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....

@sallyedmondson

In answer to your question about seeing hospital or dentist first I would say try to get a referral to the dental Hospital at Kings at the same time.

we have started process for referral to Kings however have been told it might take into next year :( we will go see a paediatrician soon hopefully through Bupa to again ask about the white poo etc issues...should we also ask for a referral to a specialist paediatrician Dentist at same time? sorry abit overwhelmed with all the different possible avenues to take :( thank you very much

@HavelockVetinari

Nobody is saying stop breastfeeding - just that it's not good for teeth to breastfeed during the night. I breastfed DS till 2y8m but night-weaned at 12 months in line with our dentist's advice to protect DS' teeth.

OP - do ask for a blood test to check for anaemia.

we are doing our best :-) as mentioned in another post she has begun falling asleep without breast feeding recently and today went first night without any bf at all at night.

blood work showed good levels of iron and haemoglobin. calcium was high and vitamin d was low. everything else was normal. all tests showed no anaemia in tests we did.

@CarelessSquid07A

Has anyone considered Rickets?

You mentioned her vitamin D is low and it can be linked to liver problems and cause dental issues.

interesting. she is quite small (although fully proportional and still on the curve, just the 25% percentile) but she had 0 developmental / motor skill issues and is definitely not weak at all. very strong little one!

@897654321abcvrufhfgg

Children with allergies also have low vitamin D

we def think she might have something unfortunately it turns out that the test we did (or paid for!) - one of those intolerance ones might have been a scam so we will def need to bring this up again with GP when we visit.

Hi OP I can’t comment on the dentistry element. However for me the white poo/potential liver/gastro issue would be more pressing. If you have BUPA you could request an appointment with a private paediatric gastroenterologist/hepatology consultant to thoroughly investigate any Gastro/liver issues. Stomach-absorption issues can play havoc with teeth and nutritional intake and getting on top of these early will help in the more long term IMO

The kings referral will be to a peadiatric dentist.

Dont get your GP to refer you about the teeth, the GP wont know where or what to refer. They cant refer any quicker or better than the dentist. Multiple referrals for the same problem is a waste of time and wont get you seen quicker

Rickets can cause problems with teeth, it can cause hypoplasia however this would be in the adult teeth not primary teeth, rickets causes problems with the development of the teeth and the primary teeth crowns have nostly developed at birth. Plus those teeth dont look hypoplastic to me.

the GP wont know where or what to refer. don’t be ridiculous, of course the GP can refer you. Competent healthcare professionals are more than able to find paths to care.

Hi Op. When dd was a baby i was told by her dentist that she was grinding her teeth and this was causing her front teeth to disappear over time . When she was 2 I got her seen privately in Harley Street as her front top and bottom teeth had almost gone. I was told it was due to breastfeeding and that if we were to wait for nhs treatment it would damage her adult teeth. We paid a similar amount to have her teeth capped privately.
Fast forward a few years when she was 8 she was seen by a gastrolenterolist, had colonoscopy and endoscopy etc and it turned out she had gerd. It was this that had caused her teeth to disintegrate and not breastfeeding. I continued to bf until she was 3 and daughter until he was 4 - no teeth issues for him.
If I were you I would look closer into stomach issues and see a gastroenterologist. I couldn't find any reason to stop bf and glad I didn't.

son until he was 4

Dd is now 16 and has never had a filling. Her teeth are great. She was put on tablets for Gerd when she was 8 to stop the acid and has more frequent dental check ups than others plus they coat her teeth with fluoride to add more protection.

If you pm me I can recommend a private gastroenterologist local to you.

Any non urgent, ie. Not Pain-related , dentist referrals are likely to take a while. Bearing in mind dentists are yet to get back to regular treatment practices such as cleaning and drilling. It make little difference to go private or nhs until they are.

@Hercules12

Hi Op. When dd was a baby i was told by her dentist that she was grinding her teeth and this was causing her front teeth to disappear over time . When she was 2 I got her seen privately in Harley Street as her front top and bottom teeth had almost gone. I was told it was due to breastfeeding and that if we were to wait for nhs treatment it would damage her adult teeth. We paid a similar amount to have her teeth capped privately. Fast forward a few years when she was 8 she was seen by a gastrolenterolist, had colonoscopy and endoscopy etc and it turned out she had gerd. It was this that had caused her teeth to disintegrate and not breastfeeding. I continued to bf until she was 3 and daughter until he was 4 - no teeth issues for him. If I were you I would look closer into stomach issues and see a gastroenterologist. I couldn't find any reason to stop bf and glad I didn't.

hi thank you for your response. our one did a bit of teeth grinding when she was much younger but thankfully stopped. our line of thinking is in line with what you are describing. i mentioned Gerd to wife and she said that whilst she did have silent reflux when she was much younger DD isnt exhibiting symptoms anymore although it must be something along those lines and we will def ask to be referred to a Gastroenterologist. dont know i fit makes a difference but shes had a very off type smell like sour milk from her mouth for ages although GP didnt think anything was wrong with that.

@Itisbetter the OP has already had a referral to the appropriate service.

Gps are not trained in teeth, trust me when I say you get a lot of innappropriate referrals for dental issues from GPs. They might be able to find a path of care but it is usually not the best path for that patient.

A dentist will know the appropriate places to refer, the waiting lists for each hospital, they will be able to describe the problems, provide the childs dental history which a GP wont. A referral from a dentist will be significantly more accurate than a GP.

Trust ME @DishRanAwayWithTheSpoon sometimes (I would hazard a guess especially when there are other underlying conditions) a GP is very well placed to provide support.

Having had GP referrals for dental issues when I practised, they very very rarely covered any of the important information. No diagnosis, assessment of urgency, relevant medical or social history, no special tests, no preventive advice given to the patient. Really unhelpful actually. The patient may as well have phoned up themselves. Would have saved time.

Yes but you CAN’T refer yourself (or at least you can’t here) so if your dentist isn’t helping you and you no longer have a health visitor then the GP CAN and should be able to help. I understand that it’s easier if your dentist is proactive and supportive and understands other issues, but we don’t live in an ideal world.

If you have a dentist, and need a referral the dentist will refer you. If the dentist isnt referring you that suggests that it doesnt need referral, but if you want to push it you can see another dentist for a second opinion. But I cant foresee a scenario where a dentist will completely refuse a referral just for the fun of it.

Going to your GP, who doesnt know the referral criteria, to get a referral to override your dentist - who does know the referral criteria is not the best move.

Your GP can refer but its usually not helpful, and a referral from a dentist is better, will be more appropriate and more likely to get you the care you need. For example we have referals to our service from GPs - it is the completely wrong service for these patients, they wait months to be seen and turn up and we cant help them.

I was speaking from experience as a parent not a dentist. I’m sure it’s very irritating not to get patients through the normal pathway, however my child very much DID need to be referred on. Once seen by the community dentist they were able to help him. He needed a GA, and still sees the community dentist regularly more than five years later, though his teeth haven’t needed further treatment.