Does a three year old need a root canal?

[widgeon13]

Not a dentist but this seems strange to me. Is there a logical reason a three year old should get a root canal? I thought baby teeth would just fall out or be pulled.

Finley Boyle, 3, Brain Dead After Dentist Visit, Parents File Lawsuit

[stomachmonkey]

I don't know but for sure I would have gotten a 2nd and 3rd and 4th opinion before subjecting a 3 year old to multiple root canals in one sitting.


Tragic.

[widgeon13]

Originally Posted by stomachmonkey

I don't know but for sure I would have gotten a 2nd and 3rd and 4th opinion before subjecting a 3 year old to multiple root canals in one sitting.


Tragic.

My thoughts as well.

[Nickshu]

Would not have been a traditional root canal but rather a pulpotomy which is necessary when severe tooth decay has entered into the "live" portion of the tooth and infected the nerves/blood vessels and surrounding bone. Same concept as an adult root canal but much quicker and easier to do.

Regardless the "root canals" had no play in the resulting brain damage. Most likely loss of airway and hypoxia from sedating her too deeply without proper airway management.

Very sad.

[Geary]

Yes .. some folks put too much faith in any & all physicians. Where our kids are concerned, far more vigilance is required. I've never before heard of root canals for tiny children .. makes me cringe.

My wife and daughter have been following this tragedy closely, as Kailua is such a small town. That dentist is toast. She was outed as something of a quack years ago.

[81Kremer930]

Good God... this is so sad and tragic. We have a 3 year old, I cannot imagine...

[widgeon13]

Thanks very much for the education on this. We have a three YO granddaughter and it's just another heartwrenching story of a three YO not recovering from what would seem a pretty straightforward procedure.

Appreciate the good info.

[stomachmonkey]

Originally Posted by Nickshu

....Regardless the "root canals" had no play in the resulting brain damage. Most likely loss of airway and hypoxia from sedating her too deeply without proper airway management.

Very sad.

You seem to have knowledge about this so can you tell us (generally) if sedation is SOP for someone that young as a matter of course or was it recommended due to multiple root canals being performed simultaneously or a combo of both?

[scottmandue]

Originally Posted by stomachmonkey

You seem to have knowledge about this so can you tell us (generally) if sedation is SOP for someone that young as a matter of course or was it recommended due to multiple root canals being performed simultaneously or a combo of both?

I'm no dentist or doctor... but had my first root canal last year at 56 and they did it with local. I could have had gas but it was extra $$ (yes, I'm that cheap/poor).

[Nickshu]

Originally Posted by stomachmonkey

You seem to have knowledge about this so can you tell us (generally) if sedation is SOP for someone that young as a matter of course or was it recommended due to multiple root canals being performed simultaneously or a combo of both?

In general almost any dental procedure can be done under local anesthesia alone. Sedation is added to manage anxiety and general "freak out" that is all psychological. While many kids can undergo dental procedures with local alone or local + Nitrous oxide, some, for various reasons (history of abuse, bad prior experiences, etc) cannot tolerate this. For these kids some form of sedation is needed.

I am not a pediatric dentist but I do a lot of gum grafts on kids age 7-10, referred to me by pediatric dentists and orthodontists. Have done as young as 4, but those are rare. Most of them do great on local + nitrous. For the older kids 10+ I will do valium + nitrous but I chose those cases carefully. Anything more complicated and I will bring in an anesthesiologist to do deep sedation.

Bottom line is that there is a spectrum of anesthetic options and there is no cookie-cutter approach. Where I see my colleages get into trouble is when they try to treat every patient the same way without any pre-procedure risk and behavior assessment. Chosing the right (and safest) way to treat is part of every case. All anesthetics have risk and bad things can happen, unfortunately, even to the best doctors.

