Holding down a toddler for dental treatment... - Mothering Forums

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#1 of 27 Old 05-04-2007, 11:35 PM - Thread Starter
 
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Anyone have insight on the long term effects of restraining a child for dental treatment?

A little info (for more info see my post in Dental
We had a consult today, and ds didn't even want to go into the room. He had been quite happy before that, and thought the aquariums in the office were very cool
He DID let the dentist look at his teeth, but refused to let the assistant clean them.
The dentist recommends doing temporary fillings with fluoride (so no drilling at all) to stop the decay for now, and coming back later to get permanent ones. He won't do sedation on kids as young as ds, so our only option (at this particular dentist) is to try to get ds to cooperate and open his mouth, and then hold him down if he refuses to do it. Dp and I would both be in the room the whole time, and would be holding ds. (I refuse to do a papoose board)

We did the same type of thing when ds was 18mos old or so- held him down to repair a cavity, but that one was drilled a tiny bit (5 seconds of drilling). I didn't think he'd remember it, but he must have, right? To have been so freaked out by the sight of the dentist chair?

Is there any way that we'll be able to get these fillings in without it being traumatic, and without sedation?

Btw, ds is VERY interested in playing dentist today...hmmm...

Becky, partner to Teague, SAHM to Keagan (7yo), Jonah (2yo)
 

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#2 of 27 Old 05-05-2007, 12:25 AM
 
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Is your child in pain from his cavities? I read your other post, but it didn't say......
while i understand that now they say that cavities in baby teeth can actually affect the adult teeth and the decay can spread....i'm really unsure about what I would do. If the teeth aren't *bothering* the child...I'd probably let it go. A "wait and see" approach, if you will. If I had to choose a remedy, I'd porobably go with sedation.....but then, I'm totally dentist-phobic, and get MYSELF sedated just to go in to the dentist.....

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#3 of 27 Old 05-05-2007, 12:27 AM
 
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Honestly, I think that even at a young age, any negative experiences with the dentist can be long-lasting. I'm proof. My childhood dentist (my Great Uncle) drilled me when I was 4, while my Dad held me down, and it is the single greatest traumatic event of my childhood. At every visit thereafter, I'd walk up the office stairs, go into the bathroom and throw up. I haven't been to a dentist in years because I'm terrified.

If your dentist won't do sedation, I'd go elsewhere and get a second opinion. My nephew (4 years old) just had cavities drilled and caps placed on molars under total sedation. I really think it's worth it to save your little one the possible trauma.

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Oh yikes, this is always my fear I had a couple fillings at 7 years old. My mom did like the PP said, "wait and see what happens" and boy am I glad!! I was old enough to say if it hurt, and I don't even remembering them hurting me at all. By 7 I totally understood and I got a special doll she bought me to take in with me. I just don't know how I'd ever be ok with holding down. I guess it's tough to make that call. Obviously you wouldn't do anything you didn't think was necessary
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#5 of 27 Old 05-05-2007, 01:29 AM - Thread Starter
 
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No, he doesn't indicate that they hurt at all.
His front teeth look like the last tooth pic on this page (, so the second last pic, on the right) http://www.kidsmiles.ca/dental_visits.htm, but they are much worst. The top, oh I'd say 1/3 to 1/2, of his top front teeth have the enamel totally worn away. And it's spreading to the teeth on either side. This is where the tooth decay was that he had worked on 1 year ago. It's definitely gotten worse, and the cavity is now around the side of the tooth, and I guess if it gets too much worse, we won't be able to even fill it at all.
The molar that he has a cavity on, is just a really deep spot where food gets stuck really easily.

I hate this decision...:

I think our plan might be to go to this dentist, and see what happens. The dentist was so great. He was very calm and confident. With the way ds reacted when he saw the chair, it's a tiny miracle that the dentist got him to sit in it at all!! lol. He made him a balloon dog, then let ds use the blower thingy to blow up another balloon, and watch it fly around the room. There is a chance that ds will just let him fill the cavities. I don't know how big that chance is...lol

If this were going to involve any drilling or shots, I don't think I'd let it happen without sedation of some sort. (past decisions aside). But this is going to be pain-free, the dentist said. so...hmmm...
So hopefully, ds won't be to upset about it. And if he is, like the dentist said, we can stop at any time since there won't be any drilling.

