistic dentists......how did you guys find yours?

Good thing is, is that Ds still has no pain. His teeth look really bad, but he doesn't complain of any type of mouth area pain, even facial pain.

How are everyone else's sweeties doing?

[sarahariz]

Originally Posted by momma,mia

My husband and I have been debating this topic as well. I am scared not to do anything, but more scared of losing my son due to GA.

I totally understand your fears. Our dd had GA Dec 4 and had 8 teeth capped-upper 4 front and the 4 first molars. One thing that really helped me decide was finding a dentist (he wasn't a children's dentist or a holistic dentist) who took the time to work with her and we were able to x-ray her front teeth. Then I saw how bad those lateral incisors were. This man had become a dentist because he had been so frightened as a boy about going to the dentist. It had gotten to the point where he needed GA himself to have anything done. He said he would be willing to work on my dd's teeth a little at a time in his office-but that her teeth were so bad, he thought it would actually be better to do all of them at once under GA. I grieved and greived, but I did appreciate his opinion. He also said he thought the lateral incisors were too far gone to cap, but the children's dentist was able to do caps under GA. I was worried if I waited longer that the teeth would not be cappable and then dd would go through years without front teeth. I was worried about self-esteem issues as she reached 4-5 years old.

Also, I researched the chance of death or brain damage extensively. It is about 1 in 35,000. The chance of dying in a car accident is probably greater-it is just that we don't go under GA every day, so we fear it more. I talked to the anesthesiologist-who had a DDS degree plus a 2 year residency in dental anesthesia, and he said in the history of his profession there had been no deaths of a child.... usually complications arise when non-trained personnel are involved and CS is more risky then GA. HTere are some great professional review articles that you can read in the file section of "veryyoungkidsteeth"-a yahoo group you can join. There is another one called "alternativekidsteeth" as well.

This was how scared we were... the day before, we met with a psychic! We were prepared to call the whole thing off if necessary!

The other thing I was worried about was if we did nothing and a tooth absessed, we'd have to take her in and have it pulled-then we wouldn't have the GA option-that seems traumatic.

Good luck.

[Destinye]

From yahoo group:

A paper titled “Antibacterial Treatment Needed for Severe Early childhood Caries” published in the Journal of Public Health Dentistry published this summer (2006).
It discusses using antibacterial treatments during GA surgery at University of California San Francisco on children with ECC. For some reason there is a pervasive thought in dentistry that removing the lesion and filling it or removing the tooth altogether will stop the progression of this bacterial infection. This is not true. This research paper proves it again.
They applied a course of providone iodine to the children when they were under GA after they cleaned their teeth twice, filled the teeth or took them out, and applied fluoride gel for two minutes. 60% of the children had new cavities in one year on 5 surfaces. The control group had 67% of the children with new decay in one year.

They found that bacterial levels rapidly recur to original levels within just one month.

They report on another study by Lopez who showed caries reduction over 12 months with bimonthly providone iodine applications were helpful.
This study also suggests that using an antimicrobial in this group of children is effective at lowering bacteria counts if used once per month.

[WinterBaby]

