Advice Needed: I think my 2 year old has a cavity

[labst60]

When we are WDW a few weeks ago, I noticed a small brown spot between DD's front teeth when we were brushing (had never noticed it before.)

It seemed to go away with some extra brushing, but has since come back and now we can't get it to go away, so last week, I made an appt. with a pediatric dentist (don't know anyone who has been to one in the area - so I have no personal references on this practice.)

Anyway - the appointment is next week, and I called today to see what I can expect at the appointment - mainly, I wanted to know if she would need xrays (since I am pg, I would want to bring my dh, so he could be with her during that process.) Anyway, then I asked how they calmed/sedated the young ones. I do NOT think she would be able to hold her mouth open to get a cavity filled. Anyway, they said they typically use nitrous (laughing gas) and will wrap them in a blanket (papyus) to secure their arms if they are worried about them thrashing around. She also said they have a movie playing to distract the child while the work is being performed.

BUT... she did say that typically parents aren't allowed in the room- but that I could speak with the doctor at the time. That concerned me - on one hand, I understand that in many instanced (granted, mine included) the child is better behaved when the parent is not there- BUT I just don't know if I feel comfortable leaving her. If she were completely sedated (which obviously wouldn't be necessary), I would be comfortable leaving her - its not that I think I know how to fill a cavity better than thay do- but if she is goign to be awake and conscious, I think she should have a parent with her for support.

HOWEVER - I have no knowledge of how this usually works - and I would really, really appreciate hearing some first-hand experiences from other parents who have been in similar situations - how did it work - were you allowed to remain with your child, etc.

Thanks so much!

 

[mom2twinz3]

Our dentist does not treat routine cavities in baby teeth unless they are causing the child pain or some other problem. At first I was taken aback but he made sense, and my son lost his tooth that had the cavity on schedule and has had no other issues.

 

[Nanisashi]

When my dd was 3 she had a cavity. We took her to a pediatric dentist, who prescribed a sedative. Well the prescription was 1 dose and she spit most of it out so when it was time to fill the cavity, it did not go well. The good thing is that they are used to dealing with fidgety kids so they work really fast. Good luck!

 

[TylerAggie]

My daughter had cavities on her top four teeth and had to have them capped. The first visit they will just look at the teeth. When she had the caps put on, she breathed the laughing gas. She was almost three and I sat next to her the entire time. It went really well. They can usually judge if your kid will behave by the way they act when they are getting their teeth cleaned. For some kids, our dentist will do the work at a hospital and have the child completely sedated.

 

[beequeen]

our pediatric dentist has a "no parents" policy in his office. I was a little hesitant at first, but there are no exceptions to his policy. Both my kids have been going to him since they were toddlers (for check-ups). They are now in their teens and have always looked forward to their dentist appointments! I had a dentist phobia as a kid. I would highly reccomend starting your kids going to a pedi dentist at a young age - even without cavities!

 

[Ellester]

I would be very leery of letting my 2yo go back alone. Last year, our pediatric dentist in Charlotte had his license suspended for mistreating children. He was "the" pediatric dentist in town, very nice offices. Since hearing of the charges about him and a big scandal with some pediatric medicaid dentists a few years ago in Charlotte, I would never allow my child to go back alone. Especially at such a young age. Just something to consider.

http://www.wcnc.com/news/local/stories/wcnc-020206-al-employees_dentist.647c2c91.html

http://www.wcnc.com/news/topstories/stories/wcnc-121803-al-medicaid.b4d99017.html

 

[*KeepMovingForward*]

I think it depends on the dentist. Usually a pediatric dentist will allow the parent back with the child. DS had to have his two front teeth pulled after falling and smashing them back into his gums. We were prescribed a mild sedative to give DS about an hour before the appointment and they used what the doctor called a "raincoat" which pretty much held his mouth open and kept the area clear of his tongue. Now as for our regular dentist-he will not allow parents in the room and he cites insurance purposes, but having two doctors in the family, I know that is not true-it is up to the individual doctor. Its probably like the hospital-if they screw up, they don't want you to be there to witness it. To be honest though, I cannot imagine a child being calm without their parent right there.

