Berkeley Parents Network: Cavities, Fillings & Tooth Decay

Berkeley Parents Network

Cavities, Fillings & Tooth Decay

Berkeley Parents Network > Advice > Advice about Health > Cavities, Fillings & Tooth Decay

Severe tooth decay in night-nursing 15 Month Old

Sept 2004

Help! My 15 mos. son has multiple chipped teeth (due to weak, decaying teeth) and dental caries. I feel like a terrible parent. Well, I guess I really am. I haven't stopped or cut down on the night nursing, not even wiping his teeth after each nursing (he hates anything near his mouth and cries like Billy-o whenever we brush his teeth). After our visit today to the dentist, the dentist finally said that the one thing in common with all babies with such decay problems is night nursing.

We also haven't been regular about his brushing. We've been making a big deal about tooth brushing - and hang out as a family brushing our teeth. My son has a sign for tooth brushing and will happily puts the brush in his mouth now and move it around. The problem is that we need to brush his teeth and he hates it. It takes two of us - which limits the opportunities - and we have to literally hold his arms down to stop him grabbing the brush out of his mouth. He cries and tries to keep his mouth closed. Everybody says kids cry when having their teeth brushed, but this seems extreme. We hate doing it and I'm sure my son has picked up on all our mixed feelings. My husband and I also get quite tense with each other during these brushing sessions which only makes things worse. I really wonder if I should see if I can hire a dental hygenist or childcare expert to help for a few weeks until we get this figured out (it would probably be cheaper than having even more major dental work to do in the future). I just ordered a video on tooth brushing techniques from a dental school so maybe that will help.I don't know. The dentist says its a matter of will power and I guess I'm failing. I am so depressed right now. I know they're baby teeth, but teeth are so important for chewing correctly, speech development, and general self-confidence about smiling and appearance. Any suggestions welcomed about who I might get to help with tooth brushing, tooth brushing techniques, and night weaning welcomed. Worried Mom

I'm sorry to hear about your child's teeth. Don't beat yourself up about it too much. There's nothing you can do to change the past, and you are obviously committed to preventing further problems.

Have you tried a battery-powered brush? They make some for kids that have small, circular rotating heads. I find them to be the easiest shape for brushing. Also, if I start out with the brush off, when I meet resistance, I turn the brush on and then sometimes baby opens his mouth (I think it tickles) and I can reach some interior teeth too.

Does your child have any interest in holding the brush himself? I give him a different brush that he likes to kind of chew on and I try to manipulate it to do some brushing when he's chewing.

I would try to keep this as ''fun'' as possible. I know it's a horrible struggle for you, but I'm not sure if holding the kid down is going to work in the long run. Kids can be really stubborn and I'd be wary that you are going to create additional problems down the line if brushing is always a trauma for your child.

And finally, are you working with a good pediatric dentist? I would highly recommend Dr. Katsura (just off Solano Avenue in Berkeley) if you are looking for one. He is really gentle with kids and relates very well to them. Good luck. Anon

That sounds like unusually high levels of tooth decay in a child who lives in a house with ''aware'' parents! I night-nursed my daughter for much longer than 15 months and she has no sign of tooth decay and gets high marks from her dentist (she is almost 4 years now). Perhaps much of it is genetics? Perhaps there are other factors contributing to the decay? Have you examined the snacks that your child gets? Our daughter's dentist gave us a list that essentially wipes out crackers from the snack options as well as juice and the more obvious items like sugary fruits/candies/etc. If he is sucking on goldfish crackers all day, that could be a major source of decay.... As far as brushing is concerned, we started our daughter around that age with brushing and started flossing at 2 years. She rarely fought it and generally puts up with the whole routine. A lot could be temperment, but also making it ''enjoyable''. Have you tried finding a comfy place for him to lie down while you do it? What about picking out some special kids music to listen to? Have dad lie next to him and read a book that he can see? Let him play with a flashlight on the wall? Maybe he could brush a teddy bear's teeth first, or pick a flavor of toothpaste. I can certainly recommend our dentist - Dr. Matsuishi in EC. He's a peds dentist and his office is very friendly for kids. Good luck!!! Freyja

You're not a terrible parent! Banish that thought from your mind!! As far as I'm concerned, night nursing is good parenting. The tooth decay at age 15 months seems more a factor of genetics and bad luck than anything else. It's rare for a child that young to have tooth decay, even if they are night nursing. So please don't blame yourself.

