Pediatric Dentist Questions

[randomkid]

I am looking to try a new dentist for DD. The one she has gone to twice before is OK - not like I'm super impressed or anything, but they came highly recommended (including by my dentist). So I'm figuring if she had a problem, they would be good. It's just very far away, I have to pay around $7.00 in tolls round trip, and I think they are overpriced. Just for an exam, flouride treatment and polishing, it was $142! I don't pay that much when I have a thorough cleaning and x-rays. She has another appt in 2 weeks and I am considering canceling it to try a new dentist.

I found out about a group from a Mom of one of DD's classmates. She raved about the practice, they are closer to us and less expensive. However, they do not let you go back with your child. I find this a bit odd since DD is only 4yo. How do I know how they are treating her, what they are doing, etc. They meet with you after in an office to tell you everything, but I think I'd want to SEE what they are doing, KWIM? Anyone else whose ped dentist does this?

Secondly, do you think a pediatric dentist is necessary? I love my dentist (which is saying a lot for me as I had horrible experiences as a child) and he will see children starting around age 4 or 5. He has several children of his own, so the dentist is not my concern, but I'm wondering if the hygenists will be OK to work with her. I'm a PT and there is a big difference between working with kids and adults, so I'm wondering if it might be the same for teeth?

Thoughts?

[SnuggleBuggles]

I don't think a ped. dentist is necessary. I was happy with our family practice until it came to the fact that he didn't believe in x-rays till 6yo. Most decay in kids starts between the teeth and we learned that lesson the hard way. If your regular dentist does them earlier though then I'd stay unless dd is having trouble cooperating. The ped dentist might have more patience and more unique ideas to keep her happy.

I don't go back but it isn't like they are locked away. They prefer that you don't go back though.

Gotta run. I'll come back later.

Beth

[o_mom]

I would not go to a place that didn't allow parents in the back. Way too much risk for me on so many levels.

I'm not sure that you need a pediatric dentist, but most regular dentists won't see them until older, though not an issue for you. If she is generally cooperative for exams, then I don't think it will be a big issue with the hygenist. If she isn't so cooperative, then you may want to try to find someone that works with kids.

[egoldber]

I take Sarah to my dentist and I am very happy with her. I have heard so many terrible stories about ped dentists and their quirks. My dentists does Xrays before 6, but Sarah would not hold the plates in her mouth (they make her gag) so we have only done very limited Xrays for her so far. I am very pleased that our dentist does not force the issue.

And I would never, ever take my child to a dentist that did not allow parents to go back. My dentist that I went to as a child was very "touchy feely" and I hated him. My mom never, ever left me alone with him and why we continued to go to him I have NO idea.

[hez]

DS goes to our family dentist. In fact, the same hygienist who cleans my teeth cleans his, so he knew her from going to my appointments with me. I was very comfortable with her because I know first hand how gentle she is :)

I appreciate going back with DS for his appointments-- the hygienist and dentist can ask me questions as they come up, and I get mine answered immediately, as well. For DS's first couple cleanings, he sat on my lap.

[jbowman]

I sought out a ped. dentist for my kids b/c I had such a great experience w/ my ped. dentist (in fact, I still, at 38, go to my ped. dentist when we visit our family in Indianapolis, LOL! I was just there 2 weeks ago. And I'm not his oldest patient!). I like the practice where my kids go--our dentist is very laid back, and there is an area for the parents to sit while the child has her/his teeth cleaned.

In the end I don't think it matters if it's a ped. dentist or not; rather you should go to someone with whom you feel comfortable. I credit my excellent experience as a child w/ me having no fear of dental appointments, dental work, etc., as an adult.

[randomkid]

And I would never, ever take my child to a dentist that did not allow parents to go back. My dentist that I went to as a child was very "touchy feely" and I hated him. My mom never, ever left me alone with him and why we continued to go to him I have NO idea.

This was one of my concerns. That, and, how do I know if they are restraining her in a way that I would not approve of. If she needs to be held, then I want to be the one doing it. I had to restrain her for her first visit, then just hold her hands for the second visit. She had to sit in my lap both times and the dentist had methods to be able to examine her well while she stayed mostly in my lap. I've heard of ped dentists actually using restraints on kids and, though I'm sure that's rare, I'd never allow that with my child unless there was no other option. I'd also not approve of someone being forceful with her verbally. I don't need any incidents that will make her fearful of going to the dentist. It's scary enough for a kid (and many adults for that matter!).

