4 year old with cavaties. Any experience?

seeking pixie dust

Mouseketeer
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My daughter went to the dentist today and has 4 cavities. She's scheduled to have them filled in a few weeks. B/c she is so timid with doctor's and nurses, we felt we needed to put her under anesthesia. I've very nervous...Has anyone had similar experience?

Also, the anesthesiologist doesn't file insurance...so we have to pay out of pocket and attempt to file with insurance. Does anyone have any experience getting insurance to help with that (it's the most expensive part). Thanks.
 
Any chance your dentist uses laser to fill cavities? My daughter had to have some cavities filled and her pediatric dentist uses a laser to do fillings, no novacaine or anything and she loved it. Wants to go to the dentist everyday:confused3
 
When my DD needed filling her dentist said they would ONLY do them if she was under. He also made her so nervous that she didn't want to see anyone. I know I am going to get flamed here but we decided to wait to have them filled. She was ready 6 months later. I personally felt that the risk of the anesthesia outweighed the risk of the cavities.
 

Yes, we did it. It was very expensive, around $6K! Make sure you know the costs and if your insurance will cover it.

Ours was at an outpatient surgery center across from a full-service hospital.

We also had sealants put on while she was under, she had 2 silver caps put on as well as clear fillings (tooth colored)

DD doesn't remember any of it, and has no fear of the dentist.
 
When my DD needed filling her dentist said they would ONLY do them if she was under. He also made her so nervous that she didn't want to see anyone. I know I am going to get flamed here but we decided to wait to have them filled. She was ready 6 months later. I personally felt that the risk of the anesthesia outweighed the risk of the cavities.


I won't flame you. Anesthesia is not risk free and repairing cavities in baby teeth can often wait. I wouldn't dream of putting a four year old under for fillings.

We also use nitrous on our kids and use a pediatric dentist. When my kids were going to my family dentist - although she is a really nice woman - they were nervous and it was alien. The pediatric dentist they visit is WONDERFUL.
 
My daughter had a cavity last year when she was 3. It was really small but they gave her the neddle and she was fine. She didnt even cry for the shot, and she usually screams for shots. She said it didnt hurt at all. Good luck.
 
Our dentist said that the laughing gas isn't an option for my child b/c she's too apprehensive and I do agree with that. She wouldn't even lie back for them to look at her teeth. For general sedation, we felt she wouldn't cooperate either. So, that just left the option of intravenous sedation. Yes, they are only baby teeth, but there is a concern that the cavity could cause nerve damage, which will be a problem in later years.

The procedure will be done in office and is much less than the 6k someone else mentioned - the total cost of the dental work and anesthesia is 1200 - still very high. Hopefully we won't have to do this again.
 
I understand their concerns but putting a 4 yo under completely is not something I rush to do either. And while we can only hope you don't have this happen again, it's very possible that it will.

The reality is that she probably doesn't have the cavities because you're feeding her nothing but sweets and she sucks on a bottle. Many children have soft teeth and therefore are prone to having them, no matter how well we brush and floss them. I have a group of women friends all of whom have 6 year old kids. Many have had this happen a couple of times. We've been so fortunate to have great peds dentists that my kids are not afraid.

We just recently took my 10 yo to the oral surgeon to have a stone removed from his salivary gland. He was very nervous (has a tendency to lose control from the thought of a flu shot) but the dr was terrific. Rubbed some numbing gel in his mouth, then gave him the shot of novacaine then a bit of gas and he was great.

Hope that this really turns out to be the only time you need to face this.
 
Anesthesia is overkill in my opinion, modern dentristy is almost painless compared to the old days of the slow drill. I'm risk averse and introducing that to the procedure is one more factor that can go wrong, a few years ago a 10 year old child was given anesthesia at the dentist (in my area) and never woke up. My DD was given anesthesia for more serious dental work (root canal, my wife made decision over my objection) and it didn't take very well. She thrashed around for 30 minutes and they finally bound her up to restrain her, it was horrible to watch.

Children aren't placed under for shots and I think they can handle it, you have to get used to pain at some point in your life anyway. I had a lot of cavities as a kid (once had 11, thankfully all in baby teeth) because of my sweet tooth and built up resistence to pain over the years. When I had my 3 wisdom teeth out I did local and walked out, didn't feel much pain even after it wore off.
 
