Dental woes

Last night I received an email, and this was part of the message:

>>I read one of the articles on your blog about teeth brushing, or lack thereof of doing it frequently.  I was very thrilled by this, as I am so bad at getting them to brush.<<

I don’t want people to think that not brushing kids teeth is recommended, and in the absence of an exellent diet and regular check-ups, issues are likely to crop up.  Let me update you on my own very recent experience.

For the last three weeks, I’ve been taking different kids to the dentist to get everyone checked before we go to Israel.  I figured that there would be more than enough things to do close to our moving date this summer, so I’m trying to do as much as I can in advance.  I am SO glad that I did this. Because our dental situation is a disaster and it would have been impossible to fit in all the appointments in the last few weeks. 

First I took ds12, who broke a front tooth when playing last year.  We had it repaired, and when playing (with the same friend) several months ago, he broke it again.  We got it taken care of again, but were told that the root had been badly damaged.  So I started off this recent round of dental visits with dd12 getting a root canal.  And he has three cavities.  Since our kids have hardly ever had cavities, this shocked me.  We’ve gotten the cavities on one side of his mouth taken care of, so I have just one more appointment for him until he’s finished (4 appointments total).  

Then I took ds8.  Nine cavities.  No, that’s not a typo.  Two appointments left for him.  Oh, and he needs palette expansion (which wasn’t a surprise), but after a trip to the orthodontist, I was told I should wait until moving to Israel to begin that.   Then dd16 (who brushes and flosses regularly) – 3 cavities and a broken tooth.  Oh, and she needs to have her wisdom teeth removed.  I juggled around the appointments I had already scheduled for the younger kids to fit her in before she leaves, since there were no open slots before her departure date.  So she had two visits her first day home (fun, fun!), and one more this week.  Then ds5 – thank G-d, two teeny tiny dark spots that I’d usually just keep an eye on and wait for them to fall out, but because of the upcoming move I want to get them taken care of.  Ds17 – can’t remember the details, but I do know that I scheduled one follow-up for him. 

And lastly (not all the kids had appointments yet) is ds3.  I could see there was some decay between his two front teeth. His teeth are very closely spaced and food gets stuck there. But I really didn’t expect anything more.  Oh boy. The dentist took a look in his mouth, then looked at me and said, “He’s got a lot going on in there for such a young child. At least four cavities.”  He recommended taking him to a pediatric dentist where they practice sedation dentistry.  So I took him to a pediatric dentist.  (Did I mention that all of these appointments were taking place in the two weeks immediately prior to Pesach?)

The pediatric dentist took xrays and before telling me the results, asked me a series of questions like these:  Does he drink juice?  No, only water.  Does he drink milk before bed?  No, only for breakfast.  Did he ever use a bottle at night?  No, he never had a bottle at all.  Does he eat a lot of sugary foods?  Aside from some snacks (from older sibling), I don’t use sugar and minimize other sweeteners.  When she finished, she  told me that he has 15 cavities in his 20 teeth.  Since his eating and brushing habits are just like ds5, this was hard for me to understand.  She attributed it to his teeth being so close together – the cavities are almost all between his teeth, not on the surface, and even if I had been more regular about brushing, it wouldn’t have helped; flossing would have made the difference.  She also said some children have bacteria in their mouths that are different than other children, and this can be a big contributing factor as well.

She explained that it will take 6 visits to take care of this , and told me what was involved in sedation dentistry.  Basically that it doesn’t always take, sometimes it partially takes, and sometimes it fully takes – but there’s no way to know.  (It made me think of an epidural.)  And so she recommended that because of his age and the amount of work he needs done, the likelihood of trauma is high, so it might be better to have it taken care of under general anesthesia at the hospital.  After weighing the pros and cons, we decided to go with this suggestion.  I have an appointment scheduled for him in June, with a pre-op physical scheduled at his pediatrician a few weeks before that.   (Lately I have been on the phone a LOT making appointments!)  Update just a few hours after writing this: I just learned that our insurance company refused coverage for ds3’s dental work.  I can’t tell from the wording of the letter if they’re refusing the hospital part or something else, so now I need to do some more research and decide what the best options from this point on will be.  We might end up doing the sedation option after all.