I'm leaning toward keeping this appt. and paying the extra $$ just for the peace of mind. Then, taking the next few months to investigate further. I will have an appt with my dentist soon and can talk to him in person about taking her there.

Thanks for all the feedback. I'd like to hear more.

[Gena]

In my area, the pediatric dentists generally do not allow the parents to go back with the child. They also will use a papoose board (http://www.quickmedical.com/olympicmedical/circumstraint/papoose_boards.html)if a child is not cooperative during an exam. Although we do allow a papoose board to be used for some medical procedures (ie stitches in the head), we do not allow it for routine exams.

However, many of the family dentists in our area do not see children under 6, so it can be hard to find a dentist for preschoolers. To make things even more difficult, we had to find one who would see a special needs child. In all honesty, I would not take DS to the dentist at this point if we weren't required to by the school system.

Luckily I was able to find a relatively close family dentist who would see my son. He is very patient and easy-going. For young kids and special needs kids he does a "no goals" exam, meaning that he only does as much of the exam as the child will tolerate, as long as there is no evidence of a problem. For DS, his exam consisted of looking in his mouth and counting his teeth. Next time we will try to do a little more. We won't even attempt X-rays for a few years. I'm very happy with this dentist.

[Fairy]

I love my dentist, but I wanted a peds dentist for DS. I think they do have a better understanding of kid issues overall, but each dentist is different, so there's no wrong way. For me, I wanted a ped, and I'm happy with him.

The $142 is not a big deal for me, sounds about normal. It's only 2ce a year, so, it's not like it's a regular thing. So, from a $$ perspective, that price doesn't sound terribly high.

However, I am NOT comfortable with not being in there wtih him. That's a show-stopper. I can't belileve a ped dentist would do that. Mine not only invites you in but has a spot all ready for you on teh same chair as DC or right next to them. You're there the whole time for every procedure. Not being allowed in with your child? Under no circumstances would I allow that. If that's the deal, then I'd go somewhere else, no question.

ETA to clarify

[JustMe]

I work for Head Start and we are very concerned with kids and dental care, so I have a lot of experience with kids who have had bad experiences, etc.

I would not go to a dentist who did not allow me to go back with dd. I understand they have their reasons, there may be ways it would work better, etc, but I know it would not work for my child. Even if she could hold it together, I know it would be very scary for her. I think this is true of many kids...although there are the kids that just have no issues with doing this, and maybe if you had a child like that I would consider it.

I do not think a pediatric dentist is necessary. I think what's important is that the dentist has patience is willing to work with kids/parents, and can be flexible.

[brittone2]

I would not go to a place that didn't allow parents in the back. Way too much risk for me on so many levels.

I'm not sure that you need a pediatric dentist, but most regular dentists won't see them until older, though not an issue for you. If she is generally cooperative for exams, then I don't think it will be a big issue with the hygenist. If she isn't so cooperative, then you may want to try to find someone that works with kids.
:yeahthat:

We pay about $80 per visit out of pocket for our kids' routine care at a pedi dentist. When they are young they do the whole exam with the child sitting in the parent's lap and then tipping the child backwards so his/her head is in the dentist's lap. DS was very cooperative with this. Starting around age 3.5-4 they started asking if he would sit in the chair, but he refused. However, they were great about continuing to do things the way we had in the past because in our lap he was willing to be still, and he did great. During his last visit or two he was willing to sit in the chair and he did great. I appreciate that they were willing to wait until he felt ready.

For procedures parents can be in the room. They did say sometimes the kids will act out more in the presence of a parent, so they ask you to consider that, but parents are certainly permitted in the room. My DS had his first composite filling done when he was 18 months and there's no way I would have allowed them to do it without being there. I know my child, and he'd be terrified if we weren't in the room during a real procedure.

Our pedi dentist isn't all that playful and fun, but he is quite patient.

[Tondi G]

I would never take my child to a dentist or doctor that wouldn't allow me to be right there in the room with them! For surgery ok sure... gotta follow the rules but for a cleaning and exam I want to be right there!

[Percycat]

If you plan to live where you are currently living for a while, I would look for a dentist closer to home. Our children go to a pediatontist and it was important to me that we went to a dentist who specialized in treating children. To be honest, I first evaluated this pracitice because it was next door to our pediatricians office, which happens to be at the entrance to our subdivision and across the street from my daughter's preschool. My pediatitian recommended it (and my father-in-law, who is also a dentist in the area, recommended it). My son has started elementary school and my daughter will in a couple years. I like the fact that the office has before school and afternoon hours and I will be able to schedule visits with little disruption to my childrens' school and my work schedules. Perhaps we are fortunate to have good choices available close by.

