AIBU to be annoyed by dentist's response?

[SleepRefugee]

Reposted from children's health for traffic!

Hello everyone. Took my daughter (4) to the dentist today as we've noticed some erosion/decay (tiny gap between front teeth) but she took one look, said there's nothing they can do and proceeded to tell me off for allowing her juice . I know juice isn't great, my daughter will dehydrate herself to the point of constipation though. Anyway, we are working on cutting down on juice.

But is it true that they can't do anything about the decay??? It's only tiny so I'm sure no anesthetic would be needed. Do I need to find a different dentist or go private? Don't want the decay to get worse obviously!

Thanks in advance.

I had a water refuser. In fact, dd1 had 2 separate periods of total fluid refusing.

She was bf as a baby, and drank water post weaning - by preference she used a bottle. All fine. Then, ataround12 months I followed advice to try to move her onto cups. She stopped drinking. She had already cut down her feedstock morning and bedtime, so was having no fluids at all throughout the day. This lasted a month (yes, really).

We got through it, and she once again drank water all fine. Then, dd2 was born and dd1 reacted badly. She again stopped all drinking. No fluid voluntarily passed her lips (nothing at all - milk, water, juice) for over 9 months. I'm sure you can imagine, that by the time she was able to sip something, I didn't give a flying fig what it was. She eventually accepted juice, but out of a carton, with a straw (which she had never had before - maybe she didn't see it as liquid that way?). For many more months she only drank minimal amounts - less than50ml per day.

So, all you non- believers, what should I have done? Let get continue to refuse all fluids, or work to get her accepting that drinking is a good idea using any fluid that was acceptable to her?

Oh, I see Pagwatch said similar, only better (as always )

I didn't know your ds was a water refuser too, pagwatch. Oh, the joys of autism, eh? Dd1 is still on drinking watch, 8 years later.

And she still drinks (now thankfully very diluted) juice. So shoot me. She has, this year, taken more than one drink of water, so maybe the end is in sight. But as soon as she is anxious (a lot at the moment) then drinking is one of the first things to go out the window.

OP, I'd ask around and try to find a more sympathetic dentist. I put up with ours, but we have very limited options. I did enjoy telling him to count up the number of sweets and biscuits his children get at school (his go to the same school as my dd2) before telling me that I needed to sort out my childrens diets. He was shocked when he heard the amounts involved (a totally separate topic, I know) although it didn't entirely stop him being a patronising git re: dietary issues.

Mrsmorton, you are obviously very experienced and I would like to ask do you think that as well as doctors not taking teeth into account there could also be some of the opposite, i.e. dentists not taking general nutritional requirements into account, particularly with coeliacs who are also getting dietician advice.
Parents end up in the middle with highly trained professionals on both sides giving opposite advice. It can be exhausting and adds to distress watching child getting teeth yanked out.

(dont want a Mrs Merton heated debate :) , just wondering?)

I was told to stop the milkshake but this contradicted advice to get as much calcium in as possible, op is being told to stop fruit juice when constipation is a problem. As a parent you just have to decide which is higher priority, and do you think dentists should recognise there are other issues in these childrens health so give realistic achievable advice, and listen ??
Also do dentists get any training about coeliac disease, and is there any research into the effects on teeth as anecdotally on this thread in less than 24 hours there are 4 examples of coeliacs who have dental issues?

Oh yes Panda, joyous indeed.

I actually did my job so well that now DS1 won't drink anything except water

I'm sorry your dentist is a bit of a dick Panda. It's grim isn't it? Another everyday thing where you have to emotionally gear up before you so it.

DS2 goes to a paediatric dental surgery now which is absolutely unbelievably good. They continue to see him although he is 18 and are happy to do so until we get him used to the idea of an adult dentist.

I have to pay a fortune but it's been worth it. He was so distressed by the special needs specialist who was one of the most unpleasant people I have ever met, who made both me and DS2 cry and who should not be allowed around people let along vulnerable children. I thought I would never get him to tolerate any other dentist after that.

I'd like to find him and punch him.

FFWD yes, totally. Although I would say that dentist probably do more general health training than Drs do teeth, we still don't add it up.

As far as coeliac specifically goes, in my experience, it's not calcium absorption that's the problem, it's the systemic poorliness caused by unrecognised coeliac disease at weaning that affects the enamel. Once it's recognised and the diet changed, the enamel (that is forming under the guns, not the stuff we can see on the teeth that are present) goes back to normal so it causes a hypoplasia similar to what we see in for eg measles and other illnesses.

Like I said before, I don't treat many children so it's not something I've much experience of or interest in

I should also declare I have a child with dairy allergies, gastrointestinal problems and a separate child who has been a food refuser. I am also a dentist. So it's not that I don't understand the issues that are being discussed.
As someone up-thread said there is decay. It's either attempting to reduce the juice or whatever is contributing to it or accepting that your child will get decay and will need dental treatment for this.

Coeliac disease is associated with developmental enamel defects and mouth ulcers.
The enamel defects are seen most frequently in the adult teeth because the enamel is forming around the time of weaning. This would support the idea that poor calcium absorption is a factor.

However enamel defects are seen in a small percentage of baby teeth. This supports the theory that the tooth formation is affected by the auto immune disease.

MinniesMate how would that kind of damage to baby teeth typically present?

Very variable in appearance Paleoish.

Can be just a slight change in colour, or roughness of the enamel surface. In more badly affected teeth there can be pits or grooves. All caused by the prisms of enamel not linking together properly.

It's more commonly seen in the baby molar teeth than the front teeth but can be present on any teeth.

Interestingly in most studies the rate of dental decay in children with coeliac disease had found to be lower than the general population.

Has, not had - fat fingers!

Oh dear. Ds3 has some tiny white-ish areas on some of his teeth, I presume this is caused by erosion? We didn't do too well at brushing till he was about two, but for the last four to five months have been brushing every night.

Do you think this is arrestable damage? I really hope so.

Psipsina check with your dentist; without seeing them it would be foolish to speculate as to the cause. Could be nothing, could be demineralization, which is an early warning that decay could start.

Brush the teeth twice every day with a good quality fluoride toothpaste - don't use any water. Aim to brush for 2 minutes.

Thank you - we manage once a day without water, he struggles, I think we get about a minute in! But it should improve once he stops teething I hope and gets less struggly.

Will persevere and yes, will take him to the dentist just to check.

Mrs morton and minnie belated thanks for your answers. I just googled hypoplasia in teeth and as its related to malnutrition it would be logical that undiagnosed coeliac disease would cause this. Not sure what causes the excess damage to baby teeth, perhaps, as they say in all the best research papers, ' more research is needed'. :)
Think the best option in the mean time is to find a dentist you like who does not patripatronise, and keep up the dental hygeine and sensible eating.