 

[hugabearjo]

I work for a dentist who does pedo days. we have a no parent policy for a few reasons. The main one is that if the parent is in the room the child tends to focus their attention on the parent and not on the provider who is helping them. We also have found that it is very very hard on parents to watch their child be papused and with the nose piece of the nitrous. If the cavity is deep then the tooth bleds and we have had two parents before making the rule that passed out, we wanted to tend to the child and had to tend to the parent as well. I know that isn't the norm but, it does happen. Lastly, we ask that parents wait in the waiting room because of the amount of staff it takes to help an anxious child. Usually I go in and start the nitrous (I am a hygienist), sing to the child, when they are relaxed an assistant comes in and we give the injection. the assistant cradles the childs head to prevent movement. this is all described to the child in terms they can understand. "We are going to give your head a hug now so that we can squirt some sleepy juice on the tooth to scare the cavity out". We then bring in the dentist and his assistant, to complete the work. We have had parents who watched from out in the hallway but, it depends how the office is set up if that is practical. I have had no kids that I ever felt like they were mistreated in any way. The wrap we put them in we call a seatbelt (something they are familiar with) we call the nose piece space man because it makes them feel floaty. We have mister bumpy and mister whistle who scare the cavity bugs out and the bug catcher the assistant uses to catch them so they can't make holes somewhere else. Please understand that we adjust this to the age of the child. At 2 usually the nitrous and the singing is all they need to feel safe.

We also don't fill baby teeth unless they are causing a problem. A spot isn't a problem. I would keep it very clean and dip a soft toothbrush in ACT Fluoride rinse each night before bed brush it. This isn't a case where more is better, just once a day with a dip of the toothbrush.

That having been said, we also have a policy that says parents (or patients) are our best resource. You know what is or isn't normal for your child. You know how they will react and that helps us help them best.

I know this is a scary time for you, I would also suggest going to the office and if your gut screams to get out of there then find another dentist. If it just is that you are nervous for her that is different.

I know it will be okay. Take a deep breath-

One last thought, thanks for being a parent who notices things and cares. That is half the battle in keeping our little ones healthy. Congrats on the coming new addition to your family.

 

[bumbershoot]

I absolutely, positively wouldn't give a DIME to a dentist who would not allow me or DH back with DS.

And I haven't.

Ped dentists vary in SO many ways. And there are many! Two of DS's teeth grew in miscolored, and they grew for awhile, then started disintegrating. Even though they were problematic, we took our time finding a GOOD dentist who believed in our ability to figure out what was good for DS.

One ped dentist started judging the problem as eating too much sugar, by simply looking at me and DH. We are both too heavy right now, but it's because we like pasta, not because we drink KoolAde every 5 minutes. He was a brilliant dentist, let me tell you. He then judged us because I left the room for when he actually looked in DS's mouth. This is something we had figured out during 3 mini-visits with another dentist (who decided she couldn't work on DS b/c she's not a ped dentist); if he's with me, he acts even younger. When he's with DH, he puts on a "big boy" facade and is quite brave. We did it FOR our son and for the dentist. Not because I'm some wimp. But that's what he felt anyway.

He then FINALLY agreed with us that it wasn't sugar-based, once he looked in DS's mouth (it was only on two teeth, with a couple spots elsewhere, but NONE on the bottom teeth where milk/sugar would have "pooled" during sleep (regardless of the fact that DS sleeps on his back by nature)). Then said that he required GENERAL anesthetic, IN THE OFFICE (not in a hospital), that we'd have to coordinate with this anesthesiologist and our medical insurance, as well as dental insurance...to get little spots filled and to have those two teeth pulled (and probably the front two, too, just in case).

We said "uh, no". "buh bye"


Found a FABULOUS dentist; a new associate working under a dentist who has been known to SING a 4 year old through a filling.

