Message for Jasper - as I have seen you around

[Blossomhill]

Having a nightmare with my dd who is 5 and has communication difficulties. She needs at least 4 fillings and have been referred to the special needs dentist at the local health clinic. We have been 3 times now and dd is having none of it, refuses to sit still and the dentist only manages to put a temporary dressing on that falls out. The dentist said dd may complain a bit of pain as she has a small abcess in 1 that could flare up. Over the last day she has been complaining and I am going to try and get an emergency appointment for tomorrow when they re-open. I am just so worried that again dd will not co-operate. Do you think my best bet would be to let her have them all done under a general, which has been suggested. Obviously I would rather we didn't go down this route but I am seriously so worried and at my wits end. Thanks Blossomhill
On a more positive note I am at St Georges again as I am going to have my impressions taken for my new tooth to go on the implant. I am so excited and can't wait Are the implant teeth more realistic then your bog standard Nhs crowns? Thanks

[JanH]

BH, I am not jasper (obv) but in your shoes I would go with a GA. She needs it doing, but she is not going to quietly sit and let it happen, so a GA is the best way.

And best wishes for your implants!

[Blossomhill]

Thanks Janh She has had a GA before but was so distressed and sick when she woke up. I was also so distressed when she was in my arms and they put the gas mask over her face, she looked really scared It does need doing though. I just keep going ove where I have gone wrong. I mean admittedly it has never been easy cleaning dd's teeth but I always have done it morning and evening. She hardly ever has sweets and never has fizzy drinks. I just think why her?

[Blossomhill]

Thanks lockets
I just feel like it's my fault that dd is having to go through this all.Then I see kids stuffing smarties and coke down them as if they are going out of fashion and ask there mums if they have had fillings and it's always no!!!!! What am I doing wrong???

[pixiefish]

BH- a friend of mine has three kids and al three eat the same sort of foods. The eldest two have perfect teeth. the youngest however has to have a filling. My friend is still brushing his teeth herself so knows it's not to do with that. I think that some people are more prone to decay than others. Don't beat yourself up about it x

[JanH]

lockets is right, you do your best with sugar and pop but some people just have softer teeth, so then you look after them as well as you can...

If she does have to have the GA with the mask, try to be calm and confident before it starts - if you are anxious she will pick that up so do your best to reassure her (easier said than done I know!)

[Blossomhill]

Thanks again Pixiefish and JanH - you are very kind. I think the fact she has special needs just makes me feel even worse as it's so hard to explain things to her

[onlyjoking9329]

i so know where you are coming from, we have only just got my three to go to the denist, bit of an asd sensory thing, abbey whos 10, but learning diffs and autism really struggles with it, last vist she opened her mouth and let the dentist lady clean her teeth, abbey has a couple of bad one but dentist says these will come out very soon, she now has a new one throu but the old one that is bad is still there pushed to the side i dunno if it will come out and am hoping it will shes not able to tell me if she has any pain ect, i think if she has to have any out then the kindest thing will be a GA, may ask them to do her hair and nails whilst she is asleep

[Blossomhill]

Good idea onlyjoking

[jasper]

Blossomhill this must be so distressing for you.
The short answer, given what you have told me is, yes, I would go down the route of a general anaesthetic.
Sounds like you are doing all you can for your dd's teeth but to recap the general stuff (forgive me if this is all blindingly obvious)make sure her diet has as little fermentable carbohydrate (basically if it tastes sweet it rots teeth easily) as possible and if you can cut out ALL sweet food and drink between meals.
It's more the frequency than the amount of sugary stuff that causes damage. A bar of chocolate eaten all at once after meals will do less harm to teeth than if divided up and given a little bit at a time throughout the day.

Does she like cheese? Finishing each meal with a lump of cheese helps neutralise plaque acids. Again make sure she has nothing else sweet to eat or drink untill the next meal.

Careful with drinks. Even milk or "pure" fruit juice/sugar free drinks if sipped off and on all day can cause decay.

Brush her teeth for her -don't rely on her doing a decent job herself- twice daily with a small pea sized blob of adult paste .(needs to have fluoride level of 1000 ppm to be effective-some kiddie pastes do have this ). Get her to spit out the foamy residue but not rinse with water - a little paste left on the teeth last thing at night helps.
If she can chew gum under supervision get her some with Xylitol in it (some of the Orbit ones, and some from Lidl)- a sugar free sweetener which helps alter plaque bacteria to a less decay causing type. I realise you may not want your five year old to chew gum !I have thought it a disgusting habit for forty years but it does have some dental benefits.

[Blossomhill]

Thank you Jasper That was very useful, especially about the cheese and the kind of toothpaste to look out for.
Will be phoning them in the morning, first thing!

[JanH]

BH, Aquafresh mildmint (green tube) has 1350ppm of fluoride (sodium fluoride 0.306% w/w); however DS2, who is a big wuss, prefers Boots Smile totalcare applemint (has croc on front)which says 525ppmF (0.4% sodium monoflurophosphate).

I have no idea how these two equate!

[jasper]

Are implant teeth more realistic than your bog standard NHS crown?

Short answer. No.

There is no such thing as an NHS crown.

I have seen crowns provided by the NHS which were indistinguishable from the other teeth in the mouth and crowns provided at great cost privately which were as obvious as a bad wig.

An implant is placed to replace the root of the tooth. The crown placed on top is made from the same stuff as a crown made for an existing "real"tooth.

There are lots of factors that influence how good a crown looks. Implant supported crowns do not necessarilty look beter than tooth supported crowns BUT most people will pay several hundred pounds to have a crown put on the implant that cost them a couple of thousand!

The current fee for an NHS crown is about £90.
If you are paying nearer £800 for a crown (following your implant surgery) you would certainly hope it looked better than one you paid £90 for!(though as I have explained this is not always the case)

GGood luck.

[jasper]

janH the Boots croc one is reprieved because although Fluoride levels are low it does contain xylitol.
I buy it sometimes because my kids do prefer the taste to the free stuff I bring home from work.
Why do they make toothpastes so minty?

[Blossomhill]

Thanks Janh

Well Jasper the next stage which involves impressions and a crown is costing £1300 so I hope it looks good for that. I am actually going to see the technician in person to get an exact colour match.
Must say though anything other than this bridge is going to look better!!!!

[jasper]

Should add that dental general anaesthetics are now INCREDIBLY regulated and safe in this country and only take place in certain centres with consultant anaesthetists and full back up.

[jasper]

Is it replacing an adhesive bridge? (may have been called Maryland or Rochette)
Should look good because the implant will help to fill out the area in the gum where the tooth root used to be.
At that price I would expect a top job. Wish I could see pictures!

[JanH]

Oh, thanks, jasper! The croc stuff is OK with you then?

DS1 (16) actually prefers the frantically minty blue aquafresh - makes me wince - the green is just about tolerable for me. I know people like to be FRESH but you can go too far!

[Blossomhill]

Yes Jasper it is a Maryland bridge. It makes the otehr 2 teeth look grey as my teeth are really transaprent. Without blowing my own trumpet without that I have actually got nice teeth. I just hate the bridge and cannot wait for it to come out! I am just so self concious because of it.
Maybe the dentist will have some photos as I am sure he took some when I had the implant in!

[jasper]

JanH for the definitive answer I would have to ask my cleverer colleagues who study cariology but I suspect they would be more impressed with a toothpaste containing 1000 ppm fluoride than one with less but with xylitol.
When I have the croc stuff I alternate it with other paste with a higher fluoride level.

[jasper]

Blossomhill that is likely to be a really great result. Single tooth implants in otherwise good intact mouths give incredible results.