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Hugs to you Mama!
My dd's top four front teeth started decaying around 15 months. Same scenario...pediatrician said, "ah....not to bad. It will probably be ok till she is older." (At the time we had a hard time even finding a dentist who would see her at that age.) Crumbling teeth also. Anyway, Long story short...(you can read my past posts for more info)...Dd is almost 5 and has had the top four front teeth capped when she was 27 months. The top two "capped" front teeth extracted 5 months later because of abscess, and two false teeth put in place with a bracket 8 months later. The reason for the delay with the "partial" being put in place was that her 2nd year molars had to be far enough in to attach the bracket. So.............................
If you do have the teeth extracted, it is really important to get the partial, not for space maintenance, as this is not an issue with the front teeth as it is with the molars. But for reasons of speech and enunciation. We noticed a considerable difference with dd once she got her partial.
Just a couple of months ago one of the teeth came loose and broke off of the partial. So it was removed for repair. Within the month that it was off, dd was very self conscious about it and I could see the esteem issues come up. Not so when she was 2 1/2 with no front teeth. But at 4 1/2 it was different.
As for the thin enamel. There is much you can do to strengthen enamel. Flouride for one. At this point, the amount swallowed is minimal risk compared to the risk of infection with extensive decay. The dentist can give you a high flouride gel that you can apply once or twice a day max. Then the other brushing can be done with a non-flouride paste. Once you get the treatment and repair and she has had two two "clean" 6 month check-ups, then you can reduce or eliminate the flouride if you are uncomfortable with it. Studies have shown that flouride and xylitol used together is also extremely effective.

As for the not being able to be there when she wakes up......why???? As a parent, I would gently insist that you be there for your daughter when she wakes up. The procedure is over. It is your right to insist. And it is ok for her to nurse immediately. Especially if she has extractions, it is helpful for the clotting to suckle. Not to suck from a straw which they will tell you, but the physical act of sucking from the breast helps with the initial healing process as well as the comfort it provides. Regardless, nursing is fine all the way up until the procedure and directly after. It is not a food or drink, but a bodily fluid.
There is a lot of information here about what can be done to strengthen the teeth and the proper way to clean them. Unfortunately, a lot of health care practioners know little about children's teeth. And you are right, breastfeeding is not the culprit. However bm on top of food residue is an issue as is almost anything on top of food residue. Unless your child is a "dawdler" nurser, the nipple of your breast is further back in her mouth and doesn't lend itself to milk "pooling" as with a bottle.
It's summer time, so go outside and make a game of putting water in the mouth and then spitting it out like a fish! This is a good way to teach them about spitting.
Lots of water is important now too. Apples, grapes, cheese, nut butters, whole grains all help to neutralize the acid that leads to the bacteria which causes cavities. Things you can do in this next month! Good luck, Mama!
 

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It sounds like you are in really good hands!!
As far as telling her.....well, the truth is something is wrong with her teeth. But being as young as she is, you can keep it really simple. "The dentist is gonna help make this tooth smooth and not so sharp". "Mama will be there, and other people are going to be there helping too." I would highlight the wagon trips and the fact that everybody is there to help. Simple, simple simple at this age. And then just focus on your calm and reassurance and prayer to whomever/whatever to guide her through the experience.

As for the partial....if it comes to that...dd's partial is a "fixed appliance". Meaning that two false teeth are attached to a wire which runs along the gumline of the roof of her mouth to brackets that are cemented to her 2nd year molars. It doesn't come off. It's fixed. No problems except when a tooth broke off which wasn't a problem, just an inconvenience.
But like you said...the focus is saving the teeth at this point.

Another thing to remember is that after Friday, the bacteria that had been eating away at these teeth will be looking for other host teeth, so it is super important to be on top with eliminating the bacteria. Brushing after everything she eats and drinks or at least as often as possible and lots of water to keep mouth rinsed. Increasing those foods I mentioned, etc.
I'll be thinking of you
 
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