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caps on 3 yr old and hypoplastic enamel

779 Views 5 Replies 5 Participants Last post by  aimeemac
my three year old ds has hypoplastic enamel(enamel is thin) on his molars. the dentist said although it is not urgent he will need caps this summer, stainless steel while under an IV sedation, we cannot be in the room w/ him.

was wondering if anyone else has been in this situation....some question i have......
1. is there anything else that can be done, not too hot on the idea of stainless steel in his mouth
2. is it truly necessary to have an iv sedation.....he is sensitive to chemicals, i think
3. anything to strengthen his teeth?
thanks in advance....
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First, I'd find a dentist that allows you to be in the room with your kiddos! I absolutely refuse to take them to a dentist where I would not be allowed to be in there with them, until they are older and can decide for themselves.

My 4y/o and 3y/o have silver caps... the only reason we chose those was it is a LOT cheaper and besides, they are baby teeth and will fall out eventually for the monies involved. After my kiddos got them, I noticed a LOT of kids have silver caps.

We never had IV sedation for the caps - I gave them a pain killer and anxiety med an hour before they would go in (RX's of course), and then the "sleepy juice" was applied via the nose mask. Only the youngest one actually fell completely asleep during the procedure, the oldest was just really really relaxed. Plus, the cool thing about my pediatric dentist - the have tv's in the ceiling and when the kiddos lay down they can watch cartoons... a great rarity for my kiddos...
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Ds had caps put on his top front teeth (4 of them). Our ped. dentist doesn't use stainless, or "siver", caps. He uses composite. And yes, they're expensive, but I'd be very worried about using stainless in a child's mouth! Children are still developing their immune systems, and the nickel, and the other metals to a lesser extent, can interfere with that. Not to mention that nickel is a fairly common allergen. If your ds seems to be sensitive to chemicals, you don't don't want to expose him, day in and day out until he loses those teeth, to something like that.

As for the IV sedation, goodness! We did choose to give ds some oral sedation. It was a combination of a mild sedative and an antihistimine. It's what our dentist uses routinely for the children in his practice. We asked *a lot* of questions when preparing for the procedure, and he said he hasn't had a child react to it yet (although that doesn't mean it couldn't happen), and it doesn't knock them out (he's very careful about the dose). It just makes them calm, and, more importantly, it makes them not remember the procedure much at all (so they're not afraid of the dentist), and it makes the time seem to pass more quickly for them. We didn't plan to do the sedation at first, but we asked some friends who had gone through the same thing with their dd, and they said they did some dental work without it and some with it, and it went much better with it. And we figured that it was just a one-time deal, and mostly fairly benign stuff. And we crossed our fingers (dh and I are pretty sensitive to chemicals, so we try to be careful with ds). Putting the caps on is pretty extensive. It involves grinding down the teeth so that they're just nubs, then figuring out what size the caps need to be, then mixing the composite and filling the forms with it and putting them on the teeth and "firing" the composites (using a wand with a blue light to harden them). It took at least an hour, probably more (I don't remember exactly) to do 4 of ds's teeth. It was pretty scary for ds, even though he had the sedation. The good part is he doesn't remember it.

Recently, ds needed a filling in one of his molars, and the dentist just drilled and filled it on the spot (again, using composite) without *anything* for the pain. (I know, I know, it sounds like we never brush ds's teeth, but we do, religiously). Ds did fine. Fortunately, I wasn't there, just dh, or I'd have freaked. Anyway, I say this because some things can be done without sedation at all.

Oh, and our dentist allows parents to be present *if* they don't make matters worse. So, we were allowed in, but told that if ds wasn't cooperative that we would have to leave. We didn't have to leave, because we were actually able to help calm him down and keep him calm (not to mention tell the assistant *not* to stroke his head because it was only agitating him). Our friend, OTOH, had to leave (actually, just the mama, not the dad) because she was making things worse just by her presence (she says it's true, the dentist wasn't just making it up). I would find a dentist how has a similar policy. I know it made a difference to ds for us to be there. And be sure and take him in at least once more before the procedure so that he can get familiar with the dentist. Our ds actually looks forward to seeing his dentist!

So, my advice is to find another ped. dentist if possible who has more open policies, and to ask lots of questions, and if need be, push and push to make sure you get what you want. One last thing. It takes practice to do a composite right, so if that's what you want, find a dentist with experience. Also, and this may seem strange, but if your ds is potty trained, you may want to have him wear a diaper or something absorbant that day. Ds is potty trained, and when we took him in recently the dentist used that red dye on his teeth, to see where there was decay, and ds reacted to the dye by peeing in his pants the rest of the day. He just had no control of his bladder. Not to mention, the stress of the event may be a bit much for your ds, and that's not a time to rely on his recent potty training. It may upset him to have a lot of accidents (it did our ds). Obviously each child reacts differently to everything, so you never know, but I figure it's an easy thing to prevent those accidents. Just a thought.

Sorry, no advice on making the enamel stronger. I wish we could figure out why ds keeps having trouble with his teeth! Hopefully someone else will have some.

Good luck, and keep looking out for your ds.

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Originally Posted by ChristieB
Sorry, no advice on making the enamel stronger. I wish we could figure out why ds keeps having trouble with his teeth! Hopefully someone else will have some.
Check out the thread in the archived topics sticky at the top.
"Remineralization and diet for healthy teeth"

And Aimeemac....So I understand the enamel is thin, but beyond that what is the state of the decay? Is it deep into the pulp and nerve? If it is, this might warrant a "baby root canal" and filling, but not necessarily caps. I would definitely get a second opinion. I just don't get why the decay would be progressed enough to warrant caps, but then he would take his time (not urgent).
There might be other options with another opinion.
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HI all....
I contacted a holistic/biological dentist who has seen a rush to cap kids teeth these days. I talked to him over the phone, so he didn't see my son, but he said that if was strange that we could take our time considering the caps.......if he warranted caps, then it would be urgent, overwise, a filling of some sort might work. Honestly, his molars are slightly gray in some areas and they aren't giving him pain yet. I know we need to take care of it, but I want to do it in a way that won't traumatize him.

As for the stainless steel, the biological dentist said they are archaic and he hasn't used them for 20 years. They are nickel and toxic. There are other options and that we could bring him in for an eval (we actually did about a month ago but ds wasn't cooperative then).

What really turned me off is that we couldn't be in the room with him. I am sorry but you can't knock my child out for 2.5 hours and be alone with him. I don't care if you are a dentist etc..........that is crazy!

Thanks for all your help. I love discussing things w/ you mamas!
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