As far as costs are concerned, the visits are only twice a year. We go to our dentist even though our insurance provides better coverage for other dentists. If our children had complicated dental issues, perhaps we would consider other dental insurance plans or other doctors. Our dentist allows parents to go back with children, but I didn't expect that to be the case.

I would do some more investigation on the dental options available in your immediate area. If you think it is important that you stay with your child during visits, only consider practices that allow this.

Good luck.

[WatchingThemGrow]

I'd want to be in there. My kids go to a pediatric dentist, and we know 3 of them pretty well. Yes, we live by a dental school :) The mannerisms and special training they have IMO make the visit a comfortable one. I couldn't imagine a "board" as a PP mentioned in extreme cases. That can really do some long-term damage I'd think as far as motivation to get your teeth cleaned. When I hear about people waiting until they are 3 to take them, it makes me wonder if "fear" will set in when they haven't been routinely going prior to that.

Building those positive relationships and trust early are important to us. DD goes around reminding us that her dentist told her to start brushing in the mornings and to floss every day. She about FREAKED on Grandma when I didn't leave a little flosser thing out last week, LOL.

Because it costs more and is so much more of a hassle to get to, I might be inclined to check out the other recommendation, but I don't know... I can actually see where our ped. dentist grew up (5 houses away) and the office is just a couple miles away - and DH's work insurance covers our visits 100%. Makes my life sound easy, doesn't it?

eta: ours does the laying in parent's lap thing - and poor me last month when DS had JUST filled his diaper

[randomkid]

We pay about $80 per visit out of pocket for our kids' routine care at a pedi dentist. When they are young they do the whole exam with the child sitting in the parent's lap and then tipping the child backwards so his/her head is in the dentist's lap. DS was very cooperative with this. Starting around age 3.5-4 they started asking if he would sit in the chair, but he refused. However, they were great about continuing to do things the way we had in the past because in our lap he was willing to be still, and he did great. During his last visit or two he was willing to sit in the chair and he did great. I appreciate that they were willing to wait until he felt ready.

For procedures parents can be in the room. They did say sometimes the kids will act out more in the presence of a parent, so they ask you to consider that, but parents are certainly permitted in the room. My DS had his first composite filling done when he was 18 months and there's no way I would have allowed them to do it without being there. I know my child, and he'd be terrified if we weren't in the room during a real procedure.

:yeahthat: to all of that. The ped dentist we went to does the same thing - DD sits in my lap, she lays back and her head is in the dentist's lap. They are also willing to work with her based on what she is ready for. See? $142 does seem really high to me. $80 sounds much more reasonable for what they actually do. It may only be twice a year, but if she needed work done, I can't imagine what the charges would be.

I also cannot imagine not being in the room with DD. I think she would be terrified as well. I haven't actually called the office yet, but according to this Mom I talked to, they don't let you go back. Guess I'll call and ask for sure, but can't imagine DD going back on her own.

[brittone2]

:yeahthat: to all of that. The ped dentist we went to does the same thing - DD sits in my lap, she lays back and her head is in the dentist's lap. They are also willing to work with her based on what she is ready for. See? $142 does seem really high to me. $80 sounds much more reasonable for what they actually do. It may only be twice a year, but if she needed work done, I can't imagine what the charges would be.

I also cannot imagine not being in the room with DD. I think she would be terrified as well. I haven't actually called the office yet, but according to this Mom I talked to, they don't let you go back. Guess I'll call and ask for sure, but can't imagine DD going back on her own.

I should clarify. Our ped dentist does not do xrays with every visit. He just had some and the fee was higher, but I don't remember what they charged. He's being monitored because he has a supernumerary adult tooth, so they check in on it periodically ;) He's been going since he was 15-18 months and they've only done xrays one other time. We skip the fluoride treatment as well. I'm not sure if that would have added to the cost.

I definitely would not consider anyone who didn't allow parents back, for a variety of reasons. I can respect that some kids act up more w/ parents around, etc. but that's my judgment call, as far as I'm concerned, kwim? I get where they care coming from, but I still feel a one-size-fits-all policy of no parents is not something I'd be okay with, especially for a small child.

eta: also our ped dentist does not take any dental insurance, which lowers their overhead and allows for a smaller staff. That may be part of the reason it is more affordable (I know some physicians that do not accept insurance but their overall rates are less expensive as a result of not being tied up w/ insurance paperwork, billing etc.)

