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Baby Teeth
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ahzuri wrote in parenting101
So I noticed today that one of my daughters front teeth is chipped, I have no clue how long it has been chipped but I'm not surprised as we've been having MAJOR trouble with her front teeth since she was probably a year or so old. The backs of the front two top teeth are completely black, I know they need work but we can't afford it and I think we probably make too much for her to be on Medicaid though I am putting threw an app at the moment for her (or would be if it didn't just go down for maintenance) and we can't afford private insurance. I've been brushing her teeth as much as she will let me but she usually ends up fighting me (like if I wanted to actually brush her teeth I'd have to hold her down and I don't want to do that it will just make it worse in the long run) though shes become more open to brushing her teeth here recently its still not really helping much.

We have taken her to a dentist and he wants to do things to her teeth.I can't remember exactly what, something along the lines of scraping out the bad parts and capping them while she is still awake but on a mix of iv and laughing gas.It however was going to cost almost 1000.00 which is something we tried to scrape together but we just weren't able to. I honestly have no clue what to do, I've asked the local county dental place and they don't do work on 3 year olds. I know this REALLY needs to be taken care of before it screws up her permanent teeth and I can't afford it I feel terrible. Her dad has terrible teeth and I don't want her to end up with those because they cause him a lot of pain but I'm stumped! Anyone got any ideas? We are currently located in Indiana if that helps. I'm looking at college dental programs atm but I don't know that they will work on her with her being so young :/

you really need to hold her down and brush her teeth and floss her teeth nightly. You realize this is why she has cavities in the first place right? It will not make anything worse in the long run. I dont know any kids traumatized by their parents brushing their teeth. Soon enough she will be cooperative, but until then its just something you need to do to prevent further problems.

The cavity pattern you have described is usually caused from nursing or drinking milk or juice in a bottle at bed and nap time.

The teeth are chipping off because the cavities are so large that they are weakening the tooth, causing them to just crumble away.

The doctor wants to crown the teeth because so much of the tooth has cavity. It is a standard procedure for children who have front teeth decay. Also the method you described is called "sedation", but be aware that this doesn't always work for children and it can actually cause adverse affects and behavior. She may need a full general anesthesia to properly treat her cavities.

have you tried asking the dentist if he would take payments? explain your financial situation? Also, you could look into care credit! If she does ending up qualifying for medicare, the treatment and procedure will be covered.

Good luck, I know what a sticky situation this is, and I know you feel bad, but kids are pretty resilient and she might not be feeling any pain right now.

I know why its chipping I just didn't notice it till today, She defiantly was a night nurser, I'd wake up with her attached to me and not even know when or how she got there. I was pretty uncomfortable when he said he wanted to do sedation instead of putting her fully under she barely cooperated with them to get the x-rays of her teeth or letting him just look at/clean them. As far as I'm aware they don't do payments I'm pretty sure my husband said he spoke with them about that before we cancelled the appointment. We actually do have care credit but not enough to cover the cost of the procedure. I'm really hoping she does so I can get it fixed ASAP I really don't it to effect her adult teeth and I know if I let it go there's a good possibility it will.

I know I need to push her to brush but its hard to brush a kids teeth who are clamped together, we've tried before with my husband holding her still and me brushing but she wouldn't open up so I'd brush the front the best I could. She did end up with a Dora toothbrush and some Thomas the Train toothpaste after the dentist visit and that seems to have sparked her to let me brush her teeth (not that she didn't have characters all over her stuff before but apparently Dora is magical like that) so I'm hoping the trend holds so I can at least keep it from getting worse while we try to find a way to get it fixed.

I'm pretty sure she isn't in any pain, shes usually pretty vocal about that lol

Have you tried an electric toothbrush? Even the kids ones generally seem to say 6 and up but I bought them for my uncooperative toddlers and they LOVED them (also with characters on).

Also mine hate mint toothpaste, even the mild kids' ones, so I had to search high and low for a 'bubblegum' flavoured one (ewww).

