Toddler Tootbrushing Tips? IV Sedation for 20 Month Old with Cavities

L.,
A recent study connected early childhood anesthesia with high incidents of special education referrals especially after 2 surgeries. I also agree with the other moms who say it is too early.
Good luck,
Wendy

I use to work for a pediatric dentist for 9 years (Ronald Singer, DDS in Valencia/Santa Clarita, CA). If that is where you're taking him, they do a fabulous job. The anesthesiologist is there monitoring everything while the dentist can concentrate on a very "cooperative" child to get everything all done at once so they are not traumatized. As long as it is IV sedation that is monitored and not a drink sedation that can be very dangerous, your child should have a good experience that he/she won't even remember. It is more expensive. The anesthesiologist will charge about $700 to $900 and it's not usually covered by your dental insurance - they usually don't consider it "necessary." However, if your child has any special needs the medical insurance will sometimes reimburse you. The night before the child shouldn't have anything to eat or drink for a minimum of 6 hours (and we would cancel many times for even one bite of food a toddler got into while mom was in the shower or not looking). The anesthesiologist we used (Marc Rosenblatt) was really super with the kids. He would talk with the child/parents in the waiting room, give them a shot to relax them and start to put them to sleep, then carry them back and hook up all the monitoring equipment and start the IV so they were not fighting, kicking, screaming and/or scared. The procedure takes about an hour from asleep to awake and he always had the parents come into the back and be chair side while the child woke up so they were not afraid when they woke up and woke up to soothing voices they recognized. He always called to check on the child later on in the evening as well. In the entire time I worked there, nothing ever went wrong and many of the children were up, playing around, and often eating pain-free for the first time in a long time by the time we called to check on them. They have been doing these procedures together for many, many years. Dr. Singer just recently celebrated his 25th anniversary as a pediatric dentist and I highly recommend him if you're going there and/or you want a second opinion.

Hi L.,
I tried looking for the "spiffies" Susan mentions below, but only Longs Drugs carries them, and the one Longs in our neighborhood doesn't have them. I figured she needs to get used to using a regular toothbrush anyways, so I gave up on trying to find the spiffies.

I'd try letting your son pick out a toothbrush that he likes. My daughter has two regular toddler toothbrushes, a Dora rotating toothbrush, and a "Hakuna Matata" Tooth Tunes toothbrush. She used the Dora and Hakuna toothbrushes constantly for the first 24 hours, then lost interest in them. She likes the "Fruity Tooty" Oral B toddler toothpaste (no flouride, has Thomas the Train on the tube). Maybe your son will like the flavor of the toothpaste and try to brush his own teeth.

I have trouble getting her to open her mouth, or to unclamp her upper lip from her front teeth. I've taught her "What do you do when you see the dentist?" "AHHHHHH" (she opens her mouth and says ahh). She hasn't seen a dentist yet, but we've been practicing this for a month or so in anticipation of her first visit. I still have a hard time getting to her top front teeth, but I just keep at it. If I need to, I use my finger to push away her lip to get at her teeth, but I try to use that as a last resort. My husband seems to have better luck with her than I do, so I usually try to have him do the brushing. You can also try letting your son brush your teeth while you brush his. Or make some kind of game out of it if you can (brush away the sugar bugs trying to eat his teeth).

Good luck!

Hi L.,
baby is too young for that type of procedure. Keep in mind with economy status not looking so good right now, anyone will do anything even if its not a good decision just to keep the money flowing into the business. I have never in my years of dental field ever came across a case of a child or toddler younger than four or five at least being treated for cavities. the child is too young. As far as the brushing tips? There are baby soft tooth brushes sold at wal-mart, etc., where you can use on your child and ensure to keep the areas of her erupting teeth clean. Keep the baby away from sweet drinks or milk during sleeping or nap time especially at night time. Even if the child wants to, give her/him water to sip on but nothing with any type of sweetened in it. Let the baby walk around with the tooth brush. It's alright for the child to chew on the bristles. I used to do the same with my children at the same age. they imitate the burshing techniques, then they just walk around still imitating the brushing and chewing on the brush :). If you don't feel right about the doctor's decision, then don't do it. As they say, "mother's know best." :) I have worked in the Pedo field as including the closest to age 24 months where Pediatricians advise parents that children at that age are too young for treatment but parents will have to help out by keeping the child's oral hygiene free of sugar and sweet drinks and food... Let me know if you have any questions...

my son went under for 1 hour at three years old....needless to say it was the only way at the time, I tried several dentists and none could get my son to sit still and stop crying. my son was so irritable and nervous that dentist could not do what they needed to do and his cavaties were getting worse. I aked the dentist if I could leave his cavaties untreated but that is never reccomended as it can decay his permenant teeth. So they put him under for 1 hour, I was nervous but they reassured me that it was a common practice and they reassured me things would be ok....and it was. so I do recommend it, dentists can get all the work done in an hour and your child won't feel a thing...think of it as a lil nap!

I would definitely get a second opinion about this before proceding with the IV sedation. I would watch carefully the foods my child is allowed to eat and make sure to brush his teeth after every meal. I would limit access to any sugary foods and make sure that grandparents, all relatives and caregivers understand why. I would make sure to offer lots of nutritious foods including fruits and vegetables.

Something that is really great that helped us in getting our child to let us brush his teeth is a set that we found at Barnes and Noble, I believe. It comes in a little box set...it is a book called "The Little Prince Gets a Toothache" and comes with a sand timer that times how long you should brush your teeth.

Best of luck,
J.

a bit OT: whatever you decide with treatment this time around, start your child on tissue salts that promote re-calcification: Calc Fl 6X and Calc Phos 6x, you can get both in Whole Foods.
Good Luck
V.

