Mo goes to the dentist (and mom has some questions).

I'll have to come back to this -- E.G.'s sick and needs attention (yeah, sozlet inherited the dramatic illness thing from him). But why is gas involved? That's unusual for kids his age I think.

Unfortunately, the cavity thing needs to be jumped on. How long he'd have the teeth in question depends a lot on the teeth of course. But if you remember sozlet's saga from when she was a toddler, she started with just one cavity (that I saw) and by the time everything was finally taken care of she had 7. I saw two others develop as I scrambled to get things lined up. (Quack dentist said the thing I saw originally wasn't a cavity, then needed a referral, then... etc., etc., took a long time... but not THAT long. It was a matter of months.)

Baby teeth are really important has placeholders for the adult teeth and also there are issues with bone loss, etc... Even though they're "just" baby teeth they really need to be attended to, unfortunately. (We had insurance but paid way extra to get composite -- the white kind -- of filling, which insurance wouldn't cover. So we paid a pretty penny. Sozlet's teeth have been in good shape since, knock on wood.)

Just from the hip, Boom, but shop around a bit for a Dentist who specializes in kids who's folks dont have insurance.

I have a girlfriend in the dental biz, and have no insurance myself. A lot of what you described sounded unnecessary to me as well.

No gas unless REALLY needed for kids, been there, done that...

I would get a second opinion on everything they want to do. Ask around the neighborhood for a dentist other parents are happy with. Do you have a dental school within driving distance? They can offer the best prices and tend to be very careful about recommending procedures.

I would not do anything on the baby teeth unless they bother him. Those teeth will one day all be gone. (altough Sozobe knows more than me on this).

I have heard a fluoride coating is a good cavity prevention method. Personally, I think ingesting fluoride is not such a good idea, I'm glad it's not in my water. You can find out more about the pro and con of fluoride on the web.

Not a big fan of knock out gas for kids or adults. I had it a twice as a child. The first time I remember having a headache for a few of hours afterwards, the second time I vomited so much my mother took me to the hospital where she was told something like the doctor had it on too high. No more for me. I've had very few teeth problems, but when I did need a pain killer I had novacaine . A good dentist can administer it with little discomfort.

(edited because I was multi-tasking when I wrote it and it really showed)

Urrrgh.



I've never in my life had dental insurance. Good for those who do.


I had a lot of cavities as a child/teen. Got one fluoride treatment in my early twenties and the cavities stopped point blank. Maybe one more, nothin' after.


Fluoride treatments didn't exist in my teens or younger. With my first cavities, it was the drill and that was it. Later, there was some water spurting from the drill, as I rode up the chair, and sometime later, shots of novocaine numbing while they went for the gold.

Research, of course.

We started taking our kids to the dentist at the age of three. He checked their teeth, offered advice and gave them a fluoride treatment. I can't remember exactly what age they were when the teeth cleanings started. Neither has ever had a cavity. They're both in their 20s now.

We've been fortunate and have always had a dental plan. It certainly makes it easier, I know. The $200 cost, Boomer, seems to be in the ball park for the cleaning, exam and x-rays. Without a dental plan, I might have balked at paying that twice a year, don't know, but from we sit now, in retrospect, it would have been worth it.

Wondering about the small cavities needing to be filled if the teeth will soon be falling out. Did you discuss that with him? Understanding that the baby teeth are markers for the permanent teeth, but wondering anyway ...

I don't understand about the gas. Why would they use gas? Modern dentistry is virtually painless these days. I can attest to that, as one who was formerly terrified of visits to the dentist.

I grew up without any gas or anesthesia. And was fine...not that I wasn't scared, but then again, one is scared even when there's anesthesia ahead. I was always fine. Cavities filling does not hurt so much as to warranty gas, not even in kids. I know... I was one.

