DS's tooth is decaying from nighttime breastfeeding, says my dentist today - he will need to go under general anasthetic to have it fixed. HELP! I need support

[RoRoMommy]

See this thread about 18m old DS's broken tooth, which has started to chip and crack away. Two of his other teeth have brownish/gray spots on them.

I went to see a dentist today and he says that DS's cracked tooth will need treatment, and because DS is 18 months old he will need to go under general anasthetic to have the procedure done. Two of his other front teeth will also require restorative work because of the decay.

The decay is, according to the dentist, due to my continuing to feed DS at night, on demand. He said that breastmilk is sugary and pools around the front teeth at night, and since there is little saliva production at night to protect the teeth, it has a remarkable detrimental effect.

I am completely gutted. Aside from the fact that my son will be subject to powerful drugs designed to make him unconscious, then will have to recover from the procedure to his tooth, the whole thing is going to cost over 2000 pounds.

And ON TOP OF ALL THAT, everything I've heard on this site, and in articles, and magazines, about breastmilk being this miracle liquid that actually has compounds in it to protect a child's teeth, I am now faced with the reality that, in my case, this is not true. My breastmilk is causing my child's teeth to literally fall out of his mouth.

Oh, and now I get to night wean. Fun fun.

I am so upset and confused. I will get a second opinion, of course, but time is of the essence as every day that goes by the nub that was my son's tooth gets smaller and smaller, and the damage gets steadily closer to the nerve, and his developing adult tooth.

WAAAAHHHHHH! Fuck fuck fuck.

Pardon the outburst. Has this happened to anyone else? Could someone please tell me I am not a rubbish mother?

Thanks everyone. Based on the advice I've had here, I've done the following:

Arranged to take DS into the emergency clinic at the peds dental institute at the Royal London tomorrow morning;

Made another appointment with a private dentist tomorrow lunchtime;

Begun the process of night weaning (this is going to be v v painful);

Signed up for dental insurance.

Coincidentally, one of my teeth that I recently had a root canal treatement on cracked this morning while I was having my cereal. Damn damn damn!

Thanks everyone for all of the advice and ESPECIALLY the support in connection with the GA, which has me very, very worried and .

Oh, and Twiglett, thanks for that: as you might have guessed, DS is also a complete fruit maniac, but he also loves cheese, so we'll be pairing the two from now on. Did you also supplement with flouride treatments? Did your dentist recommend anything to maintain his dental health?

I've done some research so I can arm myself with information for these two appointments tomorrow. I am posting here for everyone's edification:

Study concludes that "human breast milk is not cariogenic"

Infant Dental Decay - Is it related to Breastfeeding? (presentation)

Kellymom weighs in

Extended Breastfeeding Non-Risk #2: Dental Caries

Breastfeeding and Infant Caries: No Connection

Estimation of the caries-related risk associated with infant formulas

But see this study which goes the opposite way

And this study, "The results of the present study demonstrate that prolonged demand breast-feeding does not lead to a higher caries prevalence although comparison between the groups demonstrates that frequent breast-feeding and low additional fluoride use should be considered as contributing factors in the process of nursing caries"

Also, get someone to bring over kids' toothpaste from the usa. It has a much higher concentration of flouride than the uk stuff. And get flouride drops from your dentist too.

We've got something called flouride mousse--do you think that's worth trying?

RoRo: I am sorry that I did not have the chance to reply to your original thread and even sorrier that you have had to start this one.

I have a 2 yo dd who has just undergone dental surgery under GA. We don't live in the UK anymore so I cannot answer the NHS questions but I would be happy to talk about all other aspects from a BFing mother's point of view.

I have read extensively about the issues surrounding dental carries in babies/toddlers and eventually came to the conclusion that fixing the blame would not fix the problem. DH and I had to fight to have dd2 treated and I gave up fighting to prove that breast milk was not to blame.

This is NOT YOUR FAULT but you are in the best possible position to remedy the situation. This too shall pass became my mantra on the bad days.

