Tooth Decay

I know you already know not to send tem to bed with a bottle (bottle-mouth). I have seen lots of kids with this and the dentist has always recommended pulling their baby teeth. Can you talk with another dentist for a second opinion?

Hi,
I have a 4 year old whose front two teeth are bad, and that was my plan to just wait until the new ones came in, but the dentist wants to do a root canal. I might go with that, but I havent done so yet. I am going to read all the other responses.

Can anyone suggest a great pediatric dentist is the Rocklin/Roseville area

have any on the dentists recommended putting in fake teeth? When i was two i flew over the handle bars on my tricycle and knocked out my two front teeth and they put fake ones in, and that was over 30 years ago. they have to have something better by now. just a suggestion.

Hi H.. I am new to mamasource, and as a dental hygienist and new mom I would recommend treating his tooth decay. This may include removing or keeping his front teeth depending how bad the decay is. Decay is caused by many different types of nasty bacteria that if left untreated can spread to surrounding teeth. His front teeth on average are scheduled to naturally exfoliate around 5-6 years of age. He wouldn't be the only child his age to prematurely loose his front teeth. I am also interested to know if the dentist your son is seeing has prescribed fluoride tablets/liquid because he is so prone to early decay. I would highly recommend some fluoride supplementation because brushing and flossing obviously will not be enough for him and his age. Hope this helps!

My 8 y/o daughter has been on xylitol gum and candy, since she was 3 y/o. And she doesn't have cavities. You would probably have to extract the decayed teeth and make sure he chews xylitol gum (without aspartame which is in a lot of sugar free gum) after sugary snacks. You may need to brush his teeth after each meal as well. Btw, aspartame is an ingredient that can cause strokes, so I buy xylitol products without it. Check out www.luckyvitamin.com for sparx xylitol candy (choose from citrus, berry, and fruit) for $1.27 each. They give you a lot in each bottle, so it's worth the price. We buy tons of these and shipping is only $6 - flat rate. The gum is more expensive. Well, I hope this helps prevent cavities in the future. Xylitol also helps ear infections as well! It is an ingredient used in Europe since the 70's and is safe to use. You can also do a search on it and find more information. Good luck!

I think that you also have to consider that if you leave his teeth in until they naturally fall out, you have to be concerned that the rotten teeth can also lead to decay and other dental problems to his permanent teeth below. But bottom line is that you shouls get as many informed opinions as you can, and then make your final decision, and obviously you are on the right track! Good luck - H.

Hello H.,
First off I want to let you know that I am a Dental Hygienist with 35 years of experience. Some of what I'm going to say you probably have already heard from the dentist's you have consulted with. So please bear with me.
The newest trend in dentistry is to have your child to the dentist by the time the first teeth begin to erupt, usually around 6 mos. This is a big change from the 3yrs old for the first visit dentistry has used for the last 30 years. You did start earlier than most in taking your child in so I'm assuming you saw the decay in his mouth early.
It is difficult to treat very small children with severe dental disease and it usually requires sedation to adequately treat the affected teeth. This can be something like Valium and nitrous oxide done in the dentists office, where the child is not completely asleep, or with an IV sedation, where he is completely asleep. Both of these procedures should be done by someone who is experienced in sedating young children. Going to a pediatric dentist is a good start for the evaluation (and treatment) and if full sedation is recommended, going to a hospital is the safest bet. This way all the repairs can be done in one visit. (This is also the most expensive)
The average eruption of the upper front teeth is usually around 6 to 6.5 years, but this can happen as early as 5. I would suggest getting an x-ray of the area to see where the permanent teeth are. Many times when the primary teeth are extracted, the permanent teeth will erupt earlier, so the duration of speech difficulties and social problems can be cut short. On the other hand, if extraction is the best treatment now, the teeth are already in very poor shape, possibly abcessed, and already effecting the speech and having social repercussions.If they are left to fall out by themselves, you could be exposing your son to the possibility of a systemic infection from the infected teeth and severe pain and multiple uncomfortable dental visits the can effect future treatments/visits.
On occasion, capping the teeth with stainless crowns is an option if the teeth are not infected. This is a long procedure also and will prevent the speech problems but give him a silver smile, so the social effects will still be there.
In my experience, the children with extracted teeth generally get along fine without the front teeth and the speech recovers when the new teeth finally come in. He is old enough to understand that there will be new teeth coming and be able to cope with the problems short term. Once his friends get used to the new smile they won't even notice the missing teeth. Young children can be very accepting of changes once the "why" is answered.
I also have to say something about the diet. When dental disease shows up in infants, there is something going on with the diet that needs to be changed. The most common problem is Baby Bottle Syndrome. This is from giving the child a bottle while falling asleep that has the juice/milk in it and the child falls asleep with some liquid still in his mouth.This has some sugars in it and the bugs just love that and happily produce acids for long periods of time. It doesn't take long for this acid bath to begin to erode the teeth. So use water to put the child asleep (even just a few swallows at the end of a feeding) and use a soft cloth to wipe the teeth off before putting the child into the bed. Try not to give snacks that have simple carbs in them (refined sugar, fructose, high fructose corn syrup) and limit the exposures to food. Have meal times and snack times instead of unlimited food availability. The bacteria on the teeth are actively producing acids for 30 minutes after each exposure and one Cheerio is an exposure. Sugared drinks are especially bad for teeth. These are sugared sodas, boxed and bagged "juice" that is -% real juice, and sport drinks are especially high in sugar. Apple juice, if given in a bottle should be diluted by at least 50%. Sugared breakfast cereal is really bad too because it will stick on the teeth for a long time.
Dental disease IS contagious. If a parent has periodontal disease or many cavities/ fillings, those bacteria are transmitted by kissing and sharing food and dishes. If a sibling has dental disease, those bacteria are shared from dishes and toothbrushes and personal contact. So treatment of this problem involves the whole family, including Grandparents! Cavities that keep re occurring over years requires everyone in the family to be vigilant about keeping a clean mouth and a reduced sugar diet.
I hope I've given you some information you can use in your decision about treatment. If you haven't seen a pediatric dentist in your search, I would find one for a consultation and be very frank with your concerns regarding treatment options, anesthesia, and outcome. Don't be afraid to ask any questions you need to have an answer to or clarification of. The Dr. won't be surprised at any question you will ask.