[randomkid]

I should clarify. Our ped dentist does not do xrays with every visit. He just had some and the fee was higher, but I don't remember what they charged. He's being monitored because he has a supernumerary adult tooth, so they check in on it periodically ;) He's been going since he was 15-18 months and they've only done xrays one other time. We skip the fluoride treatment as well. I'm not sure if that would have added to the cost.

I definitely would not consider anyone who didn't allow parents back, for a variety of reasons. I can respect that some kids act up more w/ parents around, etc. but that's my judgment call, as far as I'm concerned, kwim? I get where they care coming from, but I still feel a one-size-fits-all policy of no parents is not something I'd be okay with, especially for a small child.

eta: also our ped dentist does not take any dental insurance, which lowers their overhead and allows for a smaller staff. That may be part of the reason it is more affordable (I know some physicians that do not accept insurance but their overall rates are less expensive as a result of not being tied up w/ insurance paperwork, billing etc.)

The $142 did NOT include x-rays. That was just exam, fluoride treatment and polishing. I do think I'll skip the fluoride next time as I don't think it's necessary.

DD's current dentist also does not accept insurance, so that doesn't add to cost as far as I can tell. I think they are just overpriced. Honestly, I don't even carry dental insurance as it is so expensive and would probably cost more than our annual dental bills (provided nobody needs major work done). I just use our Flexible Medical Spending for it.

I do still have to call and discuss the no parent policy with the potential new dentist. However, if it is a "one-size-fits-all" policy, then we likely will not go there no matter how good they might be. I'll keep looking around. My motherly instincts are telling me that it's not a good idea, and since so many of you agree, I'm listening to both!

[lizajane]

The $142 did NOT include x-rays. That was just exam, fluoride treatment and polishing. I do think I'll skip the fluoride next time as I don't think it's necessary.

DD's current dentist also does not accept insurance, so that doesn't add to cost as far as I can tell. I think they are just overpriced. Honestly, I don't even carry dental insurance as it is so expensive and would probably cost more than our annual dental bills (provided nobody needs major work done). I just use our Flexible Medical Spending for it.

I do still have to call and discuss the no parent policy with the potential new dentist. However, if it is a "one-size-fits-all" policy, then we likely will not go there no matter how good they might be. I'll keep looking around. My motherly instincts are telling me that it's not a good idea, and since so many of you agree, I'm listening to both!

i spent $250 per kid for an inital exam. or maybe less for dylan and more for schuyler, because schuyler got x-rays. or maybe dylan did, too? not sure. i all i know is that the visit cost me $500. i do not have dental insurance.

they don't forbid parents from coming back, but they don't really want you to. but their chairs are all in an open area with several dentists and hygenists working all at once. so nothing dangerous is going to happen.

i may be in the minority, but my kid does things a lot better when i am NOT there. i haven't even volunteered in his K class for this reason. the brothers went back together at the dentist and both had a great time. when schuyler had to have fillings, the moment he saw ME, he burst into hysterics. i am glad they don't make me go back with him.

[o_mom]

they don't forbid parents from coming back, but they don't really want you to. but their chairs are all in an open area with several dentists and hygenists working all at once. so nothing dangerous is going to happen.



Even with an open area, several hygenists, etc. I still wouldn't allow it. There are too many things that are considered 'standard of care' that I wouldn't allow, such as a papoose board for an exam or threats to get cooperation.

[lizajane]

Even with an open area, several hygenists, etc. I still wouldn't allow it. There are too many things that are considered 'standard of care' that I wouldn't allow, such as a papoose board for an exam or threats to get cooperation.

i have friends who know my ped. detist personally and friends who recommended him. he is sort of "the guy" in my circle. he has a 3 and 5 eyar old boy just like me. the way he spoke to the kids was awesome and perfect in every way. schuyler sucks his thumb, but does so mostly because of his OCD. i wrote that on the chart- that NO ONE could make any statement to him that would cause him to obsess- like "if you don't brush your teeth they will all fall out." the dentist did not say ONE THING to him about this thumb and was very reassuring to me that his bite has not been damaged, and if it does get damaged, we will just deal with it, as cleary it was necessary for him to have his thumb now. honestly, i was so delighted with the way he spoke to me and the kids and how i saw him interact with them. so that is why i am comfortable with them being treated alone. (well, together... with each other.)