RE the pain when my son had an abscess in one of his baby molars, he did not complain of ANY pain until the thing was huge and the tooth beyond fixing. I was astounded by this because I've had an abscess as an adult and it was incrdibly painful but his dentist said that the baby tooth nerves don't go as deep or something.

Edited at 2012-12-01 02:41 pm (UTC)

She likes my electronic toothbrush however shes kinda rough with it and the thing is expensive (even if I got it for free) so I'm trying to get the kids version on the 4th from work because we have an auction type thing and I work for a company that sells them to dentists.

I'm not even really sure what kind of toothpaste she has right now but she seems to like it, I don't know if its the flavor or the fact that Thomas the train is on it either way she let me brush her teeth again today and even asked to do it while still laying in bed!

I guess kids just really don't complain until its at ridiculous levels.

My daughter (3 1/2) will every once in a while fight me, but after laying her on the bed and prying her mouth open a couple of times and forcing the issue, she'll be good for several months before I have to "force" her again.

I bought one of the cheapy battery powered kids tooth brushes for like $5 and she'll use that by herself a couple of times a day. Then I just make sure she gets one GOOD brush in, that either I or Daddy helped with at bedtime.

haha.... I'm giggling at the image of you and D forcing open K's mouth in order to brush her teeth.

LOL I totally do the back of the jaw push thing, aka putting a bit in a horses mouth. I feel TERRIBLE every time, but geesh gotta brush your damn teeth.

While I agree that teeth brushing needs to become non-negotiable, it's not true that if you hold a screaming toddler down that eventually a switch just flips and then they're magically cooperative about it. My daughter had multiple diaper changes every single day the first three years of her life. She hated every single one of them. And yes, it is entirely possible to make it worse and then you end up with a kid that won't even go into the bathroom because that's where the toothbrushes are. Which makes potty training really fun, lemme tell you.

I don't know what to do about paying for it. =/ Can you get Care Credit? I had to do that even WITH my insurance. It's so expensive to get sedation for toddlers. I'm sorry. It really really blows that we don't have better dental coverage for it here.

This is what we did with my daughter:

1. Get toothbrushes with characters she likes. Get a lot. Offer her a choice in which one she wants. Be prepared for this to take a long time, but the more control she has over the process, the better. Yes, she is dithering to stall, but over time it will help.

2. Try different toothpastes. My daughter really likes this berry flavored one by JASON. She hates mint (so do I). Have her just put a teeny bit on her finger and suck it and see which one she likes the taste of. If she really hates all of them, do it sans toothpaste. The mechanical action of brushing the food off is more useful.

3. Get dolls, stuffed animals, puppets etc that have teeth showing. Brush their teeth. Have her brush their teeth. Have a puppet in one hand and a toothbrush in the other and pretend the puppet's flipping out and then you explain to the puppet about how food gets on your teeth and gets all yucky and you have to clean them.

4. Whatever point she flips out at, start there. Brush your teeth and talk about it, how clean they feel. Get her to hold a toothbrush. Get her to let you hold a toothbrush and touch her lips with it. Brush for as long as you can, even if it's just a few seconds. Try multiple times a day. This is going to be a project. Don't rush it. Praise her for every step.

5. Be aware that it's probably going to hurt for her to have her teeth brushed with that level of decay. Use a really really light touch and don't "scrub" back and forth, but just go in one direction, sort of like you're sweeping the brush across the tooth.

6. Pick which time works better for you to really commit like, an hour for working on this, morning or night or afternoon. Once she's got it down and is cooperative, it'll be easy to add multiple brushings a day.

If she ends up having to get teeth pulled, it's not the end of the world. Two of my 3-4 year old nephews have their top incisors out, and they speak fine, they eat fine, they don't even care. It takes a while to get used to, and you will feel like someone socked you in the gut everytime you look at it because you'll feel guilty, but it will be okay. I nearly cried every time I saw my daughter's two metal caps but now I don't even notice.

