Dentist taking the mickey?

heppy23

Took my 4 year old to the dentist (NHS) today and was mortified to learn he needs 3 fillings.

I was so gobsmacked I didn't think to ask what kind of fillings etc.

I went to book an appointment and I have been given 3 separate appointments.

This evening I have been doing some digging as the treatment of cavities in milk teeth seems to be quite controversial (from some advising nothing but improving dental hygiene if no symptoms, special coatings, fillings, etc).

What is worrying me more than anything is the 3 trips. In a perverse way I am hoping we as a family can learn from this and use this as an opportunity to eat more healthily so I am hoping that William will learn that sweets = bad teeth.

But if he is having 3 lots of injections he is going to end up totally needle phobic.

I queried with the receptionist about splitting it into 3 and she said "he wouldn't want a completly numb mouth would he?" - well I've had a lot of dental treatment over the years and I can remember having a fully numb mouth several times.

I think there is something funny going on ref payment - using my son as an opportunity to make 3 times what they would have done?

Despite me being at fault for the state of his teeth I do have his best interests at heart and don't want him traumatised by all of this.

esio_trot

I'm not sure about the rights and wrongs of filling baby teeth, or the pricing structure/payment of NHS dentists anywhere except Scotland, but I can tell you that my dentist will also only tend to work on one area of your mouth at once (split into quarters). I've read about other dentists to do this, mainly for comfort reasons/danger of injuring your tongue if you are completely numb etc. I suppose in that scenario, it really depends where in your son's mouth needs treated.

Fork86

heppy23 wrote: »

Took my 4 year old to the dentist (NHS) today and was mortified to learn he needs 3 fillings.

I was so gobsmacked I didn't think to ask what kind of fillings etc.

I went to book an appointment and I have been given 3 separate appointments.

This evening I have been doing some digging as the treatment of cavities in milk teeth seems to be quite controversial (from some advising nothing but improving dental hygiene if no symptoms, special coatings, fillings, etc).

What is worrying me more than anything is the 3 trips. In a perverse way I am hoping we as a family can learn from this and use this as an opportunity to eat more healthily so I am hoping that William will learn that sweets = bad teeth.

But if he is having 3 lots of injections he is going to end up totally needle phobic.

I queried with the receptionist about splitting it into 3 and she said "he wouldn't want a completly numb mouth would he?" - well I've had a lot of dental treatment over the years and I can remember having a fully numb mouth several times.

I think there is something funny going on ref payment - using my son as an opportunity to make 3 times what they would have done?

Despite me being at fault for the state of his teeth I do have his best interests at heart and don't want him traumatised by all of this.

We are taught not to cram too much treatment into single sessions when dealing with children. After a short while, they become irritable, cry or lose concentration and constantly shut their mouths, which can make it difficult, and dangerous if they close their mouth with a drill in place.

It is also best to stagger treatment so as to desensitise them to dental treatment, because it can be a frightening prospect. Telling a child he will only need one filling that day will also sound better than three. If this is the first time he can remember going to the dentist, then having three fillings in one go will be more likely to traumatise him and make him never want to visit a dentist again! Ideally, your dentist should try and clean his teeth with the electric brush first so as to not make his first experience too scary.

With respect to the number of injections, if his teeth in question are more than two teeth apart in the upper jaw or on opposite sides of the lower jaw, then he will need separate injections anyway.

Also, if the decay is minute and the cavity not big, injections might not be needed.

Regarding treatment of baby teeth. There isn't much controversy really. Treatment will depend on the amount of time left before the the permanent tooth should come through to replace the baby tooth, how bad a state the tooth is in, and if the child has adequate oral hygiene to maintain any treatment.

If a child is 5 and their front baby teeth are badly decayed and slightly loose, I wouldn't restore the tooth as it is due to be replaced very soon by a permanent one.

If however he is 7 and only one of his back baby teeth has a slightly large cavity, I would do everything I could do save the tooth as the permanent replacement will not be due for a couple of years. Loosing the baby tooth will leave a gap which is likely to close before the permanent tooth can come through in to it, and thus result in crowded teeth.

It is hard to comment on your child's case as I haven't examined him myself. But as he is only 4, there are no viable teeth to treat with special coatings (with fissure sealants), as none of his permanent teeth are likely to be present yet. The fact that he has 3 cavities though will probably make him a likely candidate for fissure sealants to cover his permanent back teeth, or any teeth with deep grooves.

If he has 3 very small areas on his teeth that show signs of early decay, they can be coated with a fluoride paste/varnish, but not if they have cavitated. It is probably this area that causes difference in opinion amongst some dentists, as it was common practice in the past to just drill anywhere there was decay even if there wasn't a hole/cavity present.

I apologise for the long post and hope this has answered some of your questions.

Fork86

Also forgot to mention that is advisable especially with children to only work on a quarter of the mouth at each visit. I've seen a case of a child who chewed the inside of his cheeks and lips to such an extent it was ulcerated and bloody as they couldn't feel any pain (until the anaesthetic had worn off!). Others have burnt their mouths and one chewed a very large chunk of their tongue!

heppy23

Thanks to you both.

It's the two back ones at the top and one of the back ones at the bottom so the quarters thing makes sense.

I've currently got the three appointments booked a week apart (i.e. one per week for 3 weeks), would it be worth spreading them out a bit more to give William a bit of a chance to forget what has happened?

I think I might have answered my own question there!

Toothsmith

It sounds to me like you have a really good dentist there.

The NHS has never paid by the appointment, that's probably why dentists you have experienced DID numb up your whole mouth and get stuff done as quick as possible. It probably didn't upset you, but there are plenty of people out there who have been completely put off for life by this sort of approach.

The reason that there is evidence out there that baby teeth can survive with untreated cavities is that the way the NHS worked through the 90s was that dentists weren't paid to fill baby teeth, so an awful lot of decay went untreated, and was there to be studied. Hardly the best way to come up with evidence - and there were plenty of kids that didn't get away with not having their teeth fixed properly.

By doing things well, and trying to give your child a good positive dental experience, this dentist will actually be making quite a loss on this treatment.

I would not be suspicious, and I would buy the dentist a nice bottle of wine at the end!

heppy23

Just to update this, William did fine with the first filling (a small one, tiny bit of drilling).

The 2nd one he didn't like the drill noise so we are being referred to a local clinic for the last 2 to be done under sedation.

It's really turned him round, he still asks for sweets now and then but doesn't make a fuss when we say no.

He took a balloon in for the dentist when we went for filling 2 (his idea).

ailuro2

It's a great time to teach him how to look after his teeth - the usual recommendations of, if he's having sweets give them at mealtimes not in between, how to brush each tooth properly, keep him away from fizzy drinks and acidic fruit juices. There are some great electric toothbrushes out there that have appealing kids designs on them, not that expensive either.

An ounce of prevention is worth a pound of cure if he is going to be susceptible to cavities. I'm sure the wonderful dentists on here would agree.:D