Though I continually have felt grateful for our dental insurance that minimizes the cost in dollars of all of this to us, I was really struggling with feeling guilty. Guilty, irresponsible, inadequate -I felt embarrassed for my children to have cavities like this, and along with that was the guilt that I know so much about diet and how it relates to dental health, that I should have done all the things I know are important to do.  You know how a mother’s brain has a hard time shutting off once the guilt button gets pushed?  That was me.  My consolation was that our dentist sent us to the same pediatric dentist that he sends his children to.  😛  It reminded me that all parents do their best, and regardless of their knowledge or convictions, sometimes things fall through the cracks. 

Practically speaking, after so many kids and so many years of very few cavities, what do I attribute this big change to?  A few things.  1) This year I really haven’t been as on top of our diet as I usually am.  This wouldn’t matter as much (since our not so great diet is still pretty good) if not for one older child who regularly started bringing home snacks and treats to share with younger siblings.  As a result, snacking has become much less controlled and more frequent.  You can’t compensate for this with a decent diet alone.

2) This dentist is new to us, and because his approach is more aggressive than our past dentist, I suspect that he may define cavities more stringently than she did.  Whether that’s the case or not, there definitely are issues that we need to address, so I’m not complaining or pointing fingers.  Just saying that I wonder if we’d have been told there are as many as there are. 

3) A very big factor, I think, is that it’s been over 2 years since I took the kids to the dentist, since our beloved dentist stopped accepting our insurance, and I procrastinated about finding someone to replace her.  If we were doing our checkups every six months, we would have found signs of decay when it was beginning, and for most of the kids (not ds3), it wouldn’t have reached this point. 

4) Lastly, I think brushing your teeth is valuable even if you have a good diet, but definitely if you have a lousy or even so-so diet (taking into account the added snacks the kids were given, it would downgrade our diet to so-so).  I don’t think brushing will prevent cavities if you structurally weaken them with a lousy diet (dd16 attributes her cavities to the junk she was eating at the beginning of the year when she first was away), but I definitely think it’s a good thing to do.  So please don’t stop brushing your childrens’ teeth because of me!


11 thoughts on “Dental woes

  1. From what I’ve been told by dentists (some of whom could tell I didn’t floss as often as I should, but still didn’t have problems) some of it just comes down to how hard the person’s teeth are (luckily mine are pretty hard). I don’t know how much diet would affect that. It probably would, but I got the impression some of that is just genetics. (Here’s hoping DD gets hard teeth too!)

  2. How frustrating!! Wow! Especially with your great diet!

    I hesitate to even offer advice, but my husband has Celiac disease, which is hereditary. Both of my boys have tooth decay, and I have read that Celiac and tooth decay are closely linked.
    I’m sorry that you have to deal with this!

  3. Recently we had the same kind of problems with our children and our dentist had to admit that brushing is important, but there maybe other causes. For instance it all depends on the quality of your saliva. i took our 12 year old to a natural doctor and he said there was a bacteria in his saliva which is being treated with osteoB II from Biotics. I get from total health disciunt vitamins.

  4. I am so sorry you and your kids having to deal with all these dental issues. I guess I assumed that your diet would have made these problems irrelevant. Wow, I was wrong. I am now wondering what I should do about my kids. I hadn’t been too concerned. We brush with tooth soap, but I’ve never flossed them, yikes!
    Avivah, what criteria do you look for in a dentist? I am wary of dentistry in general and don’t know how to go about finding a dentist. Does the dentist you see use amalgam?

