Pediatric Dentistry Cavity Filling Sedative?

Updated on November 21, 2008
T.N. asks from Fairview Heights, IL
28 answers

My 3 year old has a cavity between his superior central incisors (top front two teeth). I am embarrassed to say this, it's my fault I realize, too much juice and not enough brushing. Now we have a problem. He totally freaked out when we tried to use the "pig nose", nitrous laughing gas, to fill it. He ended up letting them drill out the little bit they could without using any anesthesia, and filled it...and the filling has fallen out twice now. This is because without anesthesia, they can't get all the decay out and the filling can't adhere to the tooth. Anyway, we thought we could leave it and buy some time til he's a bit older, but he's now complaining of pain. Hate for it to get infected. Soooo, now they want to go ahead and do the procedure, a shot to numb with the help of laughing gas. But, in order for him to allow the "pig nose", they want to give him a sedative prior to arrival. It's a drink that has to be approved by the pediatrician that they say will relax him so he's not so anxious. The drink is $260, with no hope of insurance coverage. We are willing to pay the price to make this less devastating to him, but I am nervous to give it to him. Anyone ever done this? Does it make him practically listless? I don't know what to do. If it were just tears, I would make him sit there and do it, but he gets absolutely hysterical and I don't want to put him through that. I am new to this kid dentistry thing. I just figured why waste time (and his anxiety) on teeth that will fall out in 2 years. Or am I naive?

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R.H.

answers from St. Louis on

That is a lot of cash to dish out to relax him for a baby tooth. Try Benadryl but not the full dose for his weight and age. Just enough to take the edge off.

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K.B.

answers from Kansas City on

I would suggest seeing if you can bring the pig nose home. So he can play around with it. Or you could play pretend dentist at home with it and see if he doesn't get more comfortable. With my son, the more explaination the better so I think we talked about the dentist for a month before we went. Also, my dentist has tv's on the ceiling so they have something else to concentrate on. I've seen a dentist game too, maybe it was a playdoh thing, but he could use that for pretend too. Help him relax and familiarize himself.

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A.Z.

answers from Wichita on

I would def. Recomend it!! I've had 2 children be put totally under just to fill cavities!! It is sooo much better for them!! My youngest is 4 and just 3 weeks ago we had him in the hospital fixing his teeth!! The loopy juice is what we call it doesn't totally knock them out just make them feel really good. It looks like they are drunk. But my son was not upset at all when they told him he had to give me his nintendo ds. If they told him before that he would of totally freeked out.it works great but be glad they caught it now instead of having to pull them out!my daughter had to have that done!! Good luck

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T.I.

answers from Kansas City on

Whatever you decide to do with the sedating, please don't wait until they just "fall out" because some kids don't lose their top baby teeth until they are 6 or even 7 1/2. You never know, each child is very different when it comes to losing teeth! One of the moms is so right, the tooth decay does not just sit there on the tooth. Eventually, it travels down into the root. If the root dies, then your poor little guy will have no chance of healthy front teeth, barring from having a false set of teeth one day at a very young age. Do something sooner rather than later!

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J.W.

answers from St. Louis on

I am a general dentist and I have been practicing for 8 years. I specialized in kids for the first 4 years of my career. I would follow your dentist's recommendations to have your child mildly sedated in order to get the necessary dental treatment done. It appears that the "drink" is mildly sedated type and he may appear loopy and semiconscious for a few hours. He may not remember any of it. I would reccomend to restore primary teeth as long as possible because it leaves space for the permanent teeth to erupt normally. Any questions? call my office at Fenton Family Dentistry- Dr. Jessica Nieva ###-###-####

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K.M.

answers from San Diego on

Our dentist uses lasers to fix cavities so there is no numbing or pain. My kids were out in about 25 minutes smiling with their stickers. You may want to find a dentist who uses lasers.

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K.T.

answers from St. Louis on

Don't know much about the sedative you mentioned, but wanted to say that we have a "high tech" dentist in Webster Groves (Dr. Kurt Weisenfels) who doesn't have to do any numbing or drilling to fix cavities. He uses lasers to zap them right out. I don't know the specifics, but he swears it's easy, quick and less stress on the kids. Our kids haven't had any real issues yet, but he's reitterated that when and if they do, it's usually not a big deal anymore with the use of lasers. Might be worth finding someone who can do the same if you run out of luck getting your child sedated/numbed. Goodluck.