I commend you on your courage to post about your concerns here. I have been so humiliated and shamed by the 7 different dentists that saw our dd2 (starting from the time she was 11 months) that I avoided the whole subject on MN...

COV: I am grateful that you posted on this thread. IME, dentists do tend to have their knowledge and expertise under-appreciated by scared, confused parents. It seems silly but it is nice to hear you say that a child with tooth decay does not mean tha the mum is bad...

For fear of sounding defensive (which I am) dd2 is our fourth child and the first with so much as a cavity.

I would LOVE to have the courage to ask for help in preventing further carries because I have been offered none here. The dentists have all been convinced that it is down to breast feeding and a lack of dental hygiene.

DD2 had her op 3 weeks ago today and the dentist did not speak to dh or I before or following the procedure. The nursing staff and the pediatrician on duty at the hospital had no idea what to suggest about follow up and thought that we might hear via the post. So far we have only received the bill.

Cadmum, that is awful! I am so sorry to hear about the lack of advice and proper post-op care and attention you received. Do you mind if I ask where you live? If you're not comfortable to say, I totally understand, just curious. So far I've dealt with the dental health industries of the US and UK, and I've found the UK to be more difficult in terms of finding proper advice and care.

What kind of surgery did your DD2 have? How did she respond to the GA? Do you have any suggestions on how to make DS comfortable, prepare him for the trip, or otherwise get through the whole ordeal?

It's so terrible that you've been subject to humiliation and shame over trying to get your DD2 properly treated. It's just unfair. Thank you for posting here, it's just so nice to hear of another parent in a similar situation, feeling similar emotions.

It was not exactly awful... but thanks for the support!

I live in Geneva, Switzerland. I don't mind saying but it isn't really relevant. Our DD2 saw dentists in Austria, Canada and here. (She was born in the US and I did find the dental care there fabulous for the rest of us!)

Kind of surgery...Hmmm... Well, she has 2 extractions and what I assume were several fillings...

I am about how little I actually know but as I said the experience with the dentist here is not relevant for your experience in the UK. The last time that she was seen by a dentist in Switzerland prior to the surgery was in May. At that time we were told that she needed "only fillings" and a possibly crowns but that she was too young to have a GA for this work. We literally had a letter through the post one day in September telling us what day to come to the hospital for an appt with the anesthesiologist. I went with the expectation that she (the anesthesiologist) would tell me that DD2 was too young for a GA to fix her teeth. I was pleasantly surprised by the whole experience with the anesthesiologist. She was amazing, compassionate and professional.

DD2 was shown a mask similar to the one that would be used to help her 'go to sleep' in order for the dentist to fix her teeth. She was allowed to play with a bear and a small mask while I discussed my concerns with the Dr. We were both assured that I would be able to stay with her until the Theatre door where she would meet us and that I would be present when DD2 woke up. This made an immense difference on the day itself as DD2 was not in the least bit afraid. I had to hide my tears (fear and guilt) as she waved to me from her cot. She was really excited about no longer having a sore mouth so that probably helped too.

She was really cooperative and helpful until she woke up in recovery without dh and I. We had been told that she would be at least 3 hours and despite my reservations, we left the hospital to pace the neighbourhood instead. DD2 was actually done in under 2 hours and was very unhappy about the i.v. in her arm and the pain in her mouth. She cried for what seemed like ages but was probably more like 8 solid minutes and she has never looked back.

The sites where there were extractions looked horrible for a few days but they didn't hurt her and never bled or anything. We weren't even offered a prescription for Calpol (which cannot be purchased here without one) or anti-b's and clearly she needed neither because she ate more the evening of her surgery than in a normal week before.

I just hope that I can maintain this decay-free mouth without always chasing her with a toothbrush. This task is compounded by the fact that she has 3 older sibs without cavities who drink juice, eat fruit and are endlessly wanting all manner of sweets which DD2 can simply never have.

