When children get cavities they are quicker to appear and faster in their progression than cavities on an adult. Mostly this has to do with the anatomy of a baby tooth versus a permanent tooth. I recommend that children start seeing the dentist at age one and then every six months thereafter. It is much easier to fill a small cavity then to deal with a large hole on a tooth.
Yesterday I had the pleasure of seeing a six year old girl that had a hole in-between two of her baby teeth. I had seen her last week to attempt to fix the hole, but it was a no go. Yesterday I was successful in filling the cavity and it brought to mind some important points on treating children: parent selection, timing, patience, and choices.
Parent selection is a key factor. As parents we bring our own anxieties with us to the dental office and we are experts at transferring these anxieties to our children. In the case of my six year old patient, it was her father that had brought her the week prior. The dad has a severe gag reflex and previous traumatic dental experiences. While he was being supportive of getting the cavity fixed, there was an aura of "is this going to hurt my daughter?" in the room. The mom was much more relaxed and matter of fact. From the onset of the appointment yesterday the mom's attitude was that we were going to get the cavity filled.
Timing when treating children makes a huge difference. If your kid is cranky or tired at certain times of day, then that is a bad time to be doing dentistry. For instance, my four year old is exhausted by 3 or 4 in the afternoon. He is much harder to reason with at that time of day. Early in the morning my son has boundless energy and he has a hard time sitting still. The best time to treat most kids is mid morning or after lunch. Also, it is important to keep in mind that when you are numb it is hard to eat and kids are more likely to bite their cheeks when numb. Thus, is important that your child is well fed before having a cavity filled.
Patience is the answer to finishing all types of dental treatment. It is important to take the time to walk a child through the steps of the procedure. In addition it is necessary to wait for them to overcome the crying that comes with anxiety of not knowing what is going to happen next. At the beginning of the appointment, my six year old patient was crying and refused to open her mouth. Once she realized that her tooth was going to get filled no matter what and I fully explained each step, she stopped crying and opened her mouth.
Choices are a funny thing when it comes to kids. The appointment with the six year old went something like this, "we can use this white and pink Mr. Thirsty or this clear Mr. Thirsty.". The point being that one way or another I needed suction while cleaning out the sugar bugs. Then I used a blue liquid, followed by a glue that was hardened by a blue light saver light and topped off with a white liquid that filled the hole. Success!
Kari Ann Hong, DDS1000 Newbury Rd. #190Thousand Oaks, CA 91320www.thousandoaksfamilydentistry.com