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C.M.

answers from St. Louis on

Thel liquid is a benaodiazepine called versed that is routinely used as a pre-op med in pediatric patients. It is related to valium and the effect will be that your son will look/act really drunk. His eyes will get goofy and he will smile and perhaps giggle and maybe drool a little. It has a good safety record. It will also impair memory formation around the time of the event so even if they do things to hurt him he won't remember.

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H.H.

answers from Kansas City on

poor thing, I can't believe that they put him through that more than once and isn't staying. I wonder if another dentist would have better luck or something better to use. My son had a small filling filled when he was 7 and had the shot and did fine. It hurts for a few seconds but don't feel a thing once the mouth is numb.

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K.P.

answers from Kansas City on

It depends on what the drink is. I would make sure they are sedation certified and they have people certified to give medical attention if needed. Sometime kids get really sleepy and the staff needs to be prepaired for this. I would ask if what they would do if this happend. If they have a good response then I would go for it. I know that it makes a huge impact on the adult teeth if kids have cavities when they have baby teeth.

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D.V.

answers from St. Louis on

The liquid sedative is probably the same thing they give to children at the hospital when they do tubes in ears or remove the tonsils. My daughter had it twice for the above procedures. They give it to them 1)to make it easier to get them from the parents and 2) to put the IV in during the operation. My daughter was two the first time and almost four the second time. She was fine through the whole thing. She actually did much better during the second one. I would probably do it. Yeah the teeth are going to fall out soon, but you don't want the gums to get infected and do more damage in the long run. Good luck to you.

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A.P.

answers from Kansas City on

O sweetheart, please don't wait til the teeth fall out. The tooth decay can travel down the tooth, into the root, and into the new tooth. It'll be just as bad for them in the future as it is now. If this is a pedi dentist, maybe they have different techniques. A sedative would probably be your best shot if he is still antsy and can't sit still for it due to anxiety. Poor lil kiddo. Hate to see them go through pain. It's not fun. :(
Good luck in whatever decision you do. He'll appreciate it for you later in the long run for not waiting.

A.

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C.L.

answers from Kansas City on

We got referred to a place in Lee's Summit, and they are a specialize in kids only. They wanted to do a bunch of work on my son all at once, who had just turned 7, and perscribed him a pill to take. Well in the end our insurance wasn't going to cover all the work, we ended up going to a place in Gladstone and they didn't perscribe a pill or anything! They just broke up the appointments, to do less at a time etc... My son just got the shot and gas and did perfect every time! Needless to say, all dentist are different in their approaches. Ask if they can't perscribe a pill which would be a little bit cheaper for your pocket etc.. Can't hurt to ask!

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T.M.

answers from Kansas City on

We had the same problem when my oldest daughter was 4 years old. The dentist consulted the physician and wrote her a prescription for the lowest dose of valium available and we gave that to her before her appointment. (Crushed up in applesauce) While this may not be for everyone it worked for her and cost $5.00 versus the $260.00 for the drink. It wore off in about 2-3 hours and she was fine. I would consult with the dentist and physician and see if this may be an option based on age and weight. She is 9 now and has overcome her anxiety about the dentist, but I certainly understand what you are going through. Good Luck

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S.H.

answers from Wichita on

Obviously dental hygiene is VERY important. I know what you mean about why bother when theyre just going to fall out anyway, but keep in mind that what you teach him now sets the pace for what he will do when hes older and on into adulthood. As someone who's parents spent thousands and thousands of dollars on my teeth (braces, pulling teeth, surgeries, etc) I now realize how much I appreciate my beautiful smile. It was the best gift my parents could have ever given me and I mean that with the utmost sincerity ! I dont have any suggestions for anesthesia for a kiddo that young because I dont remember that far back and my kiddo hasnt had that experience yet. Just make sure youre helping him brush his teeth at LEAST twice a day. Make sure you get those molars too because its amazing that even after you brush what can stay in those crevices! Did you know that missing things in those molar crevices is what causes cavities back there? I didnt until recently. Food gets stuck there and if you dont brush really, and I mean REALLY good back there the food starts to ROT! Ewww! And thats how the cavity is formed, all because you missed some food that was stuck back there. I was shocked when I found this out. Id never had a cavity until I got pregnant and I got another recently. I couldnt figure out why because I have excellent dental hygiene. I just wasnt getting back there good enough. I hope this helps and I hope you will push your kiddo to have good dental hygiene even though its a hassle at that age. Its the greatest thing you can ever do for your child's hygiene/appearance. Good luck!!