I really appreciate your posts- the more I read posts like this, the more I'm leaning toward not forcing dental work. At his age, I'm really sure that he'll remember any unhappiness about dentists, and I don't want that.

Becky, partner to Teague, SAHM to Keagan (7yo), Jonah (2yo)
 

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#6 of 27 Old 05-05-2007, 01:39 AM
 
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surely you have the option of going with a pediatric dentist...and one that will sedate if necessary...

i think if i was in your position, i would demand the sedation...its ridiculous to put a child through that much trauma...i understand the necessity for healthy teeth, but it should not be at the expense of the childs psychological health...

peace...

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#7 of 27 Old 05-05-2007, 01:48 AM
 
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We did hold my ds down to have his top 4 teeth removed he was 2y 2m at the time Since they were abcessed and he was in pain we had no choice. It would have taken months to get him in to the hospital to have it done under GA.

They couldnt give him the nitrus because that has to stay on for it to work and no way would ds allow that. So the dentist numbed his gums then pulled the teeth. It was over fast and as far as I can tell he hasnt shown any signs of issues from it.

 
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#8 of 27 Old 05-05-2007, 01:57 AM
 
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Quote:
Originally Posted by savvybabygrace View Post
Honestly, I think that even at a young age, any negative experiences with the dentist can be long-lasting. I'm proof. My childhood dentist (my Great Uncle) drilled me when I was 4, while my Dad held me down, and it is the single greatest traumatic event of my childhood. At every visit thereafter, I'd walk up the office stairs, go into the bathroom and throw up. I haven't been to a dentist in years because I'm terrified.

If your dentist won't do sedation, I'd go elsewhere and get a second opinion. My nephew (4 years old) just had cavities drilled and caps placed on molars under total sedation. I really think it's worth it to save your little one the possible trauma.
This is me. And I totally agree. I had cavities filled with no sedation/numbing when I was 5. The dentist said I didn't need it. until I was 16 mom made me go. I puked everytime...then after 16 quit going. the one and only time I went back...absolutely had to be sedated. I would have it no other way. Please see someone else.

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#9 of 27 Old 05-05-2007, 01:57 AM
 
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I posted a very detailed description of my recent experience with this over in the dental forum a couple of days ago. Something about Great Dentists. Great Experience. Real Long.

Basically, we had ART done while I held my baby. He was very upset. However! We took a lot of breaks, during which I would nurse him right back to his happy self. And the process was extremely short. I don't know if it was because of my son's personality or what, but I am absolutely positive that he wasn't traumatized by the experience. The entire time I kept thinking: Thank Gawd I'm still nursing. It made such a big difference.

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#10 of 27 Old 05-05-2007, 09:41 AM
 
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We have issues too and it's such a horrible decision to make. DH is opposed to GA for the safety risks involved (and so is the dentist) so we had the work done w/ Versed, a conscious sedation. I know he doesn't remember anything--he got a new toy to take w/ him and when we were ready to leave he actually asked to stay and play--NOT in character re: the dentist's office! When I asked him about the dentist later that day he just talked about his new toy, which was reassuring.

I pray he isn't scarred by the experience (frequent dental visits) but we felt we had no choice. He would occasionally say his teeth hurt but there wasn't a visible abscess or anything, but once we took care of the damaged teeth he suddenly began eating and sleeping better.

