OT - Pulling baby teeth?

[annakris1973]

I would definately take them to an Ortho. In my experience, a dentist doesn't always know what an Ortho would do, or how they would do it. I got suckered into paying for a large set of x-rays at our last check up with the dentist, because he assured me that the Ortho would require them. Well, guess what, the Ortho did the inital consultation INCLUDING all x-rays at no charge. So don't assume that your Ortho would agree with your dentist's plan of treatment.

Being a nurse, I also tend to go for the less invasive, less painful, less traumatic routes!!!

 

[cookie]

We have done serial extractions (baby teeth- 5 in all) with my DD (she was 8 at the time) because of severe crowding, then followed that with a rapid palatial expander (RPE) and now braces (she is 10 1/2). The extractions were done to minimize correction needed by the braces. Now she has had her braces for 6 months and her teeth are perfectly straight, and we are starting on the rubber bands to correct her bite. I'm glad we followed the ortho's advice.

 

[Darcy03231]

When DD was 8 our denist recommended she see an orthodontist for some crowding issues. Orthodontist recommended pulling two baby teeth, which we did. Her permanent teeth ended up coming in pretty straight and now other than one slightly crooked tooth all of her teeth are pretty straight and there was no need for braces. I would definitely see the orthodontist, and preferably the one you plan to use for the braces, before pulling any teeth.

 

[imsayin]

DS is 6 also, not quite 6 1/2, and he only has 1 loose tooth and none coming in. His baby teeth came in very late as well, so maybe this is normal for him

This is true that if the baby teeth come in late, they fall out later. DD is almost 13 and has only lost 8 of her baby teeth. No one has ever suggested pulling any teeth, luckily (not the dentist or 3 ortho consults we went to). The only thing she doesn't like about is that she'll be getting her braces in high school and all her friends have them now. The dentist actually said this is a good thing because an older child can better care for their teeth while in braces.

 

[StitchandPooh'sMom]

I agree with the recommendation to see an orthodontist. I am kind of surprised your dentist didn't suggest that. DD7's six year molars are coming in and running into her 11-12 year old premolars (baby teeth) and getting caught on them so the molars can't come in all the way. Her dentist wanted to pull the premolars and put spacers in to hold the spot for the adult teeth (for about five years). He referred us to an ortho, who decided to put springs in to push the teeth apart and allow the six year old molars to drop without notching out the premolars (wish I could draw you a picture so it would make sense). The springs have been in five months, and her teeth are moving enough to let the molars drop into place. It is not the same situation as your case, but our dentist recognized that there might be other alternatives that an ortho could recommend. Our dentist has no experience with the springs and didn't even think of them as an option, but I am glad we have saved her teeth so far!

Good luck to you!

 

[MEM]

I am not a dentist but I have worked at a School of Dental Medicine for 22 years. First, OP, is your 6 year old's dentist a pediatric dentist? If so, all pediatric dentists receive extensive training in orthodontics and some even have board certification in both. If not, then a second opinion from an orthodontist is a good idea.

Both of my children had to have baby teeth extracted to allow the permanent dentition to erupt. The baby teeth don't all automatically fall out when they are supposed to. There is actually genetic coding going on that tells the baby tooth to fall out and prompts the adult tooth to erupt. If the baby tooth stays in there too long, sometimes the permanent tooth can reabsorb. This is not likely at the age of 6 however - my kids were more like 9 when they had the extractions.

Regarding general anesthesia - a good friend of mine is a dental anesthesiologist. He says to avoid general when at all possible - there are so many options, like IV sedation and nitrous oxide. A combo of IV sedation or nitrous and local (novocaine) should do fine since baby teeth have little or no roots.

 

[CF'er]

Thanks Ohiominnie...... it may have been you that I "borrowed" it from. Sorry!

If you are bothered I will take it out. Just let me know. I put it in before the "game that shall go unmentioned" but I am still a Buckeye through and through.

Back to your regularly scheduled teeth pulling debate.........

 

[dahrjo]

Our pediatric Dentist recommended taking our DD8 to see the orthodontist for crowding issues. He recommended extracting 4-6? baby teeth. I went to get a 2nd opinion from another orthodontist, and he said we wouldn't need to pull any. Now what??? A third opinion?

