Teeth

    It took me a month to get in to see a dentist who did not use 
mercury (silver dental amalgam) fillings.  He was known as "very expensive but worth it".  We sat in the luxurious waiting room, waiting to see the younger of the two dentists.  My daughter played with the very nice toys for an hour. 

    The dentist came out to meet us.  This was a good sign I thought, meeting the child in friendly surroundings.  He was young, tall, attractive, and boisterous.  My daughter crawled into my lap to nurse for comfort. 

    He stood over us and asked, "How old is she?" 

    "Nineteen months,"  I answered. 

    "Does she have teeth?"  he asked. 

    Very strange question for a dentist to ask, I thought.  "Yes," I answered. 

    "Does it hurt you when she nurses?" 

    "No," I said. 

    We went into his examining room with the multiple dental chairs facing big picture windows overlooking a creek.  He pointed out the view and told me the name of the creek.  My daughter was very good during the quick exam.  He said that I needed to see a dentist who could put her in the hospital and put her to sleep in order to fill her two front teeth.  He said we also had the option of using topical fluoride nightly and hoping that she could hold out until she was older and would not 
have to be anesthetized.  He did not try to do anything to her teeth although she had been very obedient during the exam.  He called it "Baby Bottle Tooth Decay" and suggested that I stop nursing as soon as possible. 

    The second dentist was a pediatric dentist who was recommended by a nurse at our pediatrician's office.  He was a very popular dentist with a huge practice working out of two offices.  I finally was able to get an appointment.  The office we visited was the newer of the two, and the waiting room was set up for children.  It had a playroom, a theater, and a reading area where we spent more than an hour.  The exam rooms were more traditional but had a TV with cartoons playing to distract us while we waited for the dentist. 

    This dentist was older.  He spoke with me and I told him that my daughter was very verbal, that he could speak to her and that she would do as he asked.  He asked me to put her in the chair and then scoot her up.  She scooted herself up and he said, "She does understand what you say, doesn't she?"  He did a brief examination and my daughter was very compliant.  He said that he would put her to sleep in a hospital and fill the "four" front teeth with composite fillings, clean her teeth, and put a sealant on the molars.  He did all his hospital work on Wednesdays, and I needed permission from her doctor for her to be anesthetized.  I had a choice of two hospitals. 

    He said that there was an experimental treatment that they were trying at Baylor that involved painting the teeth with an orange fluoride solution, but that it left the teeth ugly and stained, and that he didn't know effectiveness or the side effects.  I asked if he had any information about this process.  He seemed surprised that I had asked.  He left the room and, when he came back, he said, "No." 

    He suggested that, if I couldn't wean her, I should at least stop nursing at night.  He did seem a little more knowledgeable about nursing and children.  Well, at least he didn't ask whether she had teeth. 

    He did not try to do any work on her teeth.  He commented that he had just tried to put a crown on a 3-year-old and that it was very difficult although all he had to do was slip the crown on the tooth.  He said that he was very concerned with looks and wouldn't do what some dentists do, leaving her with ugly metal caps.  He would do it "right".  He even did orthodontics on young children because he knew that appearance was important to little people, too. 

    I said that the cavities were progressing very rapidly; but he said, no, they had been under the gum line and that they had grown out farther so that I could now see them.  I don't know how he made this incorrect diagnosis since he had never seen her before. 

    I called both hospitals in which this dentist practiced and neither one would let a parent stay with the child in the operating room even if they had the dentist's permission.  So I called all the other hospitals in our area--same response.  I called everyone I knew to find a dentist that would at least try to do something without anesthesia (no luck).  Then I talked with the anesthesiologist service to make sure I could 
request an anesthesiologist, not just a nurse anesthetist.  I felt that there should be at least one physician in the room.  They said I could request one and they would see what they could do. 

    I was very uncomfortable with the whole thing, and I was trying to find an alternative.  My daughter had contracted a horrible cough in September which would not permit her to be anesthetized.  During this time, she also broke her arm, the poor baby. She was better around Christmas, and I was going to make the reservations with the dentist and the hospital after the holidays.  I never got a chance.  In January she contracted Bacterial Meningitis and we almost lost her. 

    We spent 18 days in the hospital and, when we went home, my 2-year-old was deaf in one ear and had to relearn all her gross motor skills, everything from lifting her head to rolling over, crawling, standing, walking....  The experience is still too traumatic for me to write about it. 

    Her hospital experience was such a nightmare that I did not want to take her back to a hospital.  She didn't want to go either.  There were times when she would wince in pain and I would ask, "Did that hurt?" 

    "No," she would say, "I'm not going to the doctor." 

    It was six weeks (and after she was beginning to walk) before we went to her pediatrician.  We talked about her teeth, and the doctor said that he felt it was always risky to anesthetize anyone, especially children, and in particular, my daughter, because of the meningitis.  He suggested we wait as long as possible. 

    I had a lot of "mommy" guilt about her teeth.  I could see definite deterioration no matter what I did.  Luckily, I had a good friend who copied for me everything that she could find on dental caries (tooth decay) and breast feeding; and, after I had access to the internet, she sent me links.  I decided that the nursing did not cause the cavities and that nursing was important to my daughter's recovery from meningitis.  So we waited for her to improve and prayed that there wouldn't be a fall that could break the weakened teeth (there were many falls--she was relearning to walk) and that the cavities would not cause her pain.  Either condition would make hospitalization necessary. 

    While we were waiting, my friend went to a La Leche League conference, and one of the speakers she chose to hear was a dentist from San Antonio, Texas who spoke about dental caries (tooth decay) and nursing.  Dr. King's theory was that dental caries was not caused by nursing but in spite of it.  She also said that she did not like to use general anesthesia for neurological reasons, and she usually avoided it.  Some 
anesthetics are neurotoxins.  Dr. King said that with very young children's thin gums, most work could be done with just a topical pain killer. 

