I’ve never been a fan of going to the dentist and I am afraid that I have let my dental anxiety get in the way of my dental care. I think I would be a good candidate for dental implants. Do you know if dental insurance will cover this?
Amy N.
Dear Amy,
I’m glad you wrote. I want to address the dental anxiety issue first, because I’m hoping to give you a solution that will enable you to have positive dental appointments that will allow you to get caught up and not lose any more teeth.
It’s tough when you’re dealing with anxiety and that fear itself can make the appointments feel more painful. For patients in your situation, we have found that going to a sedation dentist changes their lives.
With one level of sedation, oral conscious sedation, you can sleep through your appointment if you want to. It’s that strong, even though it is administered by a pill. The only real downside is that you will need someone to drive you to and from your dental appointment.
As for dental insurance covering your dental implants, that depends. If you already have dental insurance, depending on the plan, they will cover a portion of them, but don’t expect it to be much. In most cases, they’re only willing to pay a significant amount on the least expensive solution for tooth loss, which would be removable partial dentures in your case.
If you don’t have dental insurance, they won’t allow you to sign on and then immediately get an expensive procedure. Most of them will have a waiting period for anything other than basic checkups and cleanings.
If you decide to get the removable first because of the cost, that is fine. I would save up for the implants, though, because you’ll have a better quality of life with something permanent.
I am expecting my first child and have been getting advice from a friend. One of the things she told me is never to use a dentist who does not allow me to go back with my child. She did that once and they put her son in restraints. Can you tell me why they would do that?
Sally
Dear Sally,
Pediatric Mouth Restraints
There are two type of pediatric restrains. The first is pictured up above. These are mouth restraints. They are designed to help keep your child’s mouth open when they are having dental work that includes a drill.
I know of a colleague that didn’t use this once. Unfortunately, the child bit down during his procedure, which caused the drill to go through his tooth and into gums. What should have been a simple filling ended up with the child needing a root canal treatment. These type of restraints are absolutely essential.
Papoose Board
The next type of restraints I would say are only rarely necessary. Also, a dentist should ask a parent’s permission before using them. If your friend’s dentist didn’t I would say she was right to get rid of him.
Your question about why a dentist would use this is valid. Most pediatric dentists have techniques to keep children calm and cooperative. Every once in a while, however, there is a child who is so terrified that they won’t let the dentist near them and become destructive. If the procedure is not essential, normally you would just send the child home and then schedule another appointment for them, possibly using dental sedation if that is available.
However, sometimes a child has a dental emergency that has to be treated right then for their own safety. In those cases, I would understand a papoose board. Though they have been criticized, they actually feel more like a hug, sort of like a weighted blanket that closes. Every time a child has gotten into one when I have been present, they calmed right down and are able to get the dental work done with no trauma.
You are wise to be planning and learning everything you can now that you are a mother. One thing I would advise is to take your child to see a pediatric dentist as soon their first teeth come in. Don’t wait until they are older and there is a problem. You want their early experiences with a dentist to be positive ones so they are not afraid to go.
I am one of those lucky people with four impacted wisdom teeth. Only one of them is bothering me at the moment and I’m going to get it extracted. My dentist asked if I wanted to extract all of them or just the one and something about my age being an issue. I’m 27. However, he did mention that one of them has a root that goes past a nerve, which means there is a slight chance of nerve damage.
My dentist gave me three options. I could leave the other wisdom teeth until they started bothering me. I could remove all of them. I could remove all of them, but for the one near the nerve I could remove the tooth part, leaving the root and hope it doesn’t get infected. Then, if it does get infected I will have to go back to get the rest.
Is there a best way to handle this?
Samantha
Dear Samantha,
Types of impacted wisdom teeth.
I’m glad that you wrote. Your age is a factor in how you handle this. While you are relatively young, as you are currently, it is much easier to remove wisdom teeth. Once you hit thirty, your chances of complications double. They double again every few years after that as well. This is because the bone becomes less pliable and cementum builds up at the roots.