Good luck w/ your decision. I would have preferred the GA but maybe it wouldn't have made a difference--DS is already scared going to any doctor because of previous dentist visits. : I think my new strategy will be a wonderful new toy for every dentist/doctor visit.
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#11 of 27 Old 05-05-2007, 10:16 AM
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1. Cavities in children (even ones that aren't bothering them), NEED to be attended to. They can lead to a life-threatening infection if they aren't filled
2. Get thee to a pediatric dentist! Pediatric dentists are generally just BETTER at this sort of thing, in terms of comforting and relaxing the child. Our dentist has NEVER forced a procedure on our children. She's so good with them!
3. Consider sedation. Emotional trauma is not worth it.
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#12 of 27 Old 05-05-2007, 12:41 PM
 
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I might shop around for a dentist who is more willing to sedate. With my nephew, the decision was made to put him under for cavity filling, and just do all of his teeth at once.
Unfortunately, IME, holding down a child to do a procedure never ends well.
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#13 of 27 Old 05-05-2007, 01:19 PM
 
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1. Cavities in children (even ones that aren't bothering them), NEED to be attended to. They can lead to a life-threatening infection if they aren't filled
2. Get thee to a pediatric dentist! Pediatric dentists are generally just BETTER at this sort of thing, in terms of comforting and relaxing the child. Our dentist has NEVER forced a procedure on our children. She's so good with them!
3. Consider sedation. Emotional trauma is not worth it.
:
That said, if it came down to it & I had NO OTHER OPTIONS...I would NOT hold a child down for it. I have memories of being held down & they aren't fun memories! I'd rather deal with cavaties.

~Marie : Mom to DS(11), DS(10), DD(8), DD(4), DD(2), & Happily Married to DH 12 yrs.!
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#14 of 27 Old 05-05-2007, 02:11 PM - Thread Starter
 
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Quote:
Originally Posted by ThreeBeans View Post
1. Cavities in children (even ones that aren't bothering them), NEED to be attended to. They can lead to a life-threatening infection if they aren't filled
2. Get thee to a pediatric dentist! Pediatric dentists are generally just BETTER at this sort of thing, in terms of comforting and relaxing the child. Our dentist has NEVER forced a procedure on our children. She's so good with them!
3. Consider sedation. Emotional trauma is not worth it.
He is a pediatric dentist. I *think* his hope/expectation is that ds will allow it. He just mentioned holding him down as a "just in case" type thing. kwim?
This procedure will be about as bad as a normal cleaning, from what the dentist said about it.
But, yeah, I'm definitely considering sedation. I have an appointment for a consult booked at another pediatric dentist (that won't restrain kids at all), but that appointment is after the appt I have to get ds's cavity filled at this first dentist.

I love the idea of getting a new toy before the dentist! We'll do that next time, for sure!

Sigh. The other consideration (and I hate that it's even a consideration at all) is money. We have no dental coverage, and we're broke broke. We're in Canada, and we'd qualify income-wise for premium assistance (and kids dental ins), but we haven't been on the plan for a year, which we have to be before we can get it.

I dunno. I guess the best thing to do is just go to the other dentist, that won't restrain kids. It just seems like it will be a long time until we can actually fix his teeth there. It'll probably be about 2 mos, I'd guess (they are quite busy!)

But what's two months, really, right?

Becky, partner to Teague, SAHM to Keagan (7yo), Jonah (2yo)
 

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He is a pediatric dentist. I *think* his hope/expectation is that ds will allow it. He just mentioned holding him down as a "just in case" type thing. kwim?
This procedure will be about as bad as a normal cleaning, from what the dentist said about it.
But, yeah, I'm definitely considering sedation. I have an appointment for a consult booked at another pediatric dentist (that won't restrain kids at all), but that appointment is after the appt I have to get ds's cavity filled at this first dentist.

I love the idea of getting a new toy before the dentist! We'll do that next time, for sure!

Sigh. The other consideration (and I hate that it's even a consideration at all) is money. We have no dental coverage, and we're broke broke. We're in Canada, and we'd qualify income-wise for premium assistance (and kids dental ins), but we haven't been on the plan for a year, which we have to be before we can get it.

I dunno. I guess the best thing to do is just go to the other dentist, that won't restrain kids. It just seems like it will be a long time until we can actually fix his teeth there. It'll probably be about 2 mos, I'd guess (they are quite busy!)

