MeFi moms: How did you manage dentistry for your kids
February 16, 2021 12:49 AM   Subscribe

Looking for advice and compassion from other moms in terms of researching dental providers.

I’ve read a lot of metafilter over the years and have an impression of the US dental industry as very lightly regulated and more profit-oriented than I’d hope a medical profession would be. As a result I’m confused about how to find a good pediatric dentist for my 6yo medically-anxious daughter.

Any recommendations on how to find a dentist that I can trust? Are there certain accreditations or treatment methods I should be on the lookout for when evaluating local providers? I belong to a Facebook moms group and a church community, so the challenge isn’t finding providers that are recommended, but evaluating them once they are.

I guess I’d really like to hear from other smart and critical-thinking mefi moms about how they’ve navigated the pediatric dentistry world.

And for context, I think my daughter has several cavities and I’m concerned about them getting infected. Our current dentist has said he’s not concerned. When we may need to address the cavities, I’m curious about how to evaluate treatments too (X-rays, fillings, extraction, anesthesia). Thank you 🙏
posted by lagreen to Health & Fitness (19 answers total) 2 users marked this as a favorite
 
First, I am a MeFi dad that was responsible for finding our children's dentist. My stepfather was a dentist. He gave me simple advice. Make sure they are accredited (ADA - American Dental Assoc.), try to find a dentist that is at a stage in their career where your children can go to them until they are going to an adult dentist so to speak. Changing dentists when the children are young can be stressful. Plus, a new dentist may want to change treatment or redo something that may be expensive. His best advice, his "A" advice was to ask 5-10 other parents in town with children that are a little older than yours who they use, would they recommend them and why. Reputation. If you see a pattern or one dentist sticks out, set up an appointment to meet them. When talking to them get a general sense of what they believe, but try to find out if they seem to have compassion. How do they interact with your child and/or others when you are in their office. Dentistry is a skill and a little bit of an art, but it can be taught. What cannot be taught is compassion and bedside manner. The most important thing he found for success with children was if they were comfortable. Obviously, going to the dentist for children and adults can be an anxiety driver, but how they calm down a patient is important. (See if you can meet the dentists hygienist and staff too.)

If a child needs novacaine, that is a shot and children are not always the best recipients of needles. Do they explain things to both you and your child. This is what we are going to do. It is because... It may hurt, but that will be only for a few seconds then you will be numb. Afterwards, you may be sore, but you will be eating cool/cold things soon and that will feel good. Whatever level of explanation is age appropriate. Also, these days, some dentists let you choose the music or listen to whatever you want. Mine, who I went to a few weeks ago for reasons, had me tell Alexa what to play. I hear that some pediatric dentists have videos and headphones for the kids.
posted by AugustWest at 1:42 AM on February 16, 2021 [9 favorites]


When my son was small, we took him to the dental school at my local university for care, because that's where I was insured. They were excellent. The dentists were engaging and kind -- one drew him a picture of an airplane -- and the hygienists were experts and I always learned something. I'd recommend that.
posted by shadygrove at 5:57 AM on February 16, 2021 [1 favorite]


My daughter sees a dentist in the same practice I use. My impression has been that my own provider is less profit-motivated than other dentists I've seen, which makes me think the practice isn't leaning on folks to recommend a bunch of unnecessary stuff. He's never suggested any cosmetic treatments (and is very low-key when I've asked) and has recommended a watch-and-wait strategy for stuff that other dentists have insisted I need immediate costly treatment for. So, when my daughter needed to start seeing a dentist, I asked his receptionist to recommend whoever really likes to see kids. The dentist she sees is great, and is not specifically pediatric, so I anticipate that my daughter will keep seeing her basically forever.

My kid is not medically anxious (honestly she might be TOO enthusiastic about stuff like dentistry?) but we didn't know that would be the case. I like taking her to a clinic that was familiar to me, because I can confidently answer questions about what it will be like and what will happen there, and when we go I don't have any anxiety about, like, parking or whatever that she can pick up on and get stressed out by.
posted by juliapangolin at 6:07 AM on February 16, 2021 [3 favorites]


Our current dentist has said he’s not concerned.

A dentist who chooses to watch and wait rather than immediately treat things is almost certainly the kind of dentist you are looking for -- one who chooses quality patient care and minimizes intervention, over taking every opportunity to bill you for something.

If he is not a pediatric dentist, perhaps tell him that your daughter is very anxious (which I imagine he's already noticed) and you think she might do better with a pediatric dentist and ask him who he would recommend.
posted by jacquilynne at 6:43 AM on February 16, 2021 [14 favorites]


Is there a reason you're looking for advice specifically from moms and not dads? If not, you could consider asking the mods to reword to parents to avoid unintentionally perpetuating sexist stereotypes.
posted by randomnity at 7:36 AM on February 16, 2021 [29 favorites]


Look into dentists who enthusiastically offer silver diamine fluoride. I am not a mom but I use SDF instead of fillings for most cavities, and this is more commonly offered with pediatric dentists.