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M.P.

answers from St. Louis on

I had a similar situation with my son, he had 2 cavities on 2 of his front teeth as well. When I took him to my dentist he wouldn't let them do anything, so I ended up taking him to a pediatric dentist who was able to do it that same day very quickly and my son was excited about the entire visit. I don't know where you are located but the dentist's name is Kenneth Kollmann and he is in Collinsville, IL. The number is ###-###-####. He really is a great dentist and the whole staff is wonderful. God bless!

M.C.

answers from Kansas City on

My daughter was born 8 weeks premature and one of the effects of that was very light enamel on her teeth which protects them from cavities. We ended up having to fill her first cavity at the age of 2. She was fine with the pig nose but as she got older each subsequent visit to the dentist got more difficult. She was anxiety ridden - not because she remembers any pain - just because that's her nature. Anyway, all in all she had 7 fillings by the time she was 4. The last two fillings the dentist had to give her a sedative prior to the appointment. I picked up a pill at the pharmacy - it cost about $1. She took it and was calm by the time we arrived at the office. She didn't act silly or anything - just very relaxed and we had no problems. Thankfully we took preventative measures when she was that young - she is 10 now and has lost all of those baby teeth that were filled and so far has no cavities. Good luck!

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R.M.

answers from Topeka on

First of all I would talk to a pharmacist and see what other option you have to give your son...that would cost a LOT less than $260!!! I would think that they could calculate a safe dose of valium that you could give him...which is what they use for adults before procedures that are going to be nerve wracking. Is this a pediatric dentist that you are taking your son to?? They have so many tricks that they can use to get a child to relax and not be fearful.
Secondly...do NOT think that you can just let these baby teeth go because he will be losing them in a couple of years. I made the same mistake...our youngest daughter had "bottle mouth" because I foolishly let her go to bed with her bottle...when her front permanent teeth came in...guess what...the cavity had traveled down the root and had already affected the permanent teeth!!!! What a mess!!!
Good luck!!!

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M.B.

answers from Topeka on

Hi T., the best advice is to listen to Dr. Jessica on your list of responders. I have been a dental assistant for 12 years and have 6 kids and have seen this type of thing alot. The primary teeth (baby teeth) are very important and need to be taken care of just like your permamnet teeth. The sedative shouldn't cost that much. Check into alternative meds. Your 3 yr. old will have a great experience if he's relaxed and it goes quickly and you'll have no problem with future dental visits. Plus, it's usually harder on the parents than it is on the kids, so be brave. ;) Hang in there and good luck.
M. B.

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C.

answers from St. Louis on

It's important to both take care of the cavity your son has and engage in preventative dentistry. Dentists not only find cavities, they watch for gum disease (a possibility even for kids), administer flouride treatments that help strengthen teeth and screen for orthodontic issues. Taking your children to the dentist also helps set the foundation for a lifetime of dental health - kids are less likely to be anxious or develop a fear of going if it's always just been a routine part of their life.

We've never administered the sedative to our daughter ourselves, but she received it before going into surgery for her tonsils/adenoids. I'm sure every child reacts differently, but it just made our daughter relaxed and "loopy" (she kept trying to touch the TV that was hanging on the wall across the room and saying "silly...sleepy" over and over again). It definitely helped with any anxiety that she had. When they came to take her into surgery she just sat in the red wagon (that's what they do for little kids instead of putting them on a gurney) and waved to us.

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D.B.

answers from Kansas City on

When my daughter was 4, the dentist gave a prescription for a tablet of valium that I crushed and put in applesauce - I think it cost less than $1. In our case, it didn't completely relieve her anxiety - she needed general anesthesia, which was covered under medical insurance for kids under 5 for a dental procedure. That was a lot more than $260 :) (but it was for crowns on 6 molars - trust me, I know the guilt!) But if your son is willing to get in the chair (my daughter wasn't), the valium might calm him down enough.

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D.Z.

answers from St. Louis on

Get ready for expensive as grandson just had the samething done but he would not let them in his mouth so he had to go to the hospital where they put him out under the anthestic an filled the teeth. Was easy on that part, but since they xavier has picked off the thing that they put over the tooth in front. Hope your dental insurance is good as the kids was ok but they ended up paying out of pocket quite a bit. He is 3 an so I make a game for brushing the teeth when he is with us. I do a little song called scrub scrub a dub brush them toofers, it sounds corny but he thinks it is funny an I also have to brush right along with him. Good Luck. Diana Z

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K.C.

answers from Wichita on

I have two sons - a five-year old and a three-year old. My five-year old has always had perfect teeth. My three-year old had ten cavities by age two. Why, I do not know. They eat the same meals. They have their teeth brushed at the same time. I do not know the difference. But last year, my two-year old ended up getting five crowns and five fillings. I refused to allow him to be put under. We finally found a pediatric dentist 80 miles away that only used nitrous oxide. They said it was too dangerous to put a child that young under for teeth. In two visits, his teeth were done. After Tylenol or Motrin for two days after each visit, he was fine. And the dentists and their assistants were wonderful with him! When one of the assitants told me that he slept through the procedures, that if he woke up, she would rub his arm and play with his hair, and he would fall back asleep; I knew they knew a lot about kids. My son has always loved to be touched. They were paying attention. I'm just thankful we found this office!

