Tuesday, November 22, 2011

More Dental Decisions

We have come again to a place where we need to make some major decisions about Liliana's teeth.  I usually get quite nauseous just thinking about it and I'm finding this decision particularly hard.  

If you've been reading for a while, then you will know that my little Liliana has had a lot of work done on her teeth.  She has a history of rapid decay and she currently only has one of her four front top teeth left.  The other three have had to be removed at different points.  All of the work was done while we were in El Salvador and though it was traumatic for her and us, we always felt comfortable with our dentist there and her procedures.

We originally saw a dentist in the States about Liliana's teeth and after hearing the bad news decided to get the work done elsewhere.  We didn't have insurance and there was no way I could afford it.  Also Eduardo was already in El Salvador at that point and Liliana and I really needed his emotional support through the process.  

We've never regretted getting the work done down there and actually prefer the way our dentist did things.  But now that we are back in the States, our American dentists are too impressed with the fact that we had work done in a 3rd world country, heaven forbid!  It's kinda looked down upon with complete ignorance on their parts.

Anyway, the point of this is that Liliana's lone front tooth got chipped.  I think it was from trying to bite into an apple instead of letting me cut it up for her.  She was so proud of herself when she did it that I had a hard time saying no and it wasn't until later that I saw the chip :(  

So we went to the dentist that we have been seeing since coming back here.  This dentist's office was recommended to us and accepts Medicaid (which Liliana is on) and we've been mostly pleased so far.  

That was until this visit.  We went into a private room and saw the 3rd different dentist we have seen in our 3 visits and I wasn't impressed with that as I had to explain our whole story each and every time to each dentist.  Then she told me what my options are for the tooth.  

I'll back up a bit by saying that this tooth has chipped once before in El Salvador.  The dentist there suspected it would happen because of her age and the size of the tooth.  We went into her office and she quickly filled the tooth in (it's not all her real tooth).  It wasn't too traumatic.

Well this dentist is now recommending we either put a crown on the tooth or simply pull it out.  She suggests just pulling it.  Even if they do a crown at this point, it can still break, especially her being so young.  I don't know which one I want to do.  I'm completely devasted and on the fence about either situation.  

I might not feel so horrible if we were in El Salvador where I know how the procedures are done.  Here they are a lot different.  These dentists will NOT let me be in the room during the procedure and I'm freaking out about this.  I have always been with Liliana through everything in El Salvador.  They also will not put her to sleep like we've always had done.  They just give her laughing gas and she will be awake and conscious (but relaxed supposedly) the whole time.  Then to top it all off, they basically put her in a straight jacket to keep her from moving.  It all just sounds horrible to me. 

I have put in a call to the dentist's office to ask some more questions, but haven't received a return call just yet.  Once I hear back, I will make my decision about which route we will take.  Hopefully this can be the end of our dental nightmares, particularly for Liliana's sake!  

To catch up on all of our previous dental experiences, check out Liliana's TeethLiliana's Dental Surgery and Another Tooth Pulled.


Sarah A.T.J. said...

Why the heck do docs think it is a GOOD idea to let a tiny kid go through a very intense procedure ALONE? I get this when Caden goes for a vaccination, the nurses say to set him up on the exam table. Alone while you jab him with a needle? No freaking way!!! I get the vibe from them that it is odd I hold him (I'm not even nursing him during it anymore!) when he gets his shot.

With a big dental procedure it seems even more important that a parent remain with the child. You'd think docs would want this, wouldn't the kid stay calmer? Especially given all Lilliana has gone through with her teeth and people examining them!

I think American culture is one where it is normal that a parent separate from the child. Sad but true:(

Lynn said...

well my first thought would be to let them pull it - that is assuming what has happened so far and this one will in no way effect her permanent teeth from coming in - can she do much biting with the one tooth? Being as young as she is she would adjust to not having it and her eating style. It would seem easier than to keep having it fixed - but I also don't know at what age kids start loosing their front teeth for the permanent ones - how many years does she have? Could she get a bridge done?
As far as you being in the room with her I can see both points - I'm sure they have a lot of experience with parents that cause issues while in the room with them -it has to be extremely hard to watch your child worked on and some parents may "get in the way" either physically or verbally - and may even upset the child more - but they shouldn't just say no to everyone - I think each situation should be evaluated.
When you call to make the appointments can you request a specific dentist??
Best of luck to you both - just make sure she can eat her birthday cake!!

jules said...

It is horrible. When I was two or three years old I had to have an emergency root canal done on a front tooth and I guess I was hysterical and they had to strap me down and I'm not exaggerating, I have a vivid memory of being strapped to the table. My mom says they wouldn't let her in to be with me either. I would vote for pulling the tooth also but I would fight to be with your daughter at least until they give her the laughing gas, which really does relax you, and then wait outside while they pull the tooth. I think it would help your daughter feel less scared to have you there until they give her the laughing gas. And I'm assuming they won't put her to sleep because it's more expensive. Maybe you could pay for the general anesthesia out of pocket? I remember when my husband had some teeth pulled it cost about $400 more for general anesthesia vs laughing gas but he was having back teeth pulled which is more involved. The fact that it's a front tooth probably means it's a fairly quick and easy process and doesn't warrant general anesthesia. All that to say, I would fight more to be allowed to stay with her until the procedure starts than to be put to sleep. Good luck!

Lisa n Javi said...

Poor thing. I know when I was working in the office they asked the parents not to stay in the room just because the kids seemed to act out more and not behave with the parents there next to them but if they really wanted I think it was ok. As far as getting it pulled or the crown, I know she is little still but it might be just more of a pain in the but to crown it, it might not be as strong anymore because it has chipped a few times already. I wish it was an option for her to be put to sleep, it would be easier on both of you.

Tara said...

I'm so sorry to hear of all her dental troubles. I hope everything goes good for her and you guys have good experiences here as well.

I work in the field. Although I do not work in pediatrics, I do know that I'm not a fan of the papoose board. I feel understand it is suppose to be for safety reasons, but strapping a child down doesn't seem like the solution to me. If it came to that, I would opt for the sedation dentistry although that may require jumping through a few more hoops to get it approved with the insurance.

When my son goes to the dentist, I ALWAYS go back with him. If he starts to act up, I just tell him that the dentist said I can stay if he listens, follows directions, and behaves. There has been a time or two where he has tried to push their hands away (a big no-no) and I've told my little one, "ok, mommy has to leave the room now" and he immediately straightens up.

I'm guessing they probably want to do the crown because they feel another filling will break off. I hope you will keep us posted as to which route you guys decide to take.

Oh, and I wanted to mention, if you do not feel comfortable, there is nothing wrong with getting a 2nd opinion or finding a new dentist. I know it can be frustrating seeing someone different all the time. Once you find someone you trust and like.... stick with them! Request them when you make her appointments.

Wishing the best for your sweet little girl!

Marcela said...

So sorry you have been going through this. I had many dental issues after a fall from playing when I was little. I ended up getting implant as an adult and it's always been so traumatic for me.
I hope you feel good about your ultimate decision and hope your little one is feeling good and back to normal.

Kelsey said...

Thanks for all the support on this issue everyone! I truly believe that the trauma we experience as children follows us to adulthood, no matter what the trauma is. I appreciate all your support in making these tough decisions :)

mr.g said...

just put the child in the papoose board and take a photo and post it two Papoose board HQ blog .com

Brendon Spaziani said...

I am very sorry to hear this. She doesn't deserve to experience this at a very young age. But I am thankful that your last visit went okay. I wish it would continue, and I know Liliana will have a more beautiful smile someday.