But what's two months, really, right?
Ooooooh, if you're in Canada then you should look into HealOzone. I wish wish wish that this was available to me here in the states. I have seriously considered going to Canada for this treatment. It's inexpensive, and may prolong the "life" of your babe's teeth, and would be a great addition to the glass fillings. From my understanding, they go hand and hand Very well. We had Ozone treatment, which is close to HealOzone, and it dramatically helped my son. It's given me all kinds of hope that I never knew I'd have again.

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#16 of 27 Old 05-05-2007, 07:17 PM
 
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#17 of 27 Old 05-05-2007, 07:30 PM
 
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When I first married my dh, his son had very poor nutrition and ate soooo much sugar that he had 9 cavities by the time he was 7 yrs old. I went with them on the day that he had to get fillings.
This was very unpleasant for all of us. My DSS has anxiety about a number of things, the dentist included. In order for them to work on him they had to use the papoose board. Previously they had medicated him, with no results that helped ease his anxiety.
They put him on the papoose board and he seemed to calm down. Crazy enough it was almost like when you swaddle a newborn. We stood by his feet and rubbed his legs to let him know we were still there. After this very long procedure he got up and kind of sheepishly smiled at us. And said that it didn't really hurt like he thought it was going to.
the next time he went to the dentist, they pulled out that papoose board and he told them he didn't need it anymore. Ever since, he's been perfect at the dentist. He seems to even look forward to going to get a good report on his teeth. No more cavities since we changed his diet "at our House" for the past 4 years!
I hope you find something that works for you and your lil one. I remember how hard it was for him.
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#18 of 27 Old 05-05-2007, 11:37 PM
 
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I think there's a big difference in mama or dad holding a child for dental treatment than being strapped down and leaving them alone with the dentist. Obviously sedation would be a 1st choice,but if that for some reason is not possible,I would rather be there with my child,comforting them and reassuring them that this is something that has to be done to stay healthy,etc,than watch their teeth rot out of their head,infections,etc. And infections *can* be quite serious,even deadly.

I would rather restrain my child briefly to get treatment,than look at their little face in agony over infections and cavities,knowing I have the power to help them but don't. What is more traumatic for them?
(NOT saying that is what the OP is doing,by any means,so I don't want that to be taken the wrong way )
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#19 of 27 Old 05-05-2007, 11:44 PM - Thread Starter
 
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Well, I went to the library and got out two books on dental appointments, and one video. We already read/watched them all. Ds was a little distracted, but the word Cavity definitely caught his attention every time.
We have two weeks until his appointment, and I've gotten some good ideas here that I think will be helpful.
I am SOOOOO not above bribery for this. I think we'll go the day before and get a special toy to take with us (because the promise of a toy afterwards meant diddly to ds). Maybe we'll get some stickers or something else that could be fun.

I do really have high hopes that this dentist will be able to really help calm ds. I so hope that we can get this done with a minimal amount of unhappiness. I know it will take lots of patience, but I think it's possible (especially if dp is the one in charge of having enough patience lol)
And I'm thinking about getting Rescue Remedy, as well.

I hope that this goes well, and we can get these teeth filled. I LOVE the idea of doing it without drilling, and I've looked up what I think the dentist is talking about, and it seems great. So...we'll try it without sedation, and if ds is really upset, we'll have to go on to some sort of sedation.

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#20 of 27 Old 05-06-2007, 12:01 AM
 
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surely you have the option of going with a pediatric dentist...and one that will sedate if necessary...

i think if i was in your position, i would demand the sedation...its ridiculous to put a child through that much trauma...i understand the necessity for healthy teeth, but it should not be at the expense of the childs psychological health...

peace...
I agree. I would see a pediatric dentist. I've worked for one and they specialize in dealing with children's dental needs.
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#21 of 27 Old 05-06-2007, 12:18 AM
 
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We've been through 3 different pediatric dentists because of problems with dd's teeth. She doesn't eat much sugar or juice or anything, but certain teeth just kept getting worse and worse. She has a stainless steel cap on one molar, 2 fillings in molars, and white caps on 4 front teeth. The first dentist blamed everything on nursing and was very negative about it. She used papoose boards and oral sedative.