On Sunday, we were at an Ec-Pat Expo and nearly every table was handing out sweeties or chocolates. One woman actually challenged me when I said that DD2 was not able to have one so I had to ask her if she was interested in paying the dental bills and holding dd's hand as she was wheeled down to the OR for a GA because of a 'harmless' candy.

OK. I will get this novel off to the publisher to see about having it bound now...

Please feel free to ask me any questions you may have. As you can see, I feel ready and able to get this off my chest!

There is lots of great advice about prep here: www.mumsnet.com/Talk?topicid=childrens_health&threadid=621518-does-everyone-feel-terrified-at-the-th ought-of-their-child#12660069

Cadmum, that is all great, thanks so much for posting! I will be sure not to leave the hospital so I can be there when DS wakes up, I think that will make a big difference to him, poor mite.

Deep breaths for all...and two "second opinions" tomorrow! Will post updates then.

Don't beat yourself up. I'm not sure that is worth going in with tons of internet research tbh. If your lo has weak teeth then you end up having to adjust to the fact that what wouldn't harm another child might harm yours.

Ds1 has had a tooth removed under GA. Personally I would look for an NHS hospital which does this sort of thing all of the time. I'm not sure how much pead dental work is carried out by the Portland. My experience is rather different from Cadmum's but was at a London NHS hospital. A week before the extraction we were invited to the unit to have a chat with the anesthesiologist and to visit the children's day surgery unit. Ds got a chance to visit the playroom and then go up to the corridor to the theatre. There is a special car which the children get to drive to the theatre and we also got to see the theatre and the recovery room, and I had to fill out all of the consent forms.

On the day itself we had to be at the hospital 90 mins before the op in order to have the magic cream applied to ds's hand (for where the IV would be). He then played in the playroom before getting his turn on the car. Dh went in with him to theatre and the staff were chatting to ds whilst the anesthesiologist put in the iv. Ds went to sleep mid sentence. Dh then left the theatre and waited in the recovery room. Ds was through in about 15 minutes and waking up about 5 minutes thereafter. He was observed for a short while, given some painkiller and discharged about an hour later. Whole process no more than 3 hours. Fair easier than a noraml dental visit.

I would also look at a second opinion. My local community health centre wanted to remove all 4 molars, but I got a referral to a neighbouring borough where they saved 3 teeth although one still had to be removed.

DS had his done at paeds dental hospital at Kings College and I can't rate the pre-care and post-care highly enough. Totally different situation to cadmum .. very informative, felt like we were consulted and not talked down to

Our paedodontist surgeon told us that there has been an alarming increase in the number of children with insufficient enamel on their baby teeth and that research is pointing towards environmental factors.

They were keen to reinforce that it was nobody's fault but to give us good tips for future care (the cheese and the brushing delay after eating)

I agree with cadmum .. discovering who is to 'blame' is not conducive to calm.

I don't have an awful lot of experience, but a colleague has just gone through something very similar with her DS, and he has just had nearly £4K's worth of restorative work done on his baby teeth. He also had to have a GA.

Apparently, there is a growing movement in dentistry (clearly not yet prevalent in the NHS for obvious financial reasons) that baby teeth should be restored if at all possible, to maintain the health of the gum, and to reduce possible risk of infection, abscess, or damage to their permanent teeth as they descend.

"If a baby tooth is lost too soon, permanent teeth may come in crooked. Decayed baby teeth can cause pain, abscesses, infections, and can spread to the permanent teeth. Also, your child's general health can be affected if diseased baby teeth aren't treated. Remember, some primary molars are not replaced until age 10-14, so they must last for years."

Sorry I have not got the time to read all the posts but as far as I can see it you (and DS) are just unlucky.

I have bf my 3, never ever bottle fed, and got up in the night with them to bf and I have NEVER been told that it will harm their teeth.

DD chipped/broke a front tooth and it is still ok.

I am fucking sick of bf mothers being treated like we are doing something unnatural.

Grr, rant.