I'm not a neurotic mother - not at all. But I may lean largely in that direction over my daughter's teeth, lol. There is no way I could watch my daughter's teeth rot in her mouth until she seemed to be in pain or abcessed. I've never had good teeth, and had many fillings as a child. My molars had sort of natural pits in them that inclined them even more towards decay. So I kept an eye on my daughter's teeth from the time they came in. She first saw a dentist around 18 months I think just to check her teeth, growth, aquaint her with a dentist's office. But I first noticed a brown spot on a molar when she was 2. I found a pediatric dentist immediately. My dentist doesn't care to see kids before 3, and none of the regular dentists I know seem well equipped to work on very young children. We visited the ped. dentist for the check-up and cleaning. It was all very relaxed and laid back, so dd had a great time. We returned to have the cavity filled and the oppsing tooth, which was just starting to discolor, sealed. In office, my ped dentist offers sedation that you administer to the child before the visit, nitrous oxide and local anesthetics. (My friend's daughter had an extraction in office at 20m that went fine with only the sedation and local.) My dd seemed to get comfortable enough in her first visit that we opted for only nitrous and the local, and it worked beautifully. She's since gone back for cleaning, we opted for xrays as soon as her teeth had no gaps between them, since I'm more concerned about extensive decay occuring undetected between her teeth needing oodles of work than the xray itself. She developed another cavity at 3, and we had that one filled and the rest of her molars sealed split between 2 visits with the same nitrous and local combination. (DD was a fan of the nitrous after the first time, lol.) Turns out she has the same deep pits in her molars as I do, heh. Only these days there's the sealing option instead of filling them all pre-emptively like they did for some of mine. All this and my daughter still adores her dentist and looks forward to going, so I know it *can* be done. I very much prefer to address cavities asap - it can avoid a lot of trauma since they deeper they go the more drilling and time is involved to fix it. We caught a cavity of my neices early enough that a local wasn't even needed and the whole thing was finished painlessly in 5 minutes. I think the biggest key was finding a pediatric dentist my daughter liked and felt comfortable with. And keeping my own dentist anxiety wholly locked down. That's the thing that made it all easy and stress-free for us. I asked the regular dentists I knew for reccomendations to a pediatric dentist. It's worth going to see more than one for a consult and getting cozy with the office before doing real work too.

[Destinye]

Originally Posted by WinterBaby

I'm not a neurotic mother - not at all. But I may lean largely in that direction over my daughter's teeth, lol. There is no way I could watch my daughter's teeth rot in her mouth until she seemed to be in pain or abcessed.

I am sure none of us would want to let that happen and most of us are looking for a safer way to PREVENT that happening, without having to go the GA route. Sadly not always possible but if it is then for us it would be the better option. However I am sure nobody is going to let their DC's teeth rot to the point of pain or abscess. I know I would not, but there are other options. When my tooth was abscessed I used homeopathy and the doctor could not believe the infection was gone when he removed the tooth - in fact he was quite rude about holistic stuff and told me we would have to wait and be on antibiotics a week, but he would do an x-ray anyhow. He was like umm well I don't know what you did but the infection is gone.

[kellers1384]

My daughter was 2 1/2 when I took her to a pediatric dentist for a brown spot on her tooth, who siad she had a cavity. I was nervous to have it filled, mostly because of the way this so called pediatric dentist treated my child. My daughter was not comfortable at all, and I was almost traumatized by how he treated her and myself. He wanted it filled right away in his office, and I would not even be allowed in the room. Thank goodness I refused and held off for a while. My daughter was in no pain and the brown spot was fairly small still. We moved to the other side of town (we live in Houston, so the other side of town is an hour away, haha) and I took her in to a different pediatric dentist, terrified of what this one was going to do. But I knew the cavity needed to be checked. I was told by this wonderful woman, that it was not a cavity at all! It was a spot on her tooth where the enamel never developed for some reason, and the brown stuff was just food that was all stuck in the hole! she said there was no decay at all, and we could choose to leave it or to fill it. she recommended filling because it was more likely to get decay than the other teeth which were protected. she was so wonderful with my daughter and made everything almost fun for her. everything was explained to me and to my child, and when it came time to have the filling done we went into this beautiful aquarium decorated room together, my daughter laid down on the chair more like a table i guess, and i was allowed to sit on the table with her and hold her and talk to her the entire time. they gave her a little of the gas, but hardly any at all, and she did just great. i think she did so well because of the wonderful way the people at this office acted and treated her. the other dentist we were at she screamed the entire time, and they were talking about tying her down and even the possibility of having to take her to the hospital and have iv sedation just to fill a cavity, which turned out wasn't even a cavity! i'm just saying, don't give up hope! maybe you can find someone who does this, or try to find other dentists. i got lucky with mine, but maybe if you call with concerns ahead of time you can find someone willing to work with you. it was a big change, going from being strapped down and mommy not being there to help you through it, to being able to hold my baby while she was on a big comfy chair in a beautiful relaxing room with people who really cared about her and myself. it was an amazing experience. i wish i could go to that dentist. haha. good luck! it must be so hard. =0(

[momma,mia]

I have to say that I have met with 3 dentists for an evaluation and called around 10 more to inquire about our situation. I would have loved to found someone great who could have helped us. Most dentists we were referred to or consulted were only interested in doingGA.

