My 4 Yr Old 'S Visit with the Pediatric Dentist

Updated on April 18, 2011
S.K. asks from Rancho Palos Verdes, CA
23 answers

So, we've been going to this dentist since she was 18 months, once a year. The first 2 visits were fine, no cleaning. The dentist just looked and 'counted' her teeth. The 3rd visit, she was great and we got her teeth cleaned; no x-ray. The dentist showed me a few teeth to 'watch' and clean carefully. The 4th visit, the most recent one, we started out with the hygienist asking my daughter if they can take pictures of her teeth. I replied only if the dentist thinks it's necessary. She gave me a cold look and said, "it's routine, we take x-rays every 6 months". I replied, "x-rays ONLY if the dentist deems necessary". Does anyone else thinks every 6 months is excessive? My own dentist does it every 18 mos to 2 yrs. So we skipped the x-ray and went to the cleaning station. Cleaning was over, dentist comes in to examine the teeth. She said her tool sticks to the tooth in 3 or 4 places, so they need x-ray to see if it'S. cavity and how deep it is. We got the x-rays and the dentist examines them. She can't see anything with the naked eye, so she brings out her loup (a 10 times magnification magnifying glass). After several minutes, she said yes she saw 4 cavities and they need to be fixed soon. So I asked her to show me on the x-rays where these cavities are and she said well you can't see them with the naked eye. Then she concentrated for a while, with and without the loup and finally point to a spot on the x-ray and say "there it is, I can see it with the naked eye". For the life of me I couldn't see any of them. Anyways, she tells me, they'll need to put her out to fix the cavities because my daughter is hyperactive and will not sit still for that long.
She gave me a brochure from the anesthesiologist to read and think about the procedure. So, I got home feeling bummed about all these cavities and having to put her under to fix the cavities. Then, I looked at the anesthesiologist's brochure and his rate is $495/hr and we're going to need 2 hrs of his time! I almost had a heart attack! Then I called my husband and we found out our insurance doesn't cover the anesthesiologist. My issues are: I don't want to put her to sleep to fix cavities, it just seems so extreme; $495/hr, really?!?! ; is it really an immediate problem if you can't even see it with the naked eye? I looked at her teeth, I couldn't see a thing. What would you ladies do? Do you think I need a second opinion? My husband has taken my 6 yr old in for her regular cleaning and exam and he thinks she'S. good dentist, just not the warmest personality around. His coworker's daughter goes to the same dentist. She is of the same opinion regarding the dentist.
Sorry for the long post.

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So What Happened?

Thank you all for your responses. I've talked to my dentist. He also works on kids and we are bringing her in. He is willing to work with us on various options including going in multiple times to get all the teeth fixed as necessary. I talked it over with my husband and we both agree we are not willing to put her to sleep to fix the cavities. My biggest issue with the pediatric dentist is her unwillingness to work with us to comprise on a course of treatment. Her approach is to do what is easiest and most convenient to her. She'S. capable dentist but her philosophy does not align with ours. Thank you all again for your input, you've given me the courage to question 'the authority'. And I checked with our insurance, they only pay for one x-ray per year. I started questioning the routine x-ray due to our pediatrician last year saying when you take your daughter in, don't do x-rays because it's routine only when necessary. There has been a slew of articles in the news in the past year that the average american gets way too much exposure to radiation through xrays and other medical devices. So, I'm just doing my part to reduce their cumulative exposure to radiation, esp. at this young age.

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answers from Norfolk on

I would also have a talk with her pediatrician. When you introduce sedation, this becomes a more complex medical issue her primary care physician should at least be aware of.

3 moms found this helpful


answers from Los Angeles on

My kids never went to a ped. dentist. i do not to xrays automatically either. i'd wait 6 mos and go to the normal dentist. if you can not see the cavities I think you can wait.

1 mom found this helpful

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answers from Raleigh on

I would TOTALLY get a second opinion. I was told almost 4 years ago that I had 4 cavities "in the making" and that I would need for them to be filled. I found that hard to believe (as I have never had a cavity in my life) and got a second opinion. That doctor took one look at my x-rays and said, "I have no idea what that dentist saw, but he is a liar." 4 years later and I still have never had a cavity, so obviously they weren't there to begin with.

I would get a second opinion and if that dentist says no way, then I would report your current one to the Better Business Bureau. I did that with my crummy one and the Attorney General's Office ended up sending us a check for money we spent there because they were under investigation. Good luck!