I had LOTS of cavities when I was a kid. That was pre-fluoride, and also pre-Novocain as I remember, and what they had then didn't help a whole lot. Now my molars are more dental amalgam than actual tooth. My ex-girlfriend's kids all had fluoride treatments and the sealants and they had NO cavities. Do the stuff if you can afford it--you may not see the difference now, but thirty or forty years from now your kids will bless you for it. Tufts dental school does good work much cheaper than regular dentists, if you're near the Boston area, and dental schools tend to be state-of-the-art, and that means painless.

What kind of gas are we talking about? Anesthetic or nitrous oxide (laughing gas)? Nitrous gives you a buzz so you don't care about pain, but it doesn't knock you out.

Children here get local anesthesia - either with "teeth jam" (surface anesthesia), or "teeth sleeping water" (infiltration anesthesia) but not with 'gas'.
(Besides that: if gas is used - rarely with adults - that is done by anesthesits.)

Does your "gut feeling" tell you that Mo's dentist has one eye on his bottom line?

I'm not up on the latest about sealants and fluoride, but I strongly recommend getting the baby teeth filled.

Gas? Gas seems unnecessary for small cavities--unless the dentist is either unskilled or lazy or the patient is difficult.




I have no personal experience with pediatric dentistry. Perhaps pediatric dentists like kids--or perhaps they have special techniques.

Other point I meant to make re: composite is that even though we had insurance for the basic stuff, everything was expensive, as in the prices you mention sound realistic.

Might be worth it to get a second opinion anyway though, especially re: gas.

I recommend the sealant -- sozlet's had that done twice (once on the molars she had at the time, and then again when new molars came in). It's quick and not a big deal. Main thing is just having to keep your mouth open for a certain amount of time (they have things that keep it open). Impossible to know if it was necessary of course, lacking an alternate-universe crystal ball (would she have gotten cavities in her molars if she didn't have the sealant?), but cost-benefit-wise it seems good.

By the way, re: fluoride in water, if you buy any bottled water anyway, you can buy a kind with fluoride in it. That's what I give to sozlet for all of her lunches, etc.

One thing just as important as the financial and dentistry aspect of Mo's first visit to a dentist is Mo's comfort factor and the dentist's ability to read and inspire a high level of comfort in a kid.

That first visit to the dentist is a very important one. It will set the precedent for Mo going to the dentist for the rest of his life. In fact, regardless of his need to have the cavity filled, the first visit should be all about the exam, looking at all the tools and equipment that will be used, learning about x-rays and letting the dentist do a visual exam of his mouth and learning how to properly brush his teeth.

Then, schedule a second appointment for the dental work. Done right, Mo will be comfortable with dentists for the rest of his life. Scare him and give him some pain on that first visit and you'll need to put him in chains and drag him back.

The suggestion to take him to a recommended dentist that specializes in kids and their first visits is a good one.

I definitely, definitely recommend a pediatric dentist.

We searched out a pediatric dentist specifically because of K's anxiety issues. She had one small cavity in a baby tooth and he used just enough gas to zone her out (didn't put her under) and then used novacain (sp?) for the filling.

It was worth the extra cost to go to someone who specializes in kids and was particularly comfortable with overly anxious kids.

On flouride --- we have well water and asked about fluoride drops when we moved here. He prescribed them only for a year or so and then said that fluoridated toothpaste and semi-annual fluoride treatments were sufficient (they were around Mo's age by then).

Boomer - you are in luck! I just wrote a series of public service articles on pediatric dentistry last year for a local parents' magazine! They are scheduled for reprinting next year.

These should answer most of your questions. I'll "X" out the names so no one can possibly interpret this as any sort of advertisement. I was given a 600-word limit, so these should be short enough for A2K.

BTW, SonofEva goes to a Pediatric Dentist. For the last ten years, this man has donated his services two days per week, providing free dental care to children of low-income families who cannot pay for dental services. Ask yourself: Why would he bother doing fillings and/or sealants for no money if they weren't really important?

________________________________________

Dental Health

"Yay! I get to go to the dentist!"

It was time to choose a dentist for my son.