[o_mom]

i have friends who know my ped. detist personally and friends who recommended him. he is sort of "the guy" in my circle. he has a 3 and 5 eyar old boy just like me. the way he spoke to the kids was awesome and perfect in every way. schuyler sucks his thumb, but does so mostly because of his OCD. i wrote that on the chart- that NO ONE could make any statement to him that would cause him to obsess- like "if you don't brush your teeth they will all fall out." the dentist did not say ONE THING to him about this thumb and was very reassuring to me that his bite has not been damaged, and if it does get damaged, we will just deal with it, as cleary it was necessary for him to have his thumb now. honestly, i was so delighted with the way he spoke to me and the kids and how i saw him interact with them. so that is why i am comfortable with them being treated alone. (well, together... with each other.)

It is wonderful to find someone so caring, and that seems like the real reason you are comfortable with them going alone, not just that it is an open area. I was just commenting in general that an open seating area is not going to prevent some of practices I would want to avoid.

[kransden]

The ped dentist I saw in the midwest didn't allow parents to go in the back with kids, unless they were very young. Honestly, the kids just behave better without a parent. It was an open office and I was pretty comfortable about it. How you could do someting inaproppriate with 5 techs in the same room and 1 or 2 other dentists? My current ped dentist has a much better set up. It is open like the other one, but there is a little sitting area w/ coloring stuff for the other kids. Your kid can't see you, but you can see your kids. I like it a lot.

[gatorsmom]

I don't have time to read all the other posts so maybe they already mentioned these things.

Our pediatric dentist doesn't allow the parent to go back either, but the entire area is visible through windows in the parent viewing/waiting room. Maybe this new dentist has that?

I wouldn't go to a place that didn't allow me back with the child. or at least so that I could see them and they could see me. I don't think a pediatric dentist is necessary. When I was a child, my mom took my brother and I to a Pediatric Dentist and he was terribly rough. My mom couldn't be in there with us and I knew this dentist was giving my brother a terrible time. We always told my mom afterwards that we hated hiim because he was so mean but I don't really think she understood the extent of it. Obviously not all dentists are like this but it has swayed my opinions on them.

[lizajane]

i also forgot to mention a fun little fact about our pediatric dentist...

he is HOT.

like, mcdentist hot.

hot hot hot.

lol!!!

[brittone2]

i also forgot to mention a fun little fact about our pediatric dentist...

he is HOT.

like, mcdentist hot.

hot hot hot.

lol!!!

LOL. The dentist I see (regular dentist) is totally hot ;) My parents see the same guy (he was theirs first LOL) and my mom refers to him as "dr. hottie". Now I can't take my almost 5 year old DS with me to appts because even he calls him "dr. hottie" because he's heard my mom call him that so often (and as a joke my dad and I refer to him as Dr. Hottie as well). So we're sticking w/ the pedi dentist for DS LOL, mostly so I'm not totally embarrassed by DS telling on me ;)
:ROTFLMAO:

[nov04]

I don't think a ped. dentist is ready if the child does well with a family one.

I will *never* allow a dentist to see my child alone. There's no good reason in our situation.

[bubbaray]

My girls go to a pediatric dentist, mainly b/c the dentist DH and I go to is downtown where we used to live and I'm not driving 1hr with 2 kids so I can get to listen to them scream at the dentist. OK, so they don't scream anymore, but I tell ya, DD#1 used to scream blue murder. It was embarassing.

Our pediatric dentist requires parents to participate in the exams, at least with young patients (they recommend starting at 12m). They have a soundproof room (see 1st paragraph). The parent and the dentist sit facing each other, parent holding child facing the parent. The dentist puts a pillow in his lap and the child lays back into the pillow, looking up at the dentist. DD#1 is now in the "big girls" chair -- IIRC, they have about 10 chairs in a big open area. The parents can stay beside the chair or sit on a bench across the room, or sit out in the waiting room.

I can't remember what the actual charge is per visit b/c we have killer dental coverage.

I personally would not be comfortable with my child going to a dentist, pediatric or otherwise, who prevented parents from being with the child if they or the child wanted. I've never heard of a papoose board until this thread. Ugh. Brings back wretched memories of the nasty, horrible nurses we encountered in Palm Springs at the Eisenhower Medical Center in 2006, two of whom pinned DD#1 to the bed and pried open her mouth just to administer Tylenol. Um, hello, give me the damn syringe and I can do it without upsetting her. Maybe the papoose thing and pinning down children is standard in the US, I dunno. Its NOT here (Canada).