L.

Hi H.,
My daughter was just barely 3 years old when she tripped and fell on stairs (while being chased by her teenage cousins). She cracked a tooth which was scheduled for a rooth canal. Upon further examination, it was discovered that she had tooth decay in 3 adjoining top front teeth as well as the cracked tooth. Extraction was recommended because too much of the cracked tooth was damaged and fillings for the other 3 teeth would mean multiple visits for the life of the teeth (too much decay, too much blood, too much movement for growing teeth, etc. meant fillings would have to be reapplied several times).

I cried silently in the waiting room during the entire proceedure questioning whether or not I made the right decision. Speech difficulties, insecurity, and dental visit anxieties, etc. were all things to consider but our dentist assured us the risk were minimal compared to the alternatives.

My daughter is now 7 years old and she has been our toothless wonder for several years now. She did not develop any speech difficulties nor any insecurities. She was admired by many children in her pre-school and later in kindergarten (when a majority of her classmates were just going through the rite of passage) as having "lost" her tooth first. She has a beautiful smiles and most people don't realize her front teeth are missing until being around her for extended periods of time.

We considered spacers but opted against it since she adapted quickly to being toothless and because she did not encounter social difficulties. Spacers would have meant limiting the foods she ate because spacers are delicate and could fall off with a bite on an apple. Also, the spacers could not be anchored properly since her molars had not come in yet.

Although our experience were all positive (we're still waiting for those 4 front teeth to come in since she's a late bloomer), there is no guarantee that your experience will be similar. In the end it will have to be an individual choice and I can only share our experience.

Good luck!
Verna Liza

I would get a second opinion. Call Dr Koz Uyesugi
###-###-####
i take my kids to him. He is a pediatric dentist. He has been awesome. He had my girls teeth coated when they were younger so I wouldnot have some decay issues that were starting on my youngest.
He filled in the back molers with a coating to help with decay and was even able to do fillings without shots on a few surface ones. He was awesome. I use him as well as my husband. Everyone who had issues has switched over and loves him. My girls love going there ( playstation room in the lobby) and he gives a small gift after each visit! Very nice and honest. Hope it works out for you. I bet he can figure somthing out.

Marcie May San Jose

My 3 year old daughter has had this problem since she was 13 or 14 mos. old. I've taken her to a few dentists. They all have had different opinions as to why. Since she was about 17 mos. old she has been seeing an excellent pediatric dentist who is well recommended in my community. He has had us using fluoride on her front teeth since then and he monitors them with check-ups every 3 mos.

His recommendation was to wait and see if they could stay until they naturally fell out. Last fall she had an abcess above the top left tooth that became worse and he recommended pulling it. When I asked him what he would do if it were his child, he said he would pull this one and continue to monitor the others. His was wife was a speech therapist and he reassured me that her speech wouldn't be affected. We went ahead and had this tooth pulled that day.