     My friend talked with Dr. King after the conference and told her about my daughter.  The dentist told my friend to have me call and set up an appointment for an evaluation.  I called the next day, they worked us into the schedule, and we drove to San Antonio that Friday. 

     The waiting room was tiny, but filled with well-worn toys and books.  The exam room had four chairs facing out onto a court yard.  Everyone was very friendly and looked very busy.  It was treated as quite normal for my husband and I to be with our daughter the whole time.  In the chair next to our daughter was a boy playing Nintendo while he had his teeth cleaned.  Next to him, on the other side of a fish tank, was an old woman having a tooth filled. The staff was wonderful to our daughter.  They called it a "happy visit".  She received a "ride" in the Shamu-the-Whale dental chair while we waited for the dentist.  I was still filling out forms when Dr. King came over, talked with our daughter and examined her teeth; told her thank you; gave her a choice of toothbrushes; told the assistant to let her  choose three toys; and then she proceeded to the next patient.  My husband stayed with our daughter while she dug through the treasure chests.  The assistant told me to schedule four visits early in the morning so that they could fill the teeth while the patient was still fresh. 

    There was no charge for the "happy visit".  The receptionist said some children required many "happy visits" before they were comfortable and that was okay.  Would I like to schedule another "happy visit" or to schedule the procedure?  We set up four appointments, one for each tooth. 

    There was never any question about trying to repair her teeth without "putting her to sleep".  The doctor seemed very confident. 

    Dr. King didn't even mention nursing.  Well, actually, she didn't even talk with us; but, since she was willing to try to repair the teeth and our daughter liked her, that didn't matter.  I didn't know whether the doctor was shy and quiet, or busy and efficient. 

    Our daughter looked forward to her visits with Dr. King.  She even said, "Dr. King is a nice girl." 

    My husband took more time off work and drove us to San Antonio.  Dr.King worked very rapidly and efficiently.  She did not start on the worst tooth; I think she wanted to make sure that our daughter didn't dread her remaining visits.  If the dentist used an anesthetic, I missed it.  She filled the front and back of one tooth with the composit and cured the material with a bright blue light.  As things seemed to be going well, she filled one more tooth.  I did not check the time, but I think that it took no more than five minutes.  Then our daughter was allowed to choose some more toys. 

    I commented that it looked as though our daughter had two teeth done.  The assistant said that, even though Dr. King was able to repair a second tooth, we would leave the appointments as they were in case we needed them (Monday, Wednesday, and Friday of the next week - Dr. King does orthodontics on Tuesday and Thursdays.) 

    At the next appointment, Dr. King started with the worst tooth.  She put a swab with a cherry-flavored gel on our daughter's gums, waited for a minute; and then, while the assistant prepared the hypodermic behind our daughter's chair, Dr. King arranged the over-head light so that it would shine into our daughter's eyes.  They had been very careful before this to make sure the light wasn't in her eyes.  The dentist said, "That's bright.  Why don't you shut your eyes?"  She shut her eyes and never saw the hypodermic.  The Novocain shots were given and our daughter was allowed to get up and go through the toy chests while the shots took effect.  The doctor returned and drilled and filled our daughter's tooth; and then she filled the last tooth, too.  She talked to our daughter the whole time she worked.  Our daughter got her toys.  We scheduled another appointment in a month's time for a cleaning and a check up, paid our bill and left.  I don't think we were there longer than 30 minutes. 

    We were completely finished.  Not a tear.  Only once had our 
daughter looked uncomfortable and gripped the arm of the chair with her little fingers (one hand in a cast because of a broken thumb). 

My husband and I talked: 
    "Why didn't anyone else try this?" 
    "Dr. King made it look easy." 
    "If she could do this, why wasn't anyone else doing this?" 

    We wished so much that we had found this dentist over a year ago, but we were so glad to have found Dr. King at all. 

Note:  We would have paid any amount and traveled any distance to have our daughter's teeth repaired this way, without the use of general anesthesia.  We had started investing in a medical account so we could save the $4,000 that it was going to cost to have it done in a hospital.  Our insurance does not pay for anesthesia outside the dentist's office, an anesthesiologist, the hospital, nor the extra charges the dentist was charging us for the hospital procedure.  Dr. King's charges were 80 percent covered by our dental insurance and our portion was less than $75.  Even if we had flown to San Antonio, stayed in a hotel, and hadn't had any insurance, we still would have saved money over the projected cost of the hospital procedure. 

Note:  Our daughter's worst tooth started decaying first in the front.  It looked at first like a slight groove, then a gum-line cavity; then it decayed in the back; then the decay continued around the side until there was an actual notch in the side of her tooth. 

Note:  More "mommy" guilt:  I ask myself why had I accepted the opinion of two dentists, one who knew nothing about babies' teeth and the other who thought so little about anesthetizing children that he did it every Wednesday.  Why didn't I keep looking for someone who would at least try to clean her teeth?  I felt that, if they had done that much, they would have realized that they could work on her teeth with little difficulty.  Never have I felt guilty about nursing. 

Note:  I have heard since then that the Streptococcus Mutans bacteria that causes tooth decay doesn't like salt; so some health professionals suggest a salt water rinse after brushing.  I think we'll try it.  My daughter wasn't very good about spitting until recently; and I don't know how I will get "yucky-tasting" salt water in her mouth more than once, but it is worth a try. 

I hope this helps, 
Engela 
homeschoolkids@geocities.com