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....

The kellymom link has a particularly important bit of info:

If your child is getting anything other than breastmilk (including medications),clean teeth well before bedtime. Breastmilk combined with sugaris worse than sugaralonewhen it comes to tooth decay, so you want to make sure no other foods are left on baby’s teeth if you will be breastfeeding throughthe night.

It may be helpful foryour child tosip water after mealsto help wash food particles away.

Reducethe amount of timethat sugary substances contact the teeth. Don’t allow baby to carry a cup or a bottle around during the day. This results in a constant “bathing” of baby’s teeth with whatever he’s drinking. Avoid too many sugary, sticky foods as well.

You pay for private care.

Go and see a NHS dentist.

@DishRanAwayWithTheSpoon

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.

Sorry not thinking straight, it was liver issues shown by test not kidney!

Tongue is white and full of plaque but tests showed no Candida.

Sorry I'm not thinking too straight under circumstances but when you say NHS who do we.go through? Health visitor , gp, registered dentist office? Ask for Bupa referral to pediatrician?

Find an NHS dentist. Put it into google NHS dentist and then your area. You need to find one actually up and running and taking patients.

@DishRanAwayWithTheSpoon

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?

We didn't do referral as we were planning treatment in wife's country but lockdown prevented travel.

Will look into getting appointment and referral next week.

I've spoken to my wife and she thinks that once we treat it we will be able to prevent its reoccurring by active tooth cleaning and tackling the liver issues (sorry I said kidney incorrectly). My wife believes the main reason why it's progressing is because the cavaties are already there but once they're gone by taking liver medicine they won't reoccur and won't impact teeth.

@Itisbetter

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

Our dentist did fluoride treatment once and I guess we'll have to do it again If we go NHS route. My wife was just worried about over doing it as she says it might have an adverse impact long term.

@dementedpixie

The kellymom link has a particularly important bit of info:

If your child is getting anything other than breastmilk (including medications),clean teeth well before bedtime. Breastmilk combined with sugaris worse than sugaralonewhen it comes to tooth decay, so you want to make sure no other foods are left on baby’s teeth if you will be breastfeeding throughthe night.

It may be helpful foryour child tosip water after mealsto help wash food particles away.

Reducethe amount of timethat sugary substances contact the teeth. Don’t allow baby to carry a cup or a bottle around during the day. This results in a constant “bathing” of baby’s teeth with whatever he’s drinking. Avoid too many sugary, sticky foods as well.

Hi thank you for response. We brush morning, before mid day nap and before bed. We always drink water and water only (not even juice) throughout the day and always after every meal even after breastfeeding. We've never bottle fed. Wife is big proponent of BF and toddler is dairy intolerant.

Not sure I understand your comment about carrying the cup / bottle btw! Apologies.

The closest we get to sticky or sweet food is cashew nut butter.

If there is evidence that longer term breastfeeding causes dental caries it would be great if you could share it please?

As a previous poster said there is no pooling of milk in the mouth and bread milk cleverly contains macrophages to address the high lactose vs teeth issue.

I would check you are using a toothpaste with adequate fluoride, which is key. Depending on where you live fluoride is not added to water.

What have the doctors said about the white pop and the plaques are n the mouth?

My first thoughts would be something autoimmune like coeliac disease which can effect the enamel on teeth.

Does she have any other allergies or food issues aside from dairy?

Op I found this which might be something to mention to the dentist
medlandorthodontics.com.au/blog/4-causes-chalky-teeth-can/

Liver problems wont cause decay. If the tongue has plaque on it you need to brush it off! Its important to brush the tongue as well as the rest of the mouth

I wouldnt say breast milk is cariogenic, theres not really a scientific consensus - some papers are for some against, but humans have been breastfeeding for their entire existence, and ECC has not. Breast milk alone is unlikely to cause decay in 8 teeth at 21 months when good oral hygeine is maintained.

I should have said that my child with dental issues is one of twins, his sisters teeth are fine. Raisins were our only “sweet” for years but I do think they are particularly bad for teeth so that was an error on our part.

My first thoughts would be something autoimmune like coeliac disease which can effect the enamel on teeth.

Also came on to say coeliac disease. Teeth and white poo. Blood tests are not always reliable for absence of coeliac disease, especially under the age of 2.

