Help, What Do I Do Now?

My son used nitrous at age 7 for a filling. It went well although I hated every second of it. He is a much more motivated brusher now. Also, rinse is very important! It helps get to those areas in the back that kids don't reach very well. My kids are 5 and 7 and I still give there teeth a quick once over brush after they are done.

We have an autistic child, who was terrified of the dentist, but had to have caveites filled. That gas did the trick. He may not need a shot if they are shallow, but even if he does, it just has to be done, and he won't care so much with the gas going.

Sometimes you just have to do what you have to do, and for most of us, the worst case never comes into play.

M.

Just want to repeat a lot of what others have said:
1) Double check with the dentist about what sedation will be used.
2) If you aren't going to a pediatric dentist, consider getting a second opinion from them. My son really likes going to the dentist, partly because of all the cool kid-related stuff they have!
3) I had nitrous as a kid and although I remember disliking getting the numbing shots, it wasn't too bad an experience overall.
4) Getting kids to brush their teeth is no fun. My son likes his battery-powered toothbrush, but some nights we still fight about it. We have even had to hold him down to brush them ourselves. But now he knows it's really important and he can't get away without doing it.
5) Your son will take cues from your attitude, so once you are ready for the procedure, don't let on that it's something to be scared about or dread. My M. has a needle phobia and essentially pushed it on to me by getting so freaked out when I had to have shots. I outgrew it once I was old enough to go to the dr. and dentist on my own without her there creating nervous tension!

I just read a blurb in the April issue of Parents magazine about filling cavities with a laser. The article states that the laser is so precise that dentists rarely need to give anesthetic. They also say that they are increasingly available and covered by insurance like a normal drilling procedure. They gave a link... laserdentistry.com to find a dentist that uses it.

About the toothbrushing thing, I'm sure you've tried lots of things but here are two that could work... have you ever tried the colored mouthwashes that turn kids' teeth blue or green and they have to brush away the color? Maybe making a game out of it like that would be a good way to encourage good brushing. Also, kids love to be "timed" to complete tasks. So maybe set a timer for 1 or 2 minutes and if he brushes for the whole time he gets an extra story before bed, or something else he likes...

Good Luck!

You want to find a pediatric dentist not a general dentist. Pediatric dentists complete a 2 year residency beyond the 4 years of dental school. This gives them an advantage over a general dentist with respect to treating the little ones. They work in the hospital setting as well during their residency as that is where the heavy sedation cases are sent. You need to discuss your concerns with the pediatric dentist and the proposed plan of treatment. See 2 pediatric dentists if you need to. A second opinion is never a bad thing.

Anesthesia related deaths are very rare but do occur. It can occur because the child was given an over-dose, it can occur because the child can not tolerate anesthesia (just as some adults can't). Discussing your concerns with a qualified professional will make a huge difference.

I wanted to add there are also things the dentist can do to make the Novocain injection less painful like warming it in their hand before they give it and using a very small gauge needle. By using the smaller needle it may take a bit more time to give the shot but it's virtually pain free. The biggest thing is the kiddo has to sit still for it.

My 4 year old sons molars failed to sealed, and by the time we realized and took him in to the dentist he had cavities in all his back teeth, surface ones the same as your son. Since they are not deep they do not have to use a drill, which means they do not have to numb the area. With my son they used what was basically a sandblaster to erode the decay and then sealed. They did it in two appointments so he would not lose patience sitting still for so long (they did one side at a time). Not all dentist have the sandblaster tool for surface cavities, if yours does not try calling around for one who does and who will treat your son in 2 or 3 appointments without sedation.

I just wanted to add that they do not use the gas or sedation because of pain, it is to control the child. It is my opinion most children do not need to be controlled with chemicals for what is non-invasive care. My son is very active and high energy like most 4 year olds, but he did fine getting his teeth fixed with out chemicals to keep him calm. Some children may need to be sedated, but most do not, we just do not give them the chance to prove it.