They have a little kid's room with a door. TV in the ceiling playing Nemo (they never work long enough to get to the dentist scenes, LOL), which was DS's first time watching it. He had one big filling done with NOTHING, no sedative, no lidocaine, no laughing gas, nothing. Took something like 7 minutes, and he was out of the chair.

The next visit, for the extractions, he got two little shot of lidocaine, and it took even less time.

And it was all under dental insurance.

Now one of the little spots has grown bigger, so he's going back in...at his 6 month checkup he was in the main room b/c he's 3 now, and was more distracted and wouldn't keep his mouth open. Since the spot is further back in DS's mouth, the dentist is worried about DS biting the instruments and his fingers, so he has asked us to give him a prescription something or other to calm him (of course, the pharmacist said it can have the opposite reaction, and I think that would be funny...I have bizarre or opposite reactions to pharmaceuticals almost whenever I take them) down.

This dentist does restrict it to ONE parent, but the parent does go back. In our case it's DH, because DS does so much better with him.

Like I said before I wrote a novel, I wouldn't give money to an office who has the no-parent policy. I think it shows a lack of ability in the dentist and a lack of trust in the parent, and I have no interest in being part of that!


There's a yahoogroup called something like "veryyoungkidsteeth" and they do discuss alternatives to "modern" dentistry, but you can also ask for referrals to excellent ped dentists in your area.


I'm sure you can find someone better.

 

[bumbershoot]

re-read my post. want to clarify.

I know pasta has sugar; but in this case, both DH and his father had babyteeth that disintegrated, so we KNOW it's genetic. We're just glad it was only 2 teeth that were THAT bad, because almost all of FIL's babyteeth were like that, and several of DH's teeth were. The first dentist hadn't heard of such a thing, and didn't want to listen to us, because he felt he knew better just by looking at us.

The dentist we use now obviously doesn't ALWAYS not use pain medications. But they like to START at the bottom, and work up if things need it. We like that better than the "strap 'em in a papoose" from the get-go thing that many dentists we spoke to talked about.


Also, xrays...they had a swingy xray machine off the main workspace of the office, and they put DH behind the lead wall, while they sat with him (everyone in aprons) for the xray.

 

[PenguinWaiters]

My daughter fell when she was 1 1/2 and pushed her two front teeth back up into her gums. I went to "the" pediatric dentist in town who took an X-ray and said that both of the teeth needed to be pulled. He showed us the board with the velcro staps that he would use to hold her down and I about passed out. AND, he wanted to do the procedure right then. NO WAY was I letting my DD be put into that - it gave ME nighmares. He also had a no parents policy. I went to one other pediatric dentist in the area and she agreed that the teeth needed to be pulled and would do it the same way.

So, I did some research. I decided to go to someone in the state who had a good reputation, not just the closest dentist. I made phonecalls to several and asked about their policies on pulling teeth in young kids. I talked with some rude and put out people and then I found a WONDERFUL place - I could tell just talking to them on the phone. They are an hour and a half away, but we went. They were GREAT - the dentist was wonderful and took a lot of time looking at the x-ray, explaining what he saw, answering our concerns about her permanent teeth and her language development as well as his techniques for pulling teeth in someone that young (knocked out with a parent present the whole time - if she was a bit older he would use laughing gas instead). Then, he told us that he DIDN'T feel that we needed to pull those teeth. He showed me exactly how he felt the previous dentists were wrong about her x-rays. BUT, I would have had him done the work if it needed to be done. I just KNEW he was the right one.

It has been a year now, and so far he was right. Both teeth came back (just a small chip in one) and have shown no signs of infection or any signs that they are dying. I thank heaven every day that I trusted my instincts with those first two dentists.

So, trust your instict about the dentist and the office. Keep looking until you feel comfortable with the people and the procedures. And good luck! I know how scary this can be.

 

[DisneyPhD]

My oldest DD went to the dentist at 4 and had a number of cavities in her back teeth that needed filling. I felt like such a terrible mother, let me tell you. I realized later you could see it in her mouth too, that was scary. She has some on her top teeth we are just keeping an eye on. They should fall out in the next year or so.

