Teen son refusing to go to the dentist, what do I do?

[Pleasebehave92738]

My kids are registered at a dentist , are called for checkups every 6 months and we have always attended their whole lives.

My son has beautiful white teeth, not a mark on them but for some reason they are very weak. He is 15 years old.
When he was little he couldn't have dairy for 4 years so im not sure if this has anything to do with it.
He has already had multiple fillings and a tooth crack in half. These were only picked up on x rays , the dentist says they look hollow inside but perfect on outside. They are very negative with him when we go and he doesn't like how they speak to him.

Last visit she said he needed 4 fillings , all very deep and he will need sedation. If that doesn't work, root canals and maybe the teeth out at some point. They have referred him. These teeth look perfect on the outside

He is absolutely refusing to go saying that he is sick of having things done every 6 months and when he gets pain he will have the treatment but they are not bothering him currently.
What do I do? On top of that hes now said hes not going to any more check ups. And from when hes 18 he won't be going at all unless a problem.
He is bigger than me , I cant physically drag him in there and force his mouth open. But have a duty of care as his parent. Any advice please?

Does he know what treatment is to get those fake “Turkey” teeth???

I wouldn’t negotiate to be honest. It’s basic dental care, it needs to be done, if he doesn’t want to go then you’ll have no choice but to remove sweets/pocket money etc to ensure no further damage, and you can also point out to him the price of dental treatment- show him some of the photos of teeth left to rot.

If he’s currently got an NHS dentist, if it’s anything like where we are, you are struck off if you miss 1 appointment so I’d then ask him where he is going to find the money for a private check up when he has pain- £150 a pop, because you won’t be paying for it, and again show him the photos of those who failed to keep up dental care and ask if he’ll be happy to be living like that while in sixth form/uni.

But he doesn’t. He knows jack shit and it’s your job to remind him (and yourself?) of that.

Edited to add that I’d be inclined to say that you’re halving his pocket money from now on and will put the other half into a savings account for his future dental treatment.

See a different dentist

Try a different dentist and see if they have the same opinions… sometimes one dentist says filings etc are required and the next dentist says the teeth are fine!

@Pleasebehave92738 it sounds like teenage bravado as in it won't happen to me, the adults are exaggerating plus some underlying fear. It may be worth trying another dentist. Does he relate better to male or female influence? I saw this is dentist no 2 ,sometimes people have a better rapport with a different person. I sometimes transfer patients to a colleague if I think they will gel better.

He's been referred and as @Lollygaggle says the waiting times are usually lengthy so this gives some time for him to come around and realise the work is for his benefit. If he does want to talk about it -sedation is brilliant for reducing anxiety and often gives some memory loss around the procedure.

I would be trying to see if you can persuade him to make some dietary changes in stopping and thinking with the sugary drinks and snacks as they are wrecking his teeth but right now give him some breathing space. He may calm down and reflect and realise everyone including you are acting in his best interests.

I love the teenagers at work but they can be tough to get on board. Just out of interest do you go in with him or do they see him on his own? Sometimes I find it easier to talk to this age group without the parent in the room.

He has been referred for sedation, he has had teeth crack from decay in the past and needed multiple fillings in the past and has already changed dentists because the previous one also said he needed many fillings.

He has poor dietary habits causing his decay , changing dentists yet again will not help especially as he has been referred to community dentists who are experts in dealing with anxious patients.

His only way forward is to admit his poor dietary choices are causing his decay , change his snacking /pop habits and use the sedation to get the treatment he needs . Unfortunately that requires consistency with the messaging and a maturity in him accepting the consequences of his actions and changing his diet so he is not in this position a few months after treatment again.

This is simplistic. Teeth are half genes as well as diet. My husband is fanatical about his teeth and has had 3 fillings and a root canal. I’m very lackadaisical and at 30 have never had a single cavity or anything.

Genes.

Start taking a percentage of his pocket money to save up for a full set of implants. And tbh you are both facing a losing battle here, it doesn't matter how much you look after your teeth, if they're rubbish genetically speaking they will fail. I am living proof of this having inherited the Scottish teeth of my ancestors like my dad (no teeth) and his mum (no teeth). I am down to a few real teeth left, none undamaged at 55. Meanwhile rest of family inherited the English teeth of my grandad who had a full perfect set when he died at 90. My big sister has just had her first ever minor filling at 60!

I’d see about switching to a new dentist.

I’m afraid it isn’t .

98% of all dental treatment is preventable .