[bubbaray]

i also forgot to mention a fun little fact about our pediatric dentist...

he is HOT.

like, mcdentist hot.

hot hot hot.

lol!!!


Down girl. LOL

[randomkid]

Maybe the papoose thing and pinning down children is standard in the US, I dunno. Its NOT here (Canada).

Um...No...NOT standard in the US. I've never seen or heard of a papoose board until this thread nor would I allow someone to use one on my child unless it was a life threatening situation. No one has even pinned down my child (well, except for myself) and no one ever will. IMO, that is just blatant medical malpractice. Honestly, I would never have allowed that to continue. I would have immediately made those nurses stop what they were doing and said I would do it myself. If they didn't let me, I'd have refused the treatment.

When DD was around a year old, she had to have blood drawn. The RN was fishing around in her arm with that needle with no success. I calmly, but firmly told him "You need to stop now" and he did. I asked to speak to the MD and told him no blood draw for DD. The MD felt she needed the blood test and told me he would do it himself. I told him that he had one stick to get it or we were leaving - he agreed and he did the blood draw himself, on the first attempt. Recently, DD had to have blood drawn again. First thing I said to the RN was "Are you good at this? We had a bad experience in the past and you get one chance". Both of these situations were at after hours clinics, not at our regular ped's office. Every medical situation we've been in, I've held DD myself. The MD or nurse tells me where they want me and I do the holding.

If that were standard practice here, do you think I would have started this thread? It's called being your own and your child's health care advocate and the right to refuse - which believe it or not, we do have here in the US.

[gatorsmom]

When DD was around a year old, she had to have blood drawn. The RN was fishing around in her arm with that needle with no success. I calmly, but firmly told him "You need to stop now" and he did. I asked to speak to the MD and told him no blood draw for DD. The MD felt she needed the blood test and told me he would do it himself. I told him that he had one stick to get it or we were leaving - he agreed and he did the blood draw himself, on the first attempt. Recently, DD had to have blood drawn again. First thing I said to the RN was "Are you good at this? We had a bad experience in the past and you get one chance".
.

I wish I would have been more strict about that recently when Gator needed blood drawn. I know the nurse and she is usually so helpful and is very kind but she just kept fishing for that artery. I did hold down DS myself but I wish I'd just have put a stop to it. At the time he really needed the bloodwork although now I wish I"d have handled it differently. I have major mommy guilt about it. Believe me, that won't happen again.

[o_mom]

I personally would not be comfortable with my child going to a dentist, pediatric or otherwise, who prevented parents from being with the child if they or the child wanted. I've never heard of a papoose board until this thread. Ugh. Brings back wretched memories of the nasty, horrible nurses we encountered in Palm Springs at the Eisenhower Medical Center in 2006, two of whom pinned DD#1 to the bed and pried open her mouth just to administer Tylenol. Um, hello, give me the damn syringe and I can do it without upsetting her. Maybe the papoose thing and pinning down children is standard in the US, I dunno. Its NOT here (Canada).


The papoose board can have its uses. I was on one at 4 years old for stitches to my face after a dog bite. Not pleasant, but realistically, most 4 yos aren't going to hold still for stitches to the face (around 15 total). The alternative would have been some sort of sedation and I can't imagine the risks of that at a tiny rural hospital 25+ years ago. However, when DS1 needed 3 staples in his head at 4.5 yrs, there wasn't even a mention of it. I just held his hands, they had a nurse distract him with bubbles and they stapled him up (with a local).

The problem comes when healthcare providers see it as an easy way out and don't consider it a big deal. It makes their life easier to have the patient restrained and so they just do it for everything and that is not right. Kids are so many times not seen as people by society in general that it just bleeds over into the healthcare setting. It's also easy as parents to get caught up in it, not want to make a big scene, and have regrets afterward about letting something be done to our kids. BTDT, as it sounds like you have, and we just have to try to do better the next time.

[randomkid]

I wish I would have been more strict about that recently when Gator needed blood drawn. I know the nurse and she is usually so helpful and is very kind but she just kept fishing for that artery. I did hold down DS myself but I wish I'd just have put a stop to it. At the time he really needed the bloodwork although now I wish I"d have handled it differently. I have major mommy guilt about it. Believe me, that won't happen again.