Hugs for you and your DD.:hug: I just had to go through this with my DS7 although he wasn't nervous about the dentist. He had.......8 cavities!:eek: I still can't believe that from one six month check up to the next he had 8 of those things. The dentist that he was seeing doesn't like to work on little kids teeth other then cleanings and normal checkups. He recommended a pediatric dentist to do the work. They were great! He ended up only needing 7 fillings because one wasn't as deep as they thought so they just scraped and sealed it (it was a 6 yr molar). His other 6 year molar needed a filling which was done with a white filling so you can't see it, then sealed (we will have is other 2 6yr molars sealed when they finish coming in). The other 6 were baby teeth so they are silver fillings since they will be replaced by the adult teeth. My DS was given the nitrous oxide.

I was so upset that this happened. All I could think was that I did something wrong. Some of it was that he wasn't brushing correctly and needed our help. Combine that with teeth that are close together and the fact that his teeth are just affected more by sugar and you have a bad combination. My DS11 hasn't had any issues with his teeth.
 
It's so funny that this topic came up as I just took my kids to the dentist yesterday! My oldest (she's now 8) was so anxious as a young child that it took almost 2 years of periodic visits to finally get x-rays done only to find out that she had 6 cavities (they were primarily between her teeth). She was so freaked out by the whole dentist experience that gas wasn't even remotely an option (i.e. she wouldn't let the mask anywhere near her face) so she had the work done under general anesthesia. It went fairly well although she vomited several times after the procedure. Fast forward to today, she hasn't had any issues with her teeth since. She even had sealants done recently using gas and there were no problems whatsover.

I guess the point of this rather lengthy post (sorry!) is that you don't necessarily have to worry that she will be doomed to have bad teeth or that it will always be such an ordeal at the dentist. I felt so frustrated for the longest time that my kids' teeth seemed to be so bad despite my numerous efforts (brushing, flossing, limiting sugary foods/drinks, etc.) but I eventually realized that there wasn't much that I could do to change things so I stopped stressing about it! Good luck!
 
My ds was 4 when he had major dental work done on his mouth. He has 6 cavities, 3 were filled and 3 were capped, obviously all baby teeth. Our old pediatric dentist wanted to do the work over 3 visits and have him consciously sedated. We agreed that the work needed to be done, but did not want it over 3 visits.

We seeked a 2nd opinion and with our now current ped. dentist, he had the work done in 1 visit. The dentist administered the sedation orally the day of the work. He preferred this because by him doing it, he knew how much ds had actually drank, it was less than a shot glass worth. He then came out with me in the lobby/play area. About 30 minutes after he drank the liquid, I had to take him to potty, he was loopy, like someone who was drunk. About 20 minutes later, he was asleep on my lap. The dentist came out scooped him up took him into the back. They did put a straight-type jacket on him, so that if he were to wake, he wouldn't flawl his arms. The also hooked up the laughing gas. The work was done in less than an hour's time. When I went back he was groggy and his face was numb. The worst was on the way home, he was biting his lower lip because it was numb and he swelled up and was bleeding.

Ds doesn't remember a thing and he had some major work done. It was the best thing we did. He had no problems going back to the dentist and just this last visit one of the teeth he had filled at age 4, they decided to cap. They capped it without putting him under. He was fine, he's now 7.
 
The apprehension can be taken care of with something both cheaper and less risky than putting her under. I know that they gave my son valium long before that for something (which is what they gave me for my wisdom teeth before they gave me the other stuff). But I'm not a doctor or a dentist, I'm not sure what they would choose to use.

I'd get a second opinion from another dentist.
 
If you have a pediatric dentist nearby that perform waterlase/laser dentistry, I suggest going that route. My dd had one small cavity in between her two front teeth when she was 4, and I was very thankful that our dentist use laser dentistry. No novacaine, no needle, no pain at all...I was quite impress to see the whole procedure.
 
My DD was not scared luckily-I am a dentist wimp! I was concerned about the fillings she needed done 2 or 3, I've forgotten. The dentist was going to do them over 2 appts., with the novacaine, but I didn't want her to have one filling and then turn around and have to go back a week or so later (I thought this was likely to create a fear of the dentist). I asked the dentist that if everything was going well during the procedure if he would just numb the other side and take care of everything that day. He was a little leary, but said he would see. About an hour later the Hygenist brought her back to me in the waiting room. I asked how it had gone and they said she SNORED through the whole procedure and they were able to do them all at once!! Sometimes things work out much better than we as apprensive parents hope!! Good Luck whatever you decide!
 
