My toddler urgently needs dental care. I've been quoted 6k. Is this normal? London

[punjama]

Due to what we believe is digestive bacterial infection which we can't specifically diagnose (loads of inconclusive tests and white poo and tongue) our 21m toddler has loads of cavities on 8 teeth with some going into the verge of decay (she has a very healthy diet with no sweets and brush 3x a day). We've been told If she wants to keep her teeth it's unlikely we'd be able to wait 1 year for NHS. One private dental clinic we went to gave us a quote of 6k including anaesthesia in hospital. Said our BuPa would cover hospital and anaesthesia but around 50-60% of cost out of pocket. Another clinic said they'd do it via sedation and it would cost around 2.2k. is this standard? Were somewhat fortunate to be able to pay this because we deny ourselves (ie no car no home ownership no holidays etc) everything but how do others deal with it? Just wait for NHS? Were afraid that she would lose her teeth and will be toothless as a kid and get bullied....

Sorry to add - Bupa said this is routine procedure which they won't cover but dental clinic says they will write a letter saying it's urgent and not routine so might end up paying 6k worst case....but on other hand if someone finally is able to diagnose her perhaps the whole treatment would be covered? Don't know. Also need to confirm if sedation is allowed for under 5 year olds as then potentially the cheaper option unavailable

Is there an NHS referral going through?
Are you breast feeding and more pertinently, breast feeding on demand through the night?
No, that is not normal, sorry and not at all UK mainstream paediatric dentistry. Your best bet is a referral to the Paediatric dept. of a London Dental Hospital.

No, that is not normal, sorry and not at all UK mainstream paediatric dentistry. Your best bet is a referral to the Paediatric dept. of a London Dental Hospital.

Yes, this. I'd be requesting referral to a consultant in paediatric dentistry in a dental hospital.

private is expensive.
a bed as a day patient costs around a grand.

dc had a surgical procedure privately as nhs waiting times were 18months.
best 6kbever spent.

@bluefoxmug
It's not paying privately that's the issue more that the proposed treatment is most unusual.

If she has cavities she has decay.

You need to see a paediatric specialist. 8 cavities at 22months is really extreme.

Personally I dont think giving a GA to a 22 month old to restore teeth is at all ethical. Treatment is unlikely to last and she will end up needing further GAs, and end up in pain. 8 cavities at 22 months is a really high caries rate, if you dont address the cause shes just going to get more and more cavities, and restorative work will be pretty much garunteed to fail.

6K is what a private GA would cost, but I absolutely wouldnt pay that to save a babys teeth.

I also think you need to be completely honest with yourself about her diet and brushing. Im not sure what digestive bacterial infection would cause decay.

I have private health insurance, and I don’t think it’s normal. You can ask the NHS consultant to make the referral and ask them to note that without this urgent operation, your child will lose their teeth. Then a letter from the private oral surgeon to back this up should mean no copay (at least with my insurer).

They need to put a condition down, even if they’re not sure - suspected ‘disease.’ It’s odd they haven’t done that, as that’s how they help patients avoid expense. Private sector medics know how it works: nothing is ever seen as a pre existing condition, and diagnose everything.

I’d also be cautious that if they don’t know what causes it, it may continue degrading his teeth after a surgery. I’m sorry you and your daughter are going through this

Perhaps urgent isn't the best word. She is not in major pain and doesn't take antibiotics. However the cavities are all over her teeth and our local NHS dentists said whilst the treatment should be urgent that the queue would be 5-8 months waiting period and if we can we should try treat privatly. We were originally planning on travelling to my wife's country of origin (ex USSR) where it wouldnt be too much to do it but the Corona virus situation there is heating up.

The private clinic said they'd be able to say things that these cavities if untreated would cause pulpit etc and that way get the Bupa treatment however we are under impression that with NHS it is only when we get to that stage that treatment would be quick.

Thank you for taking time to respond. I think we will definitely go again to our local NHS dentist and delay the private option for now.

@RHRA

Is there an NHS referral going through? Are you breast feeding and more pertinently, breast feeding on demand through the night? No, that is not normal, sorry and not at all UK mainstream paediatric dentistry. Your best bet is a referral to the Paediatric dept. of a London Dental Hospital.

Thank you for your reply. How do we organise NHS referral? Ourselves through our local dentist clinic? Contact our local NHS hospital?

Yes she is still breast fed and breastfed through out the night as she barely eats during the day (despite a very varied diet so it's not boring and she does like it just doesn't eat much) .

[quote RHRA]@bluefoxmug
It's not paying privately that's the issue more that the proposed treatment is most unusual.[/quote]
Are you referring to the GA? What about sedation option? I am concerned as someone else mentioned that if we don't get to the root cause problem this will just resurface again.

Your NHS dentist can do a referral
My DS had teeth removed under GA as they had disintegrated due to inadequate enamel. It took about a year from referral to procedure but they weren't causing him pain.

Breastfeeding through the night is likely having an effect on the cavities.

It's the breast feeding on demand during the night that's causing this pattern of decay in a toddler. In the daytime, your wife is going to have to limit breast feeding to mealtimes.
Unfortunately this is one of the issues with extended on demand breast feeding; the effect on toddler's teeth and something that UK paediatric dentists are having dealing with increasingly.