If your wisdom teeth were not impacted, I would say leave them be. However, when it comes to impacted wisdom teeth, it is not a matter of if they give you a problem, but when. Because of that I recommend doing it now before they become a problem. The last thing you want is a dental emergency while dealing with this, especially when you get a few years older.
I like your dentist’s idea of leaving the root, but don’t have him leave the whole root. Tell him just to leave the very tip. If it is a small piece, your body will often not have an issue with it, therefore you will have less of a chance of developing an infection.
I hope this helps with your decision. Click here to learn about sedation options for your procedure.
I have been dealing with an opiate addiction. I am on the path to recovery and am in a methadone program to help with that. I go to counseling regularly and have a full time job now. I’m even working toward going back to school. the problem I’m having is my teeth. Due to my addiction, I really neglected them and now need a ton of work done. I do have a bit of dental anxiety and am having trouble finding a dentist willing to provide me with any dental sedation, let alone pain medication after the procedure. I’ve offered to give each of them the number of the clinic that provides my methadone and even will sign a waiver to let them have access to my records there. Still no one is willing to help me. If you have any suggestions or advice for me I would be quite grateful.
Once I get my teeth healthy, I’m hoping to spruce up how they look, but I think just getting them in shape will cost most of my savings.
Damien
Dear Damien,
Sedation Dentist is sometimes dubbed sleep dentistry because you are so relaxed.
You are in a tough position. In case nobody has said it to you recently, you are doing amazing things getting your life back on track. It is hard picking yourself up like that and you seem to be crushing it! That is something to be proud of.
Though you are probably feeling judged, what is more likely happening is that the dentists are afraid of the D.E.A.. There have been stories circulating about dentists getting in trouble just for being compassionate and prescribing extra pain meds.
I think you will be able to find someone who is willing to help you. Start by calling dentists whose website says they offer dental sedation. Just keep calling. You will find someone.
As for sprucing them up. An inexpensive way to make a huge difference in the appearance of your smile is to have teeth whitening done. That one simple procedure will take years off their appearance.
My daughter Ava, 4, is mildly autistic and has difficulty with new and different stimuli. Her first dental visit is coming up, and I thought bringing her favorite weighted “blankie” and her beloved stuffed panda might be a good idea. I’m just worried about keeping her calm throughout the procedure. I do have an odd question, though. She adores her twin sister Rachel and was asking if Rachel can come along and sit in the room while she gets her cleaning. The twins do everything together and have a very strong bond. I honestly feel it would really help her. Rachel is not on the spectrum as Ava is. She already had her cleaning last week (and did great!) but Ava had another appointment that day and couldn’t come in at the same time. Rachel has such a calming effect on Ava, so I thought it might be a good idea. I will sit in the room with them as well, instead of leaving the dentist with two four-year-old’s! Does this sound like something that might work?
Many thanks,
M.M.
Dear M.M.,
Twins are a special delight to be sure–congratulations! These are great questions; let’s see what we can do to ensure a wonderful first-time visit for your angel. There are a couple of things to consider:
The First Pediatric Dental Visit is Meant to be Fun
Some pediatric dentists are fine with parents coming back with their children. Others, prefer to work with the child with just his or her assistant so they can build a rapport. In fact, some children are much better-behaved on their own than their parents might suspect. This is especially true if you as the parent have any deep-seated dental anxieties of your own. Though not intentional, these fears may inadvertently be transferred to your child; children are very intuitive.
That being said, this is a “first” visit, and that makes it a special type of fun. While yes, Ava is here to have her teeth cleaned and examined, she’s also here to get a first-time view of the dental office and we want that to be favorable. We all know first impressions count, and the goal is to have her leave the chair with a smile. If this includes you and her twin sister sitting in, then it shouldn’t be a problem. Just be sure to mention this to the hygienist before being called back to a chair, so she can prepare. Explaining your daughter’s special circumstances will help.
Following Visits May be Different
Once Ava has successfully completed her first visit, she will have hopefully formed a good opinion of the dental office and what it entails. If further visits are needed, such as for fillings if any decay is found, the assistant may ask you and Rachel to remain in the reception area.