8 moms found this helpful


answers from Pocatello on

I would get a second opinion! Although it is better to fill cavities when they are small... she should have been able to at least point to the teeth which have the cavities. What I really don't understand is why you'll need an anesthesiologist? especially if these cavities are SO small! novacaine should be enough. Maybe some "laughing gas" (nitrous oxide) at the most. Anytime you are putting a child "under" it is a big deal... and the younger they are, the bigger of a deal it is! There really should be a bigger reason than a few microscopic cavities. She may be an awesome dentist... but all of this seems like it is overboard to me, and maybe a different dentist would be a better long term "fit" for your daughter.


4 moms found this helpful


answers from Anchorage on

I would get a second opinion honestly. If they are that hard to see they are probably only surface decay which means no drilling. My sons teeth failed to seal all the way and so at his 4 year check he had 4 captivities as well, one in each of his back molars. They used a type of sand blasting tool to clear the decay with no need for pain meds or numbing because there was no pain. They said if he could not sit still they would simply stop and set up another appointment to do the other side, but he surprised me and they were able to clear all 4 decay spots and seal all his molars in one appointment with no sedation.

4 moms found this helpful


answers from Fayetteville on

I had a dentist about five years ago quoting me somewhere around $8000 for all the work I "needed" done. According to him, every single one of my teeth was about to rot out of my head. I couldn't afford the work so I didn't go back. Two years ago I had a new dentist in a new town - he was basically happy with my teeth with just a couple cavities needing to be filled. No 3 root canals like the last guy was talking about. Just an example of how one doc may be wrong. (My teeth are fine with those couple fillings, btw).

I think the biggest issue is that it doesn't sound like you are comfortable with your daughters dentist. My son and I go to the same dentist and I LOVE them. They are kind and honest and patient and explain everything they are doing. I've seen them for the last couple years and at this point feel so comfortable trusting their word that I wouldn't question if they said we needed something done - they're that good.
Whether you get a second opinion or not, I'd suggest maybe looking for a new dentist if you don't truly feel comfortable with this one.

3 moms found this helpful


answers from Boca Raton on

I would ABSOLUTELY get a 2nd opinion before I would subject my child's growing brain to sedation. But that's just me.

I also don't like the sound of how they handled that situation.

I take my kids to my dentist whom I find much more competent, friendly and effective than one of the "best" pediatric dentists in our town (whom I thought was an egotistical jerk with an extremely rude staff).

2 moms found this helpful


answers from Reno on

Getting a second opinion is never a bad idea. Most insurances will only pay for xrays every 12 months and panoramic every 2-3 years. Two of my kids had to be put out for dental work, but it was major work - root canals and caps on a couple teeth and fillings on a couple others. Well worth it for major things, but my hyper son was fine with just fillings.
It seems to me that if the cavities are that miniscule at 4 years old, that your daughter might actually lose these teeth before she actually needs the fillings or they becomes any type of an issue. I would definitely get a second opinion if you decide to go forward with the work.
Good luck!

1 mom found this helpful


answers from Los Angeles on

I say get a second opinion!
Same happened to me with a "Pediatric Dentist". They cleaned my sons teeth, took x-ray and then told me he had a cavity between two of his molars. The cost to fix was going to be about $700. I asked why so expensive and they said because they are considered a "specialist" so insurance doesn't cover it.
I ended up taking my son to a "regular" dentist and they took x-rays of the same spot, did a manual test of the area and said "I don't see a cavity". I was floored! I even said "Are you sure?" and the dentist said "we will keep an eye on the area but I don't see anything at this point". I nearly hugged the man!
Needless to say I will NEVER go back to that first dentist.

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answers from Santa Barbara on

My daughter has been vistiting the dentist twice per year since she was before two and x-rays are once per year (common practice). My daughter had her four impacted wisdom teeth extracted on Feb. 1st by an oral surgeon and I'm looking at the bill - 60% was covered by Delta including anesthesia. General anesthsia fees were $422 for the first 30 minutes, $196 for an additional 15 minutes. There is no way four cavities would take two hours. You could get a second opinion and maybe this can be treated as a "wait and see". I feel comfortable with x-rays once per year, especially since it is covered by insurance.