So far, the other three are fine and the fluoride seems to be working. She speaks constantly at home and a friend even commented on how articulate her speech is. I hope this helps.

J.

Oh, do I know what you are going through. My son has saliva that's acidic so he's doomed to a lifetime of tooth enamel etching. We used sealants and flouride applications (the best flouride is the prescription --toothpaste-type) tube applied on a toothbrush (by you) and make sure he rinses it out and not swallow it. Flouride neutralizes the acid.

Wolf turns 21 next month and he has dental challenges from his acidic salivia. I'd predict this might be your son's challenge to have his baby teeth decay so fast. Just remember his adult teeth are already in place up in his mouth ready to descend. Removing the baby teeth isn't the best solution )in my dentist's opinion) I hope this helps.

Michael

My daughters' had soft tooth enamel due to an inherited lack of Magnesium; it was hard to find a good source of Magnesium for them as the liquids tasted chalky, and the chewable Calciums rarely had any Magnesium :-(. Now my girls are older and we usually use CalMag (that dissolves in water) or tablets; if they slack off too long they get growing pains (Charley horses in their legs) and menstrual cramps. Once I had built up their levels of Magnesium, they did well, but they still need to supplement every now and then. I have also heard that baby bottles, especially with juice, exacerbate tooth destruction. My daughter had a hole through her front teeth that I put toothpaste in for her picture as she had no pain... memories. The best info I have found since is Dr. Gerard F. Judd's book Good Teeth: Birth to Death, http://www.leviticus11.com/goodt.htm

About me: Mom of two healthy and now almost grown, young ladies

I recommend that you research about tooth decay on-line and get a dentist second or third opinion (they are free). Then decide what is the best thing for your child over-all. Depending on how severe your child's tooth decay is there are different procedures that can be done that might not include tooth removal. For instance, instead the pediatric dentist might be able to drilled the tooth down and put a cap on it, which looks just like a regular tooth. Like I said though, it all depends on what is the best method for this particular situation. Some cases can be more severe or less severe than others.

My daughter had to have her front tooth pulled because of an abscess & the dentist recommended removing both front teeth so that the new teeth would fall into place nicely. She was 3 or 4 at the time. She is now 51/2. Because her speech was already well developed, it hasn't really been an issue. She just lost the bottom 2 teeth, so she has had no bottom or top teeth for a few weeks. It is more difficult for her to bite into foods, naturally, but she still manages to eat pears and carrots. She doesn't have any self esteem issues related to her teeth. Most people just think she lost her top teeth naturally. Most kids between 5 & up have missing teeth. Anyhow, I guess you just have to use your best judgement. In my experience, teeth removal was not so bad. I made my husband go with my daughter because I couldn't deal with it. My daughter did fine and is doing great today. Good luck.

I had a similar problem with my four year old. It wasn't exactly tooth decay, but he bumped his two front teeth on a scooter, killing the nerves and turning just those two teeth a dull grayish color. It drives me crazy becuase I am a fanatic about dental hygiene. I teased him all the time about bruxhing on a regular basis or getting silver teeth. Now he's excited because he thinks he's getting a "grill" because of it. NO!No!no! LOL!!!

I don't thinkthere's much you can do once the teeth decay but wait for new ones. It's probably easier at this point if you either replace the teeth (I understand they have porcelin caps for children), but will be expensive. If it's that important to you, go for it.

Celiac disease can be a reason for tooth decay. You may wish to check that out as a possible underlying issue contributing to the tooth decay as well as any other health problems he is experiencing. There is a non-invasive test, via the stool, that can help you learn if this is a problem. See www.enterolab.com. You need not get your doctor's prescription but can order on line.

First of all, I'm sorry to hear about your child's situation. We have experienced some tooth problems with our son. When my son's adult teeth came in one of his front teeth had no enamel on it, so our dentist sealed all of his teeth and then applied bonding on the one tooth. The bonding matches his other teeth and nobody notices any problems which is important now because he is 10 years old now. We are waiting till he turns 16 to get that tooth capped. Speech is a issue but can be corrected when he gets to Kindergarten. Not that you would wait that long. By law the public school district must give your child free speech therapy. Insecurity yes, but with the best dental services you and your child will be fine.