Anyway it was pretty much what everyone else described. The dentist let us in the room, both DH and I. Let me tell you, I wish I wasn't there. She woke half way through and screamed the whole time. There was no talking her back, she wasn't even aware of what she was doing and doesn't remember it later. I would of much rather not been there, it was painful to watch. They had to do it 2 different times to finish them all. The oral meds they gave her before to relax her made her act very drunk. How strange to have a drunk 4 year old.

I was impressed with the dentist, she was kind and compassionate and worked fast and steady under that pressure.

We started taking her baby sister before age one.

I have issues with going to the denitist myself. One reason I put it off to long with DD. I hope they don't when they grow up.

 

[macmahony]

We have an amazing ped dentist, I love him, he loves my kids, and is wonderful. My middle daughter, who is the WORST (she has SPIT in the dentist face, while me, the dentist, and the tech, and the secretary have had to hold her down to clean her teeth), and she had a cavatiy, and I thought oh heck no, this kid will never let us get this filled. So, we go to the appt, they brought her and I back, they played with all the tools, made sounds that the tools made, and showed her the cool chair she got to sit in (also the wrap so she could not move), I gave her a kiss and walked out. (because I knew she would do better), Within 5 min the dentist came out, and I though oh no what happened, and lo and behold it was over, and she was smiling. They had laughing gas for her in case, but never needed to use it, (she had just turned 4 at the time), she was amazing.
My two oldest have been going into the dentist together since they were 3 1/2 and 41/2, the baby goes with me (she will only be 3 in august). There is a glass wall that I can see if needed, and they do not over book, I have never been there when there was another patient, and they completly focus on my children. We always see the same tech too, so they know my girls, and remeber amazing details of things we have talked about, I love our dentist.
I love our dentist, but we had also gone 3 times before the cavity was filled, so my daugher had a slight understanding of what would happen, so for your childs first time, maybe they could do a cleaning first, and schedule the cavitiy for a little while later so that they know what to expect.
If you are not comfy leaving, then don't, but if she seems to do okay, that is okay too, my kids are fine, and I trust my dentist with them. I think if you bring your little one first for a visit, that might be a good idea for all of you!
Good luck, I was terrified of the filling, but honestly it was so quick, and painless, and over so fast that I had worked myself up into a tizzy for nothing!!

 

[daandcb]

Due to an illness, my sons teeth were basically weakened and ruined. He recently ended a long series of appointments that included numerous fillings and crowns. He even had a tooth pulled as he had an extra tooth. I had asked about if it was really necessary to do all this work to his baby teeth (he just turned 5) and they pointed out that if it got to the point of discomfort, it could cause nerve damage. Thats not something I was willing to risk. While I read the reasons others have stated about the no parent, I personally wouldn't go. When my son was ill one of the hospitals we were at wanted us to basically leave so they could do as they saw fit....NO WAY!! They would not listen to us (me in particular) about what was going on and argued that something wasn't there that truely was. So I will not let anyong just do as they see fit. I know my kids best and when they are uncomfortable so I need to be around. I found a pediatric dentist and I even got a second opinion from another pediatric dentist...both allowed us in the room. The one we go to has tv's so the kids can watch movies while work is done and besides the novicaine, he has not needed any other sort of sedative. The dentist was gentle and took his time and was always there to answer questions or concerns. Basically, what i tell anyone is if you feel in the least bit uncomfortable, do not go!!! You need to be comfortable and if your not your DD can pick up on it.

 

[Beth E. (NJ)]

My daughter had a cavity on one of her front top teeth at age 3ish. We took her to a pediatric dentist and he filled it. He was wonderful -- he had a really big toothbrush and a stuffed animal with huge teeth that he demonstrated on. He showed my daughter what he would do. When he used the small drill he put a soft tip on it and put it on my daughter's hand so she could feel the vibration. She wasn't scared at all. No papoose needed.