No offense to those who've used it, but the stuff scared me when I read about it. If we must do sedation as opposed to numbing shots, I'd opt for general anesthesia, personally. Done in a hospital with people trained to do anesthesia and crash carts, etc. if needed rather than with a dentist in an office who has far less training in anesthesia. So it was just a consult/cleaning with her and we never went back.

The next place was good for a while, but they kept doing fillings on the teeth that now have caps, which kept falling out after a very short amount of time. Although one dentist in the practice was breastfeeding friendly, the other was very rude about it. We were constantly redoing fillings, which let the now capped teeth get worse and worse. She focused on the front teeth, rather than the molars, which I now think was a bad policy.

We found another place that we're happy with (but ask again in another year!) He does local anesthesia, no papoose board. She always sits in my lap. And we take breaks, and we nurse as soon as it's done. At certain points (generally the water and air tools because dd doesn't like the sound,) I do have to hold her arms. The drilling she's actually fine with. He says that the front teeth are primarily cosmetic, and he always focuses on the molars since they'll be needed much longer (age 13 rather than 6 on average) and because they do the real chewing of food. And indeed, once her molars were taken care of, her eating and sleeping did drastically improve.

It's hard work though. I hold out hope that her adult teeth will be fine. And I strive to make sure she and I (and the new baby due in October) get enough calcium, and we brush frequently and carefully. Some of the things I've found that can make a difference are: reflux (she had this as an infant, and it may have caused problems), some antibiotics, anemia/high lead (she had this too, shortly before the tooth problems started), and parents or other caregivers with active decay (I had a tooth that needed work for some time, which may have been the source of particularly active bacteria; and my mother still has rampant decay, so I watch her like a hawk to prevent her sharing water bottles, food, and utensils with dd, which she used to do frequently despite me telling her not to).

You can also look in the dental forum for info on the Weston A. Price people who feel that cavities can be cured with nutrition. I haven't been sold on the idea, personally, but some seem to do very well with it.

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#22 of 27 Old 05-06-2007, 12:53 AM - Thread Starter
 
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EviesMom - Is your dd mostly agreeable to the fillings? I know you said you had to hold her hands down a couple times, but for the most part she is ok with it?
That gives me a lot of hope! Thanks!

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#23 of 27 Old 05-06-2007, 01:38 AM
 
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Generally speaking, yes. But, the molar that now has a cap was so bad that he had to do a "baby root canal," which is different from an adult root canal, but still hard. She definitely cried during that one, and I had to hold her arms and feet at times. However, we took breaks, so she wasn't being restrained for a long period of time (probably 5-10 minutes twice; the work took probably 30 min total). And the dentist used a numbing gel, then numbing shots.

She still opens for him to count and clean her teeth, and is happy to go to the office (she's in love with a couple of the toys in the waiting room). So I don't think she's permanently traumatized by the experience. And that tooth was so bad at that point that she would cry from trying to chew with it. Badly done fillings had fallen out twice, leaving a huge hole. The work on other teeth, even the other caps, she was okay with. She was very excited to show her "new teeth" off to her friends and relatives and told stories about the teeth and it being "hard," but then would say "See my shiny new teeth? Now I can bite things like carrots and peanuts with my new teeth!"

The other problem I had with the practice that did the fillings that fell out was that they would only do one tooth a visit. It's gentler, but with the speed of dd's problems, it was just letting other teeth get worse and dragging the whole process out. This time we had 3 visits and fixed all the teeth that needed fixing (left side molar, then right side molars, then front teeth).

The second dentist had taken a lot of time to get her comfortable with the chair, which I think helps. We had several visits a few days apart where all they did was first get her in the chair, then use the mirror and pick to count her teeth, then a cleaning, then introduce the tools (light, drill, water, air) without using them on her teeth before they did any work. Their bedside manner was right, but their work wasn't working for my dd, basically.

