8YO DD has cavities and I feel like the worst mum in the world. What do I do?

[Rolypops]

DD has recently been diagnosed as autistic and she has quite high sensory issues resulting in still needing a dummy/chews at night.

We have just seen the dentist and her teeth are in a complete state we brush twice a day and do what we can, she doesn't like pop and doesn't eat sweets a huge amount but she has 3 cavities in her big teeth. She is only 8 and I feel like the worst bloody mum in the universe and have locked myself in my bedroom to cry. He said it is clear she won't tolerate proper dental treatment so they are sending her to another clinic where they may need to put her to sleep to give it to her? I am terrified she has never needed general anaesthetic before. I had no idea they were so bad, they don't look as bad as the dentist has found that they are. Her teeth have been weakened for years due to what we think is all the anti-biotics caused by a serious illness but regardless they are her grown up teeth and I have massively let her down. We have literally tried everything to reduce her reliance on dummies and chews but it is the only thing that helps her self soothe.

I don't know what to do. I just really needed to vent as DH is being very practical but I just feel devastated.

The dentist said she had 'soft teeth' as she has discoloration on her front tooth too but it isn't decay it is something else. Are soft teeth a thing? Neither of my other two DC's have ever had any real dental issues.

I'm sorry I don't have any advice, but I just wanted to say, please don't be so hard on yourself, you are not the worlds worst mum. You sound wonderful. This isn't your fault and you're doing the best you can for you DD x

Definitely don't blame yourself

Make sure to ask that they apply a cavity sealant while she's under to help prevent future cavities.

If she doesn't or won't use an electric toothbrush, you might also find a Collis Curve toothbrush useful as you can brush more of the teeth surfaces in less time!

We have started to use a sonic toothbrush recently and she doesn't mind that. They have put some white protective coating on it but now we just have to wait until we are referred.

Soft teeth is a thing, it's called hypomineralisation https://happykidsdental.co.uk/preventing-and-protecting/dental-hypomineralisation/ . The discoloured teeth is a sign of it.

My 8 year old has it in his baby teeth, he was only 2 when he got his first filling and I felt truly awful. You do get more used to it. DS has an electric tooth brush which has helped a lot, if that's an option for you. The other big thing that has helped is that he is now in 3 monthly check ups with fluoride treatment each time.

It sounds like she might have hypoplastic teeth. https://www.colgate.com/en-us/oral-health/adult-oral-care/enamel-hypoplasia-hypomineralization-and-teeth-effects#

This will be because either you were ill in last few months of pregnancy or she was Ill in first few months/year of life. Antibiotics do not cause a problem unless there is sugar in the liquid. You also need to look out for things like movicol for constipation which is full of sugar.

Dummies and chewier won't cause decay unless you dip them in something.

Are you managing to brush her teeth ok? A lot of people on the spectrum don't like toothpaste so oranurse , which is an unflavoured, non foaming toothpaste is usually better tolerated.

Other than that it's watching wa
hat she eats , no more than three sugar attacks a day and nothing to eat or drink before bed other than water.

You may also find the advice here useful https://www.bspd.co.uk/Portals/0/BSPD%20Advice%20for%20parents%20of%20children%20with%20autism%20Jan%2017.pdf

Ds2 had to have 8 teeth out when he was little.

Think he was 5 or 6.

They gave us the option of having them out with injections for pain relief and in stages.

I figured you might get the first stage done, but no way would he go in for the subsequent removals.

He ended up having them out under GA, which was stressful for me, but fine for him.

In hindsight we think he had weakness in his teeth from being undiagnosed coeliac when they were developing. His brother had nothing more than the odd filling and they had the same things to eat and drink. Also had no further issues with the rest of his teeth, baby or adult. Didn't stop me from feeling guilty.

You're not a bad mum! You've been doing your best and done the right thing in taking her to the dentist.

I'm an anaesthetist and we see lots of children for dental work under general anaesthetic - many with SN of various kinds. It's very, very safe, and less likely to be traumatising for her than attempting anything awake in the dental surgery.

