Tag Archives: Children’s dentist

Angry with Pediatric Dentist

I am so upset right now I am shaking. I had my daughter in for a checkup and he told me there is a cavity on a back tooth and he’ll need to do a pulpotomy. I had some questions. First, what is a pulpotomy? Second, why can’t we just do a filling? Third, if it is a baby tooth, why can’t we just extract it and let the adult one come in? Rather than answer ANY of my questions he said, “Do you ever get tired of questioning experts all the time? Maybe you should trust I am the dentist and know what I’m doing.” I don’t think my questions were unreasonable. AND this is MY child. Not his. Would you mind answering the questions for me so I can decide what to do?

Jennifer

Dear Jennifer,

Four Smiling Children

I am sorry that you were treated this way. I will be happy to answer your questions. Before I do, I am going to suggest you find another dentist for your daughter. You need someone who is on your side and willing to answer every single question and concern you have. It does not have to be a pediatric dentist. There are family dentists who treat both adults and children. Now for your questions.

A pulpotomy is a child’s version of a root canal treatment. They are less involved than the adult versions. It is typically reserved for back teeth and is a last resort at saving the tooth that is infected. This leads to your second question.

If it is a matter of a simple cavity, then a filling will be all she needs. I recommend mercury-free composite fillings as the safest option. Once the cavity spreads to about 30% of the tooth, then a filling will not be enough and you would have to get her a dental crown.

Only if the tooth is infected would you do a pulpotomy. You did not mention that your daughter had an infection in the tooth, just a cavity, so that makes me wonder. It may be in her best interest to get a second opinion.

Your final question was a good one as well. In some cases, it is fine to just extract a baby tooth and wait for the adult tooth to make its appearance. Back molars are different. They have to last until your child is around twelve years of age. Otherwise, that space is left open for too long waiting on the adult molars. The adjacent teeth drift or tip into the spot. When the adult teeth finally do arrive, there is not enough room for them, which leads to crowding and the need for orthodontics.

If a back tooth does have to be extracted, her dentist would need to put a space maintainer there in order to keep the rest of the teeth in place until her adult tooth arises.

I hope this helps.
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Dental Flippers for Toddlers

I would love some advice from you. I have a three-year-old who lost his front teeth due to a nasty fall that caused some nerve damage. I am really worried about his other teeth shifting into the open space. I asked our pediatric dentist for a dental flipper for him and he acted like I was insane. I know we’ll have to cover the cost because he’s on Medicaid and they hardly cover anything and I don’t mind paying. However, the only do-it-yourself ones to purchase online are only for adults. Do you know where I can get one for children?

Beatrice

Dear Beatrice,

Toddler in a dental chair

I am glad that you are trying to be proactive about your child’s teeth. There are situations where teeth are at risk to shift into the empty spaces, but that is with back teeth, especially the molars that need to stay in place until your child is twelve years old. With the front teeth, there really is not the same risk. Let’s say that he did have a back tooth come out. You would not use a dental flipper, however, for a couple of reasons. The first is it is removable. When you are dealing with a toddler, they will have a hard time keeping it in, which means it can’t do its job and they are likely to lose it. It can also be a choking hazard. A second issue will be how much he will be growing, which includes his jaw. You’d have to get a new one way too often. Instead, when a child loses a back tooth, we use a space maintainer. This is not removable by the child and will serve him for many years.

Though your dentist was correct about not getting a dental flipper, I am not convinced that he is serving you well. As a parent, it is your responsibility to look out for the best interest of your child. That includes asking questions about treatments. He should not have made you feel foolish. You may want to consider looking for another dentist. It does not have to be a pediatric dentist. There are family dentists who work very well with children. Then your whole family could attend the same clinic.

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