I was in a terrible car accident as a child (before car seats!) and ended up needing a double root canal on my 2 front teeth because they had both been knocked out. I was 4 at the time, so it wasn't time for the front teeth to come out yet and they had to re-implant them. Anyhow, I remember being awake but they did use laughing gas on me (otherwise I'd have been traumatized for life, I'm sure!). Everything went fine. The dentist that I went to growing up was so fantastic; I think what you need to do is check references carefully, and ask the dentist about what kind of sedation they use, what the risks are, etc. A good dentist will take your concerns seriously and will answer your questions thoroughly.

But the bottom line is, if your son has cavities, you need to fix them before they become big, ugly cavities. He will be much less traumatized now when it doesn't require so much work to fix, than he will be if you wait.

Also, Sonicare now makes a kids' toothbrush. Going forward it might be a good idea to get one for him. It's so much easier to keep kids' teeth clean with a Sonicare than with a normal toothbrush. My kids use it, and on their most recent checkup, the cleaning only took about 10 minutes per kid. There was no tartar buildup on their teeth at all. As they say, an ounce of prevention is worth a pound of cure, right? =)

My girls both had a tiny cavity that had to be drilled and filled... they both had the laughing gas (which was HILARIOUS afterwards)... make sure you go to an ADA certified pediatric dentist, you can even interview them first like some parents do for pediatricians. Afterwards, you can google their names and practices to see if there's any dirt about them on the internet. You don't want your son developing the same fear you have of dentists and bad things happening at the dentist. Talk to your pediatrician to ease your fear... if you've heard of a child dying from sedation, that child more than likely had an allergy to the medication. This is something that HAS to be taken care of or he is going to have a lifelong battle with his oral hygiene, and you don't want that for him either. You're a great mother for being cautious, but dentists are professionals and you have to trust them to do their job and help your son. Good luck and best wishes!

My daughter had a extra tooth growing. No need to sedate your son. A little hit of some laughing gas will work just fine. They gave my daughter a strawberry smelling mask just gave her a touch. She was alert and awake the whole time but just took the edge off. The tooth removal went without any problems. A year later she is still not afraid of the dentist and actually looks forward to the visits for the stickers etc.

I worked in pediatric dentisry for YEARS and we NEVER sedated one child! We did all kinds of work from infants to teens and never felt the need to. Dentists today don't want to deal with any crying or fear so they like to work on a dead corpse, basically. It is also RAELLY profitable from ins company reimbursement. There are still a few who do not use sedation. It's your job to find them. We have one here in Pembroke Pines. He is old school. Maybe you can come down to south FL for a consultation. Everyone loves him!

my daughter had seven cavities she was five however a mature five. She used the nitrous gas and to this day has know idea that a needle to num was even used. the doctor is npb was very good with her. His name is Dr. Goldvasser if you are interested. good luck

In spite of my diligence about teeth cleaning, my daughter has had cavities since she was 4 or 5. She has had 5 of them and has had to have 3 appointments for fillings (they will only fill 2 at a time). She has never had to sedated to have it done. They use the nitrous and she has done fine with that. Never got loopy, just relaxed enough to let them do the procedure. The worst part is after, she couldn't feel her tongue or lips for a few hours and managed to bite her lip open. Nothing serious, though.

Good luck!

I have two kids myself and from the very start I brushed their teeth every night and morning,they cannot manage it themselves all the areas, the have regular check up at the dentist every 6 months. so I let them start brushing their teeth and then I go and do the rest to make sure it is done right, they both have the tooth paste they like plus floss which they still use everyday as it has been a regular thing all their life they are teenagers and do it on their own but they know to ask me for mouth wash "orail B" as listerine antiseptic is to strong and has alcohol to dry out the mouth.
My kids do not have any cavities. you do have a change to help your son he is only four and his adult teeth will some in at the age of around 6.

Updated

Only water after brushing teeth before bed.

From your post it's obvious that you ARE going to get this taken care of, so I don't know why everyone keeps saying 'you MUST..."