Teeth are genetic you cent do much about them.
Children in the semester family can all brush teeth exactly the same and one will get lots of problems and take the best care whilst others may not but be fine.

Don't feel bad op. My ds had this too and had to have his first 4 grown up molars remove under general anasthetic because they came through soft and discoloured. The dentist was very clear It wasn't my fault....although that didn't prevent the hygienist lecturing us.

The op is very straightforward, they bought my ds back after 45 mins and withing half an hour we were walking out. He is now 13 and the next set of teeth have come through and closed up the gap so he won't need braces.

Some dentists use hypnosis for children that are very anxious in the surgery

It looks JUST like the pictures of hypomineralisation. I have never heard of this before but this is exactly the locations that DD has, the molars and her one front tooth. If it is this, it says online it can be reversed? would a really good multivitamin help? (we have massive trouble finding one she likes)

The dentist never mentioned this to us. Just called it soft teeth

This is so totally and utterly NOT your fault. It’s a result of lots of different things that are not in your control. You’ve spotted the problem and are dealing with it. You’re being a GOOD parent.
sorry for all the capitals. I would also send a virtual hug but I would probably be kicked off MN!

Hypomineralisation cannot be reversed and multivitamins do not help as the enamel on the teeth is already formed.
The main thing is brushing with a fluoride toothpaste and keeping sugar attacks to no more than three a day . Keep any snacks , drinks no sugar.
Many people on the spectrum have limited diets so this may be difficult but you need to watch out for hidden sugars eg yoghurts, dried fruit, smoothies , fruit juice, granola bars , cereals etc and be careful about not eating or drinking anything with sugar in it just before bedtime, even if you brush teeth afterwards.
The dummy and chewier are not a problem providing they are not dipped in anything.

Update on DD and her teeth. The dentist has said that it is indeed almost certainly hypomineralisation and most of her teeth seem affected. One of her back teeth is in an absolutely appalling state now and are just waiting for the letter from the dental hospital to see about treatment. My concern though is she is going to start experiencing pain as it really is awful . Will they do an emergency treatment/extraction if this happens? I am in such a state about it all and so worried for her.

I suppose my main worry is that due to her low tolerance for pain and discomfort it could quickly become a massive problem especially with school starting this week. We have to wait such a long time between appointments.

My children have this on some teeth. Are you sure it’s all the teeth? I think that would be unusual . It’s absolutely nothing to do with what you have done

If it’s mainly first molars that are affected (often this is the case) they can extract and the second molars slot in to place when they come in. Second molars aren’t normally affected the same

All her teeth might be an exaggeration on my part, but few seem to have come in 'normally' and the colour you would expect. The biggest issue is in one of her front adult teeth and her big tooth at the back (not sure if first or second molar, but second I think).

It’s most likely first molar if she is 8. First molars are the teeth usually impacted by hypermineralisation. It may be worth speaking to an orthodontist who can plan what to do

Also. You may find it looks worse than it is. These teeth tend to look really mottled and brown even before the enamel starts to degrade. You may find they aren’t as bad as you think. Hopefully she won’t get pain before you can get treatment plan sorted

@Rolypops did they mention fluoride treatment at all? For my DS, fluoride treatment every 3 months has made a big difference in the rate of decay in his teeth.

I don't know about the dental hospital and emergency treatment. However, even at our old NHS dentist if I called saying he was in pain, I'd get either a same day call back from a dentist for them to work out how quickly he needed to be seen, or an appointment within the next few days. I think they must heavily prioritize children in pain, as that was with a practice that was short of dentists as they struggled to recruit.

If your DD has an issue with pain, I'd call and hope they can escalate to find a solution. If you are generally struggling to get appointments for check ups, is going private an option at all? Once we started to struggle with getting appointments any more frequently than every 9 months or so at our NHS dentist (due to their inability to recruit to replace dentists who left), we initially moved to filling in the 'missing appointments' privately. The private dentist explicitly encouraged people to use them to top up NHS services, and children's appointments were under half the price of adult ones.