If the dentist suggests removing his teeth, then I would go with that. Your dentist is the expert on teeth, and frankly, tooth decay is not only ugly but EXTREMELY unhealthy - if you let it go without removing the teeth, he may have to have root canals because of the decay extending into the root and nerve of his teeth, perhaps also the gums.Im pretty certain you don't want to cause your child unnecessary pain and suffering just because you would rather his dying teeth stay in his mouth. Would YOU want dying, decayed teeth in YOUR mouth? Probably not. And for heavens sakes, brush the child's teeth FOR him three times a day, remove any juice or sugar loaded drinks from his diet, and dont EVER put him to bed with a drink besides water (that includes milk).
Trust me, he will be even more insecure if you leave those teeth in his mouth - especially if they are discolored. Also, leaving those decayed teeth in can cause the decay to extend INTO his adult teeth before the come up, so that when they DO errupt, they will already be in bad shape. His adult teeth should start coming in around the age of 5, so less than a year with those 4 teeth missing will not cause any lasting speech problems ( I am currently studying for my phd in speech pathology) - children that loose most of their front teeth at one time don't aquire a speech impediment that lasts - as soon as the new teeth come in, any lisping will go away.
I don't want to sound too harsh, but I can't help myself here - his tooth decay is a direct result of your actions, or inaction, when it comes to his teeth. Don't make the child suffer with ugly dead teeth in his mouth because of the care and attention you didn't give to his teeth. Have them removed - they will be just fine. I had my mother read this post, she is a pedodontist, a child's dentist, and she was floored that a 4 year old has such tooth decay that warrants removal. She, and I, both suggest you really have those things removed before you cause any more permanent damage to his adult teeth. They probably are very sensitive to heat and cold, and likely pain him fairly often - dead teeth should not be left in anyone's mouth, especially the child's. There is nothing you can do to reverse the decay, so stop it now before it gets any worse.
To any other mom's out there - as soon as your child cuts his/her first tooth, you should be wiping his tooth and any other new teeth daily with a washcloth to remove and bacteria. Once your child as 4 or 5 teeth, its time to start brushing every day.

Hi H., My 5 year old son Josiah has the same issue with his 2 front teeth. When he was one and a half, my ex used to give him bottles of milk and juice at nite without my knowing which, im sure, was the culprit to the tooth decay. My son did not like pacifiers, and never sucked his thumb, so he sucked on a bottle until he was almost 2 and a half so he could fall asleep at nite. But once I noticed the tooth decay at 2 years old, I would only give him water in his bottles, which he never really drank since he just needed something to suck on. Now that he is 5, the tooth decay is still there, but i've been containing it since age 2, and put him on a rigid dental hygiene plan at home (i make him brush throughout the day, esp. after eating sweets of any kind). Although he still has not seen a dentist yet for the first time, they are still just baby teeth. When his permanent teeth come in, it will be like starting all over again. Don't worry so much about the decay. unless it is seriously rotting and causing some pain (i knew kids at age 2 who had to get root canals), do what you intend to do - let it fall out naturally. When his adult teeth come in, it would be a good idea to be strict about brushing to prevent the same thing from happenning, especially if he has had something sweet to eat in the evening (that's when bacteria in the mouth work the hardest!) Hope this helps! Hang in there, you are not alone!

Hi H., I faced the same decision with my son - when he was almost 2 years old. Unfortunatly one tooth abscessed so we had to address it. His two front teeth were removed - I was warned about the speech concerns too. I felt so bad - he liked apple juice in his bottle and so it was my fault(in the late 70's I had never heard of anything like this. Anyway it all turned out ok - that baby boy will be turning 30 this year - he never had any speech problems and it did not seem to affect him in any negative way. His permanent teeth are fine. I feel for you - its these kind of choices that are so hard for moms.

Hi H.,

When my daughter was 2, I saw something black on her rear molar. I thought it was a raisin that was stuck. I took her to our pediatric dentist (awesome dentist: Dr Joesph Smith in San Leandro if you are in Northern CA) Well, it was not a raisin, but tooth decay. She was born with a condition called Hypoplastic Enamel. This is where the teeth are not covered completely with enamel but have patches like a Dalamtian and are therefore spongy and subject to decay. You can't see this on such small teeth especially in the back. She is 7 now, and has 2 crowns, 2 fillings and gets sealants often. Thankfully, her permanent teeth are coming in fine but are crooked! Looks like she will have braces too. She is now a pro when it comes to dental work! Ask your dentist about this condition Hypoplastic Enamel or GOOGLE it for more info.

Hope this helps!

C.
Katie 7 Danny 10

Hi! My daughter had some decay in her front teeth as well when she was three.The dentist wanted to preserve the baby teeth because he said the baby teeth hold the space for the permanent teeth. He suggested filling the cavities. My daughter was frightened of the dentist and dental procedures, so they did sedated dentistry. The dentist is Doctor Vernon Adams in Palo Alto. The teeth look great...with white fillings. You can't even tell she had it done.

S.

