Taking a 2yo to the dentist for possible cavities, help - Mothering Forums
Life with a Toddler > Taking a 2yo to the dentist for possible cavities, help
nova22's Avatar nova22 05:49 PM 12-08-2005
I was brushing DD's teeth last week and noticed some discoloration on each of her two bottom molars. There wasn't a whole lot I could do about it at the time because we were still waiting on our insurance cards (we are covered, they just haven't sent our replacement cards yet). But today, I saw that one of them is getting darker, and I also looked on the top and saw one there, too. I called my regular dentist and described it to the receptionist, and she said they do sound like cavities. The nearest pediatric dentist is an hour and a half away and they were able to get me in on Monday, and they don't need to see my insurance card at the time of the appointment (WHEW).

I really have no idea what to expect and I'm hoping someone can walk me through this. I have never had a cavity. I don't know if this will hurt her, or how I can help keep her calm during the whole appointment. I'd also love to hear from anyone who has had fillings done in a small child. She will be 2 in January. I'm scared to death for her because I have no idea what will happen and I feel so awful that this happened to her. How can I make this easier on her?

naturalmomto8's Avatar naturalmomto8 03:14 AM 12-09-2005
I just took my 2.5 yr old to the dentist today. Her two front teeth have decay, they are dark at the gumline. Anyway, they finally tricked her into letting them look, she used a toothbrush to "brush" her teeth. They referred us to a dentist that puts them out to do the work. I am totally freaked out about what I should do. There was a 4 yr old in our town a few years ago that was put out for dental work and he died. So of course that was the first thing I thought of (I always have a horror story for everything...LOL). I know I have to do it, because it can ruin her adult teeth if we don't, and there is no way she will ever let them do anything to her. But she is very weird about things that have to do with her body. I have to clip her nails when she is asleep, and it takes a few days to get them all. I was joking and said while she is out I was going to clip all of her nails too.

I have 9 kids and she is the 3rd one that has soft teeth and they get cavities easier. We did dentist appointments the last 2 weeks and 2 of my boys had 7 and 8 cavities and then 4 had none. The dentist said that some people tend to get cavities more than other people. I hate that my 2 yr old has to go through this too.
True Blue's Avatar True Blue 11:00 AM 12-09-2005
My DS has weak teeth and has work done a couple times, starting at less than 2 years old. Some dentists will do it as outpatient surgery, usually in a hospital or surgery center, and completely put them out. While that is nice bc they dont' remember anything, not all insurance companies cover this bc it is not necessary (for example, it would have cost us around $5k out of pocket!). The other problem with this approach is it is very risky to put such a young child under anesthesia, which is another reason many dentists will NOT do this. Same with conscious sedation. For the real good conscious sedation the child needs to be at least 3 and over a certain weight.

So....it was rough. DS was given a mild sedative that is in the Benedryl family. He was put in the papoose for the procedure and not happy about it, but it was really the safest way at the time. I hated it. He had laughing gas too, and once they finally got him to stop crying so much and breath in some of the gas, he finally passed out. He awoke again when they tried to do x-rays. They gave up on those and just got to work. Once they numbed him, he remained out cold for the remainder of the procedure, and my nerves calmed. Any good dentist should allow you to be in the room for the dental work.

He has been sedated one other time for another cavity and to fix one of the crowns he got the first time. That time it did not work as well and he fought it a lot more, but he at least calmed enough for them to do the work.

On the bright side, he never showed any signs of being upset by the trauma or traumatized after either procedure. He just wanted to get something to eat LOL and he usually slept for a while. He remained little worried each time we went to that dentist, only when we went back to the actual exam room, but he's been fine with the dentist. We moved recently and now that he goes to a different dentist, has no reservations about going at all.

Good luck, I KNOW how hard it is. It broke my heart but it had to be done. If you have any more questions, feel free to pm me!
naturalmomto8's Avatar naturalmomto8 08:03 PM 12-09-2005
he finally passed out.
He fell asleep and wasn't put out?? I am really interested in this...likeI said I know a little boy who died from being put out for dental work and it totally freaks me out. Was it easy to find a dentist to do it this way?? So far the 4 I have called all put them out. One does it at a hospital and the other 3 do it at an outpatient surgery place(which is the type of place that child was at).
sun-shine01's Avatar sun-shine01 08:10 PM 12-09-2005
My dd is having dental work done this next Monday and they are giving her a mild sedative an hour before the proceedure in the hope that she will fall asleep. She will be 3 next month.

She has seen 3 different ped dentist and this was the only one that suggested doing the work WITHOUT general anesthesia (sp?) but that is not the reason that we chose this dentist. I just liked her better than the other 2.

I'll post back on Monday night and let you know how it goes. I'm trying not to think about it at all because I'll just be a crazy with worry. I hope they don't use the papoose board - that would freak her out and they never mentioned it.
WuWei's Avatar WuWei 09:12 PM 12-09-2005
This is a difficult issue. There is an AP oriented yahoogroup called "Very Young Kids Teeth". There are many parents with extensive and current information about sedation alternatives, sealants, xylitol, rinses, etc. Here is the home page for the group.

