I’ve been trying to learn as much as I can about what to do about my daughter’s teeth. She is only five, but her teeth are a mess. She has four teeth on top that need to be fixed. She has small but deep cavities in the first molar on each side, and has lost a little less than half of her tooth structure in each of the second molars. She says that one of her teeth hurts when she chews, but I can’t pinpoint exactly which one. It is hard to tell if any of her other teeth are affected, as she will not let me get a good look in her mouth.
I am writing because I want to really understand all the options before I take her to another dentist. Do you think I should try a pediatric dentist? She has refused to open her mouth for our regular dentist or any of his assistants, and they suggested I try someone who specializes in pediatrics. I’m also trying to figure out if she has to get the badly decayed teeth pulled, or if there is another option. Should I request white fillings, porcelain onlays, or porcelain inlays?
And finally, do you think she will have to be sedated to get this done? Our regular dentist suggested this might be necessary, but that seems so extreme.
Thank you for your advice,
Adrienne in Tulsa
Dear Adrienne,
Let me address your specific questions first. Yes, you should seek a pediatric dentist who is qualified to do sedation dentistry. Delaying treatment will only make the problems worse.
Though she only has baby teeth in her mouth right now, it is best for her to keep those teeth in place until her adult teeth begin to come in. Not only does she need them to eat, they help maintain the spacing for her adult teeth. If some teeth must be pulled, she will have to have a space maintainer or her permanent molars will ultimately push forward and seriously disrupt her spacing, with the likely end result of substantial orthodontic costs.
As for the type of treatment you should request, you shouldn’t. It is always best to chose a dentist you trust, and then trust them to chose the treatment. Without an examination and x-rays, I could not offer competent advice on your options. It is good that you are familiarizing yourself with the terminology and different kinds of treatment, as it will make it easier for you to understand when your dentist talks about treatment options. Dental care for young children is usually focused on short-term care. If part of a baby molar is missing, most dentists will place an inexpensive crown, often made of stainless steel. This is meant to be a temporary fix, to hold the spacing for the adult teeth when the baby teeth fall out.
Finally, I ask you to look carefully at your daughter’s eating habits. The kind of decay you are describing has been “fed” all day, every day, for quite some time. If you allow your daughter to eat many small amounts all day long, you will continue to see this pattern of decay throughout her childhood. Have scheduled times for meals and snacks, and make sure she is brushing after each and every time she eats.
Best of luck to you and your daughter.