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Dental: cavities, crowns, sedation, and unsympathetic dentists!

1201 Views 10 Replies 6 Participants Last post by  dalbert
I didn't really know what to title this thread, but I really need advice and information, and I am very upset. I just took my two year old to the dentist because of a suspected cavity and she actually has about ten (bunch of tiny ones and the one biggie, in her molar which they want to crown). The only pediatric dentist in my town will not allow parents to be in the room while kids are sedated. In addition, they blamed some of her decay on night nursing (despite the fact that my husband's family has a shocking history of dental issues in general), said they could only put in a stainless steel crown, and when I got home I noticed they have her down to recieve an amalgam filling in her other molar.

The biggest issue for me right now is that I want to be there the whole time. Their reasoning is that they have to be focused 100% on my daughter and can't be worrying about me asking questions, freaking out, or fainting. They also used the excuse that this is the standard of care for dentistry and that they allow far more parental involvement than most places (directly implying I am lucky to find such a generous practitioner), and they will not budge on this matter.

I have three choices. 1) Have the work done in three visits, under novacaine only. She would be restrained by one of the soft papoose thingies, and I could be with her the whole time. 2) Conscious sedation, which puts her in a "twilight sleep." I cannot be with her and it requires fasting after midnight the day of. It's also $250 extra (on top of the $800 for all the work!) 3) General anesthesia. With this one, she gets a shot in her leg which puts her into an immediate "dissociative state," at which point I have to leave while they give her an IV of the actual anesthesia. Also requires fasting, and it is $600 extra.

When she had her teeth cleaned she was fantastic, very cooperative and seemed to think it was fun (we've been talking about the dentist a lot in preparation and she went with me recently so she would know what it was like). Part of me really thinks she could handle being awake, but most people seem to think we should have her sedated, including my husband who has serious issues with the dentist from all the stuff he had done as a child.

I will be calling around all over the area to see if there's anyone who can accomodate me, but I have a feeling it's going to be like this anywhere. Also, I'm really struggling because we are pretty "natural" and wholistic in our personal health care practice (my daughter does not have a pediatrician) and yet I am not convinced that wholistic dentistry is the way to go. I do think that metals in the mouth are a problem, and I question the efficacy of fluoride as well as the political/corporate motivation for pushing it as a positive thing for dentistry. So I don't feel particularly good about information I recieve from mainstream dentists either.

Is there anyone in the middle? Or any balanced information available on dental treatment in general?

I know I've asked a lot of different questions, but I just want any input or information/suggestions that anyone has to offer. I am really distraught about this. Thank you.
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When my oldest was that age, he needed fillings and the ped dentist gave me the SAME routine yours did. I did not want ds under anesthesia unless it was absolutely necessary, and I was not going to send him in for treatment alone.

It's great that you're going to call around, my only suggestion would be not to limit yourself to a ped dentist. We found a family dentist who is absolutely wonderful with the kids. When I asked if I could stay in the room, they said, "Of course!" In fact, ds sat on my lap for several visits/treatments. This dentist doesn't even OWN a pappoose board, as he feels it's not necessary if the dentist takes the time to explain things to the child and forms a relationship so that the child will cooperate.

Unfortunately, baby teeth have been trouble for all 3 of my kids, but they are not afraid of the dentist, they've never had general anesthesia for dental work.

If you want to come to NJ, I'll give you his name/number.
He's not perfect, but we agree on the important issues.

Seriously, good luck in your search and check out family dentists.
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Okay, I feel better already. That's good advice to call family practitioners too, although because she's two it may be tough.

My husband just called his brother (his nephew also has the family teeth) and although we disagree on just about everything parenting-wise with them, his sister-in-law was saying they went through four dentists but finally found one who would let them be in the room and not do GA. It gives me hope because we could always go up there for a visit and see that person as a last resort.

Still looking for more input!!!
Wow! That is so interesting!