I have an active, expressive little boy, and the prospect of trying to manage him in the clinical atmosphere of a dentist's office filled me with dread. He'd be all over the place! He'd disturb the other patients! He might even (shudder!) play with the instruments!

Then I learned there was a Pediatric Dentist nearby.

One foot inside the door and I could tell this would be a good experience. There were brightly colored play areas and toys, child-sized dental chairs, and an energetic staff that used kid-friendly language such as "taking pictures of your teeth" instead of x-rays. When my son winced at the bright light shining in his eyes, they gave him a pair of cool sunglasses. They even let him squirt water into his own mouth to rinse. When they were finished, they gave him a big red balloon and his choice of stickers. Best of all, the next time we needed to go, he was excited. "Yay! I'm going to the dentist!" he told everyone in sight.

Of course, there is more to choosing a dentist than finding a child-friendly environment. We choose specialists (pediatricians) to care for our children's medical needs. Shouldn't we also consider choosing specialists to treat their dental needs?

XXX XXXX, DDS, has practiced pediatric dentistry in the Tulsa area for 30 years. He administers the clinical licensure exams for graduating senior dental students throughout the United States. He's the expert, so I asked him.

I learned that Pediatric Dentists differ from general dentists in three important ways. First, Pediatric Dentists receive 2-3 years of additional training beyond dental school, normally at a university or teaching hospital. This training covers areas specific to children such as dental growth and development and care of dental trauma. "Adults don't usually get hit by baseballs or fall off their bikes," Dr. XXXXXX laughs. "We're used to dealing with dental emergencies." Pediatric Dentists have staff privileges at local hospitals and are often called when dental trauma occurs.

Second, Pediatric Dentists have special training in sedation and anesthesia. "Sometimes a child is only 1 or 2 years old - old enough to have decay, but too young to sit quietly in the chair. So they require special care," Dr. XXXXXX explains. "And then there are children who need a lot of work done. In one visit, under light sedation in the office or under general anesthesia at an out-patient surgery facility, all of the child's dental treatment can be completed safely and without emotional trauma to the child."

Third, Pediatric Dentists are specifically trained to deal with patients who have medical conditions that complicate dental treatment, such as heart problems. They also see children and adults with special needs including developmental disabilities. These patients often require sedation or general anesthesia for dental work.

Not every dentist who works with children is a Pediatric Dentist. Ask your dentist if you're not sure. While acknowledging that most children see general dentists, Dr. XXXXXX says if there are special problems they should definitely see a specialist. "Personally, I believe all children should see a Pediatric Dentist, but more importantly, all children should see a dentist!" he says.

Sounds like good advice to me.

I think that out of the about 70 dentists in our small rural county, at least a third might be specialists (with diploma) in Pediatric Dentistry.

You'll ertainly have a better choice in larger cities.

(Dentists specialise here similar to physicians.)

Bm. I have to go to work but have things to contribute.

They specialize here, too, Walter. But a lot of the people advertising themselves as "pediatric dentists" here are actually not. It's a marketing ploy. (I couldn't be that blunt in the article.)

On a personal note, I am really glad that we chose someone well-qualified to treat SonofEva. When he was small, his teeth appeared to be very normal, and I wondered if his dentist wasn't a bit overqualified. But as he has grown, it has become apparent that he is missing two permanent teeth in the front portion of his mouth where gaps are most noticeable. They just aren't there....who knows why. He also has another permanent tooth in the front that is half the size it should be. His treatment plan is complicated. Fortunately for us, he is being treated by the same Pediatric Dentist who has seen him through the years and knows his dental habits and growth patterns, so he can accurately project what he will need at each stage. It's a good thing we picked someone so qualified after all!

The problem is that cavities just keep getting worse, and that the fact of any cavities means that other teeth are much more susceptible to getting them. If cavities get bad enough, the tooth needs to be pulled. And a pulled baby tooth causes problems. In addition to what I already mentioned about placeholders and bone loss there can be problems with speech and with chewing/ eating.

