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I wanted to put a summary out of our recent dental experience. Parts of it were absolutely awful but a lot was to be learned and in the end -it worked out ok. It is really long and it was a long experience. <br><br>
I have an awesome near 3 year old with some mild sensory issues. She is extremely sensitive to noise. EXTREMELY, especially noise with vibration. About 3 months ago my mom noticed a black spot on one of her back molars. I have <i>extreme</i> dental phobia and couldnt even look at it... I did what I usually do .. I told my former Nanny (I say with a smile) She went fishing in Violets mouth and dug out a whole grain bread seed that had been in there for who knows how long. And yep --sure enough she had a crater cavity. Violet had been complaining for weeks her mouth hurt, we assumed it was just her 2 year molars. We were very very wrong.<br><br>
Visit One:<br><br>
Per my DH's request, I took her to a dentist he knew through work associates. He does computer work and he did all the wiring for her new office. He was impressed with the level of technology in her office (geek boy). It worked out in such a way, I had to take Violet to the dentist myself. He was unable to go because of work, I was *terrified* of going and made every attempt (and succeeded) to be calm. I did NOT have a good feeling about the dentist (she had no patience with Vi nor was she accommodating to Vi's needs) but because I knew I have a ton of fear and I am prone to over reacting -we persevered through the visit and Violet was given a laser filling. When we left the Dentist she said "this is something that will bother her from time to time" but said nothing more. Lets just say I was furious with DH, her and the whole experience. This post is *not* about the bad dental experience with this person.<br><br><br>
Visit Two:<br><br>
Because I was not comfortable with the visit Vi had or how traumatic it was, I made a request for my former Nanny to take her to her dentist. This happened 2 weeks after. He is a local dentist, has 4 young children and has a good reputation in the neighborhood. I did NOT want to go because I did not want Vi to pick up on my fear and I trusted my former nanny implicitly to handle this experience. When she took her, the dentist was amazing with her. He gave her a dental kit (in all of her favorite colors), went very slow with her, and let her to recoup her confidence with dentists. He however promptly noticed the filling was horrible, needed to be redone and most likely needed to have a root canal done. Violet was unable to handle any of the noisy experiences - the water in her mouth, the air, etc - he promptly stopped treatment, turned it into a play session and referred her to the pediatric dentist. Even though I did not attend this appointment, the dentist gaves my Nanny his cell phone number and when I call -explains everything that needs to happen and says to call him any time. (I was able to call this dentist several times during this experience and he explained things to me repeatedly about our options)<br><br>
Visit Three:<br><br>
The pediatric dentist got her in ASAP. My husband took her and I sat in the waiting room. Vi was in active pain and we had no idea what was going on. They did an Xray, informed us the first filling had to be removed, a root canal done, and a crown put on. They told us <b>not </b>very positive things about the work of the first dentist. When they examined Violet, They did an amazing job with the exam itself and somehow had violet stretched across my husbands lap and the dentist. They scheduled the procedure and assured us Violet would _only_ need nitrous. I was skeptical but Violet did respond really well to the dentist and I figured they were experts. To be safe, we took a nitrous mask home with us so Violet could begin to practice wearing the nose as part of dress up play . There was NO way that during something she was nervous about -she would tolerate anything on her face- this was a <i>good </i>move on our part.<br><br>
*insert MANY fights with DH about it being his fault, etc etc. A phone call was made to "dentist one" per DH and our money was refunded for the insurance, so the case could be referred to the pediatric dentist without insurance red tape*<br><br>
Visit Four:<br><br>
My mother in law and my DH take Violet for the procedure. My Dh said it was hilarious watching Violet on nitrous -she got good and tanked and was laughing about elmo and cookie monster. Then the procedure started and it was _awful_. The dentist was excellent and constantly asked my DH for feedback and guidance on how much she could handle and if it was ok to keep going on. They had to stop the procedure because the root of the tooth was so inflamed that the procedure had to stop and a temporary crown put in. Violet also emotionally couldnt handle anymore. When I asked my mother in law how it was, she said "well for 4 people holding her down - Vi did amazing"<br><br>
For the procedure to be completed on the next visit, they decide Violet needs a dose of atarax (basically super strong benedryl) to complete the procedure along with nitrous. The inflamation of the nerve also needs to come down before they can touch the tooth.<br><br><br>
Visit Five.<br><br>
At this point - I FLIP OUT. Come on, 5 visits to the dentist in a short time -this kid is going to need therapy. <br>
I am _not_ ok with Violet being given atarax. I am her mother and I know her-it is NOT strong enough for what is going on. As her mother, as someone who is terrified of the dentist, and as a special ed teacher - Violet reacts to noise in the exact same way an autistic kid processes sound. An antihistamine is going to jack her up (she reacts to benedryl like that) and it is just not ok.<br><br>
I know we have to do something -that temporary crown cant stay there. I am not angry with the pediatric dental practice and I understand they do not want to over medicate her. <br><br>
So-- insert lots and lots of phone calls. I called local children s hospitals, developmental dentistry practices that work with the cognitively impaired, consulted a psychiatrist, spoke with the speech therapist at work (good background in preschoolers with special needs), sedation dentists, etc. I learn a lot in the process... Each dentist did say, if I transferred her case -they would have to start everything all over again. <br><br>