They paint it on, it protects the tooth at the cavity, it turns the cavity and only the cavity black (not the healthy tooth), it requires no drilling, no anaesthetic, it's inexpensive, and it's over in the blink of an eye. The only thing is, it has to be reapplied every 6-12 months. No drilling!!! They don't remove perfectly good tooth to clean out the bad tooth! 21st-century dentistry has come to the USA! (They've been doing it elsewhere for a long time, Japan and Germany, I've been told.)
posted by aniola at 8:11 AM on February 16, 2021 [3 favorites]


I got the recommendation from their pediatrician and it was reliable.

Having a pediatric practice is nice when they're set up to distract kids, make it easier for them etc. Ours has video players on the ceiling, they have the kids choose a movie to watch, give them headphones with the audio. Wish I could do that for my cleanings.

I've never had anything pushed on my kids that wasn't obviously necessary. "Watch and wait" is usually good advice and suggests they're not jumping on opportunities to bill you.
posted by fingersandtoes at 8:18 AM on February 16, 2021 [1 favorite]


For a medically anxious kid, my recommendation is for parents to ask potential dentists about their pediatric anesthesia, because it turns out that a lot of places don't do that, and if you have a kid who cannot cope, it's nice to have the continuity of care when they are already stressed out. I also think that the dentist taking a watch-and-wait approach is a sign that they aren't aiming to extract the maximum amount of money from you, although if they are doing a poor job of explaining their reasoning to your satisfaction that might be a poor sign. Our dentist has seen a couple of borderline bits on already-wiggly baby teeth and avoided the expense and stress for something that would be gone before the next visit.
posted by tchemgrrl at 8:35 AM on February 16, 2021


I am the child of a retired dental hygienist from back when that required a four year college degree. I never went to a pediatric dentist, I went to whatever dental practice my parent worked at. For that reason, I take my child to the same dentist my spouse and I see. He has children at my child's school and she used to see him at Mass in the before times, so she was comfortable with him. If you like your dentist, I'd go that route.
posted by notjustthefish at 9:26 AM on February 16, 2021


We drive a little extra to get to a place that only does kids -- it's called Pediatric Dental Health Care, and has a colorful building and a staff who's devoted to kids. They handle a ton of patients, with three or four dentists & orthodontists and an army of technicians and hygienists.

We found them by asking our pediatrician, by asking around town, and by asking friends on social media. My wife visited a couple of dentists, but this one was an obvious win: they are good with children, they are flexible around family schedules, and all four of my kids like them.

Another approach is to try to find a dentist who specializes in pediatrics by training. I hadn't been to a dentist in like eight years, after a lifetime of Bad Experiences, and my wife persuaded me to go to her dentist. He was a gentle giant of a guy who'd immigrated form India where he specialized in kids. Here in the U.S. he got re-certified, and was on faculty at a good dental school. He had a bunch of tricks that set me at ease, and I would have been happy to take any of my kids to him, but we moved.
posted by wenestvedt at 9:42 AM on February 16, 2021


Best answer: After a traumatic injury to my daughter's front teeth, I found myself desperately searching for complex dental care for a kid who was TERRIFIED of dentists (long story, but our original pediatric dentist did not do the right thing after the injury, my daughter will eventually lose an adult tooth that could have been saved, and we needed a rather urgent series of root canals).

We started with different clinics, dentists and endodontists, but my daughter was too anxious for anyone to treat her, and we needed too many appointments for sedation to be feasible. And that's when we found The Best Dentist Ever. She works at a hospital-affiliated dental clinic that provides general pediatric care, and - *importantly* - they specialize in treating children and adults with intellectual and developmental disabilities. My daughter's anxiety went from a 10 (screaming, flailing, hitting, no dental treatment possible) to a 2 (sitting quietly and calmly for a 2-hour procedure with no sedation at all). The dentist is so kind and patient and competent that I still *joyfully* drive 45 minutes each way for cleanings.

So my best advice is to look for places that offer specialty care - they will have so much more experience with anxious patients. I'd also suggest pricing out standard services, including SDF for fillings (love! no needle!), and any extras you might want like laughing gas and composite fillings for molars. And FWIW, we saw a pediatric dentist originally, and I disliked her office so much that I was already planning to switch, so finding a pediatric place isn't a silver bullet. She was also twice the cost of both the new dentist and my family dentist.

