My son is six years old. I’ve just started to research dental information to address some serious problems with his teeth.

He has at least four cavities that I can see. Two of them are small in diameter, but seem to be quite deep, and two other teeth have actually started to chip away from the decay. I’m afraid there may be more, but he won’t let me get a really good look in his mouth to tell.

What are my options with these kinds of problems? I really don’t want to have any teeth pulled if we can possibly avoid it. They are all molars, and from what I have read so far that could really screw up the alignment of his teeth later on. Can they do some kind of porcelain crowns or white fillings? I don’t want them to look bad and make him embarrassed, either. I’ve read that with kids they often do some kind of metal crown, but those are so ugly!

I also wanted to ask about sleep dentistry (also called sedation dentistry). I think I am going to have to locate someone who does this kind of dentistry, because my son just will not open his mouth for the dentist or the hygienist. We’ve tried three different dentists with no luck. I was hoping he would mature enough to cooperate, but we just can’t wait any longer.

I appreciate your help,

Maranda in New Brunswick

Dear Maranda,

You’ll want to find a pediatric dentist who also performs sedation dentistry. I think you are correct in saying that you simply cannot put of your son’s dental care any longer.

You are also correct that removing the molars without also putting in some kind of space holder will cause a lot of problems down the road. Those molars are also important in helping him eat, so ideally your dentist will try to salvage the teeth rather than extracting them. In pediatric dentistry, much of the work is often geared toward short term maintenance and temporary fixes, because those teeth will not remain in place forever. Usually they will place a stainless steal crown, but if you are adamantly opposed to the steel, your dentist can work with you to find a suitable material.

Another issue that must be addressed is the eating pattern that probably produced this kind of severe decay in such a young child. The kind of decay you’ve described is caused by constant eating. If you want to put a stop to these kinds of serious dental problems, you’ll have to put a stop to the eating habits that produce them.