Ever heard of dentists sedating toddlers to fill baby teeth cavities?

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mundart
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Ever heard of dentists sedating toddlers to fill baby teeth cavities?

Post by mundart » Tue Feb 12, 2019 11:24 pm

Is it commonplace to put toddlers under to work on cavities in baby teeth?

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fortfun
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Re: Ever heard of dentists sedating toddlers to fill baby teeth cavities?

Post by fortfun » Tue Feb 12, 2019 11:29 pm

I don't think toddlers usually have cavities but if they do, it's probably the only safe way to drill/fix them.

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ResearchMed
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Re: Ever heard of dentists sedating toddlers to fill baby teeth cavities?

Post by ResearchMed » Tue Feb 12, 2019 11:31 pm

mundart wrote:
Tue Feb 12, 2019 11:24 pm
Is it commonplace to put toddlers under to work on cavities in baby teeth?
I've never heard of toddlers' baby teeth *needing* work on cavities.

However, IF that is the situation, and especially if a drill is needed... and you've got a toddler who at best would be fidgeting, and worse, would be struggling mightily (what about pain?)... and there is this drill in that little mouth?

What are the choices?

Of course, I'm NOT a dentist, and there are quite a few here on BH who are...

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Re: Ever heard of dentists sedating toddlers to fill baby teeth cavities?

Post by Ragnoth » Tue Feb 12, 2019 11:32 pm

When my sister was ~4 the dentist tried to use nitrous oxide before doing some work.

My parents put up a stink (they have a strong aversion to the use of nitrous for personal reasons), and the dentist used local anesthesia instead.

This was back in the 90's, and maybe standards have changed.

That said, a quick search online (http://www.monarchpediatricdental.com/l ... s-children) shows that it can be safe for kids, and I would guess that it's a tool that Dentists have on hand that guarantees kids aren't squirming about.

Jimmie
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Re: Ever heard of dentists sedating toddlers to fill baby teeth cavities?

Post by Jimmie » Tue Feb 12, 2019 11:34 pm

Something I never gave much thought about.

You can learn more by a simple Google search. I used the terms "toddler sedation dentistry" and learned quite a bit. Here, I only learn about money. Wish I had more. :(

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Re: Ever heard of dentists sedating toddlers to fill baby teeth cavities?

Post by pdavi21 » Tue Feb 12, 2019 11:36 pm

Why not just pull the tooth out? Is it a front tooth?
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Re: Ever heard of dentists sedating toddlers to fill baby teeth cavities?

Post by jasc15 » Tue Feb 12, 2019 11:39 pm

I was one such patient. I was probably 4 or 5, and it was pretty traumatic. I got nitrous oxide gas, which apparently wasn't totally effective. I was also strapped at the wrists and ankles. Apparently I needed a root canal, and got a silver capped tooth, which I may have actually kept somewhere after it fell out.

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mundart
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Re: Ever heard of dentists sedating toddlers to fill baby teeth cavities?

Post by mundart » Tue Feb 12, 2019 11:51 pm

Thanks for the replies. This is going to be quite expensive. I guess many dentists are now pushing hard to save baby teeth. When I was growing up (a long time ago), baby teeth were considered very expendable. We kids did not see a dentist until sometime in grade school. Somehow we and our teeth survived that old-fashioned upbringing:-)

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Re: Ever heard of dentists sedating toddlers to fill baby teeth cavities?

Post by Drovor » Tue Feb 12, 2019 11:54 pm

Our son had a defective/decaying front tooth when he was a few years old. We went with anesthesia. The other option I believe was to use a form of straitjacket. It was expensive though since it is not covered by dental insurance as a pediatric anesthesiologist was needed.
Last edited by Drovor on Tue Feb 12, 2019 11:54 pm, edited 1 time in total.

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Re: Ever heard of dentists sedating toddlers to fill baby teeth cavities?

Post by Ragnoth » Tue Feb 12, 2019 11:54 pm

Not sure about the practice, but I think having a gap in your teeth for ~years might cause other teeth to come in wonky or drift around. I remember having a cavity just left to its own devices in grade-school... but the tooth was going to be falling out and coming in again naturally pretty soon anyway.

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Re: Ever heard of dentists sedating toddlers to fill baby teeth cavities?

Post by DrakeSRT » Wed Feb 13, 2019 12:00 am

Yes, common.

shiftleft
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Re: Ever heard of dentists sedating toddlers to fill baby teeth cavities?

Post by shiftleft » Wed Feb 13, 2019 12:01 am

We avoided sedation because someone’s kid never woke up after treatment. Just did what we could until our kid got older and did normal treatment.

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Re: Ever heard of dentists sedating toddlers to fill baby teeth cavities?

