Dentist refused to remove teeth for orthodontist

[Sukey99]

Hi, Took DS (13) to the dentist to have 2 teeth removed in preparation for braces, but the dentist refused to remove them because his mouth was "too dirty" for him to have braces (he needs 4 removed altogether). I was told to take him back again next week instead, by which time, apparently, regular brushing would cure the problem. Is this reasonable? I was furious. We had gone straight from school after lunchtime. If his oral hygiene is bad, can it be cured in one week? I don't mind DS being given a rocket for not brushing his teeth properly, but he has no fillings and no bleeding when he brushes so surely the problem can't be that bad, and the orthodontist doesn't have a problem with it. The dentist refused to clean the teeth himself. Any thoughts on whether one week is enough for DS to get his mouth clean enough and on whether the dentist's attitude is reasonable would be welcome.

Mmm. I think the concern is that once the brace is in then teeth won't be cleaned properly. That is a no-no as our Orthodontist stressed to DS1 that keeping it clean is very important as you can end up with marked teeth/and or the treatment will be stopped if you aren't cleaning properly. He has to brush 4 times a day and use Tepe brushes round the brace.

How often does your DS brush his teeth?

That is just bizarre.
Do you think your DS had in unbrushed teeth?

Surely if they are that bad then you would have noticed.

What difference does it make if teeth are coming out..

He does brush his teeth every day, clearly not well enough for the dentist... He has no fillings at all. His older brother has braces already. The irony is, if DS2 hadn't had to have teeth out, the orthodontist would have fitted the braces anyway without the dentist's yay or nay. Surely the orthodontist should make the decision on whether DS's mouth is clean enough or not? The same dentist told me at the last checkup in July that DS2 really needed the orthodontic treatment.

Ultimately it will be your dentist who will have to deal with any damage that results from poor cleaning not the orthodontist. What will be your reaction in two years time if he needs multiple fillings when he has the braces removed? Who will you hold responsible?

Willdo, yes, I am aware of that. However, that doesn't help answer the question whether this is something that can be solved in one week, or whether a longer period of time is needed. As I said in my original post, I don't mind DS being given a rocket for not brushing his teeth. But doesn't one week to remedy the situation seem a bit optimistic? I don't want to take another half day off work, take DS out of school, spend money on petrol getting him to the dentist (in the local town 6 miles away) if the dentist is going to say the same thing again. Any thoughts?

Gum inflammation will resolve within a week if brushing is good enough.

Thanks, Mrs M, to be on the safe side I have postponed the appointment for a week. Fingers crossed it will be OK...!

I think the concern is that once the brace is in then teeth won't be cleaned properly

Although that's what is implied by what the dentist said, it may also be because infections getting into the bloodstream via the mouth can damage the heart - my mother, who had some problem as the result of rheumatic fever as a child, always had to have antibiotics before even normal dental work. So although the attitude of the dentist leaves a lot to be desired, it may be a good thing that your DS has a chance to get his mouth cleaned up.

Gum inflammation should clear up quickly with diligence - some of those little interdental brushes might be a good idea in addition to regular brushing.

I was told to improve my mouth hygiene in preparation for fillings the following week. One of the fillings required was very close to the gumline and it needed the gum to be less puffy and for the tooth to be dry during the process (only possible if the gum was healthier) otherwise the filling could not be done.

I bought an electric toothbrush (was advised it had to be a Phillips or Braun with a small round head, not the toothbrush heads) also I had to use the little floss brushes twice daily and finally use Oral B mouthwash twice a day (not listerine or supermarkets own).

I scrubbed, flossed, gargled and scrubbed again and even I was amazed at the difference in a week. You can't tell if his gums are bleeding until he flosses, mine didn't bleed with normal brushing but they bled a lot initially with flossing. After a week the difference was amazing. My mouth feels so much cleaner.

I only have a few fillings and have had good oral hygiene throughout the years but you can definitely up your game.

I would take the dentists advice - we all need a kick up the bum sometimes in terms of tooth brushing and high standards of mouth hygiene- it's pretty boring after all :)

I wouldn't waste time being cross with the dentist. Take his word for it that your DS needs to increase his mouth hygiene. Get scrubbing, flossing and gargling and make sure he does it really well.

In a nutshell- yes it is totally possible to seriously improve mouth hygiene within a week, and poor gums do not always bleed with regular brushing :)

Just don't let him brush within 15 -20 minutes of having eaten as itvsill damage the enamel.

Thank you all for your advice and comments. Fortunately, DS really wants the braces so is taking the brushing/oral hygiene very seriously. Or perhaps I'm just really scary??

That's good . My DD took the advice seriously when she got her brace - no more fizzy drinks and she slimmed down (which she needed to do really) because she stopped snacking on the homeward bus. Its good when kids are motivated for themselves and don't need nagging!

Sorry if I was a little short but I spend most of my day trying to motivate both children and adults to take responsibility for cleaning their teeth. Glad to hear that you have been scary I wish more parents used the scary option. With regard to your original post the orthodontist I refer to would want oral hygiene to have improved and sustained for at least a month, they also will not start treatment until the child shows significant improvement. And we can tell if they have only cleaned their teeth properly the morning of the visit. If he is struggling see if you can get some disclosing solution.

Hopefully he will be like your DD, Errol!

Not to worry, Willdo.

The brace-fitting isn't until a month from now so hopefully he will be OK. We have disclosing tablets which he has been told to use twice a week to help him.

I don't know of it's the same everywhere but where we live you have to sign a contract to ensure you will take oral hygiene seriously and you understand that if you don't you will have the braces removed.