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#24 of 27 Old 05-06-2007, 10:00 AM
 
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What about a bit of nitrous oxide? It helps make one more relaxed. I believe most dentists will use it for little people. I wouldn't use it in the office in addition to any other sedation though.

I'd definitely use the Rescue Remedy, too.

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#25 of 27 Old 05-06-2007, 11:20 AM
 
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Since you're open to bribery...

We did it in two parts. I had already been talking about how we would go to the dentist to fix his ouchie teeth. Understandably, he would get upset. So I started talking about how the dentist would have a cool toy for him--maybe a DRILL (which is ironic I know but ds is obsessed w/ tools). So by the apt rolled around when we would mention the dentist ds would talk about the drill he would be getting.

The morning of the apt he couldn't eat, drink or nurse beforehand which I knew would be tough. So when he woke up DH and I were all ready w/ a huge new Tonka truck and lots of enthusiasm, which totally distracted ds. Then once at the dentist we had the hygenist give ds the toy drill as a present. He was thrilled and played w/ it while the Versed took effect.

It seemed to make a horrible situation more bearable for ds. Hopefully this will help stop the decay. If not we may end up owning the entire Home Depot toy collection.
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#26 of 27 Old 05-06-2007, 02:17 PM - Thread Starter
 
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Quote:
Originally Posted by WuWei View Post
What about a bit of nitrous oxide? It helps make one more relaxed. I believe most dentists will use it for little people. I wouldn't use it in the office in addition to any other sedation though.

I'd definitely use the Rescue Remedy, too.

Pat
I know. I thought it was wierd that this dentist doesn't do nitrous. The last dentist we went to (a year ago) to fill ds's cavity did TRY to use nitrous. At that particular time it was a huge mistake. Ds wanted to stay on my lap the entire time, but he had to sit on the chair by himself to get the nitrous. We tried to put him down, but he was soooo upset that he didn't get any nitrous. (we kinda tried to force the issue, thinking that it would be the best thing). He stayed upset the entire time (literally about 2 minutes that the dentist worked on his cavity).
Looking back, we shouldn't have tried to force the nitrous, and just gone ahead with fixing the cavity. I really honestly believe he would have been fine if we'd gone that route.

But that was a year ago, and there's a huge difference between 18 mos and 2.75yo!
At any rate, I wish the dentist used nitrous, because it might help this time.
But I still have high hopes for this to work out well. If we can take lots of breaks, and get him a fun new toy before we go, etc, it might go well...

Becky, partner to Teague, SAHM to Keagan (7yo), Jonah (2yo)
 

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#27 of 27 Old 05-07-2007, 03:45 AM
 
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My son wouldn't even open his mouth for the dentist, much less let anybody clean them at 4. We had to go the sedation route, and I am so glad we did. Under sedation and GA they were able to get good films of his teeth and get the caps placed properly. Our top priority was to not create a negative experience with the dentist because dh's negative experiences had serious consequences for his dental health.

I am really glad we did it that way because a year later (and after a lot of occupational therapy to help us with tooth brushing issues, among all the other stuff) he willingly let the dentist see his teeth and let the tech actually brush them. (he wasn't super convinced he should let her brush them, but he could be persuaded)

It was abolutely, and without question worth all the stress on us as parents watching him go under sedation and anestesia (sp?) in the hospital because it gave us time to help him deal with the appointments he will have to do the rest of his life, but let us get the pain taken care of so he wasn't suffering any more.

If you do go that route, demand sedation before they put in the IV so he is loopy enough that he doesn't mind the IV going in.

I know that going the route we did isn't very NFL, but in this particular case, I felt like my desire to create a positive (or at least not negative) experience outweighed it, and holding him down really went against my GD beliefs.

Mom to 10yo Autistic Wonder Boy and 6yo Inquisitive Fireball Girl . December birthdays.

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