Toddler Dental "Surgery" - Mothering Forums

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#1 of 9 Old 06-16-2005, 04:18 PM - Thread Starter
 
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I'm a wreck.
I just got home from the dentist. All of my daughter's top teeth are rotting. I had taken her to my dentist about 7 months ago, when I first noticed discoloration, and was told that she just had very thin enamel so not to worry about it. They kept getting worse, and I'm really beating myself up for not going to a pediatric dentist sooner. Now one of her teeth is brown, and just yesterday a big chunk came off of the front of one of her front teeth. The dentist said she has extensive rotting, that it will progress quickly, that she needs some crowns, some fillings, and that the front 4 teeth may need to be pulled. They don't look that bad from the front, but he said the back is much, much worse. I'm a wreck. He said it was from allowing breastmilk to pool in her mouth, but was actually generally supportive of breastfeeding. I'm not sure I believe the part about the breastmilk, other than to say that she does have thin enamel (like most of my family), so she's more prone to cavities and although she is pretty good at letting me brush there were times she went to sleep without brushing. Plus I didn't brush before naps. So there was opportunity for milk to sit there with food- which could be the problem. I'm trying not to beat myself up about that because my family has such bad teeth anywhere there probably wasn't a whole lot I could have done. Anyway, the soonest they can do the procedure is a month from now, and I'm worried it will get worse before then. I see the posts about the Spry toothpaste, and will order some today. Can someone please tell me what the procedure will be like? The dentist said it will take about 2 and 1/2 hours, that I can be there when she falls asleep but not when she first wakes up. She's never been away from me, other than with her father, will she be terrified? Or will she still be sedated enough to not get too upset? I'm terrified and upset and just not sure what to do. Thanks for any help or support.
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#2 of 9 Old 06-16-2005, 08:53 PM
 
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WTF???? Your dentist told you NOT TO WORRY ABOUT IT 7 months ago???? OMG I am so angry right now. It's so much easier to fix when you catch it early.

You have a few choices right now. One is to go with the hospital/GA route. The non-surgical option is to make radical changes to your diet and start doing topical treatments. The most sure-fire bet is to use fluoride toothpaste as often as you can, like 7x a day (this is what we did, plus topical fluoride/iodine treatments at the ped. dentist office). You don't have to brush every time, you can just put a dab (size of a grain of rice) on your finger and wipe it on their teeth. The point is to apply the fluoride to the decay. We were able to kill the cavities and now she is old enough and comfortable enough to just sit in the chair at the dentist's to get it cosmetically fixed. But your DD's decay may be so far progressed that it may be into the pulp, and you will need to get a pulpotomy/pulpectomy, which may mean the hospital route. Get to a ped. dentist and cross your fingers that it's not that far progressed.

Other people have reported progress using diet change and topical xylitol gel. I have no personal experience with this though.

Here are some helpful links for you:
Fluoride debate: http://www.mothering.com/discussions...d.php?t=282787
Remineralizing cavities: http://www.mothering.com/discussions...d.php?t=276453
Arresting decay with topical treatment/using decay color as indicator of progress: http://mothering.com/discussions/sho...d.php?t=282442

HTH! and GOOD LUCK!
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#3 of 9 Old 06-18-2005, 03:31 PM - Thread Starter
 
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Yeah, we're pretty upset with our family dentist right now. She told us it was no big deal, just to make sure to brush regularly. It didn't sound right to me, so I take partial blame for not getting a second opinion. Anyway, I'm trying not to wallow in the past, kwim? We've got to face the present now.

Thanks for the input. I ordered some of the xylitol gel, and am going to check out those other threads now. The biggest problem, I think, is that her front teeth are literally crumbling away. They don't "look decayed"- they aren't black, but little chunks come off each day. The two next to her front teeth are almost gone, and about 1/2 of her left front tooth is wobbly and I'm sure will be gone within a week. I don't know if I can do flouride that often since she doesn't spit? Plus, if her teeth are crumbling like this, won't she be left with little jaggedy stubs anyway?

I really hate to have her front teeth pulled, but the dentist is saying they can't be saved. I talked to my grandparents, and was told that lots of people in my family have had this problem. My grandfather's baby teeth AND permanent teeth both crumbled away like chalk. He had dentures at 22. Great.

I hate this, hate this, hate this. I feel like I'm between a rock and a hard place. I don't want to give her anethesia, don't want her to lose her front 4 teeth- but if I don't, then are they just going to crumble away, be painful and sharp, and cause infection???

Aaaaagggghhhh.
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#4 of 9 Old 06-19-2005, 04:11 PM
 
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*hugs to you*
Depending on your DD's personality, she may actually be able to sit willingly at the dentist's office to get it fixed. My DD had come from another dentist where we restrained her (in order to avoid GA) but that was a terrible mistake and I wish I'd done the GA instead. Then I found this new dentist who I totally love and absolutely does not force any dental work on the children. So hopefully you can find a ped dentist in your area who has a similar gentle approach.