Don't feel guilty! You know that if there is a next time, you *will* speak up. That's how we learn. Your DS likely won't remember it. I've been in healthcare almost 19 years and have had a lot of experience in teaching my patients and their families to be their own advocates and I have done it myself for a countless number of patients. I was prepared in my mind when I had DD that I would always speak up.

Believe me, I felt guilty for a long time after that first occasion because I panicked and took DD to the after hours clinic with a high fever that she had had for < 24 hours (I was home alone, DH and my parents were both out of town). The next day, fever was gone and she had a cold. I discovered that if you go to the after hours clinic with a fever, they will check everything - they even cathed her on that visit to check for UTI. The second visit, the blood work was absolutely necessary as she had a fever of 106 with no other symptoms. I just decided to learn from it and after that, I've always waited a day or two before becoming concerned about a fever.

[Gena]

Um...No...NOT standard in the US. I've never seen or heard of a papoose board until this thread nor would I allow someone to use one on my child unless it was a life threatening situation. No one has even pinned down my child (well, except for myself) and no one ever will. IMO, that is just blatant medical malpractice.

To be honest, I'm shocked that you are in healthcare and would make such a blanket, generalized statement.

Whether using a papoose board, other restraints, or holding a child down is appropriate really depends on the situation and the child. As I said, we have allowed the papoose board and I have had my child pinned down. None of those instances were life threatening situations, but they were medically necessary. They were definately NOT medical malpractice.

For example, we allowed the papoose board last year when DS needed stitiches to the back of his head. We believe that the papoose board is preferable in this situation to general anesthesia, which carries certain risks. We also allowed it when he had a swallowing test done (the floroscope required him be perfectly still for an extended period of time). He was restrained (tightly wrapped in sheets) for his EEG. He has been pinned down in the doctors office for injections. DS is a strong kid and it takes myself and two nurses to hold him down while another administers the shot. Those are just a few examples.

I know that many kids do not need papoose boards or to be pinned down in these situations. They can be distracted by other things to keep them calm or they are able to understand basic explanations of what is happening so they can cooperate. I guess typical kids can be taught to undergo these types of procedures without being restrained. But I'm not raising a typical kid. I know that in these situations the papoose board/restraint/holding down was the better option for my child. It's gut-wrenching to see my child restrained, but I don't regret making decisions that are medically necessary. I don't appreciate you labelling these situations as "blatant medical malpractice", especially if you have never seen a papoose board in use. It's not a torture device, it's a medical tool.

Like I said before, we do not allow the use of the papoose board for routine exams (We don't allow sedated exams either, although they've been offered by the eye doctor, the audiologist, the pediatric dentsist, etc.). To us, that's a totally different situation. But it definately has it's place in non-routine procedures.

[randomkid]

To be honest, I'm shocked that you are in healthcare and would make such a blanket, generalized statement.

Whether using a papoose board, other restraints, or holding a child down is appropriate really depends on the situation and the child. As I said, we have allowed the papoose board and I have had my child pinned down. None of those instances were life threatening situations, but they were medically necessary. They were definately NOT medical malpractice.

Honestly, you don't have to get so defensive. I was not making a blanket, generalized statement. I was referring specifically to my own child and to this:
I've never heard of a papoose board until this thread. Ugh. Brings back wretched memories of the nasty, horrible nurses we encountered in Palm Springs at the Eisenhower Medical Center in 2006, two of whom pinned DD#1 to the bed and pried open her mouth just to administer Tylenol. Um, hello, give me the damn syringe and I can do it without upsetting her. Maybe the papoose thing and pinning down children is standard in the US, I dunno. Its NOT here (Canada).

No, it's not standard practice in the US, but I can see the need in some cases. Now that DD is bigger, it does take 2 of us to hold her down for a shot, but in that case, I take another family member with me and we do the restraining. Really, being in healthcare, I *would* consider an open wound that needs stitches a life threatening situation. If a wound needs stitches, then it is at high risk for life threatening infection. Also, using a papoose board or restraints over general anesthesia is definitely preferable (and again, general anesthesia can be life threatening). I guess I think of things a little differently because I consider all aspects of the situation. I didn't mean imminent threat - should have worded that differently. Your examples are significantly different than the one above.