Hope you feel better.

Thank you, thank you, thank you! You've all given me so much reassurance and great advice.

Ladymuck, can I ask which hospital you went to? It sounds like they were just lovely. That's so great, makes a difficult situation so much easier.

Tomorrow we are going to the Royal London, then meeting with another private dentist near the Portland. I appreciate your point about going somewhere that they do this kind of work frequently.

Thanks again--updates to come tomorrow!

I was referred to St Helier in Carshalton, which is strictly out of area for me. They were superb and I'm trying to get ds2 seen there for early intervention. The staff are just brilliant with children. The dentist there managed to perform 3 major fillings (on teeth that my local community health team wanted to remove) with ds1 scarcely noticing - no injection or anything. I felt that they thoroughly explored all the options and included me in all the decisions.

Went to the NHS emergency pediatric dental clinic this morning at Royal London hospital. The dentist examined his broken tooth and said that she couldn't see any decay. She said the yellow coloured material was dentine, tooth tissue, and the discoloration on this other teeth was nothing to worry about and was not necessarily decay.

She said we had two options: one, do nothing and wait for an infection to arise or the tooth to turn grey or black, showing it has died, or two, put him under GA and extract the tooth.

There was no option presented to fill the tooth and build it back up, as the first dentist had offered, and when I asked whether, once pulled, if anything would be put in its place, she said no. He'd have a gap there until he is six.

So it's all or nothing: meaning, wait until the tooth is obviously infected or dead, and pull it out, or extract it now.

We have another appointment with a private dentist (who also does rounds for Great Ormond Street NHS) at noon. We'll see where she comes out.

It seems quite odd to me that one dentist says, yes there are clearly signs of decay and we should do restorative work now to keep it from getting worse, while another one says, no, can't see any decay because nothing is infected or dead, so let's leave it alone.

Could this be the difference between a private dentist who is going to get paid for his work and the NHS dentist who gets a regular salary and has no incentive to do anything unless the worst-case scenario arises?

Your thoughts please! Thanks.

Perhaps the NHS dentist has no incentive to do anything she doesn't think is necessary. It sounds to me like she thinks there is probably nothing wrong with your son's tooth and so would prefer not to intervene. I'm not saying she's right, just that it may be less about being happy to wait for a worst case scenario and more that she thinks on the balance of probabilities better not to intervene without better evidence that it's needed?

I just wonder about each of their definitions of "necessary". For example, if the tooth is infected and dies, could that impact the adult tooth that is growing underneath? Would it affect DS's health in any other detrimental way? Also, if intervention was made prior to the tooth dying, and the tooth was rebuilt, any decay removed so it lasted him until the adult tooth comes through, wouldn't that be better (though not "necessary") than DS going through the pain of an infection and losing the tooth completely at some point before the adult tooth comes in (with potentially some impact on the adult tooth from the infection), and risk movement of the milk teeth that could impact the alignment of his adult teeth?

I think I am coming up with more questions for this next dentist than anything else, to be honest.

I think moogmum is right -private medicine generally and dentistry in particular tends to favour intervention even when wait and see would probably be a better option. Also more concerned with cosmetic aspects rather than health need.

Personally I wouldn't put a child through an operation if it wasn't strictly necessary.

Fact is, the first private dentist was wrong about b/f which wouldn't give me much faith in his judgment in other areas.

Ask the next dentist what the chances are of ds's tooth going black and becoming infected. If they are high, then maybe it's a pull towards having the work done. But if treatment for infection/bad tooth would be no more involved than having it done now, I think I'd wait and see if it became necessary, IYKWIM.

edam, I completely agree with you. I will ask the dentist that question regarding the difference between the consequences of a wait-and-see approach and doing the treatment now. Thanks!

edam, I completely agree with you. I will ask the dentist that question regarding the difference between the consequences of a wait-and-see approach and doing the treatment now. Thanks!

NHS dentists don't get a regular salary, they are still paid based on the work they do.