Dentist just referred my 6yo for 5 teeth out under GA. Can this be avoided?

[CreatingHavoc]

Dd has had problems with her teeth pretty much from the word go. When they came through when she was a baby they had brown marks on them, which have been largely unexplained by dentists. She also has sensory issues that mean it has always been very difficult to get her to brush her teeth and the only toothpaste she was content using was a fluoride free one. Under the advice of dentists I switched to a fluoride one but that caused further problems due to the change of taste. It was exactly the same as her previous toothpaste, just with added fluoride, but she hates it and it has made her worse if anything. She seems to hate the sensation of toothpaste being in her mouth and will spit out almost immediately. She also has an extremely sensitive gag reflex.

All this has led to her having signs of decay in 5 of her teeth, one of which is now sensitive to cold and causing pain when she eats cold things. Because she is also terrified of the dentist, the dentist we saw today couldn't even get an xray of the tooth. She said the only option now is a referral to the hospital for removal under GA. I want to avoid this as I don't want her having a GA unless absolutely necessary. I am getting a second opinion tomorrow from a private dentist but obviously they may say the same depending how she reacts and how upset she gets. Me and her dad are more worried about the GA than anything and really don't want her to have to be put through all that if at all possible.

Has anyone been in s similar situation and managed to avoid a GA?

Similar situation but he went under the GA they had to take all but four of his teeth they looked good but when they had a proper look at them they were going bad so they pulled them as its pointless doing repair work on milk teeth for a child who won't let you even look at them normally! He is still on three monthly call backs at the dentist he let's them look and paint his teeth he is doing better with cleaning now

They told me they have patients at waterfall house who they sedate every few months just to do a dental examination on them im trying to avoid this

What worries you about the GA? If her teeth are decayed then more than likely they are painful. Tooth pain is dreadful, that may be why she doesn’t want them touched. Has your daughter got a condition relating to the sensory issues or does she just not like brushing her teeth? The dentist can’t really just do nothing if her teeth are in a bad way, I’m not really sure what you think the second opinion will say. If it is difficult for your daughter to sit through a dental appointment I wouldn’t put her through it again for a second opinion

If you do go for the GA get a pre med it makes them a bit more manageable

Sounds like she has hypoplasia. I'd join one of the Facebook groups for mih or enamel hypoplasia as posters can offer loads of advice about alternative options.

No experience of this with a child but my DH is phobic about dentists, with lots of effort my very kind dentist has worked at this with him. He originally might go and just sit in the chair and have a chat but he worked up to getting a filling but dentist said he needed an extraction and he didn't want to do it as he felt it would damage the trust they'd built up and he wanted to refer him for a GA at the hospital. DH refused and said he would only let our dentist do it. He had some sort of medication to relax him, he said he knew what was going on but didn't care

Don't know if that is possible with a child. I do know that locally we have a special needs dentist who is a specialist at dealing with people who can't cope with dental treatment for whatever reason. Would that be an option? Or maybe have your dentist take out the tooth that is causing pain and see how it goes.

Hope you can work something out.

It sounds like hypoplastic teeth. That's what my son has. The protective enamel his teeth should have is non existent. He had to have several teeth out, despite him having a very tooth friendly diet as we knew from a young age so we worked so hard but his teeth were never going to last.
He had a GA and had them out. His adult teeth have mostly come in now and the back ones have very poor enamel so we're going to end up in the same boat and he'll need work done when he has finished growing.

If her teeth are so poor then they need to come out to prevent decay and infection. The cannot remove them just by giving her jags in her mouth as she wont tolerate that. Get the GA.

What is it that you're so scared of?

Bad teeth can cause other conditions so I would rather plump for the GA than allow the teeth to go worse and worse over time.

My son has hypomineralisation, he needed some teeth removed but we saw an amazing dentist (NHS) in London at guys and Thomas who put steel caps on some of his teeth. It meant that the space was protected and when the baby teeth fell out there was room for the adult teeth to grow into.
You can ask your dentist to research this and try referring there. It was years ago when we went so might be a different process now.