Post by chessknt » Wed Feb 13, 2019 12:16 am

If you decide to proceed I would recommend an anesthesiologist be present to manage the sedation since kids can have unexpected reactions like malignant hyperthermia or hypoventilatory arrest and the vast majority of dentists are poorly equipped/trained to handle them and it is your kids life that you are putting at risk.

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Re: Ever heard of dentists sedating toddlers to fill baby teeth cavities?

Post by Watty » Wed Feb 13, 2019 12:22 am

I would get a second opinion from an unrelated dentist and the kids pediatrician.

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Re: Ever heard of dentists sedating toddlers to fill baby teeth cavities?

Post by cheese_breath » Wed Feb 13, 2019 12:26 am

jasc15 wrote:
Tue Feb 12, 2019 11:39 pm
I was one such patient. I was probably 4 or 5, and it was pretty traumatic. I got nitrous oxide gas, which apparently wasn't totally effective. I was also strapped at the wrists and ankles. Apparently I needed a root canal, and got a silver capped tooth, which I may have actually kept somewhere after it fell out.
I remember getting N2O twice as a young lad in the 1940s to pull teeth. Didn't know they were still using it. The first time I think I had a dream, but I can't remember what it was. Second time there was no dream. It seemed like I'd only been under for a second or so except my mouth was full of blood.
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Re: Ever heard of dentists sedating toddlers to fill baby teeth cavities?

Post by passiveTiger » Wed Feb 13, 2019 12:32 am

mundart wrote:
Tue Feb 12, 2019 11:24 pm
Is it commonplace to put toddlers under to work on cavities in baby teeth?
https://www.today.com/today/amp/tdna113039

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mundart
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Re: Ever heard of dentists sedating toddlers to fill baby teeth cavities?

Post by mundart » Wed Feb 13, 2019 12:41 am

Thank you passiveTiger for the excellent link about 9 questions to pose before agreeing to sedate a toddler.

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Re: Ever heard of dentists sedating toddlers to fill baby teeth cavities?

Post by IMO » Wed Feb 13, 2019 12:49 am

One should be aware that sedation isn't without risks. This document is good to review:

http://pediatrics.aappublications.org/c ... /e20161212

But then again, what is one to do when they have cavities?

It may be worthwhile to see if alternative options are available that could reduce risk further?
For example:
https://www.ncbi.nlm.nih.gov/pmc/articl ... -01204.pdf


Don't have the answers, but best of luck.

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Re: Ever heard of dentists sedating toddlers to fill baby teeth cavities?

Post by Impromptu » Wed Feb 13, 2019 1:46 am

You are unlikely to need to get your kids teeth fixed if you personally brush and floss your kids teeth until they are 8 years old. Make it a part of the bedtime routine. Let them practice, but the parent should do it. Lay them down to floss so you can get a good angle.

Juice, milk, and soda are hard on teeth. Going to bed with a bottle will ruin teeth.

The risks of anesthesia are real. Statistically some kid is going to have a bad outcome.
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Re: Ever heard of dentists sedating toddlers to fill baby teeth cavities?

Post by Starfish » Wed Feb 13, 2019 2:54 am

See it as an opportunity to find the real cost of a 2$ bottle of juice, before it becomes way more expensive (adult teeth, diabetes, obesity).

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Re: Ever heard of dentists sedating toddlers to fill baby teeth cavities?

Post by mmmodem » Wed Feb 13, 2019 5:57 am

Don't know how common it is but we were given this option a couple months ago for dental work. My daughter had constant toothaches but squirmed too much in the chair for the dentist to do necessary work. We exhausted all temporary patches the dentist could perform on two separate visits but my daughter was still in pain.

We refused to pay several thousand dollars for general anesthesia. None of this would be covered by our insurance.

Instead, over a couple weeks, we conducted mock dentist appointments. We also let her choose a toy to be an award if she promised to stay still. I took time off work to hold her hand during the procedure. I'm happy to report it worked.

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Re: Ever heard of dentists sedating toddlers to fill baby teeth cavities?

Post by Rupert » Wed Feb 13, 2019 7:39 am

Pediatric dentists have training in sedation. Our pediatric dentist will sedate (note, and restrain -- they use a wooden board thing) toddlers in her office for minor work (e.g., fillings in one or two teeth). If more extensive work is needed (cavities in multiple teeth), she actually does the work in the local children's hospital with the help of an anesthesiologist. Remember that children keep some (up to half) of their baby teeth for 12+ years. Not all of their teeth fall out when they're 5. Also, tooth decay in baby teeth can damage the permanent teeth underneath them. So just ignoring the cavities (viewing baby teeth as "expendable") is not a good idea. That may well have been the way it was done in the 60s or whenever, but thank god dentistry and medicine have come a long way since then.