My DD was diagnosed with cavities due to enamel issues - our dentist put the referral in (it did take awhile) but she was then treated at the hospital (dental unit) Received excellent care, they managed to do some extractions without GA. since then she has had 6 monthly checkups, and with the use of some extra fluoride every 6 months has since been cavity free - when we went to the dentist she had some serious issues. I paid to see a dental consultant in Harley street to talk me through options / advice, and even she told me that I should stay within the NHS as I would receive excellent care - which we did!

I would ask your density’s to put a referral in for you - once that comes through appts are made quite quickly -
Good luck, I remember how stressed I was when finding out the issues we had, but after 4 separate dental visits (they did a section at a time ) it has been sorted!

@lombi

If there is evidence that longer term breastfeeding causes dental caries it would be great if you could share it please?

As a previous poster said there is no pooling of milk in the mouth and bread milk cleverly contains macrophages to address the high lactose vs teeth issue.

I would check you are using a toothpaste with adequate fluoride, which is key. Depending on where you live fluoride is not added to water.

What have the doctors said about the white pop and the plaques are n the mouth?

My first thoughts would be something autoimmune like coeliac disease which can effect the enamel on teeth.

Does she have any other allergies or food issues aside from dairy?

Fluoride toothpaste is a recommended one but we only began using it after it all began.

The GP thought it was oral thrush at 5 months and tried to treat for that but nothing happened.

All in all my wife had terrible experience and got the impression the gp was being hostile and dismissive because she is a young stay at home mum who in their view had nothing better to do than worry about a toddler.

We haven't tested for coeliac. Do you think gp would proscribe that? Either way she doesn't eat any gluten.

Apart from no gluten or dairy no other food issues.

You’ve only just started using tooth paste with fluoride in ? You should always use toothpaste with fluoride in!

The test for coeliac would come up negative, even if someone has coeliac disease, if they're not eating gluten.

Why on earth weren't you using a fluoride toothpaste already? From the 1st tooth appearing a toothpaste with minimum 1000ppm fluoride should have been used

why doesn't she eat gluten? She would need to have a couple of portions of gluten foods each day for 6 weeks for the test to be taken.

What have you been feeding your child?

and why no dairy?

Does your child have issues with gluten or dairy or have you just chosen to cut out these food groups for no reason?

It sounds like you need to night-wean your DD, as breast milk causes cavities. It's similar to allowing her to drink sugary juice all night long (although of course breast milk is healthy - just not for teeth).

Her diet during the day might improve if she isn't getting so much milk at night - her white tongue suggests she's not getting enough iron, which is common in children who take too much breast milk and therefore eat insufficient foods rich in iron. This can cause serious issues later on, so do make sure you address it.

It’s sounds like Enamel hypoplasia rather than simply breastfeeding.

I was going to mention coeliac.

I have 4 kids. 3 have never had a single cavity. The other has had multiple cavities and his baby teeth were practically crumbling away when they eventually fell out. He's 13 now and has several cavities in new molars that have only been present 2 years. We clean daily, never have fruit juice, sweets rarely etc.

One of my others is an autistic young adult. He cannot stand to clean his teeth and only uses those chewable plastic mini brushes that you get for travelling, and not that often. I think he has used a brush and paste maybe twice in the last 3 years. I am not proud of this but just as a contrast. He also has a diet coke habit. He had perfect teeth with no cavities at his last checkup.

I am convinced that some people have teeth that are more susceptible to cavities. Absolutely convinced. I got so sick of dentists shaking their heads at me and telling me toddler DS mustn't have sweets and fruit every day. When my other 3 had an identical diet (low in sweets, no fruit juice, no fizzy drinks, and limited fruit, in order to support my cavity laden toddler).

@ToothFairyNemesis it sounds like both - the hypoplasia will be exacerbated by breastfeeding during the night. And hypoplasia doesn't cause white tongue, anaemia does.

Have you been supplementing with vitamin drops? This is especially important if you don’t think she’s actually eating much food but instead stocking up on breast milk at the expense of other nutritional sources.

Were you actively avoiding fluoride? It sounds like you don't trust it judging by an earlier comment

Our dentist did fluoride treatment once and I guess we'll have to do it again If we go NHS route. My wife was just worried about over doing it as she says it might have an adverse impact long term