2 year old dental recommendations

[BK911]

Apparently the wifey and I havent been the best parent oral hygienists, and my 2 year old baby girl has 6 cavities.
Her 4 front teeth and 2 more in the back.
Dentist is recommending putting her to sleep to install caps.
My out of pocket is close to $1k.
This is for teeth that will fall out in a couple years.
I dont mind spending the money if I HAVE to, but would rather not if not needed.
Cant they just do fillings?
I dont care what the teeth "look" like, as they are not bad and actually look pretty straight.
I just dont want my baby in pain, or permanent damage somehow.
Wanted some input from you smart people.
What would you do?
Second opinion?

[Nickshu]

Primary teeth function to guide the proper eruption and development of permanent teeth.

Perhaps more importantly they guide your child's airway development which is critical to learning disabilities and ADHD, among other issues. Currently an intense area of research in medicine.

So you need to do what is needed in order to keep their mouth healthy and generally intact.

That said I do see over-treatment planning in pediatric dentistry in my area. I would not recommend you do nothing, but perhaps get the opinion of another pediatric dentist...your best bet is find your fee-for-service pediatric dentist in the area and get their opinion. The over treatment planning I see in my area is at the insurance farm pediatric DDS's. In particular the overuse of crowns/caps when composite bonded fillings will work fine. Not saying caps are not needed, they may be, but another opinion may put your mind at ease. Just my $0.02.

[craigster59]

A friend's 3 year old is in the same boat. She brushes 2 times a day but still had 6 cavities. The dentist wants to do fillings and a root canal. Is it normal to do a root canal on a 3 year old?

[vash]

i kinda remember all my teeth coming out..

i dont remember a whole lot about my baby teeth. i know i didnt get any fillings. we did get them pulled with they started to loosen.

wow..i would have been a crap parent. but well never know

[LEAKYSEALS951]

This is what I do and is right up my alley. We treat a lot of children, some in OR/ full sedation. Although I haven't treated children under general sedation for several years, I do treat a lot in house.

In addition to above comments about spacing, I usually tell parents to think of baby teeth like a race. Yes, on one side of the coin, baby teeth will eventually fall out. On the flip side, cavities will continue to grow until the teeth become painful and abscess. Questions regarding restoring vs. waiting generally revolve around which will happen first. For example, a back first molar might have a cavity. On an 8 year old, there might be no sense in fixing it, since it will probably fall out in a year or two, before it hurts. The same tooth on a 2 year old might have to make it 7+ more years before it will naturally exfoliate. In that case, the cavity will win the race and cause problems well before then.

Then the case of how to fix it comes into play. Even in the dental community there are different philosophies on treatment. Capping everything tends to lead to a very predictable result, but can lead to over treatment. On the other hand, placing simple fillings as a conservative effort can lead to increased failures and less predictable results. Generally, pediatric dentist who handle sedation cases are more likely to be more aggressive (since sedation is involved) to get the job done right the first time. There is nothing worse than having to send a child back into sedation to redo something. In my experience with anterior composite fillings, the results can be hit or miss. A lot depends on missing tooth structure and hygiene. In some instances, composites work great, in others, they can be a disaster.

Today alone, I have redone fillings on three pediatric patients (not ones I originally placed). The work was not done wrong, however, I wouldn't have used those materials in those circumstances. The thought of "never enough time to do the job right, but always enough time to do it over" is not something you want to subject anyone to.

I would get a second opinion and ask the original dentist questions like "why NOT anterior composites on the front teeth?"Without an exam and radiographs, it's hard to say.

[1990C4S]

Have you considered seeing a pediatric dentist? is that a thing where you live?

[wildthing]

I would be hesitant to put my two year old on anesthesia for such a procedure. Then again, I'm no doctor, and my kids luckily haven't had any cavities at that age.

[1990C4S]

Depends on who is doing the sedation. I would want an anesthesiologist. Depending on where you live a dentist might be allowed to do it.

[Neilk]

What causes so many cavities? High sugar diet or do some children have a strong propensity for cavities?

[BK911]

Thanks guys.
2nd opinion, with me there instead of just the wifey.

Not sure why all the cavities.
No soda, very little candy, brush several times a day, parents both have good teeth, ???
We are on a well so the little ones take some fluoride supplements.
And we also eat a LOT of fruit, so maybe citric acid?

[Rickysa]

Yes, for sure, fix it.

The front teeth should last another 4-5 years at least before the permanent teeth come in (usually age 6-7), the back ones much longer. If you extract the baby teeth it will delay the eruption of the permanent teeth because the child is so young.

How it is done (caps/fillings/nerve treatment) depends on how badly the teeth are damaged...can't be diagnosed on a website.

I can't comment on what environment (GA, conscious sedation, etc.) as I'm not a pediatric dentist...I just do braces. But I would do it in a way your child won't remember it and do as much as you could in one visit (if it were my child)

Caps/crowns on baby teeth are for when the teeth are too badly damaged for conventional fillings, or require nerve treatment (pulpotomy eg)

Best of luck!! But, again, definitely get them fixed...if not it will only lead to pain for your child.

We are on a well so the little ones take some fluoride supplements.

Have you ever had the fluoride level checked by her dentist?

[wildthing]

Originally Posted by BK911

brush several times a day

Maybe this is a problem. My kids only brush once a day until they are in school (5+).

No cavities.

Not based on scientific study, just a sample of 3.

[LEAKYSEALS951]

Originally Posted by wildthing

Maybe this is a problem. My kids only brush once a day until they are in school (5+).

No cavities.

Not based on scientific study, just a sample of 3.

Interesting..what toothpaste?

edit- meant for OP, not Wildthing... but since we're on the subject- what toothpaste does wildthing kids use? and are they on flouridated water?

[aigel]

Fruit juice?

I am all for modern medicine but no way in hell would you put my 2 year old under for dental work. We'd have to find a way to fix what can be done with local anesthesia.

My kids have had cavities but not at 2. 5 maybe? Old enough to get them filled with local anesthesia.

[LEAKYSEALS951]

Originally Posted by aigel

Fruit juice?.

That's one part. The next question is did mr and mrs op have a lot of dental work themselves?

[LEAKYSEALS951]

And the final question..... Does Jr. OP have spaces between the front teeth? or are they butted up against one another like adult teeth?

[wildthing]

Originally Posted by LEAKYSEALS951

Interesting..what toothpaste?

edit- meant for OP, not Wildthing... but since we're on the subject- what toothpaste does wildthing kids use? and are they on flouridated water?

We use Orajel until they learn how to not swallow, or to spit out regular toothpaste.

I don't know if our water has fluoride. We drink tap filtered through the fridge.

[BK911]

OK guys, after doing additional investigation considering some of your awesome comments, I think I found the smoking gun.

Baby Girl started showing some discoloration on her teeth, so Mommy stopped the fluoride supplements.
Time for Daddy to start getting involved with Mommy duties.
Hate to micro manage, but obviously its necessary.

All of Baby Girl's teeth are straight with no gaps.
Mommy and Daddy both have excellent teeth.