K.

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S.D.

answers from Topeka on

I have a 5 yr old son who is so terrified of the dentist I have taken him since he was 1 yr old and still no luck in convincing him to get his teeth looked at.Now just a few months ago I took him in he has cavaties that could of ben caught early in between his teeth in the back on both sides that just grew so fast and I knew he needed caps on them it was hectic I even called my pediatricians office for help and there wasn't any edative medication that they would give him the only option for me was the Gas to relax him or to go to another dentist who knocks them out well that was to extreme for me so I refused to get him knocked out he did however with my parental conset get tied into a blanket to help prevent him from grabbing the instruments along with the gas and that helped we got it done and they fixed everything they didn't want us to have to come back.Your not the only mother whos child has cavaties even when we try our best they still will get them.

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V.T.

answers from Kansas City on

My two youngest children had several problems with their teeth. We had to take them to Children's Mercy for surgery so the dentist could take care of it. The sedative should be good as long as the pediatrician approves it (to make sure there are no drug interaction possibilities). It's a lot easier and less expensive to do the sedative in the office than it is to go through the hospital for surgery.

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S.M.

answers from Kansas City on

Hi, T.! I had a similar situation when my little girl was three, a huge cavity. I had never taken her to a dentist, because my siblings and I had not had cavities in our childhoods, so I wasn't concerned. So I was shocked to find a huge one in one of her molars! HUGE! I was still living in Washington, and made an appointment with the best pediatric dentist in the area, even though we had no insurance, because she was so young, and I didn't want to freak her out. I was reassured when he told me that early cavities are almost always due to genetics, and follow the paternal grandfather, if I remember correctly. He explained that even though we had been relaxed about toothbrushing, it was not my fault she had this monster cavity. This dentist was ultra-professional, but also ultra-kind and protective, and so I was shocked when he said that he would have to put her under general anesthesia to do the procedure! He just would not take chances with a child entering hysterics during the procedure by being awake at all, or being traumatized. I was even more shocked when I saw the bill projection...somewhere around $3,000...as I said, we didn't have insurance. (The bulk of the money was for the anesthetist, not our dentist.) That made the procedure almost impossible for us, at the time. Long story short, we prayed our guts out, and asked if he would try doing it without the g.a., taking our chances that if the cavity was too deep once he got in, we would have a couple hundred dollar bill for a failed procedure, and still have the big one to do. He was willing after some hesitation, and God answered! My daughter did great with local anesthetic, albeit with some tears, the cavity was small (although he had been almost certain it would be deeper) and the bill was totally manageable.
I know not all of that applies to your situation, but my thought was (besides praying) that if, unlike us, you do have insurance, is it possible it would cover general anesthetic? Sometimes, these categories of coverage are nonsensical, and they could cover something on a technicality even though it's much more expensive. The other thing I would say is that it's worthwhile to find a great dentist with great staff...it makes all the difference in that awful chair if the kids feel loved, safe, like the office, and are skillfully distracted by highly trained staff...if you've ever had a great nurse give your kids shots v. one who's just doing her job, you know what I mean. I hope it goes great for your little one...it's a tough situation!!! God bless you, and show you what to do!

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J.B.

answers from St. Louis on

Ask the dentist if they use a (papoose) for children that won't hold still. My daughter is special needs and we used it for when the ENT ran a scope down her nose to see her vocal cords. She didn't like being in it but we didn't have to hold her down and of course a sedative was out of the question as they wanted her to cry and make sounds.

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L.K.

answers from St. Louis on

I have not taken my child to the dentist yet, because I have been looking for a child's dentist that does sedation dentistry. (The nearest one is 60 miles away.) I have read up on this subject, and it seems to be safe. It calms the child, does not make them listless at all. If they have tried other things that didn't work for your son...I would say go for it. You can always ask your dentist to give you more information on it, and ask a lot of questions if you are worried about it. Good luck!

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