If you tell us where you are someone might have a specific recommendation - if you're anywhere near Providence I can make the best referral ever.
posted by zibra at 11:02 AM on February 16, 2021 [4 favorites]


Sometimes you just have to try it out. I took my kid a couple times to a nearby pediatric dental clinic that had good reviews online. My kid was a very uncooperative toddler, but I didn’t feel like they were trying very hard. So I asked a friend where she took her kid, and she told me about a pediatric dentist in a distant suburb who she’d follow to the ends of the earth. We went there for our kid’s next visit, and it was magical. The vibe was great, the hygienists were all fantastic, and the dentist is super smart and communicates so well with both kids and parents. Now I, too, will follow this dentist to the ends of the earth (or until my kid is old enough to be embarrassed about going a dental clinic with a custom two-story school bus playhouse in the waiting room).
posted by Maarika at 11:10 AM on February 16, 2021


When I was younger I learned that cavities were forever and that they had to be drilled out as soon as they were detected. My current dentist says neither of those are true. Some will go away with diligent brushing. As I understand it, they can see the extent of the cavity on the X-ray, and only ones that are large or growing quickly need to be removed quickly. So I see a willingness to do watchful waiting ("conservative treatment") as an excellent sign that a dentist (or other professional) is judiciously weighing pros and cons. In fact, a cavity like that would be something that I would use as an example to get a sense of how a dentist approaches problems. I don't think you'll have a hard time finding a dentist who drills at the first sign of a cavity, what you have is what's harder to find. No one's teeth are perfect.
posted by wnissen at 1:14 PM on February 16, 2021 [2 favorites]


Some dentists in the US still practice boarding - where they strap the kid down to a board to practice dentistry. Avoid that.
posted by zenon at 1:57 PM on February 16, 2021


Another MeFi dad here - we found our kids' dentist by asking friends w/kids for recommendations, and then winnowed down the list based on location. I'm currently handling the appointments, etc.

And for context, I think my daughter has several cavities and I’m concerned about them getting infected. Our current dentist has said he’s not concerned.

I've found, both w/my kids' doctors and my own that, while it's obviously wise to be a critical consumer of medicine and get 2nd opinions in serious cases, you are better off finding a provider you can trust and deferring to their expertise on something as minor as a cavity*. Balance the low relative risk against the time, stress and likelihood of success of doing research as someone who has not been to medical or dental school.

My son hates going and always puts up a fight - our dentist is pretty good at handling him, and my impression is its just something you get good at when you've been in the profession for a while. I'm always much more upset by it than she is.

* I say this as someone who has bad teeth as a result of taking crappy care of them as a kid and has had a lot of dentistry in the last decade. I have had some ugly cavities, cracked teeth, etc., and have yet to have an infection or abscess.
posted by ryanshepard at 1:59 PM on February 16, 2021


Dentists who work well with autistic children is an indicator as well as a more wait and see approach. I found my children’s present dentist in a place where I had no social network in the area by first going to her for a cleaning then sent the husband. We thought she was very good with us and then sent the children. She was excellent with my autistic son. I wrote a google review that she was excellent with children though not listed as a pediatric dentist. So, a search for dentists comfortable with autistic kids maybe an option.
posted by jadepearl at 2:09 PM on February 16, 2021 [1 favorite]


You say your daughter is six? Are these cavities in teeth that are going to fall out anyway? My kids both had “maybe cavities,” or the beginnings of cavities, in several of their teeth at that age, but their dentist (a pediatric dentist, at that) never suggested drilling/filling. I don’t think infection/abscess is common in kids unless they’ve had some sort of trauma to the tooth. It sounds like your current dentist is taking a reasonable approach-watchful waiting of cavities is definitely A Thing, so is applying a sealant to the tooth. Less intervention is surely best, if you have an anxious child.

Honestly, I have switched practices a couple of times over the past decade due to moves or insurance changes, but every pediatric dental practice I’ve taken my kids to has been fine. I found our most recent practice on Yelp. I’m not sure I agree with your assessment of dentistry in the US as “lightly regulated,” but I think all signs point to you having a fine provider right now.
posted by little mouth at 3:34 PM on February 16, 2021


My boys were both so anxious at our regular dentist. He recommended a pediatric practice. It has made all the difference. These dentists and hygienists know kids and challenging kids. They have strategies that work. Plus the special sun glasses for during the cleaning and balloons after are cool too.
posted by peeps! at 4:41 PM on February 16, 2021 [1 favorite]


Response by poster: Thank you all so much for your help! I really appreciate the comments about bedside manner and suggestions for specialty dentists. I'll ask around and perhaps look into someone who is skilled in working with individuals with intellectual or developmental disabilities...someone who puts a priority on the child's emotional as well as physical wellbeing.

And randomnity, as for why I targeted this question to MeFi moms, it's because I just love the ladies. I am always interested in the voices of women and especially other mothers.
posted by lagreen at 5:04 PM on February 17, 2021 [1 favorite]


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