When my DD needed filling her dentist said they would ONLY do them if she was under. He also made her so nervous that she didn't want to see anyone. I know I am going to get flamed here but we decided to wait to have them filled. She was ready 6 months later. I personally felt that the risk of the anesthesia outweighed the risk of the cavities.

I completely agree. GA has a risk of death, and I'm not putting that risk on my son for ANY teeth.

And if a kid is that scared of any medical person, perhaps a change in medical person is in order.

2 of my son's teeth came in yellow, and over time turned brown and started crumbling. It took us over a year to find a dentist with a brain in their head, and that intelligent dentist was also TERRIFIC with him. First visit was just to check his teeth out and get xrays. Appt was done with DS's head on hubby's lap, with DS's legs on the dentist's lap. Second appointment was to do a quick filling, which was done the same way, and didn't require any pain relievers. 3rd appointment DS was brave and hopped up on the chair, and the two awful teeth were pulled with just a hint of lidocaine.

It really helped that the dentist had a TV in the ceiling, so DS could watch Finding Nemo each time he went in. I joked with Dr Ben about that movie choice, and he reminded me that at any appointment the kiddo is never going to see the dentist scenes, LOL.

Today we actually have an appointment, a regular checkup, and DS has been asking for weeks to go there. When we go to the chiropractor we drive by the dentist's office, and he begs to go in there each time.

Take the time to find a dentist that your child is comfy with, take the number of appointments, or perhaps just arrange to visit the office without appointments that you have to pay for (hang out in waiting room, see other kids go in and out, etc), for kiddo to get comfy being there, and THEN see how kiddo feels about the whole thing.

And if you find someone with TVs in the ceiling, that's an excellent bonus. :goodvibes
 
I work for a pediatric dentist. We use Nitrous Oxide on most of our patients. We reserve general anesthesia for children younger than 3 and special needs children. This is always done in a hospital setting due to the age of the patients. You could wait for a few months to see if maturity helps with the anxiety. I only recommend this if the decay is not deep. If your dentist doesn't feel they could manage the child long enough to administer the nitrous, you may want to seek another opinion. I will also add that we do not allow parents in our treatment rooms and this alleviates a lot, but not all of the behavior issues. I do not know your situation, but anesthesia does come with risks. As for administering medications prior to the appointment, they are often unpredictable in children. Hope this helps. I'll be glad to answer any questions you may have. I have been a dental hygienist for 20 years.
 
I work for a pediatric dentist. We use Nitrous Oxide on most of our patients. We reserve general anesthesia for children younger than 3 and special needs children. This is always done in a hospital setting due to the age of the patients. You could wait for a few months to see if maturity helps with the anxiety. I only recommend this if the decay is not deep. If your dentist doesn't feel they could manage the child long enough to administer the nitrous, you may want to seek another opinion. I will also add that we do not allow parents in our treatment rooms and this alleviates a lot, but not all of the behavior issues. I do not know your situation, but anesthesia does come with risks. As for administering medications prior to the appointment, they are often unpredictable in children. Hope this helps. I'll be glad to answer any questions you may have. I have been a dental hygienist for 20 years.


I am also a hygienist (for 10 years) and totally agree! I work for a general dentist and we also sedate with nitrous oxide, but if we have a child like your daughter we refer to a pedodontist (the couple that we refer to also do not allow the parents to come back and do IV sedation in hospitals) - While it is a risky procedure, a tooth with deep decay and possible abcess/infection (now or in the near future) is extremely unhealthy for children of that age and can be life threatening if left untreated for too long - many people downplay the risk with tooth infections. I applaud you for taking such good care of your daughter's needs and agree that a second opinion is never a bad thing. Good Luck! :grouphug:
 
We just went through this June 17. our 4 yo DS was placed under GA and had 3 caps, plus sealants, a cleaning, and x-rays. A couple of weeks prior he had the laughing gas and had temp. fillings put in. Our ins is paying approx 50% but would pay for none of the sealants. I asked for the sealants anyway and we just pd. out of pocket for those. I felt like for a kid with this many dental issues at 4 we wanted to cover ourselves. I was a nervous wreck but I asked to meet with the anesthesiologist as well as the nurse anesthesist. i asked lots of ques and I know they thought I was a nut job. Good luck. Let me know if you have any questions.
 












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