Holy Rotten Baby Teeth, Batman

April 18, 2009 1:50 PM

My three year old just had his filling break off (or fall out) his front tooth a mere seven days after having a dental procedure. Needless to say, it looks AWFUL. Is there some dental technique I should ask my dentist about to get something that will provide a more permanent(ish) solution until his adult teeth come in? Lots more below.

We had been giving our son on-demand Milk + Carnation Instant Breakfast as a weight-gainer of sort since he was about 18 months old -- on our doctor's recommendation. Apparently all of the sugar hit his front teeth constantly because he was taking it through the sippy cup resulting in - yep, a handful of cavities on the front teeth and incisors. The pediatric dentist said he needed fillings, and he ended up undergoing a fairly length dental procedure that involved sedatives, nitrous, and being strapped to a papoose (and heartbreaking crying and screaming). We were not told that there were any restrictions on regular eating habits or that the fix had been anything less than successful.

Four months later, when my son was eating carrot sticks, I was horrified to find that one of the fillings had broken out, leaving two huge holes in the front tooth and incisor (the filling had been between the two teeth, and apparently they did a fair amount of drilling to make a place for it, as the cavity itself was very small from all outward appearances when we took him in initially). We took him back to the dentist again and went through the whole ordeal of sedatives/papoose/etc again. This time, he also got a root canal, a new filling, and a crown. The dentist (a different dentist from the first go-round) told me that he shouldn't eat whole apples/carrots/other hard foods that put a lot of pressure on the front teeth and indicated that there was a good chance that the filling could break out again, because it was hard for a filling to bond to the smooth surface of the front teeth.

Seven days later, we're back to a broken filling and a huge hole. We've been very diligent about not letting him bite into hard things with his front teeth (or at all, for that matter). Is there really no good way to fix baby teeth in the front?

(FYI - I'm waiting for a call back from the dentist now ... as it's a Saturday, all I could do was call his answering service)

PS - I'm not interested in "they're just baby teeth; ride it out" types of advice. Kids can be cruel, and I'm not sending my kid to preschool with a rotten broken tooth right in the front. You can disagree with that decision, but I'm not looking for advice on it.

posted by swilkerson to health & fitness (15 comments total)

It can be a bit of a crap shoot - the dentist has lots of different options for fillings. While it is no fun a small filling shouldn't require intense dental procedures, and you may just end up getting regular filling work. The kid will adapt to it. Given the description of the procedures involved I am guessing the second dentist is aware of the problems, they sound relatively pro-active. Even a small kid can exhert tremendous pressure on their teeth - so perhaps the front teeth filling will not be able to standup to the abuse or will sheer off.

I've had similar problems and over the dentists have used different materials, crowns and anchors, and these cost real money - you might consider just having the front one causing all the trouble pulled out. I learned how to whistle, it wasn't a big deal. Take the thousand a tooth you just saved and put it in the college fund. The kid has already had a root canal - which I am guessing is still pretty rare on a primary (baby) tooth, and a crown. Pulling the tooth might not be an option but don't reject it out of hand if it is an option. You can tell the kid that they are closer to being adult without it.

Also: the kid might be grinding their teeth while they are sleeping (bruxism) - you might need a to get a mouth guard.
posted by zenon at 2:30 PM on April 18

Wow, that's a whole lot of trauma for cosmetic purposes. I wouldn't send my kid to school with a rotten, broken tooth either, but I would have it pulled. FWIW, I lost both of my front teeth at about his age in a terribly tragic bunkbed-related accident, and I don't recall ever being teased about it.
posted by LittleMissCranky at 2:47 PM on April 18 [1 favorite]

Yeah, I smashed up a tooth at about three from a rock incident. Got it yanked, and that was the end of that. No problems in adultood.
posted by Inspector.Gadget at 2:55 PM on April 18

I agree with LittleMissCranky and would have his teeth pulled. They're going to come out eventually anyway, and little kids with missing teeth don't draw attention. Kids CAN be cruel, so I fully support your decision to not just let them be as is.

Also, given his terror about the dentist, you might want to avoid putting him through more work than necessary. A friend of mine had similar dental issues as a kid, and didn't go to the dentist from the time she was 15 until she was in her 30s out of remembered fear. The amount of money, time, pain, and drama she's devoting to this now could have been so easily avoided.
posted by peanut_mcgillicuty at 3:00 PM on April 18

It seems like pulling one or both would be the best solution. Is there even enough left to work with to do additional work at this point? Pulling baby teeth is not nearly as bad as a root canal, so that probably wouldn't be nearly as traumatic.
I remember there being kids who prematurely lost one or more front teeth (including my sister who lost a front tooth when she was 3 in an unfortunate slide incident) when I was little and nobody made fun of them. It wasn't considered weird. Kids are pretty good about knocking out baby teeth in falls, etc. Not to mention that kids usually start losing their front teeth in kindergarten or first grade, so there's not that long left to go before a lot of his peers are missing various teeth.
Pre-school kids are also not generally cruel like kids who are 7+, and by the time he's that age all of his peers will be in various states of front-tooth missingness, and half-grown in permanent ones.
posted by fructose at 3:11 PM on April 18