Hi there,
My son fell against a bathtub and knocked one of his front teeth out while my neighbor was watching him. By the time they got in touch with my husband and got him to the dentist it was too late. He was 18 months old. The other front tooth remained in place but grey and dead for another year. Eventually the dentist recommeded removing it. He did fine with no front teeth and they came in at about 6 years old. He is now 16 with no lasting effects (emotionally or otherwise). I asked him and he doesnt recall being teased about it. Hope this helps if you do end up removing them, which I would recommend. My uncle is a pediatric dentist and he told me that there are many illnesses and infections that stem from poor oral hygiene. Good luck!

Hi H.. I am an RDA with 10 years experience in a Pediatric dental office. If the four front teeth are to the point where several dentists are recommending extractions, you may not have a choice. If the teeth become or are infected and it goes untreated that infection can spread through his face to his brain. This is not something to be taken lightly. Make sure you get several opinions and make sure you are seeing a PEDODONTIST and not just a general dentist who works with kids. There is a big difference. The Pedodontist will have 2 additional years of schooling behind them, with training in just this type of case. If you are near Fremont I would recommend Dr. Jason Law, he is great! If the teeth can still be saved the option may be for pulpectomy (baby root canal) and crowns. Good luck!

I would get a second opinion. With that said, tooth decay is serious and if it spreads to his jaw and upper bone very serious. I had a cracked tooth which led to an infection in my bone and the tooth had to go ASAP. I then had to have a bone graft - not fun. We need to have an intact mandible and maxilla to hold teeth in place whether they are baby or adult teeth. Best of luck!

We had this problem when my son was about two and a half and I took my son to every dentist in Marin. We finally went with a pediatric dentist in the City - Dr. David Rothman ###-###-####. I am an attorney, my father is a physician and I grew up in Marin so I had great resources in making my decision. Dr. Rothman taught at UOP dental school and has been instrumental in passing legislation such as that which allowed my son to have his crowns put on at Children's hospital and our health insurance had to pay for it which alleviated much of the expense. This is huge because children die every year by having problems with anaesthia in dental offices where you don't have experts and back up in case of emergency. Dr. Rothman has taken care of three of our four children and the fourth he was very honest and referred her out to someone he thought was more appropriate for her age and condition. We have been going to him for nine years. The children love him which is a plus. He is absolutely brilliant and dedicated to his profession and not just out to make a buck. I know this is traumatic and it is so important to get the right person. You would really do yourself and your son a service to consult with him at least as a second opinion on anything another dentist suggests because he has taught a number of local dentists and can give you feedback on whether it is a good plan. The same son who had the decay was later told by a local dentist in a social context to get braces. Dr. Rothman told us my son would likely grow out of the issue, which he did. He saved us thousands of dollars in orthodontia not to mention the pain for my son of having unnecessary braces. We are very grateful for his help over the years. He is not inexpensive, but he is the best and we decided to go with that. ###-###-####. He's on Union Street in the city, which is not bad if you get an appointment that does not end you up at rush hour.

HI! Sorry to hear about this issue for your little guy. I am not too sure about this but I do know that for prevention going forward, try products with Xylitol listed in the ingredients, preferrably the first. Google it and learn more. We use a tooth gel on brushes everynight, got it from our dentist. Also, we have some mints that we chew up and eat after meals. Good luck!

H... I also work in a dental office and keeping the decayed teeth in his mouth is NOT the healthy thing to do. Decay is caused by bacteria. It can become very uncomfortable for him if they abscess ( become infected ) then he will need Pulpotomies ( Baby Root Canals ) and then cap the teeth. Pulling a tooth will rid him of the decayed teeth... Think of your child's health first( thats why you are posting here I am sure ) over aethetics. When the adult teeth do come in, I suggest sealants. Follow Erica's advice as well.

Hello H., When my daughter was four, she had one decaying front tooth, with just a little hole in it, that eventually led to part of it chipping off. The dentist said we could remove the tooth, and I knew it would be falling out eventually, but I did not want her to have to have it removed. Instead, the pediatric dentist, drilled the tooth down and put a cap on it, which looked just like a regular tooth. I did not want her to be teased about having the decay or, like you mentioned in your message, possibly have to deal with any type of speech impediments or other problems. We were able to do this with low cost and no pain through the Head Start Program. I hope this helps.

Be sure she is not getting a lot of suggery foods, drinks etc. Just stop it! Be sure she is getting an all purpose vitamin. Try it. It may take a while but don't give up. JJJ

Sounds like a tough situation. Not sure if you've gotten a second opinion yet, but I have a FANTASTIC pediatric dentist I would highly recommend... His name is Dr. Greg Rabitz and he's located in the Willow Glen area of San Jose. Best of luck to you!