Extensive Dental Work Questions...

[uggaugga]

I have a 2 year old and recently got a second opinion for her - first dentist said all teeth needed crowns, but the second opinion we paid for out of pocket mentioned 14 crowns. I think 14 crowns is better than 20, but I'm still not excited about this...it's a lot of dental work and I'm still having a rough time with it. I still don't have pictures as she won't let me look and they so far won't do x-rays unless they're under sedation. Of course, they will know more after x-rays. I am taking her to another dentist (that the second opinion dentist referred me to) this week to hopefully get a treatment plan and everything because I was told they take our insurance, but I don't feel too much at ease because I was at that dentist when I was a kid. I mean, that was so many years ago (like 17 years ago), but I remember they didn't numb me enough to fill cavities and I cried, but they didn't stop working nor ask if I still had any pain and never re-numbed anything. All the numbing was done before all 5 cavities, not one at a time before each cavity drilled. By the time they got around to the last few cavities, it's like the numbing wore off. Another time, I went in with a wisdom tooth infection as that is where my mom scheduled me and he poked the infection with one of his sharp tools and it freaked him out when I jumped and he said, "Yes, that looks painful." My mouth was throbbing again. I'm kind of scared to take my own child there, but as for local places that take our insurance, it's what we have here. I tried to get her in to see the dentist that was recommended by the second opinion as they said they heard a lot of good things about him.

I'm terrified about sedation being used on my child, scared that the worst will happen. I'm worried about her being hungry and thirsty and being dehydrated for so long beforehand. They have the same anesthesiologist as the second opinion I went to and they had a lot of good things to say about him. I'm concerned about leakage from the root canals and infection that may be left in those teeth making her sick down the road. I'm concerned about chemicals used in the process that could be absorbed by her little body. After all, it'll be about 12 years before they are all out of her mouth. I am thankful they aren't permanent teeth, but it's still so extensive I wonder how much pain she'll be in following the procedure. Of course I'll have infant Tylenol on hand, but still. The benefit is that she'll hopefully have molars to use to chew until they do fall out. Do baby teeth normally fall out when they are supposed to when there are root canals on their teeth or do they have trouble sometimes? Her worst teeth are her molars...I'm not sure if a dentist would only do the teeth that are causing pain since she's under anesthesia and they will probably do every little bit they can, but I am still concerned about the extensiveness of this. I feel so helpless right now...

 

[Dr M]

Good day,

I remember your case and I understand your fears. A lot of parents are scared, especially when it comes to sedation of their children. Usually we wait up until 2 years of age, because then the " potential risks " are a lot less.
It is common to keep the kids from eating and drinking before anaesthesia, so she shouldn't have any risk of dehydration. She might only be a bit irritated, but in the long run, it is worth the trouble going through this process.
In terms of the planned crowns and pulpectomies; This treatment is done to try and keep the baby teeth in the mouth for as long as possible. Besides the fact that they assist with eating and speech development, they also keep space for the permanent teeth. If baby teeth are lost too early, there is a higher risk that orthodontic treatment might be required at a later stage.
That being said, there is still a chance that the pulpectomies might fail after a few years, but every year won means a lot in the development of a child

 

[uggaugga]

Good day,

I remember your case and I understand your fears. A lot of parents are scared, especially when it comes to sedation of their children. Usually we wait up until 2 years of age, because then the " potential risks " are a lot less.
It is common to keep the kids from eating and drinking before anaesthesia, so she shouldn't have any risk of dehydration. She might only be a bit irritated, but in the long run, it is worth the trouble going through this process.
In terms of the planned crowns and pulpectomies; This treatment is done to try and keep the baby teeth in the mouth for as long as possible. Besides the fact that they assist with eating and speech development, they also keep space for the permanent teeth. If baby teeth are lost too early, there is a higher risk that orthodontic treatment might be required at a later stage.
That being said, there is still a chance that the pulpectomies might fail after a few years, but every year won means a lot in the development of a child

Yeah, the pulpectomy failure is what I'm so concerned about because she'll have about 14 of them and it seems with that many something is bound to go wrong. Granted, some will probably be in her mouth for only 2 or 3 more years, but the molars of course will be there for much longer. I keep telling myself I need her to not be hurting on her bottom molars anymore and need them to continue to chew food and let the adult teeth come through the best way possible. It feels like the options are narrow at this point and it's so sad. Although, it still is a small victory that a second opinion vouched for less crowns than the first dentist we took her to. We'll see how the next appointment goes and when they can schedule her in.

I'm glad to hear that the risks at 2 years of age are a lot less since she's almost 3. I think just as a parent I'll be worrying up until the point she wakes up from the surgery or at least is at home and the anesthesia and everything has completely worn off and she's more comfortable with the new crowns. I'll try hard not to worry about it as much.

Thank you again for your input.

 

[uggaugga]

Got back from the dentist today. Now all we need to do is wait for the call to schedule the appointment after insurance approves it. It's not going to be until January/February that they can get her in. So like 2-4 months...This is so difficult because her back molar does bother her. Not sure what else can be done for her except give her Tylenol for the pain when she has it.

They only offer IV sedation there, but I have heard that this is safer than general anesthesia? Is it? Are there any drawbacks to it?

The dentist mentioned a risk of breakage from the front baby teeth. He mentioned that if they end up doing pulpectomies on those, they are usually so thin that there isn't much left and often times they start breaking after the crowns are put in place leading to another IV sedation appointment to pull the teeth so they may just recommend pulling them instead of even bothering with the crowns. Space maintainers were not mentioned, nor am I sure they even do those for front teeth, but if it's all the top front teeth I am worried about the permanent teeth coming in causing issues. I'm not liking what I'm hearing on that, but I am glad that he was honest about it. I'm thinking I may have them leave the front teeth alone and then if it absolutely bothers her that we will definitely make sure to bring her back and get it pulled. My oldest that has been seeing a different dentist mentioned they did a "wait and see" approach and her's are worse than my 2 year old's and they have been for a while, but the dentist would always mention, "We will keep an eye on them and do what we can because it won't be too long before they fall out. If they cause pain and problems, then we will address it." My 5 year olds front teeth have generally been pretty worn down, but she has already lost 3 baby teeth and two more are wiggly so the decayed ones are almost all gone and the permanents have been looking good so far and coming in well. I don't know, it's a huge decision to make and I'll see what my husband thinks, too.