There are a very few, rare genetic conditions which affect tooth enamel and dry mouth can make you more predisposed to decay but the truth is if you adjust your diet ie the number of times a day you eat or drink even a bite or a sip of something sugary you will stop the decay in its tracks.

There is over a hundred years of study of this from studying cultures where sugary/starchy food was not consumed where they had no decay until a western diet was introduced, through to some definitive but ethically dubious , studies just after the Second World War.

For the vast majority of people there is no such thing as “weak teeth” just diets that need adjusting.

No one in any family eats and drinks exactly the same things in the same way and , in general, it’s grazing or sipping on sweet/starchy things that cause the problems. Not just sweets but yoghurt, raisins, energy drinks , flapjacks, fruit juice etc.

https://www.who.int/news-room/fact-sheets/detail/oral-health

He has already swapped from another dentist who also said he needed a lot of treatment and has been referred to a third dentist for sedation for treatment .

A fourth dentist will say the same thing and he will still have to go to the third dentist for sedation.

All of this is yet another avoidant behaviour not addressing both the cause of his problems (the diet habits he needs to tackle) and the solution to the immediate problem ie having sedation to allow the treatment of the very large amount of decay he already has.

So if this is his 2nd dentist because you left the first one because they too were "negative and abrupt" and your son didn't like them then maybe the problem isn't the dentist. 🤔

I’d be honest. Once you turn 16 / 18 you will have to pay for any treatment yourself. And it’s very expensive. Also if you aren’t registered with a dentist it can be expensive and difficult to get one. The wise decision is to get these things sorted while you are young. But the choice is yours.

Find him a dentist who can treat him without much pain. A dentist that does sedation will possibly be better with him. Meanwhile a cm cube of cheese after meals will help keep his mouth alkaline and reduce decay. Buy him an electric toothbrush if he doesnt use one already, get him dental tape to floss. Encourage him to chew on xylitol gum as it helps the production of saliva and also stops bacteria adhering to teeth. Discourage fizzy drinks.

The lack of calcium in his diet when young wont have helped but he can limit the amount of work he will need if he really tries.

Natural consequences will occur, he will get pain and then wonder why he didnt engage

Painful for you to see OP but thats how it will be

He is old enough to give his own consent and if he doesnt consent then no one would be able to force him.

We thought the other dentist may just love doing fillings! And he didn't like being told every time that he needed them whilst she tutted and told him not to drink fizzy drinks
I have spoken to him about it at length but he won't budge at the moment so I've told him that this is something he will have to sort himself as an adult.
I have weak teeth, I have had 2 fillings and 2 teeth out. I was fine until pregnancy but that seemed to have affected my teeth .My husband has never even had a fillings and doesn't look after his teeth at all

I can only give you my experience. My son is only 8 but refuses to open his mouth for the dentist. I had a letter saying that if he didn’t have the treatment he needed (filling - baby tooth) then I would be referred to the relevant services (assume social services) so we went again and he refused to open his mouth. So I said ‘what exactly do you think I can do about this?’ He got referred to a different dentist (he is autistic I should mention). But what makes me cross is that if you weren’t registered at a dentist no one would ask why! They ask when your child joins school but no one asks after that. No one would question the lack of treatment for example but those of us that try to do the right thing are vilified. Son is still on the waiting list which is ironic because it’s fine for them to leave your child on a waiting list but it’s not fine for you to struggle to get them to accept treatment.

I don’t think there’s much you can do at 15 to make him go, especially when you know it won’t be pleasant. Maybe give it another 6 months, what can you do really? Punish him? But he might actually be right, I’ve certainly had teeth filled that could have waited when I didn’t have any pain. On the other hand my OH didn’t see a dentist for years and he has a list of pain and can’t get on a waiting list for a dentist.

Who would be a Mum eh?

The problem with waiting until there is pain on a youngster particularly but the principals are the same for adults

the nerves are much larger the younger you are , so you are much more likely to need root filling or extraction , the longer you wait the worse the decay gets

for a patient that needs sedation there is no way to do emergency treatment with sedation , and the worst time to go , when you are nervous, is when you are already in pain

there is no incentive to change the dietary habits which are causing the decay and so you are doomed to continue to need more and more extensive treatment

98% of dentistry is avoidable if we change our eating and drinking habits. However that is really difficult to do with adults , let alone difficult teens. It is much easier to blame others, or genetics or weak teeth rather than make the changes that will keep teeth healthy. The unfortunate truth is that, except for some very rare conditions and people with dry mouths there is no such thing as weak teeth and if we take charge of our health and make the right choices there is no reason we should need fillings .

unfortunately with teenagers there is a problem with many accepting that their actions have consequences and that bad things will happen unless they chose well. It’s why treatment of teenage diabetics , for instance, can be very challenging.