Ah ha yeah defiantly don't need potty training to be more of a challenge than it already is.

We have care credit but have used a lot of what we did have to get teeth pulled for my husband (way before her teeth issues) so not much left on it at the moment. If all else were to fail tax time is coming up and then we could afford to get her teeth fixed then. My daughter seems to have a thing for her Dora brush and Thomas the train toothpaste now. She actually let me brush most of her mouth tonight so I think that's a good step forward, she was even giggling as I did it. I will defiantly take the steps you've mentioned starting tomorrow so we can get her brushing her teeth. I have a chance to get a really nice electric kids toothbrush at work here soon and I know she is in love with mine but shes a bit rough and doesn't like when the back of the brush head touches her teeth (though really who does) so maybe that will be the key to getting her to brush since the heads on that one are backed with rubber.

I would feel pretty guilty (hell I already do) but I'd rather have them pulled if it got to the point where it was starting to effect the gums than to have them mess up her adult teeth. Thank you for all the helpful information :)

If you don't find a solution with a college program etc., try and ask the dentist for financing, i.e. making a payment plan over four or five months... if he's a good dentist, he should be willing to work with you for the sake of your daughter. Otherwise, get a second opinion. From the description I agree that something needs to be done, but only a dentist can tell if there is a cheaper alternative to the capping. Maybe the college dentists (I guess you mean dentist med school students working during training?) can - if they can't treat her - give a second opionion? It *would* be good to look at a child for their own trainig purpose after all (if you are willing to argue with them when they say they're not taking such young kids). Good luck!

roseredhoofbeat's advice is really good, but I just wanted to add something to the "While I agree that teeth brushing needs to become non-negotiable, it's not true that if you hold a screaming toddler down that eventually a switch just flips and then they're magically cooperative about it. "

It's definitely true that it helps no one to have a kid that is too traumatized to use the bathroom, but not having a magic switch doesn't mean that it will automatically never work. My son did not respond at alllllll to your #1-#4, we were so frustrated eventually, haha. Fortunately for us he came around despite being force-brushed once daily.

After a decay that was fixed under general anesthesia, we insisted on brushing with my son, and he had phases where he was good about it, then he fell and split his lip and afterwards did the flailing/screaming/refusing thing (mind you, after the split lip had healed, of course we were very careful and a bit more lenient when he was acutely injured). I remember that there were about two consecutive months where 90% of the mandatory evening brushings (we did handle the morning brush more leniently) took place in a stronghold on the floor to keep the angry toddler in check. Of course we kept explaining, reading books, buying different brushes and toothpastes etc., but after the cavity I was not going to let him go to sleep without having the teeth brushed (they were nearly extracted and it was a huge scare for us since he was just starting to speak). At some point it just got better, and now he only does his refusal dance once every week or so. I didn't really follow a fixed strategy, but just kept doing what I found necessary. While I insisted on the brushings and held him, I made sure not to hurt him while holding (just blocking his movements without clamping down on his body) and kept talking matter of factly about the need of removing the rests of the food between the teeth. I made sure *not* to be angry or otherwise upset, or to make it look like a punishment.

To add, my son was never afraid of the brushing, it was more of a battle of wills and he was angry to not have the last say (he was two when we started, and is now turning three). Even after crying and struggling during brushing, he would always willingly and cheerfully let me floss, so it was *only* the brushing act he didn't want me to do (and it had nothing to do with pain or new decay, we're going to dental checks once every four months and he's great and brave at the dentist, to my big surprise). My very gentle dentist did the same with his kids and said they came around eventually. So yeah, my veto is for brushing at all costs, unless you notice that your kid is seriously reacting negatively to it, i.e. developing fears or completely avoiding the bathroom for example. I must add that I brushed (and still brush) his teeth in other rooms sometimes, and not always in the bathroom - like on the bed, sofa or even in his room (i.e. when he refuses to come to the bathroom), because I thought the act of brushing must be feeling forced enough, I didn't want to insist on brushing at a certain place, too. I also wanted to show him that it doesn't matter where he brushes, just that he does it.

