3 year old needing a filling

[Worried8263839]

I’m am mortified. Whilst we don’t know for sure, our last dentist visit for my 3 yo highlighted a concern with one of the back teeth as could develop into a cavity. I’ve been so diligent in brushing and reducing any sugar intake etc but it looks to me like it is now a cavity. We have another dentist visit booked for this week but wondering if anyone has had any experience of this? It’s hard enough getting him to open his mouth at the dentist, let alone allowing a filling. I’ve no idea how it will be possible and feel so awful that he is even in that position.

It's relatively common for kids to need dental work (paed anaesthetist) although would say 3 is pretty young, most are 5 plus. When it's multiple teeth/Dental clearances (multiple removals) ss referrals are done but I don't get involved in that aspect so can't say much more

What is the UK coming to? SS referrals for extractions. FFS. But the teeth could be saved with fillings. But the NHS doesn’t routinely do fillings for young children. So they escalate to unnecessary and dramatic intervention then refer the parents to SS for the privilege and to deflect from NHS dentistry’s failings. So very glad we went private to get actual fillings for DCs’ hypocalcaemia-caused cavities when the NHS offered to remove his teeth after 2 years of them all being on a government-funded furlough holiday “due to Covid” which is why it got so bad despite my trying to get a dentist to look at it.

Thanks for your input. Are the fillings done in a normal way to an adult? I just can’t imagine it.

My DD was referred for gas and air at a specialist unit, as she wouldn’t tolerate having it done at the dentist. They were so nice that she didn’t need it in the end, and just had the filling. Although mine was a bit older than yours.
Don’t feel bad. My others are adults and still haven’t had a filling, yet this one did and has never needed another. I personally think there was a problem/weakness with that tooth.

Thank you. I had one when I was very young and it gave me a life long fear of the dentist that I’ve tried hard to make sure my son won’t have the same so just gutted. It’s not causing him any pain yet thankfully but would rather getting sorted before we get to that point.

As he's so young I'd expect they'd put him to sleep to do the filling, I can't imagine a 3 year old cooperating well enough to do while awake. DD had to have a tooth pulled out when she was 5 (she had knocked it partially loose and it was hurting her) and was hard enough to get her to cooperate then (dentist had to take lots of breaks and wait for her to be ready to hold her mouth open again - luckily was a very patient dentist!) and that's two years older than your child.

She did have a filling when she was about 9 and that went fine, they didn't even use local anaesthetic and she wasn't bothered at all!

I’ve done many fillings on 3 year olds , however there are also many 3 year old I’ve had to refer as they could not do operate.

If a three year old needs to be referred it will be for a GA (put to sleep) and the tooth and any others that look dubious will be removed . This is because they don’t want to repeat a GA . In many cases in a baby tooth if you have notice the hole it has already gone through to the nerve and a simple filling will not save it.

Going forward it doesn’t matter what they eat or drink at meal times, it could be all sweet stuff and wouldn’t harm their teeth . It’s what they eat or drink inbetween meals that’s the problem as every sip or bite , even if they brush teeth afterwards, attacks the teeth for an hour afterwards. That’s anything sweet or starchy including yoghurts, smoothies, raisins , granola bars, flapjacks, crisps , fruit juice etc

Now is the time to make the dietary changes that need to be made.

several misconceptions here

child fillings are done routinely on the NHS , however on such a young child co,operation is key and also size of filling . Not all baby teeth can be saved and a 3 year old with decay in a molar that supposed to last for another 7 years that needs a general anaesthetic is far better off having the tooth removed than a repeat GA as most baby molars that have large holes will already have a dead nerve and the start of an abcess.

Dentists did not shut down over covid. In our area between end of March 2020 and May 2020 we could provide emergency treatment ,in our practices ,only and after that provided all treatment but with added precautions that drastically reduced number of,patients we saw despite working increased hours. In many areas dentists were relocated to working in dental access centres which were better set up for aerosol proceedures between March and May 2020.

Until end of 2021, beginning 2022 anything that generated an aerosol (drilling) meant special precautions including gowning up , using respirators and leaving a room fallow after each treatment for up to two hours. This drastically reduced the number of people a day a dentist could see. Coupled with the fact dentistry was the highest risk for clinicians to catch covid staff illness also impacted number of patients seen a day .

Dentists were not eligible for furlough payments , full stop . Most are still paying the debts incurred through decreased income and paying for the ventilation , foggers and other equipment necessary to meet covid regulations to practice.

This is what every dentist and staff wore in my area all day every day during covid . We were exhausted . I lived in a caravan on my drive so I didn’t pass infections onto family as dentistry was deemed to be so high risk . This was the same for every dentist I know and the toll taken on our health is why so many of us have had to retire early , exhausted .

A hall crown might be possible for your child. You should
ask about that OP. If the cavity fulfils the clinical criteria, placement of hall crowns are better tolerated and are gold standard in paediatric dentistry versus conventional restorative treatment with all that involves.
Are you following prevention to the letter and keeping all sugars to the 3 mealtimes?
Invluding sugars in drinks? Physical brushing for your child with 1500ppmF toothpaste? Spit no rinse afterwards?
Has your dentist done 3 monthly topical fluoride varnish? Arresting any active caries may be possible. As is the use of something called SDF. Silver diamine fluoride. These are all things in the paediatric toolkit. If a referral for GA is needed, it
will be almost certainly be for extraction/s as the other dentist @Lollygaggle says.
Inhalation Sedation technique probably not going to be successful in a child of 3. We cannot hold children down on a papoose board in the UK.
I also agree with everything @Lollygaggle
states and it is pretty clear that a lot of posters on your thread have no insight apart from their own anecdotal experiences.

Excellent advice from @27pilates . The only things I would add is that if the nerve inside the tooth is already dead a hall crown is not suitable and it will require good co operation though in experienced hands placement can be quite quick on the right tooth .

Personally speaking although I have used silver diamine on adult teeth I would be reluctant on baby teeth particularly if cooperation is not good as it can be quite caustic on gums . It will also stain the tooth black.

thankyou for the advice, I really appreciate it. He doesn’t drink anything other than water but we haven’t been keeping to sweet stuff just at meal times but he has very limited amounts, maybe twice a week. I also didn’t know about 1500oomF toothpaste so will look in to this.

the dentist hasn’t been able to do the varnish because my son as just kicked off and she said we’d try next time so I don’t realise the importance of it. I’m so worried about it, so preventable and feeling like a shitty parent right now.

What does he eat inbetween meals ?
Does he eat or drink anything before bedtime?
Have you been using a fluoride containing toothpaste?
Is he taking any medications ?

It’s not just sweet stuff it’s also starchy things because starch converts to sugar in the mouth and decays just as well as sweets .

My daughter developed a cavity at 3 due to uncontrolled silent reflux. She had a relapse with her reflux at 2y9m and it took over 6 months to get it under control with medication during which time 3 of her molars got damaged. One developed a cavity and two others had staining.
By getting her reflux under control and being extra careful with diet, high fluoride toothpaste which we put directly on her teeth before bed and fluoride treatment at the dentist every 3 months meant that the cavity didn't get any worse. When she was 5 they were able to do a no drill filling on the tooth