Also another of my children has sensory issues and we asked our dentist to refer to the local specialist dental service. They are used to dealing with children and adults with extra needs and are brilliant, and have the time and understanding that you need.

My daughter (then 10) had similar and was sedated for the removal of one. I had to push for sedation as they wanted to just remove but she's very anxious so I pushed for sedation. Never again, she was pretty aware all through, traumatised, it seemed like gas and air (which did nothing in my labours either)
So I would (and will) push for a GA or far deeper sedation should she need anything else (which she will as she also has weak enamel)

The main problem I have with the GA is the associated risks that come with it. I know it's a very small risk but I have pretty bad anxiety about anything health related. I have always been fine with the dentist though, despite having gas and air to have teeth out as a child. My eldest is also fine with the dentist so I'm not sure where her anxiety comes from. I think it is purely a sensory thing. She doesn't have a diagnosis of anything yet but my eldest is autistic so there's a possibility of something. I personally suspect adhd/spd but school are just monitoring her atm.

The risk involved with GA is tiny. I know it’s difficult but you are letting your anxiety get in the way of your daughter’s treatment. Sore teeth and sensitivity are awful even as an adult. I would put my trust in the dentist and cancel a second opinion, she will only be upset again

Thats perfectly reasonable but you might want to reframe it and think about the risks of having bad teeth. Infection, sepsis, heart problems etc etc

Both of my DS are waiting for dental treatment with GA. I am very worried but I have come to terms with the fact that they couldn't tolerate treatment awake - the dentist said it would be a lot worse to start it and then have to stop halfway through

@bellac11 fair point. I am reassured slightly by others experiences. I think I'll still take her for the second attempt/opinion, if only to try and get an xray of the tooth that's bothering her.

Thanks everyone who mentioned enamel hypoplasia, the dentist we saw yesterday was so much better. She managed an x Ray and she does indeed have hypoplastic teeth and her top front 2 teeth are worn down almost to the nerve! I thought they looked odd. No NHS dentist has ever mentioned this. She does indeed have 4 or 5 teeth affected by decay but only 2 currently have deep holes. The one causing pain is one of those, although the pain had settled down yesterday. The private dentist yesterday said she does need those teeth out as they will only continue to cause problems but also said even urgent hospital referrals can take a long time. So in the meantime it's just monitoring.

I'm so annoyed that none of the NHS dentists we've seen previously have mentioned hypoplastic teeth. They have all been told that her teeth came through with brown marks on them and they just shrugged it off and said antibiotics probably caused it. That's it, no further information. If I'd known I would have been far more persistent with the fluoride toothpaste from a younger age. As she was actually brushing her teeth properly with the fluoride free one I thought that was better than not brushing well with fluoride toothpaste but clearly I should have persevered more. If I'd had known sooner we could have avoided the GA :(

Some children with sensory issues do not like the foaming action of most toothpastes. Oranurse toothpaste has the full amount of fluoride but no flavour and does not foam. I get it from Amazon. It made a huge difference to tooth brushing battles with my DD.

We had a truly awful nhs dentist that never picked up on any problems with ds teeth until it was too late 😢 He also tried to refer us for GA but I found a brilliant Bupa dentist and she has given us a 6 month treatment plan to stabilise the teeth until they are (hopefully) ready to fall out naturally. A few of the teeth have been painted with a sort of resin , I think, that prevents further decay and another has had a steel cap put over it. She pulled 1 out with an injection but this was over an hour appointment where she explained everything that was happening to ds, and let him play with the equipment. Ds is neurodiverse and it never would have happened under the previous dentist!

Waiting lists for GA are so long and the dentist told us that removing many baby teeth early can cause the adult teeth to grow in crooked. The state of NHS dentistry is appalling in the UK and makes me so angry.