 

[claudia]

after working in the dental field for many years my advice would be to take your son to atleast 2-3 orthos for a consult. Also, IMHO I would never allow any general anesthesia....risk/reward...no way. With baby teeth most of the root is resorbed by the time they need to come out so there is little to no pain with an extraction, but for a child that does have a high anxiety level you would have to weigh out how much this would affect him and if it is worth putting him through this. Sweet air may be an option.
It's amazing to me what these kids are put through today for ortho. My son has been going through this since he was 9 (he is now 16)....mom's big teeth, dad's small jaw) He has been through extractions, palate expanders, braces on, braces off, now coming up and getting ready for a different kind of palate device to help with a growth problem in his lower left jaw....it just goes on and on. Good luck with your son...

 

[steen995]

I am not a dentist but I have worked at a School of Dental Medicine for 22 years. First, OP, is your 6 year old's dentist a pediatric dentist? If so, all pediatric dentists receive extensive training in orthodontics and some even have board certification in both. If not, then a second opinion from an orthodontist is a good idea.

Here's the dentists bio from his web page. What's your take? I didn't even know about the children behaviour background. If he's thinking DS needs to be knocked out I guess he'd really know, huh? As long as DS doesn't know something is going on he actually has a high pain tolerance (he usually didn't even know he had a ear infection). It's the fear of pain that gets him totally bonkers.

"Dr. XXXXX grew up near Dallas, Texas. He attended Austin College and received his Bachelor of Arts degree in 1995. He completed his general dentistry training at the University of Texas Health Science Center at San Antonio in 2000, and had the opportunity during those years to participate in children’s behavior research at the University of Washington. This experience allowed him to work closely with parents and fearful children, which eventually let to specialty training in pediatric dentistry at the Ohio State University and Columbus Children’s Hospital in 2000-2002.
After completing his Master’s degree in the field of child behavior, he moved to Seattle in August of 2002 and realized his long-time goal of living in the beautiful Northwest. He looks forward to working with the superb team at XXXXXX Dental Care, and helping to provide quality dental care for the children, adolescents, and teenagers in the South Sound area."

 

[ohiominnie]

Thanks Ohiominnie...... it may have been you that I "borrowed" it from. Sorry!

That's alright. I distinctly remember PM'ing it's original owner and asking if I could use it too! It's just so cool!
I'd take it out now b/c my siggy is getting cluttered, but I'm afraid I wouldn't be able to get it back in!

ON THE TOPIC OF PULLING TEETH:
Dd had to have a tooth pulled that had had a root canal. Adult dentist did a root canal on a baby tooth. Switched to a pedi dentist several years later and he ended up pulling it and putting in a spacer. They used nitrous and she did fine.

Fast forward many years and ds had to have 3 baby teeth pulled at the recommendation of the orthodontist. Our normal pedi dentist was on a leave b/c his son was undergoing bone marrow transplant. The sub was nice, but thought my son was a "big boy" and could "tough it out without nitrous." I told him I wanted him to have nitrous, that's how Dr. Bob did it and my dd had tolerated it well. He convinced me (stupid me for not fighting) that he'd start, and then see how ds did. If he was anxious, he'd give him nitrous. Well, ds nearly jumped out of his seat and clawed at the air. It was so sad. THEN sub dentist says "yup, guess he DOES need nitrous." jerk. At that point, though, ds was freaked out and never really did get comfortable. He still death gripped the armrests like he was going to die.

 

[nuke]

My son had perfectly straight little baby teeth. I thought we would get lucky and the adult teeth would follow right behind. Wrong! His two front teeth took their sweet time falling out. So the adult teeth came in really high up and looked bad. Our dentist assured us that eventually they would come down and look right. He was correct. It's now a year later and his front teeth are right where they should be. I still think he will need braces but I don't see any rush. When he's 11 or 12 we will take him to the ortho.

I only needed braces on for 12 months at 13 and didn't have any teeth pulled. Dentists always ask who my ortho was because they are amazed at how aligned everything is. Sadly he died a few years ago so I can't bring my son to him. He was a sweetheart.

 

[ohiominnie]

which eventually let to specialty training in pediatric dentistry at the Ohio State University and Columbus Children’s Hospital in 2000-2002.

He must be good.

 

[MEM]

Here's the dentists bio from his web page. What's your take? I didn't even know about the children behaviour background. If he's thinking DS needs to be knocked out I guess he'd really know, huh? As long as DS doesn't know something is going on he actually has a high pain tolerance (he usually didn't even know he had a ear infection). It's the fear of pain that gets him totally bonkers.

