ISO dentist advice re anasthesia


Shockingly, it turns out my 5 y.o. son has between 4-8 cavities in spite of a nearly sugar-free diet and assiduous brushing; go figure. My husband and I are at a loss of the best next step and welcome advice. Over the past month we have seen 3 dentists and gotten conflicting info/treatment plans. One dentist (Dr. Mary Burke) suggests laughing gas; another (Dr. Norman Schwartz) says only novacaine is better. He also believes one or more of the teeth should get crowns instead of fillings, which seems very strange to me but apparently that is not such a big deal for baby teeth. My son is extremely afraid of even sitting in the dentist's chair and we went through a traumatic half hour yesterday, trying to get him to cooperate for one Xray. Dr. Schwartz believes if I am not in the room, and if he uses something that (to me) resembles a straightjacket, all will be fine and he can do the work in 3-4 appointments. At first I was ready to go this route but now feel quite doubtful that my son will cooperate and/or get through this without significant trauma. (He has had other medical procedures in the past which left him with a deep seated fear of being "held down" or "choked" even though nothing of the kind was being done to him.) My son also has sensitivity with his face being touched, which may mean that laughing gas is too hard to endure, as it is held over the nose. Has anyone on this board gone through something like this and can you speak to the merits of various pediatric dentists? (We'd prefer them to take our insurance, Metlife Dental.) My son didn't feel comfortable with either of them but the dentist he liked is a general dentist (Dr. Clapcich) and says he needs a pediatric dentist to get these cavities dealt with. Also, do you have any thoughts on the pros and cons of anesthesia for kids this age? I spoke to someone at Westfield Dental and they sounded impressive but would love others' opinions. Many thanks.

We have been very happy with Dr Fried, who is great with my kids, and would recommend him. But if you're concerned about potential trauma because of your son's reaction, you might want to consider looking for a dental practice that specializes in treating people who are afraid of the dentist rather than a practice that specializes in treating kids. I have a friend (adult) who goes to such a practice; I'd never heard of one til hearing her experience. Can't think of the name, but if I come up with it I'll post again. Anesthesia's risk/ benefit trade off is different for everyone, but it sounds like it could have a significant benefit for your son in that it would let him miss this experience. 
Side note: I wonder if the cavities are related to the lack of fluoride in the water in essex county,which drives me crazy. 

Dr. Fried is great with kids. My son had horrible issues and Dr. Fried saw him about five minutes a day to get him comfortable.  That said, when we used him as our dentist my son did need a cavity filled and that was a bit too much. We did the straight jacket route. (Dr Fried does not do this. He sends you to another doc) Definitely awful for little ones. Luckily DS has no memory of that visit. Doing it for several visits imo would be traumatic. 

We went with Dr. Burke/laughing gas for my pain phobic son and it really helped. I would think that Novocaine is administered via needle and that would not have gone over well in our case. And as I recall, it does hurt a little bit even after the numbing agent. We did not have such a high number of cavities, which as I understand it is likely due to genetics, not diet.

Good luck!

Doctor Fried and his staff are wonderful with kids.  

I have heard that Dr. Bae (sp?) in South Orange is very good for people who are nervous about seeing the dentist.

Good luck.

I am not sure you want another dentist recommendation. I have been extremely pleased with Dr Bohrod on Morris Ave. (Springfield). I have a daughter who is on the autism spectrum, and is very squeamish, and super sensitive to pain. And her fear of "the needle" may be greater than her sensitivity to pain.  Maybe because we had her teeth coated, she had no cavities for years. But without brushing, the decay caught up with her. We have had to make many trips, so she doesn't get overwhelmed by any one job, but she has managed to pull through. I think his work is excellent, and the staff are very warm and kind. 

I seriously recommend that you schedule a consultation with Dr. Mitchell Bayroff, who has an office in Summit.  He is a pediatric dentist, who welcomes kids with developmental disabilities.  I understand that you son has no disabilities, but if you want to avoid a papoose board, Dr. Bayroff might be a good solution for you.

When my son with autism was 5, over ten years ago, we found he had 4 cavities, one in each of his back molars. The dentist we were using (Dr. Sommers in Livingston) recommended using a papoose board to strap him down while she filled them . But because my kid had autism, and was reluctant to allow us to put things like tooth brushes in his mouth, we had spend a good 2 years teaching tolerating a tooth brush, and prepping for a dentist visit. I was pretty sure that if we strapped him down for a procedure all our teaching would be wasted, and we'd never get him back to a dentist easily.  I did not want to throw away all that effort - and I did want my kid to continue to tolerate dentist visits for many years to come. 

Dr. Bayroff offered us the option of doing the fillings while my son was under general anesthesia at Overlook hospital. A bonus was that while my son was under anesthesia, the dentist could take x-rays and put sealant on all of his other molars.  (This would have been very hard to do if my son was awake.)  It was a difficult decision because who wants to subject their kid to general anesthesia is not really necessary?  But it worked for us. 

My son, now a teenager, likes going to the Dr. Bayroff.  He has not had a single cavity since his initial four.  I have never regretted this decision, unlike several friends of mine who allowed dentists to use the papoose board.  Of course, your mileage may vary, but if you're looking around for other options - Bayroff may be one.

Trust your gut.  If you think the papoose board/ being restrained would be hard for your child, find an alternative.

Good luck.

finnegan said:

 I have never regretted this decision, unlike several friends of mine who allowed dentists to use the papoose board.  

 I have wondered if using a papoose board on a child might have the potential to turn a fear of the dentist into a full blown phobia.

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