Brushing toddlers' teeth is incredibly, incredibly difficult. I have a 2 year old that acts exactly the same as yours - nothing seems to work to get him to let me brush his teeth, except pure perseverance, stubbornness, and a willingness to do something that he hates. I can completely understand that it is hard to make yourself do it. That said, it does need to be done. Making it absolute solid routine that teeth get brushed every morning when you wake up and every evening before bed, may make it easier for you rather than harder... he may realize it's inescapable. Once he knows for sure it will happen whether or not he struggles, he may give up the struggle.

For the techniques... some of these have worked briefly for us, and some have been suggested to me but haven't worked, but they may work for you. Distract with funny noises, songs, tickling, etc. Start a routine of singing the same song every time and only sing while he's letting you brush - make the song last a couple of minutes, and he will eventually get to know that when the song is over, brushing is over. Ask him to roar like a lion or bear, or to let you see if there are any monkeys in his mouth. Get him a couple of interesting-looking or electric spinning toothbrushes and some good flavors of toddler toothpaste, give them funny names, and let him choose which to use each time. Let him brush your teeth while you brush his. Give him a sticker if he lets you brush his teeth. Talk to him about ''cavity bugs'' and that you need to clean them up, and that not cleaning them up means that his teeth may hurt later. Pretend that the toothbrush is something that he likes - a train, a vacuum cleaner, a kitty. If he's teething, ask him to open his mouth so you can have a look at the new teeth he's getting. You could try taking something away if he doesn't let you brush, like a favorite toy... I haven't tried that one.

If you want to wean at night, it may be difficult if you are cosleeping. If he's in his own crib or bed, you can start a pattern that he doesn't come to your bed until it gets light out, or after a certain time in the morning. If our son wakes up in the night, my husband goes and sleeps in his room on the floor. Jen

You might try an electric toothbrush to help get your son to brush - our 15-mo son clamps his mouth shut when we try to use the manual toothbrush, but loves the electric one to the point of asking to have his teeth brushed even when he doesn't need it. I think the vibration feels good on his gums. If you don't want to shell out for a big electric toothbrush, you could try the Crest ''Spinbrush'' or something similar. JP

My daughter had oral surgery at 2 1/2 and my son had oral surgery at 18 months and age 2 and will probably need it again soon. It's horrible. You can't both be home every time you want to brush his teeth. To brush my 2 1/2 yr old's teeth, I sit on the bed with my legs stretched out in front of me, position him so that his head is toward me and my legs are holding down his arms. That way I have one hand for the toothbrush and one hand to open his mouth. Needless to say he hates it. So do I, but I've gotten used to it. I wonder if I was less brutal if he would be less resistant by now. But I have no choice; I have to do a good job each time I brush his teeth. The teeth, the night nursing, the dentist.. it is all the biggest stressor in our marriage. It's so discouraging.

The light at the end of the tunnel is that my daughter, now 5, can brush her own teeth, floss, and swish around flouride rinse. Her teeth are all coated, and we get regular flouride varnishes, and she's only had one cavity since the oral surgery at 2 1/2.

Try and get the January and February, 2003 editions of the Journal of the California Dental Association, which has excellent information on taking care of your teeth.

