What can be done about decaying baby teeth?

I have a four year old son who has some fairly significant dental problems. Before I take the next step, I am trying to research as much as I can. At least four of his upper molars have cavities. The ones in the first molars are small, but quite deep, and the second molars on both sides have started to chip away because of the decay.

What I want to know is do I have to have those second molars pulled, or can we put some kind of a crown on them until his permanent teeth are ready to come in? I’ve also seen where other dental websites talk about white fillings, porcelain onlays or dental bonding to fix teeth that have been chipped or damaged. Which would you suggest for a child his age?

I’m also wondering if I have to send him to a pediatric dentist. We’ve had two different dentists, and my son refuses to open his mouth for them. Do you think I will have to have him sedated for treatment? That seems so extreme, but my son now says that one of his molars hurts when he chews, so I think I have to take action.

I appreciate any insight you can give me.

Thanks,

Ellen

Dear Ellen,

Yes, I do believe that you need to visit a pediatric dentist, and yes, it is likely that they will need to sedate your son to get this dental work done. So you’ll need to locate a good pediatric dentist that practices sedation dentistry. Even though he only has baby teeth right now, those teeth are still important. He needs them, not only to eat, but to maintain the proper spacing for his adult teeth. If he does have to have those molars pulled, your pediatric dentist should suggest the use of space maintainers. Without them, his permanent molars will drift forward, and you’ll almost certainly be looking at fairly pricey orthodontic work when his permanent teeth are in.

In young children, the goal of most dental work is usually short-term maintenance, so the pediatric dentist may place a stainless steel crown. This will cost considerably less than a porcelain crown.

Of concern here is also the behaviors that led to this problem in the first place. Decay to the degree you describe has to have been fed all day, every day. I would lay good odds that your son is a “grazer,” in other words, that he eats pretty much continuously all day. If this is the case, you’ll need to find a way to change that eating pattern, or your son will continue to have serious dental decay problems all his life. At this point, he really needs to be eating only every three or four hours, and because of his problems, you should have him brush his teeth every single time he eats. If he cannot brush, have him rinse his mouth out with water.

Posted in Sedation Dentistry, Tooth Decay, Uncategorized, White Fillings | Comments Off

Can a fast diagnosis of a sensitive tooth really be accurate?

One of my molars has recently become really sensitive to everything - heat, cold, even air. The tooth has a large filling, so I started to worry that maybe the filling was thinning or something, or had a hole in it. I went to my dentist, and she blew air on it a couple of times, then put some kind of gel on that was to desensitize my tooth, and that did take care of the pain right away. She said if the pain had stayed, she would have to remove the nerve of my tooth, but I want to know how she could know that with a couple puffs of air? My dentist is always in a really big hurry, so I was too nervous to ask her to explain how she knew what was wrong, or if it could be anything else. I guess I am kind of nervous that she did not really figure out what is wrong.

Oliver in Bostwick

Dear Oliver,

Diagnosing the causes of dental pain issues can be a clear cut process sometimes, and it sounds as if this was the case with you. Different sensitivities tell your dentist fairly specific things about what is wrong with your tooth. Sensitivity to air is an indication of an unprotected spot on the tooth, which can be treated with a desensitizing bonding agent. In your case, the pain was transient, meaning that it went away after the desensitizing agent was applied. That further indicated that the pulp or nerve of your tooth was irritated, but had the potential to heal without interference. If the pain had lingered, your dentist would probably have recommended a root canal treatment, because that lingering pain would have been an indication of irreversible irritation.

You say your tooth has a large filling, and that causes some concern over whether or not that filling could be leaking, or have decay under it. Certainly most competent dentists would check the integrity of the filling first, to make sure that was not the cause of the pain. If the tooth continues to trouble you, it may be time to consider a root canal treatment and porcelain crown.

The greater issue here is your lack of trust in your dentist. Trust is the key to good health care, and dental care is no exception. If you are not comfortable asking your dentist questions, she may not be the right dentist for you.

Posted in Porcelain Crowns, Tooth Decay, White Fillings | No Comments »

Considering Clear Choice Dental Implants for my awful teeth

My whole mouth is in horrible shape, I have very few good teeth left. I’m embarrassed to smile, talk, and have a hard time chewing. The worst part is I’m a 30yr. old single man that has no confidence in myself due to being embarrassed by my teeth. I was considering Clear Choice Dental Implants because I like the idea of having all my teeth replaced with a more permanent solution and hate the idea of dentures at my age. I called for a free consultation and they warned me it would probably run $25,000 to $35,000. I can’t afford that! My parents set back some money when they sold a house to pay for my teeth to be fixed but not that much. Do you have any suggestions for me that will help me?
- Brad from Georgia

Brad,
That seems almost criminal to take all your teeth out at age 30 and place implant-retained dentures. And going to Clear Choice - they usually use the short-cut all-on-four dental implants technique, which puts all the implants in the front and leaves the back of your jaw so that it will eventually atrophy. By age 50 you will have practically no jawbone left in the back of your mouth.

My suggestion is to find a dentist who will work with you and your finances and phase the treatment, and save what teeth you can. If your financial resources are limited, just have the most essential things done now, and work at it gradually, so that over a period of years you get back into good shape.

Then while you’re doing that, try to focus also on preventing further deterioration of your teeth by eliminating snacking. A lot of people don’t realize that when they get a lot of cavities, it’s often because they’re snacking all day long. If this applies to you, you can save yourself a lot of future grief by severely limiting the snacking. No amount of brushing can keep your teeth clean enough if you’re snacking all day long.

Posted in Dental Implants, Tooth Decay | No Comments »