Finally, I get a hold of another one of the doctors at the pediatric practice. I beg him to give Violet a general anesthetic. Apparently this one doctor in that practice did moonlight at the local hospital to do general anesthetic for dental procedures. Even though we have excellent insurance, I was ready to pawn my wedding ring if I had to pay for it. I wanted her to NOT hurt. I just wanted this whole thing to be over with.<br><br>
This guy is *so* arrogant but he really seems to know his stuff. He took every phone call I had and spent 30 minutes + each time on the phone with me. He chewed me out for my own dental fear and also listened with compassion for Violet. <br><br>
He told me that he would *NOT* give Violet a general for one tooth. Absolute not. One tooth, 10 minutes of work. NO. He explained that he was also the end of the line for dentistry. He was the guy they called when no one else could do the work. He told me that we had more options than just atarax, and said we could do Oral Versed but in our neighborhood it could be difficult and costly to locate. He wanted to make me aware that by sedating Violet, it could <span style="text-decoration:underline;">magnify</span> her sensory issues and make it a worse experience for her and at the very least I needed to know that. He also warned me the more relaxed we made Violet -the more possible it was for her to struggle with airway issues. He said little ones can arrest quickly and it is not pretty. I realize he is a doctor and trying to scare me and at the same time - I have to at least listen. He said "Michelle -10 minutes of her hating it but being alive and strong after..." <br><br>
In the end, he and I agreed to do Oral Versed. He tells me it also can cause amnesia for the experience. He also agreed to use many cognitive strategies that Violet worked well with. Violet understands numbers and counting - is the concept of "when I get to 5, I will be done" and he said he would use that with her. He would do everything to gain her trust and work with limits that she set. He was very clear that she would cry but it was normal for her to be upset. He also said they were going to confine her arms to minimize her fighting/need to be held down. I was not happy but it seemed ok. In the end -nothing would be perfect.<br><br><br>
The day of the appointment comes along -it works out that my DH has to take her alone. He goes and picks up the Versed. Getting Violet to take it was not so pleasant - they ended up giving it to her in a syringe in the back of her mouth. They sent DH to the waiting room and had them play with Vi. They told him in about 8-10 minutes Vi's eyes would glaze over and she would zone out. Dh held her and read to her and yep time passed and she zombified.<br><br>
They put her in the baby straight jacket and started to work. The dentist was awesome and did much of the work by hand so he could avoid noise. He was able to use gauze instead of the suction straw which cut out a lot of the noise that Vi struggled with. He did not give her nitrous -DH says that he wishes they would have so Vi would have felt silly but she didnt actually need it. They completed the procedure - some tears but nothing overly bad. She was ok. (They used some type of numbing gel so the would do the Novocaine shots -she was oblivious to them) <br><br>
Now.. here is the funny part... After the procedure, DH is at the counter getting paperwork to go home. Vi hears Elvis in the waiting room and begins to dance around. She promptly falls over like a drunken sailor. No big deal..they come home... DH goes to work, Vi has an average day.<br><br><br>
Enter bed time - DH is changing her into jammies and I say,<br>
"Pie.. did you go to the dentist today??"<br>
*nods*<br>
"Vi were you dancing and you went crash???"<br>
She proceeds to look at me like I am on crack and has no idea what I am talking about. She did not remember ANY of it. The little thing of versed making her forget it all - worked. She has absolutely no memory of getting her root canal. THANK GOD.<br><br>
So-- whats the moral of this?<br>
Im not sure. I guess -trust your gut. If you dont think a dentist/doctor etc is doing a good job -listen to yourself.<br>
Kids need good dental experiences. Our nannys dentist who gave Vi the dental mirror, the special tooth brush, etc -really restored her faith in dentists. She actually played dentist with her toys and friends after that.<br>
If you think your kid needs more pain medication or anesthesia - there are levels of it. Their are pro's and cons to each one. Learn them. There are a smorgasbord of options.<br>
I would hands down do Oral Versed again with my kids if they ever had to have anything medical done that would be unpleasant. I am SO glad she has no memory of it.<br>
The right care provider will work within your kids limits -they will also tell you the reality of whats going on.<br>
Becareful of whole grain bread seeds <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/irked.gif" style="border:0px solid;" title="irked">:<br>
The root canal was awful and it totally sucks that any one, much less a child would need one. <br>
I suspect, even if dentist one, wouldnt have IMO NOT screwed up the filling, because the decay was so deep, she would have needed a root canal to begin with. <br>
Find people with good information who care. Dentist two didnt have to take my 8 pm phone calls where I was frantic saying "My baby has to have a root canal..oh my god" but he did and explained everything.<br>
Dont assume that switching care providers is the answer. When Vi struggled with the 4th visit, it was very hard to not take her to someone who would do what I wanted. Im sure if I would have kept calling, I would have found someone to knock her out in an OR.<br><br>
Thanks for listening - Im not sure why I posted this - if anything it was nice to write it all out.<br><br>
Note: We recently transitioned to a new nanny, but it has nothing to do with the dentist.
 
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