Pediatric Dentist Archives - Kentucky Dental Group

Do Dentists Use Restraints on Children?

Posted on August 31, 2022 by writeradmin.

My sister-in-law and I were talking about our children’s teeth. I mentioned that my son loves his dentist. It’s actually where I get most of my reading done while I am waiting in the waiting room. She said I should never let my child go back to the dentist without me there because some dentists restrain children. I was shocked. I think, though, if my son were being restrained he wouldn’t like going to the dentist as much, right? should I be worried?

Pamela

Dear Pamela,

First, to put your mind at ease, I don’t think you need to be worried at all. Your son loves the dentist and I don’t think he would if anything unpleasant was happening. It sounds like you’ve given him a good foundation in dental care so that his appointments are fun and not about painful dental emergencies. It also sounds like he is happy, confident, and self-sufficient. So, don’t let your sister-in-law give you doubts. I am not espousing one method of parenting over another. I know plenty of parents who go back with their children and they do very well also. The key is knowing YOUR child and what works for them.

Second, let’s go over this idea of restraints. There are two types of restraints in dental care. Those pictured to the left are sometimes called mouth restraints or mouth props. They are designed to keep a child’s mouth open during the procedure. This is for their protection.

A colleague in dental school once told me that he didn’t use one and the child bit down while he was drilling. This caused the drill to go through the tooth and into the child’s gums. He’s never done a procedure on a child without one since that horrible incident. This type of restraint I would say is necessary and makes the child comfortable and safe.

There is another type of restraint, called a papoose. I’ve pictured this below.

Pediatric Paposse Board

These are generally only used in situations where there is a dental emergency and the child will not calm down enough for them to get the work done. It feels like a hug on the child and almost always calms them down. Most dentists who regularly work with children have ways of calming even difficult children. Though, sometimes if it is a highly invasive procedure, you may want to consider dental sedation as an alternative.

As I mentioned earlier, I don’t think you have anything to worry about. Your son seems to be perfectly content with his pediatric dentist.

This blog is brought to you by Lexington, KY Dentist Dr. John Weaver.

Why Extract Baby Teeth

Posted on April 19, 2021 by writeradmin.

My six year old daughter has decay on two of her back molars. The dentist is being a bit rude and wants them extracted immediately, but they are baby teeth. Why is that the right choice? Won’t they just come out? Why pay to pull it?

Sara

Dear Sara,

There are a few things going on here. First, I will say I am sorry your daughter’s dentist was rude. I wasn’t there and don’t know your dentist, but is it possible it was more urgency that came across as rude? It is unusual for a children’s dentist to recommend that a back molar be extracted on a child that age. You mention decay. I wonder if that decay had turned into an infection. I know it is a baby tooth and they do come out, however back teeth are different for reasons we’ll go over in a moment.

Bear in mind, I have not examined your daughter, but here are some possibilities and what to do about them.

1. The teeth are deeply decayed and they going to break and lead to infection. If there is enough of the tooth left to save some of it, you could do a pulpotomy and place a dental crown on it. A pulpotomy is simply a child’s version of a root canal treatment.

You mentioned that their teeth come out. So you are likely now wondering why do a pulpotomy when you can just get rid of the tooth? While it is fine for most baby teeth to be removed prematurely, the back molars need to stay in place until she is twelve years old, when her next set of molars typically come in. In a six year span, her other teeth will drift toward the empty space, then when her adult molars finally do come in, there will not be space for them and it will turn into a crowding problem that needs orthodontics to fix. Getting the crown, will preserve that position so the adult teeth can come into the right place.

2. The tooth is already infected beyond what a pulpotomy can help. Tooth infections are considered dental emergencies. This is because the antibiotics cannot “treat” the infection only hold it back temporarily. If a dentist doesn’t get in there and remove the infected pulp, the infection will spread. Think about how close your daughter’s jaw is to her heart, lungs, and brain. Sadly, people still die of tooth infections, even though it is completely treatable.

If her decay and infection have progressed, then even though it is a molar the tooth will have to be extracted. If that happens, make sure to get a space maintainer. This is a device they can place which will keep the space protected so there won’t be crowding.

Because your daughter is likely already in some pain and you don’t want it to be a traumatic situation for her that makes her afraid of dentists for the remainder of her life, I recommend you go to someone who uses dental sedation. This way it will be an anxiety-free/pain-free experience for her.

This blog is brought to you by Lexington, KY Dentist Dr. Weaver.

A Broken Front Tooth

Posted on October 24, 2020 by writeradmin.

