My 5 Year Old’s Teeth are Rotting

I have a difficult 5-year-old. I do brush her teeth, but she is a nightmare when I do it. Actually, she’s a bit of a Tasmanian devil. This is especially true in the dental chair where she refuses to cooperate any time they try to do work on her. She now has one molar with a cavity, two that the dentist is saying need to come out, and decay on several other teeth. What is your recommendation for something like this? I don’t know how to get the work done for her.

Patty

Dear Patty,

Young girl in a dental chair smiling

I can tell you are worried and want the best for your daughter. I do have a way for your daughter to get the dental care she needs with minimal fuss, but I am also going to suggest some tough love to help in the long run with her oral health care. The extensive amount of decay you are describing at her age is almost always a result of constant snacking and drinking.

Our saliva is a big help in the fight against decay. It contains minerals that help fight bacteria between meals. But, when we are snacking or drinking (with the exception of water) too often, it doesn’t give our saliva time to do its job. This leads to extensive decay, even when we have good oral hygiene.

I’m going to strongly recommend you don’t let your daughter eat between meals for a while. She won’t starve and it will help her be hungry for the nutritious meals you make rather than snack throughout the day and not get the value out of the healthy food you make. Juice and soda should also be limited because of the citric acid and sugar contained in both of them.

When you have a child who will not cooperate with their pediatric dentist but there is important work that needs to be done, you may have to use dental sedation. This is sometimes called sleep dentistry because even adults are so relaxed when they use this aid that they can sleep through their entire procedure.

What you don’t want to do is put off this treatment at all. Tooth infections are considered dental emergencies. This is because our jaws are close to our hearts, lungs, and brains. A dental infection can turn life-threatening quickly.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.

CEREC Crown Disaster

I was told getting a CEREC crown would be a snap and fit better than other crowns. Not only was I in the chair for over three hours, but the crown didn’t fit properly. She said it was because my tooth was in really bad shape so she had to take a general model from the database. It doesn’t fit at all like my normal teeth or even my other crowns. In fact, she had to grind it down because it didn’t fit in properly. Now it hurts. What do I do?

Carol

Dear Carol,

porcelain block for CEREC crowns

Something is wrong here. Let’s start with your dentist’s statement that she had to use a general model from the database. Her reasoning that the tooth was in too bad of shape doesn’t make much sense to me. Of course the tooth was in bad shape. That is the whole point of needing a dental crown! Why would you put a crown on a healthy intact tooth?

CEREC crowns should fit better than other crowns because they are designed and milled using precision software. However, computer software is only as good as the person programming it. Though, this software is pretty user friendly. For instance, let’s say you were missing your lower left molar. Your dentist would program that in and the software would give her a basic shape to use for that type of tooth to start the design. From there, images of your surrounding and opposing teeth give her the remainder of the information she needs to input into the software. Then it designs the crown.

Your crown is uncomfortable and she had to do grinding on the tooth, so clearly this didn’t happen properly. There are so many things that can go wrong with a dental crown. Here are just three:

  • Open margins. If the crown does not fit the tooth perfectly around the complete circumference of the tooth, then you will have a gap where bacteria can get in leading to decay under your crown.
  • Bite Design. When a bite isn’t designed properly, it throws off occlusion and you will end up with painful TMJ Disorder issues.
  • Poor Contouring. If the tooth is not contoured properly, you will have gum inflammation, which will lead to gum disease.

What this boils down to is you need to have this tooth looked at by another dentist. If they can tell you what is wrong with it, you can get either ask her to re-do the crown or ask for a refund and have it redone by another dentist.

This blog is brought to you by Gilbert Dentist Dr. Matt Roper.
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