I risked the swallowing of the fluoride toothpaste because I felt it was better than the alternative (continuing decay). As long as you use a teeny tiny amount (the size of a grain of rice) then swallowing is minimized.

Black color is actually a good thing, it means that the decay is dead. One of the threads I linked to above talks about it.

Bad teeth are due to poor nutritional status, which can be passed on through the generations. So most likely if you have a history of poor teeth, then you and your children will have problems as well.

If you can stabilize the decay and change your diet, then you decrease the risk of abscess. The teeth will still be sharp (makes for some pretty painful breastfeeding) but you may prefer that over GA.

HTH!
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#5 of 9 Old 06-19-2005, 05:23 PM
 
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Hugs to you Mama!
My dd's top four front teeth started decaying around 15 months. Same scenario...pediatrician said, "ah....not to bad. It will probably be ok till she is older." (At the time we had a hard time even finding a dentist who would see her at that age.) Crumbling teeth also. Anyway, Long story short...(you can read my past posts for more info)...Dd is almost 5 and has had the top four front teeth capped when she was 27 months. The top two "capped" front teeth extracted 5 months later because of abscess, and two false teeth put in place with a bracket 8 months later. The reason for the delay with the "partial" being put in place was that her 2nd year molars had to be far enough in to attach the bracket. So.............................
If you do have the teeth extracted, it is really important to get the partial, not for space maintenance, as this is not an issue with the front teeth as it is with the molars. But for reasons of speech and enunciation. We noticed a considerable difference with dd once she got her partial.
Just a couple of months ago one of the teeth came loose and broke off of the partial. So it was removed for repair. Within the month that it was off, dd was very self conscious about it and I could see the esteem issues come up. Not so when she was 2 1/2 with no front teeth. But at 4 1/2 it was different.
As for the thin enamel. There is much you can do to strengthen enamel. Flouride for one. At this point, the amount swallowed is minimal risk compared to the risk of infection with extensive decay. The dentist can give you a high flouride gel that you can apply once or twice a day max. Then the other brushing can be done with a non-flouride paste. Once you get the treatment and repair and she has had two two "clean" 6 month check-ups, then you can reduce or eliminate the flouride if you are uncomfortable with it. Studies have shown that flouride and xylitol used together is also extremely effective.

As for the not being able to be there when she wakes up......why???? As a parent, I would gently insist that you be there for your daughter when she wakes up. The procedure is over. It is your right to insist. And it is ok for her to nurse immediately. Especially if she has extractions, it is helpful for the clotting to suckle. Not to suck from a straw which they will tell you, but the physical act of sucking from the breast helps with the initial healing process as well as the comfort it provides. Regardless, nursing is fine all the way up until the procedure and directly after. It is not a food or drink, but a bodily fluid.
There is a lot of information here about what can be done to strengthen the teeth and the proper way to clean them. Unfortunately, a lot of health care practioners know little about children's teeth. And you are right, breastfeeding is not the culprit. However bm on top of food residue is an issue as is almost anything on top of food residue. Unless your child is a "dawdler" nurser, the nipple of your breast is further back in her mouth and doesn't lend itself to milk "pooling" as with a bottle.
It's summer time, so go outside and make a game of putting water in the mouth and then spitting it out like a fish! This is a good way to teach them about spitting.
Lots of water is important now too. Apples, grapes, cheese, nut butters, whole grains all help to neutralize the acid that leads to the bacteria which causes cavities. Things you can do in this next month! Good luck, Mama!
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#6 of 9 Old 06-19-2005, 11:52 PM
 
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you are living the story of our lives here. dd had visible decay along time ago. took her to the ped dentist and was told not to worry, treat her with floride. went to another dentist a week later, and was told she had three cavities. I wanted to save those teeth badly, so we went to a dentist office where a family member works. yet another ped dentist. by the time my dd (2 yrs old) went in for her dental surgery she had to have 5 caps/crowns and 1 filing. We choose to use GA, at the Children's hospital, due to the fact that I was scared to have her restratined, and she won't sit still for that long. The dentist was super nice, and even saved some teeth that really should have been pulled. She has nice enamel colored crowns/caps on all four front teeth, and 1 silver cap and filling in the back. Yes, when she came out of the anestisha it was pretty bad, but I can't imagine having those teeth pulled. I used to nurse her at night all the time, and was told that that could have caused it, but the dentist said it had to do with the fact that bad teeth run in the family. We have good teeth brushing and always have. i wish you the best.

