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FAQ:  Pediatric - Children's Dentistry



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Question:
I recently brought my two and a half year old daughter to the dentist for the first time. I had noticed some spots on her back teeth. I was nervous about bringing her because for a while she would really fight to have her teeth brushed. She did really well at the dentist though, and they were able to x-ray her.

The pediatric dentist said she indeed had beginning cavities on her second to last molars and some starting to form in the between her top front middle teeth in the back that you could see on the x-ray(he said her teeth are tight for her age and flossing is important). As a preventative measure he also wants to seal her back molars since they are deep and cavities will probably form there.
I asked how he would do the work and he told me sort of matter of factly that she would go to the hospital and be put to sleep. My heart dropped. I have a seven year old who had a lot of dental work (while conscious) and was hoping to avoid that with my daughter by catching it early. I've never had anyone in my immediate family be sedated that way before and the thought of putting my small child to sleep terrifies me.

I am scared of the risk that she might not wake up (that my child could possibly die just to get her teeth, which will fall out, fixed). I am glad that at least he does it in a hospital where the child can be monitored. Before I left the office I asked the assistant if there was any other way. She said we could possibly do it in the office, but that she would have to be in something like a papoose so that she won't be grabbing at drills and that if she starts moving to much the dentist won't fight with her. The experience could be traumatic and might not work anyway.

She did well for the checkup but I'm not sure how well she'll do being strapped down or how still she will be for that kind of work. This is the first time we have seen this dentist. I told them I would call them back with a decision. I don't expect you to tell me what to do, but is there any advice you can give me or information on anesthesia and the risks involved. Do children ever die from being put to sleep or even from anesthesia while being conscious while having dental work done?

Also, I have a 7 month old who got his first teeth last month (the two front bottom middle) and his top right eye tooth has just come out with the top left eye tooth about to emerge also. My other children got their top front middle teeth after the bottom. Is this normal or okay not get teeth in this order? Will it have any affect on his teeth now or later? ...Amy

Answer:
Amy, it is totally normal to be anxious about having any type of procedure done in the operating room, especially for teeth! I do go to the operating room every week and we have very good success. Usually, the children that do not wake up from general anesthesia have other conditions and are usually not healthy.

However, there are other ways to have the procedure done. I usually will not sedate children who are under 3 years of age. This is done in other pediatric dental offices; but I prefer to have their organs a little more mature prior to sedation. Also, whenever I sedate, I use the papoose. (the sedative that I use gives them an amnesiac effect, so they do not remember being in the papoose) When I see patients and they are well behaved for radiographs and the exam, I will usually try to do treatment in the office and if that does not work, I will then go to plan B.

Also, since you have seen a pediatric dentist, I would feel very comfortable with his/her decision on treatment. You definitely have the option of getting a second opinion to make sure that the treatment has to be done in the operating room.

The usual sequence of eruption of primary teeth is: central incisors, lateral incisors, first primary molar, canine and second primary molar. It is not uncommon to have these teeth out of order, so do not panic. I'm sure they are all there.

Editorial Staff

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