  5. Wow. That’s a lot to go through — in each kid, and cumulatively for you as their mother!

    While I’m makpid on brushing my kids’ teeth, I’ve been really bad about dental visits…I think this is the push I need.

  6. oy- sorry for all of the hassles! just an FYI- our 2 youngest both needed sedation dentistry -one in the hospital and one in the office-for the hospital one, i asked what would happen if the sedation in the office didn’t “take” and i was told that since it would be potentially so dangerous for the child to squirm with sharp tools and such in his mouth, he would be forcibly restrained! the device they showed me was a cross between a straight-jacket and a backboard, and the thougt of my little boy being scared and in pain and strapped down freaked me out so badly that we paid the extra to have him in the hospital. that was several years ago, and my now youngest did the in-office sedation without any incident. drugs have gotten lots better in the last few years and there should be no reason why the dentist should have to worry about the sedation not working. there are always alternate medications to try… please ask the what-if questions so you can make a better decision about what to do. good luck either way!! big hugs- julie

  7. When I moved to Baltimore I went to a local adult dentist who was noticeably more aggressive in finding and treating cavities than my prior dentist.

    Also, he drilled a lot longer and deeper than my old dentist – on what he told me was a “small” cavity. It was sore for 5 days after!

    You might want a second opinion before you consent to medical sedation on a 3 year old.

  8. i kind of agree with a second opinion with jay. we went to a new dentist and he told my husband he had 11 cavities. then we went to his childhood family dentist and he told him he only had one (and it was hardly a cavity). scary. thanks for sharing this. i haven’t taken my kids to the dentist yet (only because i don’t think they’ll be happy with sitting still). but now i’m going to look into it, and be more religious about their brushing (i got relaxed over pesach because every other night was a yom tov or shabbos!)

  9. Aviva we have also had dental issues with my younger kids. imo, it has more to do with nutritional deficiencies during pregnancy when the teeth are forming. That is the only thing that seems logica, at east in my situation. Having many kids close in age and nursing can be very taxing on the body’s mineral & calcium stores and the supplements we take or took may not have been bio-available to our babies at that time. my 3 youngest have had decay in their milk teeth which are much more softer that the permanent teeth and thank G-D their permanent teeth have been cavity free. Even my 2 year old has decay and he hates juice, drinks only water and some coconut milk &breastmilk. I also agree that celiac/gluten needs to be looked into, maybe other food allergies. I have found that supplementing with vitamin D and K ( I use thornes K) has helped keep the decay at bay. When they have this decay< ithink supplementing is in order! at least for a while. With my 7 year old I went to 2 dentists, when he was 3 . One pushed for seadtion and the second (who was older and I knew from before but didn't take our ins) opted for taking care of the few bad ones and leaving the front teeth as is, since in his opinion they were not going to affect the permanent ones and would be coming out in 2 years. This has worked well for us,since we minimized trauma and his permanent teeth came in and look great. My 23 year old was told at age 18 to have her wisdom teeth out, but they were not really bothering her and we didn't have dental ins at the time, so we took and wait and watch. The 2 bottom ones have come through and very minimally pushed her teeth closer together, but they are not overlapping and still look fine and her bite is still good. We are still taking a wait and watch with the top 2.
    I do not know the reason for your dd wisdom teeth needing to come out, but sometimes it is because they might upset the bite or just push the other teeth closer. If it is not a structural problem but only mininal cosmetic, you can weigh the pro's & con's etc; We use xylitol and I have also been using a combo of clay & Xylitol with my youngest which I think is even better. you can pm me if you want more info, idon't want to go on and on……:)

  10. oy vey. I’m not going to complain because Ds16 needs his wisdom teeth out and Dd13 needs hers out as well as me needing a dental implant! I’m sorry you’re going through this tsorres. I agree that with the 3 yr. old maybe several sedation appointments is safer than general. My kids have had sedation with a pediatric dentist since they were very young with excellent results and basically no trauma. Hatzlacha!

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