Personally, I would not allow our conscious son to be immobilized against his will. That sounds terrorizing. I would not want anyone to ever do that to me! As a critical care nurse, I understand the concerns regarding anethesia, but partial sedation in a facility not equiped for life theatening emergencies would be a concern too. The group can provide some references and resources for more information.

A friend's daughter just had extensive oral surgery done at the main hosptial out-patient center. She had a nasal spray preliminary sedation (Versed) and general anethesia. She needed eight teeth addressed. Two crowns, two caps and sealants, caries, etc. Their daughter is almost four. In September, they were told that the surgery was indicated. However, there was no pressure to push the child beyond her willingness nor to rush to have the procedures done urgently. The surgery was this past Tuesday. So, the main point is to expect and to provide ample opportunity for briefing the child and consideration of the child's (and your) comfort with the facility, sedation alternatives, respectful attitudes of the staff and dentist compatibility.

Btw, they were told that the issues with their daughter's baby teeth would not have progressed to damaging her permanent teeth. But the teeth may break off or become uncomfortable for eating, in addition to potential cosmetic issues since two front teeth were involved with some soft tooth, mild decay formation.

Another friend saw 5 dentists that were pushy, rude, rushed and condescending to their daughter (the patient) before they found an incredible dentist. That dental office was extremely child-friendly, including coming out to the waiting room and meeting her without expecting her to sit down, open up immediately. The patient and respectful attitude of the dentist was the critical element in their daughter consenting to participate in the examination and treatments.

Parents share experience information dealing with issues with their young children's teeth dental health. (Mainly ages 0 to 6 years -the preschool years).

Discussion includes:
- developing good dental health habits in young children. - tips tricks to make dental hygiene fun(or at least not a horrible daily struggle!) - choosing child-friendly and child/parent-respectful dental health practitioners. - what to do when things go wrong: dealing with decay,cavities or disease after they've occured. - where/how to get work done - anesthesia choices, pull vs. crown/cap. Implications for speech development, confidence, trust in dentists, further damage, further treatment. - supporting children through procedures, to minimize anxiety pain for both children and parents. - supporting breastfeeding despite ignorance from breastfeeding un-informed health professionals. - the impact of not breastfeeding on short and long term dental health (caries, jaw and facial development, teeth alignment, speech development) - supporting attachment parenting through dental procedures. - sharing resources.

This list is a spin-off from a breastfeeding and attachment parenting list, so breastfeeding beyond a few months is accepted as the norm, and gentle and respectful parenting is the goal. Persons who have not breastfed are welcome, but should understand and respect that breastfeeding for months and years is the perspective this list is based on.
HTH, Pat
True Blue's Avatar True Blue 12:21 AM 12-10-2005
Yes, he went to sleep without anesthesia (a minor miracle for him). His teeth needed to be cared for. I HATED having him in the papoose, but I held his feet and was there for him the whole time. There was no way they could have done his teeth otherwise, and his teeth were in dire need of care. I really don't want to be made to feel guilty for my decisions. He was not quite 2, and we were talking about his 4 front upper teeth. I put it off for months. I wavered back and forth on the whole issue, and even considered just pulling them instead and having a bridge put in, since pulling would not require sedation and is a 10 minute procedure. However, he was learning to talk, and they could not put in a bridge until his 2 year molars were in, and they had not even broken through yet. Thus, he would have been without teeth for MONTHS during a critical speaking phase. I didn't think it was a good idea. We had no idea when his molars would come. He probably would have been close to a year without teeth.

At any rate, he was mad to have to be still (he NEVER sits still, even now LOL) but he was fine. The few times he's had to be papoosed at the dentist, it never ceases to amaze me how as soon as we "release" him, he smiles, gets up, says thanks to the dentist and takes his prize!! I was sick with guilt and fear before his procedures, and while it was miserable while he was going through it until he fell asleep, he was always completely, totally fine the second they were done.

OH! I brought his favorite cd (the Wiggles) with me to be played on the dentist's cd player while they worked on him. It helped him feel more secure and familiar. If they don't have one, bring your own!!! Or if they can let you put in your own video on their tv, that would be good too. Also, if they do need to use the papoose (the only other way I can think of your child being still enough otherwise is if you lay on top of them and restrain them yourself) dress your child in lightweight but long sleeve top and pants as a barrier to where the velcro goes around the wrist and ankles. I know that sounds so awful....and I guess it is...but yoru child's mouth pain will be gone after the work is done. I KNOW my DS could not have been comfortable. He had 3 pulpotomies and 4 crowns. He had to have felt better afterward.
Annikate's Avatar Annikate 12:37 AM 12-10-2005
Been lurking here because I'm getting ready to make ab appt. for dd too. I lurk on the dental forum from time to time too.