In pediatric dentistry there area cases of kids, mostly low-SES, where they have rampant tooth decay from dental neglect, parents who avoid taking their kids to the dentist b/c they are scared themselves, this propagates the cycle of fear/pain/experience since the kids only see the dentist to have a major procedure, not a simple cleaning, etc. It's a bad deal. Many of these kids go to the OR at great expense, every 2-3 years for dental work with virtually no homecare or preventive care in between. Very sad.

[nostatic]

Demerol for a 3 year old?

[intakexhaust]

Awful.

A few more cases-
Dental visit ends with Harlingen boy

Blue Island teen dies after root canal - Chicago Breaking News

When I was a kid we had a crook dentist. Little did I or my siblings know and it took awhile before my parents caught onto the scam. We'd go in for a routine check-up and the dentist would say we have cavities start drilling away and filling with some white crap. My mother was sort of surprised but since this was a well known dentist in town with a nice place and after he explained 'how great this magic filling was', she would pay the bill and away we went. Six months later, the dentist tried the same thing but my mother knew we had no cavities. Never returned.

A few months later, the white mortar started to break apart and fell out. We went to a semi-retired dentist working out of a room in his home. He was PO and told my mother none of it was necessary. He cleaned out the crap fillings and replaced with silver. Fees were whatever she could pay or even nothing.

[ckelly78z]

There is no way I would subject a 3 year old to a major dental procedure, and I don't know why a Dentist would try to attempt such a thing on such a small child.

[Nickshu]

Originally Posted by ckelly78z

There is no way I would subject a 3 year old to a major dental procedure, and I don't know why a Dentist would try to attempt such a thing on such a small child.

Most of the time it's due to chronic dental pain and debilitating decay that prevents the ability to eat/grow/thrive. Also risk of systemic abscess traveling to the brain or bloodstream. Sadly we have seen a few deaths in the USA in the past couple years from untreated/ignored dental infections, some of which were kids. Unfortunately some parents have this mentality and let their child's oral condition deteriorate to the point of being life threatening before pursuing treatment.

What happened is a very sad tragedy but not a reason to avoid necessary dental care. Be cautious, check credentials of your dentist (especially sedation training). Laws vary from state to state on sedation licenses, many of which are too loose.

You should be aware of some of the challenges in providing dental care to low-SES children in the USA. Unfortunately most of these deaths have been in low-SES clinics where undertrained providers are pressured by their organization to do procedures they are not proficient in. Parents also pressure these clinics b/c their kids need care but they can't afford a trip to the OR to have it done. Many of these organizations cannot afford to hire competent practitioners because they rely on Medicaid dental reimbursement which is often lower than practice overhead. Until recently in my state Medicaid would reimburse 60% of my fee, but my practice overhead is 70%. They wonder why no one will sign up for it. Heck I would do it just as a service to the community if I could break even on it, but I can't afford to take a 10% loss.

[Joe Bob]

Yank it......geez, one will show up later to replace it....

[RussianBlue]

Yeah, 'baby root canals' are very common -- sometimes upwards of 10 to 15+
They take about 5 minutes to do.

'Baby teeth' are necessary for many reasons including eating and guidance of permanent teeth - heck the molars need to last until up to 12+ years old. This is why they are repaired and not pulled....

Not a big fan of GP's practicing pediatric dentistry and even less a fan of them using oral sedation.
Even a pediatric dentist would be challenged by the rare airway complication but they are way better trained and will monitor the child as required by law.

Regardless of amount of sedation used here, more than likely this child was not monitored properly and experienced unmanaged respiratory depression leading to cardiac arrest.

Sad, and unnecessary...

[afterburn 549]

Your doc needs one in the head.......thats B>S>

[Nickshu]

Originally Posted by Joe Bob

Yank it......geez, one will show up later to replace it....

True but that wouldn't solve anything since the kid would need to be sedated for the extraction too. Very sad mismanagement of a case by someone who got in over his head.

[afterburn 549]

Its a $$$$$$$ 4 root canal.... if he would admit it

[rfuerst911sc]

Why not perform a vasectomy while you're in there ? This is wrong on so many levels what were the parents thinking ?