"Dr. XXXXX grew up near Dallas, Texas. He attended Austin College and received his Bachelor of Arts degree in 1995. He completed his general dentistry training at the University of Texas Health Science Center at San Antonio in 2000, and had the opportunity during those years to participate in children’s behavior research at the University of Washington. This experience allowed him to work closely with parents and fearful children, which eventually let to specialty training in pediatric dentistry at the Ohio State University and Columbus Children’s Hospital in 2000-2002.
After completing his Master’s degree in the field of child behavior, he moved to Seattle in August of 2002 and realized his long-time goal of living in the beautiful Northwest. He looks forward to working with the superb team at XXXXXX Dental Care, and helping to provide quality dental care for the children, adolescents, and teenagers in the South Sound area."

Some doctors will take the path of least resistance and in some cases that would be general anesthesia. I have been fortunate to work in dental education and have dentists who use the least amount of any type of anesthesia and sedation necessary. My son is autistic and his team worked with him on overcoming his fear of the unknown so that he didn't need more than some light IV sedation for his extractions.

It sounds from his bio that he does have specialty training in pediatric dentistry, so that is a good thing. The Master's degree in Child Behavior doesn't mean anything (to me) unless part of that was working with live patients in a dental setting.

I would still seek a second opinion from an orthodontist.

 

[ElizaB39]

Get a second opinion. My DS9's bottom two front permanent teeth were coming in behind bis babyteeth. I was freaked out, but my dentist said don't worry about it, they will fall out, and the perm teeth will come forward. Guess what, the baby teeth fell out, the perm teeth came forward and boy were they crooked! They are now so nice and straight. I am so glad that we waited. He wille eventually need and get braces, but when he has more perm molars in.

 

[CF'er]

Originally Posted by steen995
which eventually let to specialty training in pediatric dentistry at the Ohio State University and Columbus Children’s Hospital in 2000-2002.


When I was looking for a dentist here in Georgia I found an "approved" one on our insurance. I saw this in his Bio and picked him on the spot. He was there during the Woody Hayes era and is a great dentist. I just hope he doesn't retire soon. I am a true dental

 

[shelly3girls]

Like everyone else has said, I would definitely get a second opinion. We just took our DD8 who has severe crowding to an Ortho who uses the Damon system of braces. Originally our dentist said she would need teeth pulled and a palate expander put in. The ortho said that this newer braces system has decreased the need for the expander from 40% of their patients to 4%. DD falls into the ones that will not need the expander (but would have using conventional braces) Our ortho did the first consultation free including a full set of x-rays. He will see her again in 6 months and keep checking on her until the optimal time to put the braces on. This made much more sense to me than pulling tons of teething, putting in spacers and a palate expander, then braces. The ortho also said this system takes less time the previous systems!

 

[trulygoofy]

Unfortunately my kids have long roots on their baby teeth and most need to be pulled. They would not have fallen out on their own and the baby teeth would have come in where they shouldn't. They also have small mouths (physically anyway) so the first 3 have had about 8-11 pulled each. The hard part was when the first 2 had to have 4 baby teeth pulled and the 4 big teeth underneath cut out. All this and they will still all need braces, but they would not have room to straighten out without "sacrificing" some.
I had teeth pulled when I was a kid and I was traumatized. The Dr. was friends with my mom and would stand talking to her while waving the needle around. I still hate needles, but my kids do much better than me. When they were pulling 4 teeth from my DD I almost passed out. They had to get me to a chair and got a cold cloth for my head while my poor daughter just watched after having teeth pulled (she should have been getting all of the attention), so now my DH must take them.

 

[tmarquez]

I didn't read all the replies, but wanted to say that when I was about that age, I had 8 teeth pulled. My adult teeth came in straight, never needed braces or anything.

I remember being afraid because it just sounds horrible...that's alot of teeth. But I don't remember it hurting.

 

[ohiominnie]

Was telling dh about this guy's bio. Dh went to OSU med school and then did a peds residency at Columbus Children's Hospital. He said Children's is one of the premier dental residency training programs in the country. He said when he was there there were actually ppl from Gr. Britain training at Children's b/c it was superior to anything they had there.

I'd still hesitate to do general in a dentist office. Nitrous Oxide works pretty darn well, IMHO.

(looks like this guy was at Children's after dh was already through there, otherwise I'd ask if he knew him)