Update #17 Big dental issues in my DD1 and I'm freaking.

[nfowife]

My DD1 does not have great teeth. She had her first cavities in first grade and it's started to go downhill since then. Anyhow, she has NEVER missed a 6-month checkup.
We recently moved to a new state and in October she saw a new local family dentist. At that time she needed 2 fillings, one was a possible pulpotomy but the dentist was able to do just a filling in that tooth. However, that office did not supply laughing gas as an option and after the experience, I decided going forward to change to a dentist who does offer it as it makes for a much more pleasant experience IMO.

Fast forward to a few weeks ago when one of her prior fillings developed a crack (at some point unbeknownst to us) and developed into an abcess causing pain. This happened at the very end of January/beginning of February. We went to the new dentist (got us in same morning I called, on a Monday) I was planning to switch to for the next cleaning and at first he didn't realize there was an infection/abcess so he was just going to replace the filling. Then while drilling he realized there was an abcess/infection so he immediately stopped, wrote us a prescription for an antibiotic and referred us to an endodontist for the work (we live in a rural area with only 1 pediatric dentist in the immediate area who has a not-great reputation). Got to the endodontist that Friday and my DD was just too anxious and also the tooth was quite hypersensitive at that point that nitrous and novacaine was not enough for her to have the work done then. So, the endodontist said she would recommend we switch to a pediatric specialist to have the work done and moving forward. So fast forward to the following Tuesday and we go 45 miles away to the pediatric dentist who also attempts to fix the tooth and it is just not going to happen. She feels because the tooth has been exposed for a good week now (since the first dentist drilled out some of the old filling and then stopped) there is too much hypersensitivity. She places a temporary filling in the tooth to help with the pain and says we can try again in a few days or we can move forward and do the work under anesthesia at the hospital. I pick the hospital.

So I have had to go back and have all her x-rays from all the dentists and her original checkup in October sent over. Just got a call that not only does the original problem tooth need a cap (tooth T) but other teeth (A, B, F, J, L) will need caps or fillings, in addition to 2 adult teeth that need fillings. I am freaking out! First off how come none of this was mentioned to me at her last cleaning- that is what they are going off of (the x-rays from that cleaning). All this cannot just have popped up since October, and if it was shown on the October x-rays why didn't that dentist propose to do the work then?

I feel like I have just spent close to $300 on 3 consultations getting this one tooth addressed but I feel like I should also now be getting a second opinion before going forward with all this new work. Doesn't this sound crazy? We always took pretty good care of the kid's teeth (and do not drink soda, or juice in the house ever) and my other 2 have never had any cavities yet. Always brush twice a day and we do flouride mouthwash as well. Since this episode I have been the one doing the flossing each night, and have also started xylitol supplements. The dentist also said she will do additional (free) x-rays in the OR and that her care plan might be amended but she is going off of the October x-rays for the treatment plan right now.

I'm thinking I will ask for the proposed treatment plan in writing with copies of the x-rays they are using to base the plan off of and have another dentist look at it. We have a family friend who is an endodontist. I mean, I'm sure this is a nice and trustworthy dentist but we don't have a long history with her, so really aside from this one treatment from her I don't know her from Job. Also I have major dental anxiety myself and crappy teeth so I know she might have genetically just have her mom's crappy teeth. DH OTOH has never had a cavity.

Help me. I am freaking out. And, thanks for reading this long dental saga.

[Katigre]

Can you pull the tooth? At this point, especially if it's a baby tooth, that would be my preference.

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[nfowife]

We have opted to save the tooth (T) at this time because it won't naturally fall out for a few years and if they pull it we would need a spacer. We are trying to avoid orthodontia.
My freak out isn't because of the original problem tooth; I'm upset that there are apparently all these other teeth with decay issues that were somehow evident on the October x-rays and was not told. I'm confused as to why that would happen and so feel like a 2nd opinion is called for? This is a major amount of work on multiple teeth, kwim?

[Momit]

No real advice, but I would encourage you to get a second opinion. I remember reading an article years ago that discussed how widely dentists varied in their proposed treatment plans when presented with the exact same x-rays and symptoms. As with any profession, there are good dentists and bad dentists, but I remember being surprised at the time at the difference in their recommendations.

[94bruin]

If your daughter has a lot of primary teeth that need work, it's best to go to a pediatric dentist. I don't really get why she was referred to an endodontist for a baby tooth. That's not really their area of expertise. A root canal on a permanent tooth is much more involved than a pulpotomy on a baby tooth. (usually referred to as a baby root canal.)

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[egoldber]

If it makes you feel better, my younger DD had similar tooth issues. She had an abscessed tooth in the fall and MANY cavities. Our dentist referred us to to a pediatric dental specialist. She recommended pulling the abscessed tooth at this point because we were unlikely to be able to save it anyway. She also had a crown and numerous fillings. We have had to really step up her dental care. This is foreign to us because NONE of the rest of us has these issues!

[nfowife]

We are seeing a pediatric dentist. That is who is recommending all this work be done under the anesthesia while she is having tooth T worked on (pulpotomy and silver cap). We just don't have one locally so started with a general dentist, then endodontist, and ended up at a pediatric dentist 45 miles from where we live.

I am going to call them tomorrow and get all the x-rays and plan emailed to me and see about getting another opinion. If she needs the work, of course we will do it and it would be easiest to have it done while she's already under general anesthesia as she has proven to be an anxious dental patient. I just want to be sure that all of this work is actually needed, kwim? I just don't understand how, with brushing and generally pretty good dental care and no big dietary changes, she suddenly has all these issues since October or why if they were evident on her October x-rays, that dentist (who we no longer see) didn't mention them.
Do you think I should call that dentist who did the cleaning in October and ask him what the heck is up?

[trales]

Is this all being done at CHAD? We have a good Pedi Dentist practice in Concord if you need a second opinion. I would get a second opinion, even if you have to travel down to Boston, Concord or Manch for it. Good luck, that sounds awful.

[twowhat?]

A second opinion will help you feel better, but I just wanted to say that our pediatric dentist (I respect him very much) says that in baby teeth, a cavity that needs to be filled can form within months. For adult teeth it takes longer before a filling is needed because the enamel is thicker but baby teeth have thin enamel.

My DD1 had 3 cavities (eek!) just recently filled that developed between cleaning appointments. The dentist physically showed me the cavities so they were real - they weren't there at the last cleaning and they were there at this cleaning. So, it's within the realm of possibility. And we have the same dental care routine for my twins (flossing every night, sonicare twice a day) but DD2's teeth are perfectly fine!

So sorry for your DD It sucks hard to have bad teeth.

[AmyZ]

Sounds awful. I agree you should call prior dentist and ask about X-rays. Going forward, I would take her for cleanings every 3/4 months, even if you have to pay since it won't be covered by insurance.