And baby teeth start falling out at age 6 or so but don't finish falling out (and being replaced by adult teeth) until 12 or 13.

(Sorry I'm scattershot on this thread, have been busy throughout!) (Hubby's better though.)

(Dental Health, Article 2)

"Let's count your teeth!"

As a first-time mother at age 40, I wanted to do everything right. So as soon as those first darling little baby teeth began to come in, I started asking people when I should take my son to the dentist. Various books I read suggested ages two through four, or even waiting until he started school. Friends told me I should wait until he was at least three. The pediatrician's office said, "Oh, anytime you like!" There didn't seem to be any clear cut guidelines out there.

Today, the American Academy of Pediatric Dentistry recommends that all children visit the dentist as soon as their teeth come in - preferably by their first birthday.

"Isn't that awfully young?" you may ask. Not at all! According to Dentovative Service Foundation, it is important for the dentist to assess your family's dental history early to identify potential problems before they occur. Growth and development problems often run in families.

A family's dental habits also affect the child's brand new teeth. It is vital to educate parents about diet and hygiene and how important they are to a child's future dental health. Most dental disease is preventable with good hygiene practices and a healthy diet.

"But…one year old?!" you say. "Why, they're barely walking!" True, but decay often causes serious problems for infants and toddlers. It is not at all uncommon for dentists to see multiple cavities in one- and two-year-olds. By all means, don't wait until your child is in pain! At that point, they are much more difficult to treat. It's so much better to have a pleasant, pain-free first visit and learn how to avoid such unpleasantness in the future.

So, now that you know WHEN to go, what should you expect on the first visit?

I talked with XXX XXXXX, a Pediatric Dentist who practices in Broken Arrow. "We try to have fun, particularly the first time. We want the kids to feel warm and invited. With very small children, we have them lie down on Mom's lap and lean their head back into the dentist's lap while we take a good look in their mouth. It's more comfortable for them that way," he says.

Most Pediatric Dentists' offices avoid using formal language. "We tell them we're just going to count their teeth," Dr. XXXXX says. "We don't normally do a full cleaning the first time they come in. We show the parents how to brush and floss their child's teeth for them, and we talk about diet and hygiene."

If your child is a little older, it might be a good idea to bring him or her in for a walk-through first so they can get a good look at everything and ask questions. My son and I did this, and most dentists welcome such requests. "Children are usually impressed by bright colors, fun objects, and the open environment" that is typical of many Pediatric Dentists' offices, Dr. XXXXX explains. "They like watching other kids interacting with the dentist and staff."

The parents' attitude is tremendously important, according to Dr. XXXXX. "If you are a frightened dental patient yourself, try not to convey that to your child. We want your child to think of their dentist as a friend."

A child's first visit to the dentist can set the stage for their future relationship with dental professionals and begin good habits that will last a lifetime. So it's very important to make it a good visit. Don't put it off!

Dentovative Service Foundation is a 501(c)(3) non-profit organization dedicated to promoting dental wellness in children. Call Dentovative at (918) XXX-XXXX for more information or to receive a list of qualified Pediatric Dentists in the Tulsa metro area.

Recommended Books

Does A Hippo Say AHH? - Fred Ehrlich, MD
Does A Tiger Open Wide? - Fred Ehrlich, MD
Does A Lion Brush? - Fred Ehrlich, MD
Dora, Show Me Your Smile - Christine Ricci
Harry And The Dinosaurs say "Raahh!" - Ian Whybrow
What to Expect When You Go To The Dentist - Heidi Murkoff
My Dentist, My Friend - P. K. Hallinan
Caillou, A Visit To The Dentist - Johanne Mercier
Barney Goes To The Dentist - Linda Cress Dowdy
Going To The Dentist - published by Usborne Books
Danny Goes To The Dentist - published by McGraw-Hill
Berenstain Bears Visit the Dentist - Stan & Jan Berenstain