Good luck everyone - I'll be checking to see how your appts. went. BTW, Pat, I don't see the link to the yahoo group - can you post again? Sounds like a good one.
naturalmomto8's Avatar naturalmomto8 09:45 PM 12-10-2005
and we were talking about his 4 front upper teeth.
My dd is having the same problems. I know I have to do something, I am so glad that you explained what they did for your son. I am going to find a dentist to do it like yours did. I feel like a weight has been lifted, I thought I had no choice but to have her put out...thank you so much.
stiles' mummy's Avatar stiles' mummy 11:26 AM 12-11-2005
Our ds (30 months) has had some dental work done as well. He had a temporary filing put in back in October. They do not put them under for this. I had to bring my mum along to help hold him though while the pediatric dentist did his work. My heart broke for my little guy, he was crying and carrying on . He has a fear of doctors in general, so this certainly didn't help. The temporary filings last between 2 - 3 yrs. Then they need to be redone. This is a good alternative before the permanent teeth come in. Unfortunately, ds has to go back next week. I found another cavity in his bottom left molar. And we are religious about brushing his teeth now . I'm not looking forward to this visit. One thing that the pediatric dentist kept stressing was that I wean ds from night feedings. I'm not convinced that's what caused the decay. From my research I found that bottles and breast milk are very different. Anyone else have any thoughts on this???
WuWei's Avatar WuWei 01:05 PM 12-11-2005
Please go to the VeryYoungKidsTeeth web site. It is full of AP, breastfeeding parents (and a few dentisits) who have documentation for uninformed dentists about breastfeeding, night nursing, and the dangers of forced dental procedures. And information regarding dental care alternatives that dentists and parents can provide regardless of breastfeeding.

klg47's Avatar klg47 04:56 AM 12-12-2005
Our first ds had a crown done under general anesthesia when he was almost 2. He was on Medicaid at the time, so it was free for us.

Our 2nd ds, at 20 months, needs 3 fillings (in his molars) and 6 crowns. We had the three fillings and two of the crowns done last week. We wanted to do general anesthesia, but we absolutely could not afford it right now. We do not qualify for Medicaid or CHIP, but still don't have enough money to pay basic bills. I know that many parents let the kids teeth go, but I really felt like I wanted to get it done. Even though ds does not appear to be in any pain, I think he has just gotten used to it and doesn't realize that the pain is not normal. Since he got the fillings in his molars he has been eating WAY more than usual. Coincidence? Maybe.

Anyway, I wanted to get it done now (I'm not sure if we'll have insurance in the future), so we did the oral sedation/nitrous oxide/papoose board route. He screamed and cried and it was absolutely AWFUL while they were working on him. After they numbed him (the worst part), the dentist went out while she waited for the numbing to take effect. DH rubbed ds's head and talked softly to him and kissed him (I was holding his feet), and he fell asleep!! He stayed asleep for all the fillings but woke up during the crowns and was screaming the whole time they did that.

The second they were done, ds was fine. He slept on the way home, nursed for half an hour at home, and then appeared to be totally and completely normal. Perhaps he has long-lasting psychological damage, perhaps not ;-)

Two days later, one of his crowns fell off! I took him to the dentist right away. He gave the dentist a REALLY scuzzy look when he saw her, and he started sobbing as soon as he saw the chair. This time I just held his arms and legs while they re-cemented the crown. He sobbed and cried the whole time, but again, the second it was done, he appeared to be totally fine.

Anyway - if you do the oral sedation, it will be REALLY hard on you (and your kid) during the appointment, but afterwards, your kid will probably be totally fine. Remember - since you are practicing AP principles, your child trusts you and you are able to help them through difficult things and they are better able to "recover" from trauma (in my opinion).

It will be even better for both of you if you can find a gentle dentist you really like. We don't like our dentist really at all, but that's a whole different post. And you should probably just assume that the dentist will lecture you about breastfeeding and weaning. If you're a non-confrontational type, just nod your head and then forget everything they say.

sun-shine01's Avatar sun-shine01 05:32 PM 12-12-2005
Just home from the dentist. DD who will be 3 next month had her 4 top front teeth capped due to cavities.

They gave her the oral sedation meds and she was asleep in 15 minutes and snoring. They took her to the back and they did put her in the papoose thingy but she was asleep and was not aware of it. After about an hour they came out to get me and had me sit with her until she woke up. She sat up and said, "hey mom, look at my teeth" in a very slurred voice and was trying to smile.

We left and she did whine/fuss on the way home but only because she did not like the way her mouth was numb and tingling. She also was asking to eat and telling me that she was hungry. (dentist said no food for 2 hours after proceedure to let the numbing wear off) After about 20 minutes she fell back asleep (the dentist said she probably would) and so I drove around for 2 hours until she woke up just to keep her asleep and then we went home. She immediatly wanted to eat and was feeling fine but I gave her some childrens motrin just because.

Now she has had lunch and has nursed a few times and is feeling fine.

I'm sooooooooooooooooo glad to have this over with and hope that others have a good exprience with their little ones dental appts.