Edited to note: I'm not at all suggesting that sedation of toddlers for dental work is not something to be taken seriously. It is. There are some horrible stories in the news from time to time about procedures gone wrong. So do verify your pediatric dentist's credentials and experience. And do see a pediatric dentist, as opposed to a regular one, for this sort of work.
Last edited by Rupert on Wed Feb 13, 2019 8:46 am, edited 1 time in total.

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Re: Ever heard of dentists sedating toddlers to fill baby teeth cavities?

Post by rich126 » Wed Feb 13, 2019 8:06 am

shiftleft wrote:
Wed Feb 13, 2019 12:01 am
We avoided sedation because someone’s kid never woke up after treatment. Just did what we could until our kid got older and did normal treatment.
Sadly that is a risk that always exists with sedation for any form of surgery. You get the occasional news story where a teenager has wisdom teeth surgery and there is a complication and passes away.

I was fortunate where I never needed sedation from the time I was a kid (had tonsils removed) until I was in my 50s and even then I was worried. Fortunately it turned out fine (a couple of procedures, one sedation was required and one was recommended) but nothing works 100% of the time.

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mundart
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Re: Ever heard of dentists sedating toddlers to fill baby teeth cavities?

Post by mundart » Wed Feb 13, 2019 9:49 am

Right on the mark, Starfish and Impromptu. Letting a toddler fall asleep with a juice or milk bottle and plying children with all kinds of sugared drinks from juice to soda is rampant in this country. Yes, brushing and flossing after every meal is essential. The failure in these regards for this child has resulted in a lot of pain for the child as well as the prospect of trying to finance huge sums of money to try to save every baby tooth. And anesthesia for a baby tooth in a toddler does seem a little excessive. Hopefully the parents can do a better job of both diet and dental hygiene in future. Meanwhile maybe they can sell their car to finance the first tooth, then mortgage the house for the rest. I should have been a pediatric dentist:-)

The comment of the true eventual cost of a bottle of juice was a cogent one.

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Re: Ever heard of dentists sedating toddlers to fill baby teeth cavities?

Post by bryansmile » Wed Feb 13, 2019 10:59 am

I did not have my child's baby tooth fixed when it showed decay. It fell out eventually.

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Re: Ever heard of dentists sedating toddlers to fill baby teeth cavities?

Post by getthatmarshmallow » Wed Feb 13, 2019 12:25 pm

My son needed a root canal at age four. His teeth were perfect, with no decay, and he hasn't had problems since. What caused the tooth to die? The dentist said 'Young boy? Probably trauma [i.e., ran into something]." We caught it only because of a routine cleaning, and elected to save the tooth to help the permanent tooth come in straight.

In any case, he was sedated with nitrous (bonus: kid totally grooving out to his own reflection in the mirror), and the dentist de-pulped the tooth. Every other appointment we've handled with no sedatives, and given the risks, I'd consider general anaesthesia only in extraordinary circumstances.

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Re: Ever heard of dentists sedating toddlers to fill baby teeth cavities?

Post by snoopdoug1 » Wed Feb 13, 2019 12:29 pm

My son had to get a tooth filled when he was 3. They used nitrous oxide as well as local. They also had a movie on a screen for him to watch. It worked very well for him. After that, we sealed all his baby teeth because he had very deep grooves. Hopefully we won't have to do that again thanks to the seals.

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Re: Ever heard of dentists sedating toddlers to fill baby teeth cavities?

Post by voodoo72 » Wed Feb 13, 2019 12:48 pm

mundart wrote:
Tue Feb 12, 2019 11:24 pm
Is it commonplace to put toddlers under to work on cavities in baby teeth?
I would not say its common but sometimes its needed based on child cooperation as well as the amount of decay. Sadly I have seen kids who are 5 to 6 years old with a mouth full of decay. Parents as stated will let a child go to bed with milk as they think since it has calcium its good for the child. Its the worst thing you can do. At bedtime the salivary flow decreases and all that milk residue with lactose gets used by the bacteria in the mouth to produce acids that destroy the teeth. Keep in mind baby teeth are small surface area, so when decay starts it spreads fast, REAL FAST. The reason for sedation is children can be difficult and hard to cooperate, and the first appt maybe ok, by the second they know whats coming and they put up a fit. So PEdo will recommend get it all done in one sitting. Now for the bad, putting children under sedation is not for the faint of heart, outside of using nitrous, I would never recommend allowing your child to be sedated at an office. The best option would be a hospital where if something goes wrong it can be addressed immediately. I did sedations in my residency and my anesthesia attending hammered into my hear " KIDS ARE NOT TINY ADULTS". Best of luck

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Re: Ever heard of dentists sedating toddlers to fill baby teeth cavities?

Post by LadyGeek » Wed Feb 13, 2019 4:10 pm

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