So yeah, find out what works for your kid, but know that it can or can not work out easily. It is the best way to work with her (roseredhoofbeat's #4 above), but I think this can be done parallely to a consistent brushing in the evening that you must not skip when she already has a damage. We did the fun and explanations in the morning, and would force him in the evening if thirty minutes of bargaining and fun would not make him cooperate (mind, I spent months with that, sitting in the bathroom with him for 30 minutes and trying to coerce him into it, and sometimes it worked and sometimes it didn't, it's definitely worth the time when you get a willingly opened mouth once out of three times! And yes, neverending praise on that day then. But the times it worked got more frequent, and the time got shorter.) When he absolutely refused to open his teeth, I told him that we would not leave for book and cuddles in bed before the teeth were brushed properly, and that I could very well wait. I actually sat in the bathroom reading a book a few times while he distracted himself, waiting for him to give in. What helped him was being brushed by a hand puppet, singing during brushing (him, too) and having a timer running for an hour before bedtime - if he came to me for brushing before the bell rang, we'd play whatever he wanted, read, cuddle etc. If he had not brushed by the time it rang, he'd go to bed alone without book reading. During the hour I would absolutely refuse to play with him before the brushing. He didn't go to bed alone *once* - the few times when the bell rang, I said "quick! To the brush! If you do it now we'll read a book anyway, even when the timer rang", at which point he'd be in the bathroom, mouth open, in no time. Of course, this sort of soft pressure might not work on all kids, some would probably laugh and go to bed alone (then picking another approach is necessary).

Good luck, OP, and just pick out the bits of advice that work for you and her.

Btw., I'd definitely prefer general anesthesia to sedation as well, as many kids react paradox and get hyper instead of sedated. But my husband is anesthetist, and good at what he does, so I'm biased. Always talk to the doctors and find one you can trust!

Edited at 2012-12-01 01:21 pm (UTC)

You're right- I shouldn't have generalized. =)

Yeah there is an actual Pediatric Dentist in town and I mean to call on Monday to see if they do financing, the place we went to before was a family dentistry. We have a few colleges in town that I know have dental programs so I'm going to phone around on those as well so we will see.

Just an FYI, some states (mine, for example) no longer include dental care in their Medicaid.

All states are required to provide dental for children with Medicaid. (http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Benefits/Dental-Care.html) They can choose not to for adults, though.

OP, I would call your local department of social services and see if they can refer you somewhere that does payment plans or something. And I would force the teeth-brushing at this point.

Huh. Well, I most definitely got a letter from the state about two years back telling me that Medicaid no longer covered dental for my son due to budget cuts, so.... That really sucks if it was a mistake. I could have used the coverage for him.

Just noticed that that link says October 2010. Maybe they cut it then reinstated it a few months later? But I was never notified that it was reinstated.

I just put my daughter on Healthy Families and she has dental coverage. Its low cost medical, dental and vision ($24 a month)

Yeah, I tried to put my son on Healthy Families and they told me I made too little and needed to go through Medi-Cal, after Medi-Cal had just kicked me off for making too much. It's... interesting. Now I put him on insurance through my work, which my ex refuses to help me pay for, and half my paycheck goes to medical insurance! Joy.

Well I got a letter that said Healthy Families is going to merge with the medi-cal program next year so maybe you will be able to apply again! :)

that is just unfortunate. :(

Some states have health insurance programs just for children who aren't otherwise insured with higher income brackets than Medicaid... Ours is called Colorado Health Plan Plus, and that is how my daughter is insured since neither of our jobs offer insurance.

Also, I *think* the Medicaid income minimums are higher for pregnant women and children, so it may be worth looking into.