Kristin- Wife to J, Mommy to B (11), M-S (8), and little J (4) and J&J (7 months)
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#7 of 9 Old 06-21-2005, 06:52 PM - Thread Starter
 
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Thank you for sharing your experiences. It helps in some strange way to know that other people got the brush-off too. Like maybe I'm not a complete idiot for falling for it. Anyway, I have and update. Two days ago a huge chunk came out of her front tooth, leaving just a jagged (and very sharp) point. I'm sure it is hurting her tongue and lip, if the tooth itself isn't hurting, and it definately hurts ME when nursing. So I called the dentist and got the surgery moved up to Friday. I'm terrified, but I really think it is the best thing. I'm really hoping for caps rather than extractions, but am looking into the kiddie partial just in case. My dentist says he does them, but not often because they are removable and the kids tend to take them out and lose them. Has this been anyone's experience? At least we can get one if we want to. Hopefully we'll she'll have caps and we won't need to.

The surgery center has been wonderful. We're going on a tour tomorrow. They have flavored gas (kids pick their own flavor), and they cart the kids around in little red wagons. I got the name of the "best" anethesiologist, and have made a special request for him. I'll find out tomorrow if we got him. The charge nurse has called me three times to answer all of my questions. I've been pushing to be there as soon as she wakes up, but they're saying it's a multi-patient post-op room and nobody can be there. They assure me that the moment she stirs she'll be brought to me- before she can full wake up. I'm going to talk to the post-op nurses during our tour.

Malamamama- I love the idea about spitting the water outside! My concern is that we're on a well and it has Arsenic. It's a borderline amount, so a little probably wouldn't hurt her, but we have a special faucet with reverse osmositized (is that a word?) water for drinking. Maybe we can take out a pitcher of good water and try it. Or heck, just try it in the kitchen sink! She loves to drink from the spicket like a "water fountain". Hmmm... thanks for the idea.

One other question for everyone. How much should I tell her? Should we tell her that her teeth are getting "fixed"? We've been afraid that will make her think there is something wrong with them. Any other suggestions?

Thanks,
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#8 of 9 Old 06-22-2005, 02:42 AM
 
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It sounds like you are in really good hands!!
As far as telling her.....well, the truth is something is wrong with her teeth. But being as young as she is, you can keep it really simple. "The dentist is gonna help make this tooth smooth and not so sharp". "Mama will be there, and other people are going to be there helping too." I would highlight the wagon trips and the fact that everybody is there to help. Simple, simple simple at this age. And then just focus on your calm and reassurance and prayer to whomever/whatever to guide her through the experience.

As for the partial....if it comes to that...dd's partial is a "fixed appliance". Meaning that two false teeth are attached to a wire which runs along the gumline of the roof of her mouth to brackets that are cemented to her 2nd year molars. It doesn't come off. It's fixed. No problems except when a tooth broke off which wasn't a problem, just an inconvenience.
But like you said...the focus is saving the teeth at this point.

Another thing to remember is that after Friday, the bacteria that had been eating away at these teeth will be looking for other host teeth, so it is super important to be on top with eliminating the bacteria. Brushing after everything she eats and drinks or at least as often as possible and lots of water to keep mouth rinsed. Increasing those foods I mentioned, etc.
I'll be thinking of you
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#9 of 9 Old 08-24-2006, 01:25 PM
 
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hello... i aaccidentally happened onto this site and read your posts/conversation from last year and god, i wish i had found it sooner! i went through much anguish when my daughter (now 4 1/2 yo) had an abscess affecting her top 4 front teeth at age 3. her teeth could not therefore be salvaged and i agreed to hav them pulled... my ped dentist advised to come back at 3 1/2 yo to have the partial put in. OH! but i forgot to tell you that this particular dentist i chose because he did not use general anesthesia, which was a huge concern for me as i didn't want to put my girl "under" at such an early age. so anyways, she was restrained, and the faculty was so nice, warm and gentle that i felt safe and that my girl would be ok. the procedure (teeth extraction) took less then 20 mins and my girl came out crying but she still turned around to say "thank you" for the toothbrush and sticker she received... did i mention that i wasn't able to be inside the room with her during the procedure?

ok, so now, my little boy (23 months) has major decay and i didn't want things to progress into an abscess the way they did with my daughter so i opted to have his teeth capped (silver crowns). fortunately, they were able to salvage his front teeth, but again i wasn't able to be in the room with him during the procedure... it took a little less than an hour. he was also restrained for the duration of the procedures. i've cancelled their follow-up appointments with their dentist because i got SO much heat for having agreed to the procedures for my boy at such a young age and much more, i wasn't in the room with him while he was restrained and crying for me the entire time... i feel so guilty, really... but my boy is ok... i mean, i'm sure he won't remember it. my daughter actually enjoys going to our dentist because he gives such positive reinforcement to the kids and his style is great, so i feel quite comfortable with him.

my concern now is the content of the crowns that my boy has now... do you know if he may be at risk for hypermagnesemia or mercury toxicity? have you heard anything about this kind of thing? i mean, he was pretty young when this happened... just last week in fact... but i feel so much safer now that his teeth are capped.

well, thank you for listening and i hope to hear from you soon!

pamela
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