Feel free to email me. Sarah

My son didn't like me brushing his teeth at first. He loved chewing on the tooth brush and it seemed like at first, I held him down EVERYTIME and he screamed EVERYTIME. Then finally I said, 'If I can't brush your teeth then you can't have the toothbrush to chew on.' He tried me once, I took it away and ever since it has been pretty easy. Sometimes I tries to fight with me but I just say 'do you want it when we are done?' and then he cooperates. I try to do everyday morning and night, night is easy b/c it is with the whole bath thing. Hang in there. I use to let him chew on the toothbrush we were using, then I got smart and got him a different one. now I use a crest spin brush to brush his teeth and he chews on the regular one when we are done. he just turned 2. Good Luck! Laura

3-year-old needs a filling

Sept 2002

I have a 3 1/2 y.o. who has had a cavity on one of her molars for about 2 years. I took her to the dentist over a year ago, who said we should put off filling it as long as possible, due to the complications of the procedure and a small child. She said to try to hold out until (at least) she complains about it...well, the time has come and I'm terrified! The tooth is pretty much eroded and she complains ocassionally that it hurts. My problem now is, what next' My insurance will cover a most of the filling costs, but as far as ''putting her under'' we'd be responsible. Are we talking thousands of dollars here' And, do we have to put her under, or would not doing it traumatize her for life' Also, has anyone heard of Dr. Laston in Berkeley' He comes up as a doctor who would best work with the insurance I have. distraught mom

This happened to me, and it's very important that you find a great pediatric dentist. There are many schools of thought about pediatric dentistry, and going with the wrong one can cause a lot of future trauma.

When my daughter was 2, we had no dental insurance and I was stuck taking her to a dentist who was extremely anti-breastfeeding and judgemental. He physically kept me out of the room and pulled her tooth under local anesthesia while restraining her on a board. I found another dentist the second time through, someone who was trained for pediatric dentistry. There were some improvements: she discussed treatment with me and used valium for major treatments. However, my daughter was understandably fearful by this time, and the new dentist's solution was to punish her for crying by restraining her and threatening to keep me out of the room. By this time, it took weeks of preparation to get my daughter into the exam room without restraining her.

The next time we had a dental problem, I was more careful. We found a very capable dentist who understood that we were faced with overcoming my daughter's terror in the long term, not just a quick fix. She was frank about the problems (and a little judgemental) but created a treatment plan that took the trauma of dental work into account. We used valium and nitrous oxide for the treatment and although it was scary at the time, my daughter didn't remember a thing about it, which is the best possible outcome. The dentist was able to complete a root canal, cap the tooth, and clean the other teeth in a short time, all with me in the room. She said that pulling the tooth could have led to major problems when the adult teeth came in unless she inserted a spacer. She was in LA, or I'd give you her name.

When I moved here, she suggested that I contact the American Academy of Pediatric Dentistry http://www.aapd.org/, then interview the dentists I located. Ask about what strategies the dentist does with fearful patients, if they let you be in the room, their policy and experience with medication, etc.

Finally, don't go to a dentist who tells you or your child that you're at fault. A little sermon about brushing and flossing is ok, but that's it. Good luck! Sarah

My daughter has had cavities since at least age one. We first took her to the dentist when she was almost 1 1/2, where they felt the best thing to do at that point was to put flouride varnish on and brush religously. That was at Wampler et al. Due to changes in insurance we went once to the UCSF clinic and had a horrible and tramatic experience with pre-doc students with no apparent experience with children (we picked that clinic because it offered pediatric dentistry).

Since then we've gone to back to Wampler et al. and worked with ''Dr. Arnold.'' I think they do a great job of building trust with children to be able to do work without general anesthesia. Our three and a half year old (despite her earlier fears) recently sat through a ''scoop and fill'' filling without local (it was pretty big, but not to the nerve). She's looking forward to going back to the next 2-3 appointments for her other cavities. We're paying for it out of pocket because they don't accept our insurance plan (Health Families Delta), but if the alternative is to pay a huge chunk out of pocket for anesthesia, it might be cheaper. It's actually been quite reasonable. Even though we've had quite a bit of work done, I suspect it's costing us less than a private plan that would cover dentists of this quality.

Two more things:

We've avoided Laston because we've heard negative things about him from friends and neighbors, and if I remember correctly had a phone conversation with him that left us underwhelmed. You might look at the other feedback about him on the website.