My nine-year-old daughter fell and chipped her front tooth. I went to our pediatric dentist and he wants to put a stainless steel crown on it. It’s her front tooth! Is there any other possible solution for this?

Karen

Dear Karen,

Many general dentists will see entire families

I haven’t examined your daughter, but if the pulp is healthy a chipped tooth can be solved by dental bonding. You’ll want a cosmetic dentist to do this, however. Your pediatric dentist may not be qualified. That may be why he or she suggested a dental crown to begin with.

However, if the pulp is damaged, then a dental crown may be necessary. That doesn’t mean it has to be a stainless steel crown. There are other options. On a front tooth, I would recommend a porcelain crown. This will look the most natural. You’ll need to be aware that your dental insurance, will usually only cover the cheapest solution. You can ask your dentist to bill the insurance for the one they’ll cover. Then, you pay the difference for the better treatment option.

My concern is that your daughter’s dentist doesn’t seem to be giving you all your options. This is important for you to make the right decision.

Another thing to consider is to see a general dentist who treats children. My experience has been they have a broader view of treatment. They’re still qualified to treat children and all did a pediatric rotation, but they deal more with other issues, than most pediatric dentists do. An additional benefit is your entire family can be seen by the same dentist. This will also enable him or her to see patterns in your family’s genetic make-up that will allow your dentist to be more proactive in your child’s care.

Go ahead and get a second opinion to see if the pulp is in good shape or if a dental crown is truly necessary.

This blog is brought to you by Lexington, KY Dentist Dr. John Weaver.

Daughter Resists Dental Care

Posted on July 29, 2020 by writeradmin.

My five-year-old daughter hates the dentist. She’s hard to treat under the best of circumstances, but the last few appointments it has become clear she has a lot of decay, more than I would expect for a child her age. I assure you we do brush her teeth. They can’t get to it because she won’t stay still in the chair. Every time they try she takes off running. What do we do to get her the treatment she needs?

Pamela

Dear Pamela,

Kids are tricky sometimes, but it is fairly normal for them to be rambunctious. One thing I would suggest is you find a pediatric dentist who also offers dental sedation. This way your daughter can receive all the treatment she needs while sleeping through the whole procedure.

What you don’t want is to let the needed treatment go and then have a dental emergency on your hands. This can not only end up with your daughter in a lot of unnecessary pain, but dental emergencies have a way of turning into life-threatening emergencies quickly.

I did want to address her extensive decay. I do believe that you care about your daughter and that you are brushing her teeth as any good parents would. For her to develop significant decay at her age would mean that she is having tons of snacks and possibly juice or soda throughout the day.

It may mean some tougher love on your part but if she is snacking a lot or drinking sugary drinks, her body doesn’t have time to keep her teeth properly defended from all the intake. My suggestion would be to limit her snacking to no more than one a day. You’ll likely find she is eating her meals better as well, as a result of having to wait on her food.

This blog is brought to you by Lexington, KY dentist Dr. John Weaver.

Dental Flipper for a Pre-schooler

Posted on April 17, 2020 by writeradmin.

My son, who is three years old, had a fall which caused him to lose his two front teeth prematurely. I’ve heard that children need to keep their teeth in order to prevent shifting and crowding. My dentist said that won’t be an issue, but I’m still worried. I’m looking at dental flippers online and they only seem to make them for adults. What is your recommendation for a toddler?

Robin

Dear Robin,

Many general dentists will see entire families

While there are some teeth which have to stay in place until your son is around twelve-years-old or you risk shifting and crowding, that is only for his back teeth. If these teeth have to be removed prematurely, your pediatric dentist would need to place a space maintainer. Your son lost his front teeth. These teeth won’t have the same issue and he’ll be fine.

I want to discuss the dental flipper, though. Let’s say for argument’s sake that he did need a replacement. These are only made for adults for a reason. First, they are removable. This will be a choking hazard for a young child. Even if it weren’t a choking hazard there would be other issues.

Because it is removable, you would likely have a hard time getting him to keep it in his mouth. Plus, it clasps onto his teeth. At his age, his teeth and jaw are in constant flux and growth. You would have to constantly replace it.

I hope knowing the front teeth will be fine puts your mind at ease. I can tell you are a caring mother.

This blog is brought to you by Lexington, KY Dentist Dr. John Weaver.

Can a Tooth Infection Cause a Fever?

Posted on March 31, 2020 by writeradmin.