Hi, L.. A dentist I no longer use strapped my daughter down and forced treatment. She has horrible anxieties that we still deal with, ten+ years later.
My two youngest children were both sedated at around the same age as your son. It was easy and they were both back to normal the next day. They have no anxiety or problems and love going to the dentist.
Good luck. :-)

i havent had to deal with that yet. but as for brushing tips heres what i do with my daughter. i have her sit on the counter facing me and i brush her teeth for about 1 mins. then i let her do it. also she has an electric toothbrush she likes (she picked one out just likes daddys). also my daughters dentist has us use a floride toothpaste once a day (i just let her use a SMEAR of ours because she likes the mint). so in the morning she uses the training toothpaste and at night she uses ours. we make it part of our morning and night routine. i hope this helps good luck!

Hi L.,

I am a dental hygienist and I am so sorry you are going through this with your baby. I believe the 2 main reasons they are recommending the IV sedation for your child is to not have this be a traumatic experience that will scar his dental experiences for the rest of his life and so the dentist can complete the best restorative treatment without a child who is crying, moving, closing his mouth, etc. It is VERY hard to perform precise and perfect dentistry on someone who is fighting you. At such a young age, he will probably not remember the nice and calm dental experience, but the bad one may stick with him in his subconscience. It's so sad to see kids and adults with extreme dental anxiety. As far as brushing tips go: when we see tooth decay in children under the age of five, it is usually related to diet and sugar containing beverages (milk and juice), whether it is from a bottle, breast, sippy cup, or regular cup. Generally, I only give my kids milk at meal times. Each sip of a sugar containing beverage lowers the mouth pH to a demineralizing level. If the bacteria that causes tooth decay is present in the mouth, decay can happen on the teeth. When kids are constantly drinking throughout the day, it'a a constant environment for tooth decay with each sip. So when we eat, our pH is altered in the mouth. So by only allowing milk or juice to be given at meal times, I am limiting the amounts of time throughout the day that the mouth is in a tooth demlinerlizing environment. Water keeps the mouth at a normal pH. So, throughout the day they are drinking water. I hope that makes sense. For my kids, at that age I would wipe their teeth and gums with a washcloth when I cleaned them up before taking them out of the high chair. They had a toothbrush which they pretty much just chew, but that helps the teeth too!! All the other tips that have been given are great. Eventually with my kids, they would have their turn and then it was mommy's turn and I would sing a song while I brushed their teeth. I wish you the best with your little guy!!

They told me that too but I refused and it was great! There was no drama and I was glad I didn't drug and tie down my baby! I'd go to a really good dentist. Are you on the Big Island. We have the best one here!! My kids never even feel the shots she gives!! Melissa Bodeaux, I know I spelled her last name wrong, but it's close.

As for the brushing, we just had to hold them down and brush fast hopefully without screaming. It is tough at that age. They get over it. You can try letting them brush your teeth and trying to get them to let you brush theirs...

Good Luck!!

Well L., I was in the same situation and my son had 7 cavities. I was already very aprehensive about it because the dentist office is not the ideal setting for iv sedation. Let me tell you a little bit about IV sedation. Medications are given via the iv to make your child "fall asleep" these medication depress the breathing and this alongwith blood pressure and heart needs to be monitored along with oxyen needs to be given.. I have talked to many anesthesiologists and they stated this is not to save in this enironment. I work in the operationg room during surgery (Operating room nurse) and I have seen adults that are closely monitored go down hill really fast almost to the state of death. I was so terrified that I put this off for 3 months and my sons teeth got worse. Long story short I opted to have him papused he fussed and screamed the whole time because he didnt like neing restrained however I am so happy it went this way. You can draw your own conclusions, but 1st find out who the anesthesia doctor is and go on line and look him/her up also please feel free to contact me via email if you have any questions. Also insurance doesnt cover this you will pay out of pocket around $650-$1000 for this. The money for me wasnt as big an issue as the chancesthat are being taken with my 2yr olds life. God bless.
J. C ____@____.com

**Adding this:
you can get Spiffies, directly from their website. This is where I got mine. I use it with my son after brushing, before bed as an added preventative measure. And between brushings too, if he eats anything acidic/sweet/sticky.
My son loves pineapple and oranges!

I don't know what "IV Sedation" is, sorry. For my daughter, who was older though, they gave her some kind of drink, to relax her. But for a 20 month old... I am not familiar with IV sedation. Maybe try do a Google search on it online. Or, I know dentists also use the "laughing gas" method as well.

But as far as brushing a toddlers teeth... I use with my son something called "Spiffies" tooth wipes.
www.spiffies.com
It is VERY good, for using in addition to after brushing, or anytime, as a prevention against tooth decay....
Also, don't let them sleep with a bottle, unless there is only water in it, otherwise tooth rot will/can occur. And for my kids, I limit juices.

For Tooth-brushing at this age or any age, we all use the Oral-B "Pulsar" tooth-brushes... it cleans better than just an electric toothbrush. Both my kids like it. And I find it cleans so well... I love this tooth brush!

All the best,
Susan

L. C

Many of the suggestions you have been given are very good, I would also get a second opinion before settling for any one type of treatment. However, I took my children to the dentist when they were 2 yrs old, but until then (in 1975) I was told to use a damp cloth and wipe their gums and incoming teeth. This would work until they could brush with a tooth brush. It worked really well, my youngest never had a cavity for years. Of course, this would not last for ever. But this is what I was told after I had each of my children (my children are all grown now). Their teeth are as healthy as they can keep them now days. I hope this helps.

L.,
I heard the same study as Wendy on NPR just a couple of weeks ago. Don't want to scare you, but definitely research/weigh all your options. Here is the article:
http://www.npr.org/templates/story/story.php?storyId=1023...