So…she does need teeth out under GA, is that the upshot?
I thought your daughter just cannot bear tooth brushing so how would you have persisted with the fluoride if you’d know about this condition? You do know they are baby teeth and would fall out any way? V v odd

@CreatingHavoc dd had limited enamel on 4 back teeth. The same place top and bottom. This was due to antibiotics when I was 18/20 weeks pregnant. It is not that uncommon. DD was also terrified of the dentist. She let the dentist try and do a filling because it was hurting but it wasn't done properly. An abscess formed.

I have never seen a 5 year old in so much pain. She was referred as an emergency to the Waterfall clinic and still remembers the clip going into her hand for sedation. She was numbed and bit her tongue and a bacterial ulcer formed. She was so unwell she lost 11lb.

That is the consequence of not having a GA combined with a dentist who frankly was not good enough (practice changed hands) but was private. It took a referral to a London teaching hospital to get the bacterial ulcer sorted out and there was a query re plastic surgery on her tongue. She still has a ridge on it.

A new and excellent dentist referred her immediately and urgently to twonlocla hospitals and said just go to the one that comes through more quickly. Three teeth out under GA and she has no or little recollection of it. Certainly no trauma

Just get your dd sorted out and avoid what dd went through. The risks of GA are infinitesimal. They are probably higher if an abscess forms.

Finally, sort out your dd's dental hygiene. Ours was excellent and those 4 teeth still rotted. But good habits are needed to be embedded before the next set of teeth.

Surely your dentist, no matter how terrible, told you to use fluoride toothpaste? They give it away for free, they always tell you to use it with a minimum favourite content of X amount.
That's really basic dentistry advice you get right from the start. You'd have been told that the stuff you were using was pointless.

How did your daughter even try fluoride free toothpaste? If she had never tried it then she would never know a different taste existed and she'd have used the fluoride one.

Hopefully you can fix that now and start using proper toothpaste, but it isnt fair to blame the dentist for that error and that is something the dentists talk about at every check up.

*minimum fluoride content

I have been battling with getting her to just brush her teeth for years so when she accepted the fluoride free one it was a relief so we just kept using it. As I said earlier, I thought brushing with something was better than the stress of getting her to use other toothpaste.

@Eyerollcentral yes, she need the baby teeth out because the nerve is potentially dying off and could lead to infection and abscess. It's a molar and wouldn't fall out for around 6 years yet. She obviously can't have a sore tooth with a potential infection for 6 years.

@WeepingSomnambulist if it was just the one shit nhs dentist I might be inclined to agree but she has seen a few and none ever mentioned the condition or said anything was unusual with her teeth at all. I feel incredibly let down. I find it awful that NHS patients are given so little time or care. We are pretty much treated like second class citizens.
Of course they all say the same thing about fluoride toothpaste but trying to get her to use the toothpaste was horrendous. I just wish I'd known about the condition sooner.

@Lieinrequired interesting, when you say no flavour, how does it taste?

@RosesAndHellebores that sounds awful, your poor dd. Yes I think a GA is probably the best best for the two problem teeth at least.

@ItchyLips thats great that a bupa dentist helped your son. My dd wouldn't even let them put the fluoride paste on her teeth and only just managed an xray so I'm not sure if she'd cope with an injection and standard extraction unfortunately. How old was your son when he had it done?

Your poor DD, how stressful for you all.

I may be way off base here, but when my eldest was a toddler and refusing to let us brush her teeth for a while, we used these. Do you think with a bit of toothpaste on your DD might try them? I know they're for babies but possibly better than nothing? The sensation would be different to brushing, and she may like the sensory feedback of chewing? Also, more control for her than an adult brushing her teeth?

www.boots.com/brush-baby-chewable-toothbrush-2-pack-10272365?cm_mmc=bmm-buk-google-ppc--PLAs_HeroCompare--Baby_Accessories-_-UK_Smart_Shopping_Baby_Accessories&gclid=CjwKCAiAheacBhB8EiwAItVO2-B3x2DsQcBJOSZkpg9ta34KMygT7KWjpiRkOcdHMNFiN3ICJzm22RoCTscQAvD_BwE&gclsrc=aw.ds

I'm sure the GA will be fine, and worth it for her to be unaware if she already struggles with the dentist.