Dental help needed

Bobbycat_2

Hi there,
Really need some urgent dental advice.
My son has been seeing the local community dental clinic for children/nervous patients for the last five or six years after an original referral from his dentist after needing a small filling at aged 8. We regularly went to appointments every six months.
A few months ago we realised that we hadn't been for a while so I rang them and we had been discharged and they had forgotten to notify us. They told us to find an NHS dentist. We contacted his original dentist and had to wait a few months for an appointment.

He has just been for his check up and he has very bad tooth decay in his last lower molar that she feels needs to be extracted. She feels that his wisdom tooth coming through next to it would close some of the gap left. The only other option is root canal treatment that she is unable to do but can refer us to a specialist who visits her surgery for a cost of £600 for the treatment plus the cost of a private crown. Or she can refer us back to the community dental clinic that missed this in the first place and discharged us without telling us.

I really don't know what to do. I have called 111 whose only advice was to call all the other NHS dentists in our area and see if they will carry out the work on the NHS.

Really need some advice on what to do. Absolutely don't want him to lose this tooth as teenager.

brook2jack

First things first is he needs to look at his diet and radically change it. This tooth will have only been in his mouth a couple of years and already it is so badly decayed it needs either taking out or root filling.

The problem is a tooth that is root filled has a shortened life span , it will need crowning and in a teenager who still is getting decay and has not modified their diet this lifespan will be even shorter. Many dentists would advocate extracting this tooth and allowing the wisdom tooth to take its place as the better long term solution.

The community dental service is very overstretched and these days if at all possible children are expected to return to general dentists once community has got the treatment done.

By all means get a referral back to community but for the reasons above they may very well decide extraction is the best option anyway.

In the meantime encourage your teen to make the diet changes to make sure this is their last treatment.

Toothsmith

Agree with Brook

Bobbycat_2

Thank you so much for the advice.
The community dentist team are brilliant and when I spoke to them today on the phone they said they have a waiting list of over 3 months! I honestly can't see them being able to spend the time on a root canal.
Will the wisdom tooth naturally move towards the gap?
We honestly don't know what to do for the best. If we see a specialist and pay for the treatment plus the crown and then later lose the tooth the wisdom tooth will then not be able to move over and he will be worse off.

Toothsmith

Bobbycat wrote: »

We honestly don't know what to do for the best. If we see a specialist and pay for the treatment plus the crown and then later lose the tooth the wisdom tooth will then not be able to move over and he will be worse off.

Exactly right. Even if it does very well and lasts 20 years (longer than average) he'll still only be mid 30s!

I can't say if HIS wisdom tooth will move nicely, I'd need to see it to give that opinion, but it easily could do, and if the dentist who's seen it thinks it could, then I would trust that advice.

Sometimes extraction is the best option. It won't be a failure so long as he learns from it and adapts his behaviour so it doesn't happen again.

brook2jack

You need to discuss this with a dentist who can see your son and his x rays. However I would avoid becoming fixated with saving this tooth at all costs when it may be best to lose the tooth.

He needs to change his diet now (e.g. no more than three sugar attacks a day, nothing to eat,drink before bed other than water etc) otherwise not only is this tooth dubious others will be. This tooth will only have been in his mouth possibly three or four years at most and already he has severe decay in it. To be honest the big problem is not the amount of time he may have to wait for treatment but treatment planning for the best in a teenager with active dental disease.

Spending money on private root fillings or crowns on a teenager who has not got their diet under control may not necessarily be buying the best treatment for them.

Bobbycat_2

Thank you so much guys.
It was such a shock to take in. He has only had one small filling on a milk tooth in the past.
We honestly didn't think that his diet was too bad. He only drinks water at home, no sugary drinks at all. He was taking a capri sun and a snickers bar to school each day as an energy booster at break time (not anymore). I also do a lot of cake making at home and these are available. I guess it adds up. I have removed all sugary snacks from the house now.
He has admitted that his teeth cleaning could be improved. I don't think that he was getting his brush right to the back. He is going to a group visit at the hygenist for advice on brushing, flossing etc.
I am replacing all our house snacks with savoury snacks and fruit.
Also thinking of buying some disclosing tablets to help him with brushing.
It has really frightened him to be honest and I do think that he will learn from it.