What has breastfeeding got to do with it? I bf two children to age 3 and they both fed through the night and their teeth are absolutely perfect in every way. More so than bottle fed sibling.

@DishRanAwayWithTheSpoon

If she has cavities she has decay.

You need to see a paediatric specialist. 8 cavities at 22months is really extreme.

Personally I dont think giving a GA to a 22 month old to restore teeth is at all ethical. Treatment is unlikely to last and she will end up needing further GAs, and end up in pain. 8 cavities at 22 months is a really high caries rate, if you dont address the cause shes just going to get more and more cavities, and restorative work will be pretty much garunteed to fail.

6K is what a private GA would cost, but I absolutely wouldnt pay that to save a babys teeth.

I also think you need to be completely honest with yourself about her diet and brushing. Im not sure what digestive bacterial infection would cause decay.

Hi. Thank you for your reply.

Do you recommend we organise the pediatric specialist through Bupa? My daughter is on my work plan with them (but not dental). Or contact through NHS?

We have done loads of blood, stool etc tests and they show that she does have some issues perhaps some sort of Candida type infection. I don't know specifics as my wife deals more with this but she mentioned some tests showing kidney issues k think.

The diet is definitely fine - fruits, veggies, carbs, meat etc no sweets. My wife is stay at home mum and she spends all day researching and reading etc but we still breastfeed at night and during day .

Your dentist will make the referral on the NHS. Make an appointmrnt with your dentist, Im suprised they havent done the referral already.

The private dentist might be able to save her teeth but it wont be long term. Something is causing the decay and it will cause the work to fail and it will cuase further decay. If she is going to need a GA the best option is to just remove these teeth, it is the only option that garuntees no pain/abscess formation and no repeat GAs. A peadistric specialist might be able to do some work under local to save the teeth.

What is she eating throughout the day? Are you using flouride toothpaste?

Sorry cross posted. I would do it through the NHS personally

A candida infection is likely with a white tongue and is relatively common in breastfed babies but it would cause decay. A kidney infection wont cause tooth decay.

@RHRA read the link, you are talking rubbish
kellymom.com/ages/older-infant/tooth-decay/

It can be treated through the nhs. I’m not sure the earliest you can have your teeth treated with fluoride but that hardens the teeth and should buy you time. You need to be referred if your dentist can’t help. My GP did it for us because our dentist was being obstructive. Ds has treatment under the community dentist (hospital based). He had a general to do extensive work and has been much better since

@ItsSpittingEverybodyIn

What has breastfeeding got to do with it? I bf two children to age 3 and they both fed through the night and their teeth are absolutely perfect in every way. More so than bottle fed sibling.

Breast milk is cariogenic, i.e. contains sugar that causes dental caries. The on-demand nature of night breast feeding & the consequent pooling of milk around teeth then is the key factor. There is scientific evidence to back this up and unfortunately, those of us involved in this line of work can vouch for this; we have to accept what parents & carers tell us if we do a dietary & oral hygiene analysis & there is no other reason for this type of toddler rampant caries.

We still breastfeed during the day and night, no your wife Does and you also say she hardly eats anything during the day, perhaps she’s full from milk? A toddler wouldn’t normally feed or be awake overnight so perhaps cutting down to bedtime before teeth brushed and after breakfast before teeth are brushed. So she eats in the day she has food before her milk. No point having a varied diet if she isn’t eating it. The cavities may be from breastfeeding over night they may not be. But you’ll be lucky to get a day case in an nhs hospital for a 2 year old usually where I work only paeds anethatist will work on kids under 5 and with Covid 19 only urgent and emergencies are being operated on but hopefully that will ease off soon. Do get advice from your dentist ask for referrals and surely if your child has digestive/kidney issues a paediatrician has some involvement? Also as above Candida can be easily treated have you tried treatment? Have you seen a gp?

Go NHS -ask your GP to refer to MaxFax as well.

The only decent dentists I have had have been NHS.

You can search for an NHS dentist near you on this site. www.nhs.uk

Dental surgeries will not always have the capacity to take on new NHS patients – you may have to join a waiting list, look for a different dentist who is taking on new NHS patients, or be seen privately.

Once you find a dental surgery, you may have to fill in a registration form at your first visit, which is just to add you to their patient database. However, that does not mean you have guaranteed access to an NHS dental appointment in the future.

Problems finding an NHS dentist
If after contacting several dental surgeries you still cannot find a dentist accepting NHS patients, call NHS England's Customer Contact Centre on 0300 311 2233.

@ItsSpittingEverybodyIn
Don't be so rude, have you forgotten your manners?

I have no vested interest in whether the OP breastfeeds until whenever, but there will be repeat dental GAs until this is addressed, if everything else ( diet & oral hygiene) is spot on.

@RHRA you profess to know so much but if you read the link actually there is no pooling of milk around the teeth with bf, only bottle feeding. Saying that bf has caused this tooth decay is very damaging and uneducated remarks like that probably contribute to the UK having one of the lowest bf rates in the world.
If you are a dental professional I suggest you do more research into breast milk and breast feeding.

Eh, dental treatment is free for kids, unless I'm missing something.

@Devlesko

Eh, dental treatment is free for kids, unless I'm missing something.

You obviously are. Try reading the OP again...