I think it is great when someone finds a great dentist and their child does well. Not everyone is so lucky. Yes, lucky. If it were determination or preparation that would get you an awesome dentist who will work wonderfully with your child, then we would be there.

Most every dentist I called either did not take children as young as my son, wouldn't allow me in the room, or would want to do GA. I have to stress that GA scares me very much.

So, even with the odds being 1 in 35,OOO, knowing that I am putting his life at risk is too hard. It is also hard seeing his teeth in bad shape, but I am doing all I can to preserve them and to keep them as clean as we can.

[momma,mia]

If anyone knows of a dentist even close to our area (southeast Missouri). I would be grateful to hear about them.

[Ruthe]

Originally Posted by nancy926

I had to comment on this because I wrote her second reference! LOL. I used to freelance for NIDCR and helped write that piece (well before I had any kids).

BFing and decay is a controversial topic. It's hard to study because so few kids nurse long enough to have enough teeth to study.

My DD had decay on her 1-yr molars by the time she was 17 months old (and still nursing day and night). I firmly believe the night nursing contributed to the decay (coupled with food particles from solids). Exclusive breastfeeding may prevent decay, but once you introduce other types of sugars, IMHO all bets are off.

It's also a genetic crapshoot. My younger daughter is 15 mos and I have an eagle eye on her 1-yr molars. So far they look fine, so it's possible her teeth are just better, or her molars don't have the deep grooves in them that can trap food and bacteria.

I absolutely agree with everything yu say. Exclusive bf should not cause decay but clearly night-nursing can contribute to the problem if certain other factors come into play. Maybe mom wasn't in the best of health during pregnancy, (I conceived one year after a major stroke that I was still recovering (am still recovering) from, and I am not as young as I used to be, heh.) Maybe this depleted mom did not get did not get enough extra calcium during pregnancy and breastfeeding. Maybe mom didn't insist on proper brushing when her toddler protested and struggled. My fault. But my day and night breastfed daughter's decay didn't become noticable until around 22-23 months, a few months after she (finally) began picking at solids a bit. Then boom, from 3 gray spots to noticable tooth deterioration 5 weeks later. Suddenly her teeth are rapidly decaying, but they seemed relatively fine for most of her breastfeeding life? The one thing that changed is that she eats solids other than breastmilk now.
However the pattern of decay is that her top front teeth are decaying, but not the bottom teeth (Covered by the tongue while breastfeeding.) Her molars have significant decay top and bottom on the side she lies on while night nursing, but very little on the "up" side. So how could I deny the effect of night nursing on her already decayed teeth? We are trying to night wean before her repairs, scheduled a month from now. After our second consult next week that date could change, but we WILL get repairs done ASAP because this is progressing. I've started supplementing myself and using flouride on her teeth and I will get some xylitol. I'm worried about how bad this will be in a month; right now she doesn't need extractions but who knows what could happen. This is a nightmare. :

[Natalya]

Originally Posted by nancy926

Xylitol (a sugar substitute) has been shown to reverse early decay and help prevent it. If you're not into fluoride, xylitol would be a good alternative. It's in some gum, a few hard candies and should soon be in toothpaste if it isn't already.

I found xylotil at the Whole Foods around here, and I am going to add it to ds' toothpaste. He complains about how the Tom's of Maine stuff tastes anyways. Thanks for the idea!! I also just give him a spoonful of it before going to bed (do you think that's ok... I want it to be sitting on his teeth, right?) and of course, he LOVES that.

[momma,mia]

I got the gum with xlyitol and wouldn't you know, my son doesn't like it.

Personally, i think it tastes pretty good.