You Know Your Autistic Child’s Tolerance Best
Autism and its effects can be a challenge for parents. In the practice, we often see patients on varying degrees of the spectrum, and what works for one may not work for another. Some may require prior medication, such as dental sedation. Some require shorter visits; some do fine without any of these. I’m glad you’ve had the foresight to suggest bringing her special blanket and stuffed toy. These things will certainly help. You know her best, and we don’t forget that.
Twins Are Wonderful
All children are gifts, yet twins are another thing altogether! I can recall having 5-year-old twin girls in the operatory once, very similar to your situation: one in the chair, the other watching from the corner. These two had formed their own rudimentary language, and I’ll never forget listening to them talk to one another in their unique chatter! It was an amazing experience.
I have a five-year-old daughter who is extremely uncooperative at the dentist’s office. I have been through four pediatric dentists in our small city trying to find one who can get her to cooperate and it just hasn’t happened. She needs a lot of dental work and is having trouble eating. I’m worried. She has four teeth with decay right now and some of them have even lost tooth structure. What do I do?
Katie
Dear Katie,
I can tell you love your daughter Katie very much and want to get her the best care possible. She is in a position now where you almost have a dental emergency on your hands. The first thing I would do is find a dentist who works with children and also offers dental sedation. It does not necessarily have to be a pediatric dentist. There are general dentists who are good with children. If she is uncooperative, this will at least allow her to get the work done she needs.
While these are baby teeth we are dealing with, they are still most important for her to keep for two reasons. One, so she can eat properly. Two, if any of them are molars, she will need to keep those in place until she is twelve years old. If the teeth cannot be saved, then make certain the dentist places space maintainers there to keep the space open. Otherwise, her other teeth will shift and it will lead to crowding.
One other thing, the only way to get that much decay at her age is for her to snack quite a bit during the day. You may have to show some tough love. Do not let her eat between meals. This includes having too much juice. Try to limit her to water until her teeth are under control.
I am absolutely appalled. I took my daughter to the pediatric dentist for the first time. I got a little nervous when they didn’t let me back with her, but I didn’t want to make her worry so I pretended it was no big deal and she’d have a lot of fun. You can imagine how heartbroken I was when she told me that she got scared so they strapped her down. When they brought her out I could tell she’d been crying. I called, thinking I must have misunderstood her or she didn’t know how to explain what actually happened. They told me it’s standard procedure in dealing with an uncooperative child. Please tell me that’s not correct. She doesn’t ever want to go back.
Amy L.
Dear Amy,
Dental Care for Children Should be All Smiles
I’m heartbroken with you for the trauma your little girl experienced. I believe what you’re referring to is a papoose board. It wraps the child which essentially keeps them from moving during their appointment. It used to be a regular practice in many pediatric offices but has come under fire in recent years. Even the American Academy of Pediatric Dentistry has warned of its drawbacks and said parents have the right to terminate its use at any time.
While some children do better alone, many feel comforted knowing the mother is there to look out for them during their appointment. The goal of pediatric dental care is to give children a positive experience and get them excited about taking care of their teeth. I’d say your pediatric dentist totally failed at that.
Finding a Good Pediatric Dentist
You’ll obviously want to switch to a different practice. You can take your daughter to a pediatric specialist or a general dentist who enjoys treating children. One way to know how good a general dentist is with children is the age they’re willing to first see them. If they say around two years of age, you can feel pretty sure they’re comfortable with the wee set. If they say 8-10, then I’d look elsewhere.
Given your daughter’s experience, you’ll want a dentist who will let you go back with her. She’ll need to feel safe. You may also want to give her some nitrous oxide. It’s commonly called laughing gas and will help relax her. Wherever you end up, be sure to check their reviews ahead of time as well.
Please tell the new dentist what your daughter went through so they’ll be prepared to handle her understandable fear. We want to get her on the right track having positive experiences.
Most adults who end up with dental emergencies do so because they had a traumatic experience as a child and now avoid the dentist until their services become unavoidable.
For those patients, we recommend oral conscious sedation. It’s stronger than nitrous and will allow them to sleep through the appointment. That would be the last resort with a child, though. Let’s see if we can’t get her relaxed and happy without it.