I’m worried about my daughter but my pediatric dentist won’t see her during the quarantine. She’s had a loose tooth bothering her and now she has a fever. I called in but they said a tooth infection doesn’t have a fever. Is that true? Do I really have nothing to worry about?

Mandy

Dear Mandy,

I’m hoping there is some sort of miscommunication here. Maybe what your pediatric dentist said is that a tooth infection doesn’t usually have a fever. However, any infection can cause a fever. Before you panic, that doesn’t mean your daughter does have an tooth infection.

My guess is you are very diligent with her dental care. Unless there was a cavity they were watching at her last checkup, there likely isn’t one now that has progressed far enough to become an infection. It’s likely she’s fighting something else off right now. You mentioned the tooth is loose and bothering her. Sometimes loose teeth can be painful themselves.

Because of COVID-19, they’re asking us to stay quarantined and only treat essential cases. I’m sure this is making you nervous because it feels like you don’t have access to the care you need for your daughter. You’re a caring mother and want the best for her. Here’s my recommendation.

Keep an eye on her. If the pain in her tooth gets worse, pull it. It’s loose and should come out without too much problem. If there is an infection there, pulling the tooth will take care of it.

If you do that and she’s still in pain a couple of days after you pulled the baby tooth, you can call the dentist back and tell him you want to come in for an emergency dental appointment. It shouldn’t still be hurting a couple of days after it is removed.

This blog is brought to you by Lexington, KY Dentist Dr. John Weaver.

Is a Pulpotomy Really Necessary?

Posted on January 31, 2020 by writeradmin.

My daughter has an infection on a baby molar. My dentist wants to do a pulpotomy on it. What I don’t understand is why we just don’t pull the molar. It’s not her permanent one. When I asked her dentist, he just said, “Because as her dentist I’m telling you this is the best option.” What I wanted to say was, “Well, as her parent I want to know why.” but I was too chicken. I’ve scheduled the appointment but I really want to know why before I follow through with this.

Jen

Dear Jen,

The answer to this really depends on the age of your daughter. Her baby molars need to stay in place until she is around twelve years old when her permanent molars come in. When they’re significantly younger than this, one option is to do a pulpotomy. This is essentially a child’s version of a root canal treatment. It will help her retain a necessary tooth.

Another option is to extract the infected molar, however, you will need to place a space maintainer where the tooth once was. This is a more invasive treatment, but sometimes becomes necessary when the tooth cannot be saved.

If you don’t do either of those, the infection will spread. Tooth infections are considered dental emergencies and need to be taken seriously. The jaw is close to the heart, brain, and lungs. You don’t want the infection to reach any of those areas.

If you extract the tooth without a space maintainer then her other teeth will shift into the open space. When her permanent molars start to come in, it will lead to crowding of her teeth. Then, you’re talking about needing orthodontics which could have been prevented. Keeping this space secured is much less expensive.

A Word about Your Pediatric Dentist’s Response

I’m not happy with your his response to your question. You are the parent and he is ethically obligated to give you all the options available in treatment. In doing that, it means also explaining the pros and cons to each option, along with his explanation for his recommendation.

His arrogance in being questioned makes me wonder whether he’s giving you any of your other options. This isn’t the best care for your child. While you need to get your daughter’s infection dealt with. I think you should start looking for a new dentist for her. If you live in a small town which doesn’t have many pediatric dentists, you can also see a general dentist who is good with children.

This blog is brought to you by Lexington, KY Dentist Dr. John Weaver.

Is a Pulpotomy a Necessity?

Posted on July 30, 2019 by writeradmin.

I have a child who has a large cavity. The dentist wants to do a pulpotomy. It’s a baby tooth. The tooth is going to fall out anyway so can’t we just let nature take its course? At the most, I’d think we could just pull it. I feel like this is an unnecessary procedure.

Stan

Dear Stan,

It sounds like your pediatric dentist isn’t very good at explaining the reasons behind his treatment recommendations. As for whether you can just let the tooth fall out, it really depends on how far gone the tooth is and where the decay has reached. For instance, if the decay has reached the pulp of the tooth, which I suspect it has, leaving the tooth in place to fall out on its own will lead to a severe infection.

Tooth infections are a dental emergency. Unless the infection is physically removed it will continue to spread. If you think about how close your jaw is to your heart and brain, you can see how a fast moving infection can turn life-threatening quickly.

Now, if it was a front tooth, just pulling it would be fine. Back molars are different. They have to stay in place until your child is around 12-years-old. Without that, the other teeth will shift which will cause severe crowding as his other teeth come in. Believe me, you do not want the added expense of braces if it can be at all avoided.