I feel your pain! My oldest daughter is 4 and loves brushing her teeth, she even begs us to swish with the Listerine! She is awesome about it and her teeth are beautiful. My two year old daughter, on the other hand, likes to brush her own teeth, but hates when we try to help her. So she's kind of just sucking on the brush and swishing it around at the moment. I don't want to really get in a fight with her over it because right now she likes to do it, and at least she's getting the brush in her mouth. When she was just a baby she fell and knocked out one of her bottom front teeth (oh my god, I cried for days! Guilt cakes) and I'm worried about her front teeth because she was addicted to apple juice (that's all she would drink, she can't have milk) and even though we got reduced sugar juice I just know it was terrible for her! I desperately want to take her to the dentist but have no $$. I'm signing up for some stuff right now so hopefully it will go through and it will get fixed. But I would say, scrape that money together before it gets worse! Maybe borrow some money from parents or something? I'm sure some dentists somewhere offer payment plans! Call all of them!
good luck. I know how bad it feels!

You could look into Weston-Price, a book called Nourishing Traditions. It's decried by a lot of mainstream dentists but I do have a couple of friends who have seen fantastic results in children with dental caries that sound very similar to what you're describing. The decay halted and there was even some re-mineralisation.

It is basically changing the child's diet to include a lot of things like bone broth, real butter, NO added sugar (I haven't read it myself but I think that's the gist of it).

With all due respect, but there is no scientific evidence backing up these claims (scientific as in published in a medical journal or pubmed) and seriously, while it might not do any harm to follow that diet advice when you are malnourished and actually get things from the butter and bone broth that you didn't have before, suggesting it to someone dealing with serious defects in teeth is not different from suggesting prayer to cure cancer.

I've seen som pics and read some reports about that, and many people who swore on this diet talked about their kids having "translucent parts" on their teeth prior to getting miracle cured by the diet. Having translucent teeth just means they are badly mineralized and lacked something in the first place. In these cases, non cariotic holes due to lack of mineralisation might improve when nourishment is provided. On people with a normal, balanced diet and normal teeth (with or without decay), the effect can't possibly be significant enough to "heal" cavities, which are caused by bacteria and not a simple matter of remineralisation. (Admitted, I didn't do a scientific counter study.)

I find this book very dangerous. You say "mainstream" dentists, but really, all these guys spent 5+ years in university to study nothing but teeth and jaw anatomy and physiology etc.

Edited at 2012-12-01 03:21 pm (UTC)

I do not think that the idea of optimizing your or a child's diet is wrong, I just disagree with the "and simply curing cavities with it!" and looking down on dentists part. I do believe that the wholesome diet and lack of sugar likely helps in halting the progression of cavities, though.

Sorry for the rant.

Edited at 2012-12-01 03:26 pm (UTC)

I'm right there with you. Weston Price was kind of a nutter anyway.

Like I said, I haven't read the book/other materials or followed it myself. I treated my kids' cavities the mainstream way. I just mentioned it as something the OP could look into, as I have seen my friend's results for myself, whether or not it was due to following these methods. I didn't say "this is awesome and you should definitely do it".

I have had to pin both my kids to get their teeth brushed. The way I've found easiest is to actually lay them on the floor put my leg over their middle I pry their mouths open and my hubby brushes the teeth. The oldest at five has no problem brushing her teeth or having me brush them. The youngest I still pin and brush her teeth. The reason your daughter is fighting is that it probably hurts. I know my sil never brushed my nieces teeth and she ended up with cavities and now she REALLY hates brushing her teeth.

I'd talk to the dentist about a payment plan, or find one that will set up payments for you.

I don't know if this helps at all or not, but I found my 2 year old fights teeth brushing less once we switched from a "soft" toothbrush to an "extra-soft" toothbrush.

In addition to brushing and flossing, rinsing with a fluoride rinse or listerine can be helpful. My kids do both, when little I dip the toothbrush in listerine and run it along their teeth. Or Act.

Also fluoride tablets if you're in an area where there isn't any in the water.

I would ask the dentist what color the caps would be. A metal cap ought to be a cheaper option to a tooth colored cap.

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