I stand by my judgement that the scenario above was medical malpractice. It is completely unnecessary for two adults to pin down a child and pry open her mouth for Tylenol, esp. if the parent is capable of getting the child to take the medication without doing that. I really think you mistook what I was saying. I felt that the PP was slamming our healthcare system and I was letting her know that what she experienced is not the norm and WAS unacceptable. Sorry if you took offense. Please re-read my post and you may see that I was talking specifically about my child and the PP's experience.

ETA: I should not have allowed myself to be baited by bubbaray's comments. This thread is about pediatric dentists, not a debate on restraining children in healthcare situations.

[kransden]

A papoose board typically isn't used for normal kids in normal situations. My dd had a cavity on the front of her tooth. At age 2 they don't use anesthesia. So they restrained her using the board. It was horrible but necessary. I was there the entire time. My new dentist also does special needs children. I imagine he uses it for some of them during a regular exam too. Who wants to be hit or bit? So don't knock them until you understand them.

[brittone2]

DS had his 1st cavity filled at 18 months and I held him. It was awful but I think he would have been even more freaked out by the papoose board. Our pedi dentist gave us the option to try to hold him.

It wouldn't have been that bad, but they were trying to place the composite filling on the back of an upper central incisor. There isn't much surface area to work with, so the filling kept falling out, and it took many attempts to get it in place, which added to the craziness.

We survived though.

[toothfairy]

A papoose may be used in dentistry for patients when their safety is at risk and are not meant to punish or "force" a child.

I am not a ped dentist nor have I used a papoose, however I have observed papoose use for pediatric and mentally retarded patients. We as dentists use sharp instruments, work in tiny confined spaces and use very technique sensitive materials to fix teeth. We want to do a good job, do it as quickly as possible, and restore a person to optimal function.

That said, their are many personalities in patients and dentists and many different approaches to how treatment can safely be administered: each patient should decide for herself and her child what is suitable.

As for whether or not a parent should be present during a child's treatment, well, I have my personal philosophy and mode of practice. I completely understand as a parent why one would wish to be present during a child's treatment. However, as a dentist I know that I must be able to care for a child, attend to his or her immediate need and repair the tooth (not always as simple as it might seem!) or teeth, without any other distraction. Parents can be helpful in the treatment area but by the same token they sometimes are not.

This is just me. I wouldn't totally knock the idea of not being present in a treatment room before you get to know the dentist.



Amy

[MelissaTC]

Getting back to the the original post....

I pay $172 for an exam, fluoride and x-rays. Our Ped dentist does not take insurance but gives me a form to file with my insurance. I decided to try my dentist who is a family dentist. I LOVE him. I hate going to the dentist. But I love him. He is gentle and I have seen him with kids and thought it would be great for DS. Well, DS was due for x-rays but my dentist does not do them until age 6. When we came back at age 6, DS had cavities between his teeth. DS had perfect teeth until that visit and I am convinced that if he had
x-rays the first visit, we would have seen the start of that mess. I wound up having to take him back to the old Ped dentist where we were welcomed with open arms and great treatment. The Ped dentist had a different take on things from my regular dentist (DS has a gap between his two front teeth and is a thumb sucker). Needless to say, I am paying $172 in two weeks to go back to Dr. Rob.

I go back with DS but he is getting to the point where he doesn't need me. They have an open area with 8 chairs in a semi-circle and flat screens on the ceiling so the kids watch Disney movies. The Dentists make their way around the circle. If they are doing a filling or other work, they have the kids in an exam room. I have been in that room with DS and I was expected to be there. When I brought DS there for an emergency at two, I was asked if I thought he would do ok without being restrained by me or otherwise. DS did fine in the big chair. He loved wearing the sunglasses, and all the silly names and tricks they do with the instruments.

HTH!

[Fairy]

No snark in any way intended here, but I honest don't think Melissa or anyone else was trying to slam the US Healthcare system. I don't want to put words in her mouth, but my impression, here, was simply that she was saying, this is how it works with my DCs' dentist, which reminds me of another medical experience we had once; and then she said being unfamiliar with US Healthcare, which is alot different than Canada's, she wasn't sure if that was a standard or familiar experience in the US. I truly didn't read that as a slam or a bait at all.

If she was baiting? Dude, crappy job (haha).

I do think the concept of restraints in denstistry as a valid topic/concern in discussing possibilities our kids might go thru. Pappoose boards DO get used, they have their uses, and whether I believe in them or not I have no real idea, I've never had to think about it, thank you God. But I can absolutely see how thiat subject organically emerged in this discussion.

I do hope you figure out what you want to do, you've got some good advice here.

-- Hil