Also, although it might not help you're specific question, there's an interesting piece in a recent issue (July? 2002) of Mothering magazine that talks about recent research that's found that Early Childhood Caries (ECC) is caused by a particular bacterium, rather than primarily by the bottle or nursing or diet. Peter

5-year-old's first cavities

Nov 1999

Our 5 yr. old son has to have his first two cavities filled. They are small and are between two adjoining molars. We'd like to hear about other parents' experiences with kids' first cavities. Our son goes to Dr. Wampler but we were disappointed by the brief time the dentist spent with him at the most recent exam. He did not reassure either my son or my husband about the upcoming procedure. We would like to know what the procedure is like. How much it hurts, and if we can expect him to go to school afterwards.

My kid had 6 cavities filled at age 4.5 yrs. The first dentist, Dr. Mendoza-Sobel, used laughing gas, local anesthesia, a tooth dam,& jaw clamp. The latter items were uncomfortable and the actual procedure hurt because they hadn't checked that the local was properly administered. The second dentist, Dr. Katsura, used a local which they ensured took proper hold. They used the same instructions my dentist used for me, such as moving tongue away. There was virtually no pain. My child could not eat anything for 1 hour afterward while the fillings set, but otherwise there was no problem.

To the parent concerned about having her five-year old son's cavities filled, I understand your concern. My five year old also had his cavity filled recently, but before I agreed to it, my husband and I sent him to a different dentist for a second opinion. I wanted to make sure that in fact it was urgent that we get this done, and how bad it truly was.

I chose not to attend the appointment only because my son is more babied by mommy. But my husband, who did attend, said it was not as bad as he expected. Unfortunately he had to have his hands tied down for the fear that he might try to reach for the dentist's hand or move. But with my husband near, my son felt safe knowing that daddy was not going to let anything happen to him. First he was giving laughing gas, and then a local anesthetic was inserted into his gum. It was not very painful, according to my son, but it did frighten him when the doctor placed the mask over his face and the needle in his mouth. The procedure lasted for about 45 minutes, but my son was a little drowsy after wards. We kept him home so that his dad could supervise him and make sure he wasn't experiencing any side effects. Luckily we had nothing to worry about.

The price, after my insurance kicked in was $81. I am not sure what insurance you have or how much your dentist will charge for the procedure, but I can't see it being more expensive than $120. The only thing I suggest is that you find someone who has a lot of patience with kids and is understanding with a child's fear of needles and doctors. The only bad experience we had was the dental assistant, who my husband said was not very pleasant. Otherwise, the dentist was great! Good luck with everything.

Silver vs. tooth-colored fillings for 7-year-old

July 2002

My child is about to have his first three cavities filled. His dentist recommends tooth-colored fillings for the temporary teeth and then silver for the permanent tooth. This is actually the opposite of what I'd been thinking, so I wonder how others have made their decisions about this or what advice their dentists mayhave given them. I understand that tooth-colored looks better--but are also more expensive and take longer to put in--which is a consideration for a 7-year old. Thank you. LTR

I personally have both silver and tooth colored fillings. I don't know which take longer. I don't know which is better for young children. I do know this, and offer it for your consideration... I only have had temerature sensitivity issues with my metal fillings (''No ice please!''), and not with the white ones. Rose

Hi, Your dentist was probably thinking that since the tooth colored fillings don't last as long as the silver ones and are less toxic to a younger person (silver fillings contain mercury--yikes!), that he would use those for the baby teeth and use silver ones for the permanent teeth. If, however, the filling is not too deep or large and you aren't concerned about replacing the fillings every 10-15 years, I would go with the tooth-colored ones every time. I can't address the length of time it takes to put in (but I think it was about 15-20 minutes...?), but the material is less toxic to immune systems and looks worlds better. My only filling is tooth colored, and I have had it for about fifteen yearw. My dentist says it needs to be ''touched up'' now, but otherwise I have had no troubles. Good luck. elizabeth

The opinions and statements expressed on this website are those of parents who subscribe to the Berkeley Parents Network. Please see Disclaimer & Usage for information about using content on this website.