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answers from San Diego on

Hi there, I'll try to be quick. I have 2 kids daughter 8 (never had a cavity wearing orthodontics now) son, almost 6 (has had 4 cavities and lost his front tooth from a fall at age 3) Prior to his fall off the couch where he didn't get his hands out in front of himself fast enough, he had only had flouride brushed on his teeth at the dentist every 6 months starting at age 2. They just brushed that on and did a quick visual once over on his teeth. They had to do xrays because when he fell all 4 front teeth had trama, only one came out and over time the others were all fine. All of this gave him a very negative feeling toward the dentist. Shortly after all of this he had his first real cleaning at age 4 and they found a cavities between the back 2 teeth on both sides of his mouth on bottom. My dentist says I have weak enamel. My mother does too and from the looks of it my son is following after me. We do a flouride rinse daily, floss, we still brush his teeth for him 2 to 3 times a day. Because he was so afraid of the dentist office in general they decided to used Versed (the amount was based on his weight which they took before giving him the dose. It made him calm and tired. Then they used a little laughing gas and novacain during the procedure. The Versed makes them kind of hazy about the events and he has no memory of the entire process. He remembers going and getting a toy from the prize box (while we waited fo medication to kick in) That's it, I did take him to my dentist to verify she thought it was necessary, she looked at him free of charge. I also talked to our ped and she said the medication should be fine for him. I didn't want him going through this again so we had his baby molars sealed even though they don't usually seal baby teeth. It's been 2 years now and no additional issues so the seals seem to be helping. Trust your instincts.

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answers from Las Vegas on

Second opinion, and don't be afraid to switch dentists. Then find out how often your insurance covers x-rays; many only cover them 1x year.


answers from Seattle on

I am not appalled that your daughter has cavities. I have 3 kids, 2 with teeth and my first son has NEVER had a cavity and has healthy strong teeth, my second son has had 4 cavities filled and he was 4 when it happened too. Sometimes kids have teeth with bigger "grooves" and get cavities easier. Totally not your fault.
Anyhoo...I didn't really understand why you didn't want the x-rays done. They put a huge "gown" cover over my boys and it just x-rays their teeth. Kids grow a ton, and my boys get them done every 6months. I would rather have them fill my kids teeth when it's a small cavity, which is what it sounds like your daughter's is, then when they are huge and painful. I am sure you know that things can change rather quickly. Better to be cautious.
Second, when my son got his 4 cavities filled he didn't even need novacane. I am curious if your daughter was flinching and pulling away when the dentist was sticking her teeth? If she wasn't then she probably doesn't need to have novacane either! yeah! I have actually had two teeth filled in my life and never had any novacane since the cavities were so small. So, in YOUR your daughter hyperactive and will she not sit that long? We went in for two sessions....two cavities filled in each session....and it only took about 20 minutes. You could even bring in an Ipod or something that she could listen to or watch while it's being done.
If your insurance allows it then I would get a second can bring the x-rays you got done with you. I would also find a different dentist...I wonder if you could bring her to your dentist?
Good luck



answers from Los Angeles on

wow..that seems very extreme for a 4 year old! To be parents didn't take me to a dentist til i was 9 ! I'm 46 and got my first cavity at 40..
i haven't taken my 5 year old in yet..ugh! now i feel like i need to get on that..i think b/c my last dentist was a scam artist..she was so odd..i had my teeth whitened..they looked exactly the same when she was done they did before..i would definitely get a 2nd opinion..especially since they want to put your daughter under..that is a huge deal..even people w/ pets opt to go to dog clinics that don't put your animal under to clean their teeth b/c its dangerous..
if anyone gives u a hard time..tell them that...and say you're just not comfortable w/ a 4 year old being put under for cavities on teeth that she is going to lose soon anyway..and that you have a bad feeling about the dentist..Lots of people like our pediatrician that we got rid of..they just weren't there when he had a weirdo nervous breakdown in front of my son and i...just b/c they like him..doesn't mean i know?? go w/ your a 2nd opinion..that's a lot of money ..maybe get a better dental plan and wait..then have her teeth fixed when she's 5..




answers from Los Angeles on

I'm all for second opinions if need be. That's why I highly recommend visiting Dr. William Domb of Upland.'s a little far from us, but it is definitely worth the journey to see this phenomenally, stellar, holistic dentist whom Dylan adores! He grants so much love to children and is so spirit of play and always on the cutting edge of new holistic technology. In fact, Dylan recently got his first cavity a few months ago, and Dr. Domb was able to handle it naturally with no drilling at all. We so love Dr. Domb! : )

Here's his contact data:

190 North Mountain Avenue
Upland, California 91786
1-###-###-#### / 1-888-809-0150

Another stellar dentist who comes highly recommended is Dr. Hila Robbins. : )

Here's her contact data:

10231 Santa Monica Blvd., Suite. B
Los Angeles, CA 90067

Feel free to call me if you have any questions. You can always reach me at: (323) 906~2784.