Also, don't prejudge how your son will react. My son, at 5 (he's 7 now) had to have a NON-loose front tooth pulled because he had an abscess on his gum from earlier trauma (most likely a fall at 2). I was SICK over it and could not imagine how this could even be done....my husband ended up taking him to the appointment and said he acted like a real champ. This was my normal dentist, not a pediatric dentist. She hid the needle, told him she was going to "put his tooth to sleep" and then proceeded to YANK it out. My husband said his little head was even coming up off of the chair. But you know what? I was definitely more traumatized about it than he was. he was fine. He had always had good previous experiences at the dentist so he trusted her and wasn't afraid.
Whatever method you find & use, don't pre-judge how he will do. He'll pick up on your anxiety for sure.

I personally wouldn't let a regular doctor ,give my child any gas or else unless, he is trained in Anesthesiology.
I did hear about the boy who died, maybe rare but real.
So I would research a trained Dentist...
Good luck

Are these his "baby" teeth?
Perhaps a pediatric dentist can help you.
I live in SE FL and can refer my Boca dentist, Marisol Ruiz. All female staff, all MOMS, ###-###-####; and dedicated to the patients. My kids love going to the dentist. Go figure.

Did you speak to your dentist about sedation vs giggle juice (that is what my girls' dentist calls nitrous)? Also, did you ask if any of that would be needed? Both of my daughters have had surface cavities taken care of without any numbing at all. When my girls have needed deeper cavities filled we opted for just regular numbing. Neither one of them freaked out or even cried. they chose a flavor for topical numbing, then had the shot. Quick and easy. Their dentist is all about the kids. They give them sunglasses to wear and have monitors mounted over each chair with headphones so the kids can watch movies while they get work/cleanings done. He explains everything to them so they know what will happen doesn't start until they are calm and ready. My kids have never been afraid. Look around for a good pediatric dentist. Visit the office. Get referrals. There is no need for the dentist to be anything but fun for them. I know it is hard, but just walk your son back to the treatment area then cheerfully leave. 'Have fun! I'll be waiting in the waiting area!' Sometimes having M. there looking worried (or even just feeling worried) makes it worse. If you have chosen a good children's dentist, he/she will know how to handle your son's fears.

Now, back to the actual problem. You say he hates to brush so now he has cavities. Kids rarely like to brush, or pick up their toys, or do homework, or whatever. He needs to know there is no choice. There should be no arguing, whining, fighting about it. At four he is perfectly capable of doing what he is told. If he argues about it, there needs to be a consequence for that. For teeth related issues, I would cut out all desserts/sweets for the day if he doesn't brush without complaint. If he keeps complaining he loses sweets for another day.(sweets being not just candy, but anything even slightly resembling dessert, sweetened cereal, jam, chocolate milk, juice, make it really strict to make your point). If he can't take care of his teeth then he can't eat things that will damage them. A day or two without anything sweet will make him re-think his opposition to a simple toothbrush.
At four, he should brush his own teeth then have you go over them to get the places he will miss. Use the pink tablets that show him where he is missing, so he will learn, but you will still need to help at least once a day for the next couple of years to make sure they are really getting clean.

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Both my sons have had cavities filled and one has had a cap put on. The one with the cap is 5 and just had it done. We have used the nitrous for this both times. It's a really light dose of it (just no eating 2 hours before for us). They weren't wobbly or anything else. It really just relaxed them and made them not so anxious. It was personally not an issue for us. I knew they had to get their teeth filled and I would rather use the nitrous instead of them freaking out over a needle and being afraid of the dentist from now on. We also use a pedi dentist that is awesome. I would try the nitrous first and see how he does. If some of the cavities are just surface ones, can they do it without numbing him ? My oldest just had one like that. Quick in and out.

I haven't heard of any child dying of sedation. Have you talked to your dentist about options? Also get the real statistics on the dangers. Maybe your dentist can make you feel better and more confident. Good luck!

I didn't hear the sedation story either. My daughter is 3 1/2 and just had 2 cavaties filled. She had the laughing gas sedation.

Talk to your or a pediatric dentist. The cavaties MUST be taken care of. Keep in mind tho that they may not let you be in the room when the cavaties are being filled. I tried to take a stand on that and they said they wouldn't do the procedure with me in the room becuase the kid will watch me for reaction and its harder.

M.