My pediatric childrens specialist believes the opposite! That parents are a great benefit and it helps the child tremendously! He prefers the parent be involved...BUT, he also asks that the parents do NOT talk to the dentist OR the child!!! They are simply there to hold the child and having the parents present is calming and reassuring, kwim?

My ds was about 18 months and he needed the top four teeth pulled and the back molar crowned! He was sedated with the twilight sleep medication (not enough pain medication though IMO) and it was VERY traumatic....just TERRIBLE...but, within a couple hours afterwards everything was fine!!! Parents DO faint and become upset!!! I do see the dentist point on that...but, with the right education and information beforehand, to prepare the parents...they can avoid that, kwim?

The dentist I went to only wanted ONE parent in the room with the child...but, had a huge window the other parent to "view" and for the child to see as well!

Why will they let you be their if you use novacaine and go for three visits..but, not if you have her sedated and in one visit!!!!!!!! They will be doing the same darn thing and IMO they are treating you the same way some OB's treat women!

"Sure, you can choose to try and have an VBAC but if you go over X amount of hours, or if I feel the baby is X amount of weight or if X,Y,or Z happens I will knock you out and you will have an emergency c-section without your partner present...HOWEVER, if you choose what is more convenient for me and pick a date, I will allow your partner to be involved, you can be awake and we will pick whatever date suits your fancy...preferable first thing in the morning on a Monday!!!"

What the heck kind of choice is that!!!!!!!!!!!!!!!!!!!!?

They are going to strap your dd down and do it all quickly in one babying of any kind and get it all done and overwith...with you present they are going to want to be kinder and gentler and that is possibly why it takes them longer..the three days, kwim? The dentist was rough on my ds and I wanted to punch him and protect my ds...but, it was OVER completly in ten minutes..not even!!!!!!!!!!!!!

That is what they are doing to you it seems...they are forcing you to make the choice they want..even though that choice is not what is best!!!

My dentist did not like the idea of general anesthesia because the parents could not be present and he felt it was more traumatic having the child separated..whereas with the sedation the mother and child can stay together....there is no logical reason, IMO, why you can attend the session with the first option but not the second!

I wanted my ds put under...I was so angry that he was pushing the twilight sedation on me...but, in the end he was right (other than the fact I don't think he had enough pain medication)!

I think this lady is pulling your chain at how you are lucky they are letting you be involved at all....and even if is telling you the isn't right for them to do that, kwim?

Anyways...I can't offer any other advice but for you to go with your "heart"!!!!!!!!

Keep us updated!!!!!!!!!!!!!!
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When my dd was 22 months old, our ped dentist told us that she needed crowns on all her top front teeth (she blamed night nursing). We decided to just try to slow down the decay with flouride varnishes. Then we found out about all the controversy surrounding flouride and the shady corporate motivations that drive the PR around it and decided not to do any more flouride, plus we were continuing to night nurse. We printed out several studies and took them to our next visit. Dentist was furious and said we were being misled and our dd would suffer for it. (But she didn't have any studies on hand to back up her strong opinion in support of flouride and against night nursing...even though this is her profession). Then, a tooth chipped and she seemed almost pleased that her doom and gloom forecast seemed to be unfolding before us. She said that we've made a choice to pursue surgery rather than utilizing a less invasive treatment approach, which made us feel absolutely horrible. We took her to a couple more ped dentists, who both concurred that crowns were necessary at this point. We scheduled a surgery with the one ped dentist who would do it w/out GA (and was much nicer and open minded than the first one), but the surgery date was 3 months out...dd would be 2 1/2, which made us feel a bit better about it. Meanwhile, during that time we aggressively pursued a vast array of alternative approaches to slowing/stopping decay and were fanatic about dental hygiene. Something worked. We don't know what it was, but we believe it was likely the aggressive homeopathic remedy (calc. phos). We saw a significant difference and when we took her back the week before her surgery was scheduled, the dentist agreed that the surgery was not critical. He didn't remember telling us that it ever was (but he did). He said her decay was very mild and that if our main concern was just the health of her permanent teeth, then it made more sense to wait and see. He explained that the worst case scenario was that she'd get an absess, in which case he'd extract the tooth immediately so as not to allow it to impact the permanent teeth. He said the only reason to get the teeth crowned was for aesthetic reasons....if we couldn't deal with her having a missing tooth in the event of an absess forcing extraction. But now he was saying none of them looked all that bad. But he refused to believe the decay had been reversed or stopped. But we see the difference and it's amazing. And this guy is sure singing a different tune than he did several months ago when we first brought her in. I wish I knew for sure what did the trick. I also wish I could get some dental professional to concur that what we saw happen is actually possible. (But I'm pretty sure that won't be Smilemomma because I've read her posts about decay being irreversable). It's a mystery, but I'm not about to look a gift horse in the mouth! Here was what we did:

Weleda Children's Tooth Gel (no flouride)
"Gum-omile Oil" (almond oil, willow bark extract, chammomile flower extract, clove bud essentil oil, and vitamin E)
Natural Dentist Herbal Mouth & Gum Therapy for children
calc. phos. (thru homeopath provider...much higher doses than avail at stores)
brushing after every meal, snack, or nursing (toothbrush with us at ALL times!)
no more sticky foods and very limited sweet foods
and we did eventually night wean (but because I needed sleep, not because we believed it was bad for her teeth)

Good luck...hope something works for you!

Di (mama to Rylee 11/25/01)
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I knew you'd say that Smilemomma. I had read in another post of yours about remineralization involving a black color, which has never entered the picture for us. It was a brown color with some holes. The holes are still there, but the brown color is significantly diminished in all but one tooth (which also has the worst holes). Maybe something we used actually bleached it out?

In any case, would you agree that the worst case scenario at this point is that she gets an absess and needs a tooth extracted and that if this is done quickly, it won't affect her permanent teeth?

Thanks for all your expert and sympathetic advice in all these posts. I'm mostly a silent reader, but I've very much appreciated all your posts in this experience that has presented the greatest challenge yet for me as a mother!

Di (mama to Rylee 11/25/01)
We did the conscience sedation when dd was 2 years old for 5 crowns and 2 fillings (the crowns also had the pulpectomy I think) and she was fine. It took 2 visits, but I was much more comfortable with that than with general sedation.

I was able to stay in the room with her- I had to see 3 dentists before I found someone who was ok with this.
I called all over town and had many interesting discussions with dentists and their receptionists.

I finally found someone 40 minutes away that allows parents for the conscious sedation, and we have an appointment at the end of the month.

I am very overwhelmed by all the thinking I have had to do about this, and disappointed that so many dentists are either totally mainstream (pro flouride and amalgam) or holistic (don't do anything until the tooth falls out).

I am shocked that I have had so much trouble finding a dentist who will work with me, as opposed to handing down edicts and treating me as if I don't know anything about my child.

Thank you to those of you who shared your stories.
Hmmmm....well, maybe it is a mineralization issue. There's only one tooth that looks serious, with a big hole and significant brown coloring (mostly on the back of the tooth). That's the only one that didn't get any better (actually has gotten worse). I felt better about this last dentist saying that the worst case scenario was an abcess, in which case he could remove the tooth without any further problems if we got to it quickly. But it sounds like there are actually far worse scenarios that he never mentioned. Maybe we need to go visit yet another dentist or two. As much as I wanted to believe that guy, his personality was kinda like he was trying to sell me something. So, I'm glad I checked with you!

What do you think about the idea of capping all the teeth that are showing the slightest hint of decay to get it all done in one shot, versus just capping the teeth that truly look like they may present a problem?

And, when is this book of yours coming out? I can't wait to read it!

Diane (mama to Rylee 11/25/01)
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