A pulpotomy is essentially a root canal treatment for children. It’s designed to remove the infection while still saving the tooth. There are times when the tooth can’t be saved. If your child’s decay progresses that far and the tooth has to be removed, make sure your pediatric dentist places a space maintainer there to keep the other teeth from shifting.

This blog is brought to you by Lexington, KY Dentist Dr. John Weaver.

Pediatric Dental Filling Keeps Falling Out

Posted on May 15, 2019 by writeradmin.

I took my daughter to see the dentist a couple of months ago. I was a bit surprised when he said my daughter had three cavities. I’m very diligent with her dental care and even brush after her if I don’t think she’s been through enough. However, I agreed to the fillings as long as he did the white fillings. He didn’t have a problem with that. Unfortunately, every one of the fillings has fallen out…twice! I don’t know if this dentist knows what he’s doing. Should I go elsewhere? We’re a small area and not many dentists do white fillings out here.

Miranda

Dear Miranda,

Based on what you’ve said, I think it’s possible that your dentist did the white fillings just to make you happy but isn’t as experienced with them as with the amalgam fillings. Their bonding methods are completely different. Without adequate experience with then, he may not realize how important it is they stay dry during the bonding process.

If any moisture gets under the filling it breaks the bond. With children especially, this can be challenging. They are wiggly and move their tongues quite a bit. There are methods a dentist can use with children to help keep it dry but he may not be aware of these. Additionally, even with those methods, some children just have trouble cooperating with this particular procedure.

Helping Wiggly Children Get White Fillings

Don’t feel bad if your daughter is one of the wiggly ones. Children are supposed to be wiggly. It’s part of their charm. However, medical procedures sometimes require them to be still. In that case, many dentists will suggest some form of dental sedation. Even a mild sedation, such as nitrous oxide, can put a little one to sleep allowing the dentist to get straight on with the work at hand.

As far as seeing another dentist, you could look for a mercury-free dentist and see if they work with children. A general dentist is qualified to work with children, so you wouldn’t necessarily have to see another pediatric dentist. Each of them did a pediatric rotation. You would want to make sure they enjoy children though. This way your daughter is more likely to have a positive experience.

This blog is brought to you by Lexington, KY Dentist Dr. John Weaver.

When Do You Transition from a Pediatric Dentist

Posted on February 15, 2019 by writeradmin.

I have a 15-year-old who still goes to a pediatric dentist. He seems content there but I read online that when they hit their teen years you are supposed to transition them to an adult dentist. Do we have to do that right now if he’s happy there? Also, if we do, does the pediatric dentist recommend a general dentist for you or do you just start trying dentists?

Katherine

Dear Katherine,

Many general dentists will see entire families

While it varies from practice to practice, most pediatric dentists will let a child stay through 18 years of age. If they’ve been there most of their lifetime, they’ll even let them go a little further while they find a general practitioner they love.

While there is no hard and fast age, you should be able to tell when your son is ready to switch. At some point he may indicate that it feels childish there. Others are quite content staying until they’re 18. It really depends on both the practice and the patient.

They grow up so quickly, there really isn’t any reason to rush him. That’s especially true if he’s happy there. These type of positive experiences will help him with a lifetime of good oral hygiene with regular dental visits.

General Dentists Who Treat Children

You mentioned needing the pediatric dentist to recommend a general dentist to you. Does this mean you don’t have a dentist for yourself? If that’s so you may want to ask for that recommendation now and get started at the practice yourself.

It’s usually helpful to get a general dentist who also treats children in case your son expresses a desire to switch. These dentists are usually more patient than most and will be a good “first experience” for your son in an adult practice.

is it possible the reason you don’t see a dentist regularly is because you have some dental anxiety? If so, don’t feel bad. There are a lot of adults who avoid the dentist. However, it will be easier for your son if you’re established at the practice too. It also gives the dentist an idea of the dental genetics of your family so he can be proactive in treatments.

Dealing with Dental Anxiety

Not may people can just will anxiety away. I often suggest that anxious patients see a sedation dentist to get comfortable with dental work. Most sedation dentists offer two different levels of sedation, depending on your level of anxiety.

The right level for you will allow you to have a pain-free/anxiety-free dental appointment. Because you’re so relaxed, you can get more work done each sitting, allowing you to get caught up on any necessary work quickly.

This blog is brought to you by Lexington, KY Dentist Dr. John Weaver.