Milk teeth extractions :( any advice from dentists?

[selfpreservation010708]

Hi all, posting here for traffic. I am devastated after a visit to the community dental clinic this morning.
My ds, now 7, was born prematurely, very difficult birth. When we took him to our local dentist as a toddler, the dentist asked immediately was he prem, as his back teeth were underdeveloped and erupted with weak enamel (I understand this is called hypoplasia)and indicates prematurity.

I truly, have always been religious about dental hygiene and he has what I think is a decent diet, no fizzy drinks, just water or very dilute juice to drink, chocolate is an occasional treat, he doesn't have much fruit but lots of veg, drinks with a straw, etc. I have good teeth myself and one small filling at age 38.

At our last check up 6 months ago, all was seemingly ok, again dentist commented on his 'mottled' number 6s but basically go away and keep up the good work on the brushing. When you look at his back teeth, they are very pitted and see through in places.

Then, about 3 weeks ago my son was complaining of a sore tooth and when I looked a back tooth had a piece which had snapped clean off. Took him to dentist who put a temporary dressing on it, said the tooth would likely need to come out, and referred us to the community clinic where they arrange the extractions under general anaesthetic and sedation.

Been for our appt at the community today and they have assessed him and declared that 5 back teeth need to come out as well as the broken one, as they are weak, showing minor decay but unlikely to hold up til age 9 or 10 when they'd be falling out to make way for the adult ones. I am mortified as I felt we were doing everything right, but I feel I have failed him and have cried my heart out today.

I wonder if I should get a second opinion as to whether 6 teeth really need to be taken out, the dentist we saw today said fillings are pointless as it will mean repeat dental visits for my son and this is the recommended course of action for any teeth which are likely to become problematic before they fall out naturally.

Any dentists or anyone been in a similar situation with their child? I'm absolutely gutted.

I don't have any experience in this sort of thing but if you can , try and get a second opinion with another dentist

We're just sending this over to children's health at the OP's request.

If you do get a second opinion, you need one from a specialised service dentist. That's usually either the paediatric dental dept at your local dental hospital or children's hospital or another dentist within the community dental service. No point whatsoever seeing another general dentist, Private or NHS. What is important is that the dentist/ service is able to provide treatment under sedation, or more realistically with 7year olds facing extraction/s, GA.

I work in the specialised children's service and sadly this is an all too common typical situation-the general dentist refers for 1 extraction under GA. Then, when we initially assess the child and take appropriate radiographs, there are very often many more decayed teeth, that just haven't been noticed 😮by the referring dentist.

Sometimes with permanent molar hypoplasia, we can "nurse" the teeth along until the ideal age to minimise spacing -usually around 9-10 years. This can involve placing stainless steel crowns or composite restorations, or another type of adhesive restoration. It isn't always possible to do this though, as hypoplastic permanent molars are be susceptible to caries unfortunately and quite often the children have severe toothache / abscesses.

How many of the recommended 6 teeth are the first permanent molars, just the 1 that has broken, plus 5 baby teeth?

The vast majority of 7 year olds would have GA for permanent teeth extractions. Planning for GA does have to be radical to include any other poor prognosis teeth. Bottom line is this avoids a repeat GA for extractions and no child should ever wake up from Dental GA with untreated caries in their mouth.

Hope the above helps. Good luck OP.