@Pleasebehave92738 I am in my late 60s and have a condition where my teeth, molars in particular, were soft and 'hollow' from when they were formed. It was discovered by the school dentist when my adult teeth were coming through - I think I was about 7 at the time.

What happened to me was that my molars were 'drilled and filled' almost as soon as they emerged and dental treatment since has been to remove and replace old fillings from time to time. I still have them, touch wood.

I'm telling you this, partly to make people aware that there are conditions like these which have nothing to do with dental hygiene, dietary sugar and good habits. I suspect your son's not being able to take dairy products for four years has not helped his situation, but you are where you are with this.

My current dentist told me that not all dentists are aware of/able to treat these congenital conditions, so I'm wondering whether the way forward for you is to find a specialist dentist? We have a dental hospital near here in Edinburgh, maybe there is such a facility that you could be referred to that one of the consultants would be able to advise about a course of action for your son? Many NHS hospitals have specialist dentists on their staff - maybe your GP could refer if your own dentist seems reluctant? Your son might be more comfortable seeing someone in a hospital setting, where the initial consultation will be just X rays and examination.

Anyhow, I hope you do find a way forward for your boy. I can understand his reluctance to continue treatment, but probably like you, I feel that he will be better off in future if he is treated now instead of looking at dentures/implants going forward.

The lack of dairy has no effect on teeth that are already formed , the calcium lack would have to be so severe that he had rickets first before the teeth are affected and the teeth that he has that are decayed would have mostly already been formed.

There are conditions that can cause poor enamel but the OPs son does not have any of them . They are readily recognisable and OPs son has now seen two seperate dentists.

OPs son had already been referred for treatment under sedation so will have a third opinion when he goes to see the community dentists .

However the decay he has, the pattern of it, the multiple fillings all point to decay doe to grazing or sipping on sugary /starchy foods and drinks inbetween meals . The teeth that appear ok on the outside but rotten on the inside are absolutely typical of occult caries which is decay that appears in this age group .

OPs son has already been referred to community dentists and I’m afraid as part of his maturing he has to realise that his oral health is in his hands . He can chose not to go , he can chose to continue his diet but there will be consequences very soon.

Chosing to have sedation now , rather than waiting until he has an emergency , will be much easier and less painful/traumatic for him.

Choosing to change his diet now , rather than blaming over eager dentists or “weak teeth” means he will not have to have such extensive treatment in future.

@Lollygaggle wrote, "There are conditions that can cause poor enamel but the OPs son does not have any of them . They are readily recognisable and OPs son has now seen two seperate dentists."

Are you assuming that @Pleasebehave92738 's son doesn't have the conditions because 2 dentists said so? Are dentists so much better at ruling out obscure conditions that other medical specialists?

Also, the enamel situation can occur because the pregnant mother is not absorbing enough calcium for whatever reason.

You also said that 4 years no dairy would have no effect on a child's teeth - do teeth no longer 'remineralise' after eating cheese, or has the body stopped reutilising calcium from teeth when there is not sufficient calcium included in the diet? The body is quite good at moving calcium around to different areas when it needs to.

And she's going to physically get him there how?

Cheese does not remineralise enamel , it lowers the ph of the saliva quickly ie it makes it less acid so stops enamel dissolving and allows calcium from the saliva ie food not the body to be deposited ,

calcium is not moved from the body to enamel or from enamel to the rest of the once it is formed, it is inert.

Teeth are prioritised over almost anything else so a mother or child so deficient in calcium would result in rickets , long before the teeth were affected.

Dentists are the specialists in oral medicine , they spend years studying it all through their careers , unlike doctors who have a couple of hours training, at most .

The conditions that effect enamel on the teeth eg amelogenesis imperfecta , dentinogenesis imperfecta etc are easily identifiable by a dentist because they make the outside of a tooth look different. Even the quite minor problems like MIH ie molar incisor hypomineralisation are easily identifiable because the enamel looks different.

OPs son has teeth that look normal but x rays show decay inside. This is a very common problem particularly in younger patients and why dentists take x rays because often you do not see decay on the outside of the teeth until the decay is massive . It is not at all unusual for a patient to have a lot of decay in their mouth yet no obvious holes.