With lots of love,
L. and adventurously spirited and imaginatively creative, 3 year old, Dylan Orion. : )



answers from Los Angeles on

It's true that some cavities, ones on the biting surfaces, are not as visible on the radiographs/xrays. And the rate for the anesthesiologist are pretty standard. However, it things actually happened as you described, I would definitely get a second opinion. Call a nearby dental association or dental school for referral would be the way to go. Good luck!!


answers from Los Angeles on

Get a second opinion!



answers from Washington DC on

I have mixed feelings about this post. First, I think x-rays ar a good thing, so I am not sure why you would balk at getting this first set done. It gives a lot of info about the teeth, theri health, and the adult teeth coming in. However, I agree 6 months seems excessive. Our pediaatric dentist does them yearly which is about the same as my adult dentist. Kids mouths change more than our's, but 6 months does seem excessive.

Next, I completely disagree about the "gas" anesthesia for a child. Myself and my kids have only gotten novacaine and I see no reason to do otherwise unless your child has a lot of fear. And I basically believe parents convey that fear to their kids anyway. A good pediatirc dentist can do a great job keeoing anxiety low. Regardless of your opinion however, it shoudl be an option for parents and child, not a mandate.

Also, at my dentist there is no "anesthesiaolosit to my knowledge. The dentist provides the gas. For kids, they aren't doing oral surgery or anything.

As far at the "not with the naked eye" question - I have had a variety of dental work done. I believe your child probably has caveties. I find it hard to believe a dentist would lie about this. Cavities are about the quality of the enamal and soft spots and not just big gaping black holes. YOu can't necessarily see cavities. And yes, cavities get worse, and can cause bigger problems if untreated! That said, I am appalled that a 4 year old would have cavities at all!!!

So, long answer short, seek a second opinion if you don't trust this dentist. That will cost you too, but you shouldn't put your child in a situation you feel uncomfortable with. There are plenty of good dentists.



answers from Los Angeles on

I have NEVER had my children put to sleep for ANY dental procedure. Our old dentist used to give them a pill by mouth before they came in that would make them calmer and relaxed. No biggie. Our new dentist doesn't even do that. My littlest one had a root canal on a baby tooth too!
Get a 2nd opinion!
And, really, if you can't hardly see it, do you need to worry about it now? Maybe you can wait 6 months and see.



answers from Minneapolis on

When my daughter was 4 she had 2 cavities and I could see them on the xray and they didn't sedate her at all. It took 30 mins per tooth, had to do it in 2 sessions since one was on one side and the other was on the other side. I would seek out a 2nd opinion, I have done that for my son (special needs) because the dentist didn't want to sedate him for his dental work and would pin him down it was horrible - his teeth were so bad that the first time we saw the new dentist he had to have 5 hours worth of sedated work done on his teeth (they can work faster with sedation, he had to have cavities, 2 root canals, selants and a ton of work).



answers from Los Angeles on

My daughter is 5 and has been going to a pediatric dentist every 6 months since she was 3. They do take X-rays to see how the teeth are growing, and to see if there are any problem areas. Thankfully she has never had any cavities so I can't really respond to how they would look on an X-ray. But in response to if this is an immediate problem if you can't see it with the naked eye, it doesn't sound like it just suddenly happened this visit, if at your last visit a year ago the dentist gave you a couple teeth that you should 'watch' and clean carefully -- it sounds like there may have already been some signs of possible weakining or decay that she noticed at that time that she was hoping you could avoid dental work on if you were vigilant, so maybe over the course of the year those weak spots got worse?


answers from Los Angeles on

Just because other people tolerate her doesn't mean you have to. I'd look for another opinion if you are concerned. From your side of the story it almost sounds like punitive dental work. Like, you declined our ridiculously frequent Xrays therefore we shall insist on more expensive work, buahaha. Weird. If it were me, I'd look into another dentist. Changing is super easy with our insurance; probably is for yours, too.



answers from Los Angeles on

Definitely get a 2nd opinion if only to make yourself feel better. My niece had to be put out when she was 6 because she had to have crowns put on her molars...It cost a lot and she was pretty groggy when she woke up. But we only put her out because it was a major procedure. I wouldn't put my kid out for a cavity. My other niece had laughing gas when she had cavities filled and she was fine. If you really need to do this you can use local novocaine or the laughing gas. You just have to convince your daughter that she has to stay still. Good luck!

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