Friday, June 22, 2012

Refusal of dental treatment and "weighing" the risks

I want to preface this brief-ish post with the fact that I understand the need for good dental treatment and proper brushing. We started brushing our kid's teeth before teeth erupted, using a finger brush and xylitol. Attached parents do care about their children's health and wellness - they just often have to look a bit deeper to find a provider who talks and listens and willing to work with the needs of the child and entire family. Attachment parenting friendly dentists and doctors are sometimes hard to come by.

Early  tooth decay at around 21 months old.
When our now 4 year old was just 15 months old, we discovered that, in spite of brushing and no juice/soda, etc, her teeth were not staying bright and white :( So at 21 months, we called for a dental appointment with a highly advertised children's dentist who was also recommended by our pediatrician. This dentist had a child our age and was expecting as well (so was I at the time). When we first called for an appointment they said they wouldn't see her yet but then when we indicated she already had decay, they agreed to see her - she was around 22 months old.

My daughter is a light-weight - from her daddy, not me, that's for sure, though breastfeeding and not giving her junk food probably helps, the fact remains that she wasn't even 20 pounds and the treatment recommended included the need for her to be put under. The dentists's office had three anesthesiologists whom they worked with, but only one was willing to do it due to her weight.

After weighing the risks, costs and potential benefits, we decided against doing the treatment at the time and instead figured we would have it done on our next trip to India since the cost would be cheaper and they would be more likely to allow me in the room during treatment. So, this past year we were able to get her teeth cleaned and capped in India. The caps didn't stay, but for a while it was helpful and reassuring.

Fast forward to this year, I called to get an appointment for her to get a check up, cleaning, etc. and wasn't able to make one. I got a call back today indicating their office, after review with the dentist was refusing to keep her on as a patient because we didn't do the treatment when she was not even 2 year old, when even some of the anesthesiologists wouldn't take on the risk.

 We really liked the physical office of that pediatric dental office. For our family, we had to look at the risks/benefits and also find some place we were comfortable having service done. I did not like that for her treatment at that office I would not be able to see her throughout. In today's day of patient abuse, I'm sure most parents want to at least physically see that their child is okay, if not be with the child. I do understand that many parents may interrupt what is happening, but being able to physically see what is happening gives parents reassurance.

In the end, since I wasn't able to make an appointment right now, I called around. I wanted us to see a holistic ADA dentist who didn't use fluoride and instead uses oxygen treatments, but being out of network and the increased cost, I decided that the best bet would be a non-children's dentist.

We were happy with the cleaning we had done with a "regular" dentist last week at Stetson Village Family Dentistry. They are a new office, with a single "empty nest" dentist who moved down from small town Iowa to be more than a snowbird. The dentist's demeanor was reassuringly upbeat, his office staff nice, and he was not at all pushy. He was gentle with my daughter, allowed her to be brushed in my lap and explained everything to her so that she was comfortable. Even with her decay, he didn't chastise me. He asked how we brush and when and affirmed our belief that we are doing our best... and that we should save our nickles and dimes for potential braces later. He asked that we continue to watch that her front teeth don't begin to show signs of abscess or infection in her upper front teeth that have decay, and check around her lip tie (aka maxillary labial frenulum) and to come back if we see any signs... but if not, just to come back in 6 months for another cleaning. How reassuring!

Note: This post is not at all endorsed by any dentist group, etc. Just an FYI on our situation and view.

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