Nthing the pulling - I lost my two front teeth naturally at four, and didn't get my adult ones in until I was seven - don't recall anyone (other than family) ever mentioning it.
posted by coollibrarian at 3:11 PM on April 18

INADentist, but 3 years old seems to me too young for having teeth pulled. Usual wisdom is that the gap will tend to close which causes big problems down the line. And the OP is right about having milk teeth treated properly. Its a myth that that shouldn't be necessary.
They should be able to anchor those fillings better than they did.
I think I agree with others that the visual effect of 'no incisors' would probably not be a huge deal at that age, whatever His Own Parents (naturally!) would think.
posted by Namlit at 3:19 PM on April 18

Honestly, pre-school peer cruelty will be remember for a far shorter time than, say, middle school peer cruelty. What are they going to call your child? Snaggletooth? It's not like this is a permanent problem.

Not to shift the energy, but perhaps you're more worried about what other parents might say to you or develop as an opinion about your child? Seriously, after all this ordeal to get the teeth dealt with twice now, maybe you're just (nearly) torturing your child for your own peace of mind?

I cannot remember ever seeing children with baby teeth with fillings in them when I was growing up.
posted by hippybear at 3:23 PM on April 18 [2 favorites]

If 3 years old is not too young, my vote is to yank them. I had seven baby teeth yanked at once when I was young. My jaw was too small for the size of my teeth growing in, and they had to make room!

It was not too traumatic, except for only being able to eat soft foods for a week or two. My parents didn't make a big deal out of it, so I didn't pay any attention to it.

I taught pre-school for 4 years, and most of the kids had jacked up teeth anyway. Too young for the perfect, blindingly white work to be done yet, all my kids had snaggle teeth, overbites, and all different color variations. Nobody thought anything of it, they are too busy fighting over the most popular toy to worry about what they looked like.
posted by lootie777 at 5:42 PM on April 18

I had some rotten baby teeth pulled young too (I think I was 5) and I seem to remember wearing a metal retainer or spacer like thing. These were eye teeth though, not front teeth, but maybe there's something they can do to maintain the gap.
posted by cabingirl at 6:33 PM on April 18

I agree with the 'pull 'em out' advice. I knocked out one of my front teeth at the age of two and my other front tooth fell out at the age of six and didn't grow back properly for a long time so I was gappy for a while and I have no memory of being teased in any hurtful kind of way about it. Maybe it would be best to let your kid be gappy for a few years (really little kids aren't that cruel, particularly if the gappiness is not seen by your son as being that big a deal because it's so very temporary).

It's excellent that you're on top of your son's dental hygiene at such a young age, but it might be worthwhile giving up on these baby teeth and concentrating on the permanent ones to come.

I know it's annoying to get answers that relate to the thing that you've specifically said you didn't want to hear about, but I do think that having his baby teeth pulled, resulting in a gappy smile which is rarely a target of toddler scorn, is preferable to multiple procedures on what are essentially temporary teeth that could perhaps result in your son fearing future visits to the dentist. A gappy smile is better than a rotty tooth smile, and your son has better teeth to look forward to, and they're not that far away.
posted by h00py at 6:06 AM on April 19

Thanks so much for the thoughtful answers (ignoring the mean post or two - don't you people have anything better to do?). I feel better about the prospect of possibly just having a tooth or two pulled (especially considering the fact that maybe other kids his age will also have a lost tooth or two - naturally or otherwise). It doesn't sound like anyone was familiar with any procedures that might help with better bonding, but we're headed back to the dentist on Monday, so we'll see what they say!
posted by swilkerson at 6:43 AM on April 19

I don't know if they still do this (get off my lawn), but after falling off a file box as a toddler, driving one of my teeth up into my gum, and subsequently having it pulled, I had a falsie on a retainer plate-thing that I wore for several years, to keep my teeth from spreading all over the place -- and to address the cosmetic issue.

(FYI, my mother found that damn thing EVERYWHERE -- buried in the sandbox, covered in dog hair on the floor, etc. I figure it's part of the reason my immune system is so tough. :-P)
posted by liquado at 12:08 PM on April 19

for what it's worth, at our dental school we pull front teeth that are not salvageable all the time, we call it "four on the floor." It's tough to fix kids front teeth if there is not a lot of enamel to bond to, the only other option would try stainless steel crowns, but they are really ugly and would probably just fall off anyway. He'll do fine with missing a few baby teeth early.
posted by amalgamator at 3:01 PM on April 19

One of my classmates knocked out his front teeth in grade school and was promptly handed a neat retainer with fake ones on it, which enabled him to pull the Best Trick on Earth: pretending to sneeze, unhitching the retainer, and delivering it onto an unsuspecting classmate's desk with his hand as he completed the "sneeze." Still wet.

When you're a grade school boy, this is the best party trick you can imagine. Your kid will love it, if your next pediatric maxillofacial prosthetics specialist goes that route.
posted by fairytale of los angeles at 6:42 PM on April 19