Dentistry

A few years ago, one of Wesley’s routine dental checkups revealed he had a few cavities on his molars. We are very good about brushing his teeth, but everybody’s bacterial flora is different and his seems to trend toward the tooth decay kind. My beloved family dentist referred us out to a pediatric dentist because, he said, he could do the work but can’t do the sedation, and he doesn’t want to traumatize him and make him hate the dentist, so it’d be better to go to an actual pediatric dentist who will make it a friendly procedure.

That dentist was located in a bigger town an hour away, because while they have an office here where we live, Wesley’s dental plan is through Medicaid and the office here doesn’t take Medicaid.

At our first appointment, with a two-month-old Thora in tow, the dentist asked if I breastfed her. I replied that I did, and he (a dentist, mind you, with no formal lactation training) told me not to breastfeed her on demand – I should instead keep her in a crib, take her out to feed her, swab her mouth with a cloth or a special infant toothbrush, and then put her back in her crib. To prevent cavities. I guess? On the teeth she didn’t have yet? This is patently incorrect information and I was SEETHING and he must have noticed the face I was making because he backtracked a little and said, “Well, it’s your choice but that’s what we recommend.” I was texting my IBCLC mom in a fury before we even left the parking lot.

Later in the appointment he made a point to tell me that “juice is bad for kids’ teeth” as though I had no idea, and without first asking me if we let Wesley drink juice. (He’s allowed to have it elsewhere, but we don’t keep it in the house.) I was convinced it was because he was on Medicaid, and OBVIOUSLY if you are on Medicaid you are the sort of person to put Mountain Dew in your baby’s bottle at night.

So! We got off to a bad start, but this was the only dentist that would do the kind of sedation required for the appointment who also took Medicaid (I called EVERYBODY in a 60 mile radius) so we were essentially stuck.

He had caps put on four of his bottom molars. This was done at two separate appointments, because they failed to explain to me at the first appointment that they wouldn’t be doing all of them at once and I was confused why they were having me schedule another appointment.

After he had the caps put on, he was in INTENSE PAIN for… weeks? I’d say? The caps go a little below the gumline, so I assumed this was par for the course and we gave him ibuprofen for the pain for a few days, and while he continued to complain about it occasionally, it eventually went away and we assumed everything was fine.

He had a cleaning several months later and everything looked good. I should note here, that every single time I spoke with them on the phone, I requested the office in our town as it was mere blocks from where we lived versus an hour’s drive away. I was told every single time that while yes, it’s the same dentist and many of the same hygienists, it was a completely separate business and they don’t take Medicaid so nope, had to be the office an hour away.

(This makes me so annoyed for people who don’t have it as easy as we do – what if you only have one car and your spouse takes it to work? What if your car won’t make the hour’s drive in wintertime? What if you can’t find childcare for your kids’ siblings? What if you can’t afford to take off work for most of the day to travel for an appointment? The whole system is so time-consuming.)

The next appointment for a cleaning was set for the beginning of December. Daniel took the morning off of work and we made the drive down there (because siblings are not allowed back with older children, one of us had to stay with Thora and the other was allowed to go with Wesley). During his cleaning, the hygienist was asking about the weather and school and we revealed that I actually had to get him out of school early to make the hour’s drive to their office. She looked very surprised and said, “Well, you know we have an office where you live, right?” And I replied that of course I did, but I’ve asked about it every single time and was told we couldn’t go there because he has Medicaid and they don’t accept it. She exclaimed, “Oh! Well our main dentist retired in July, and we hired a new lady and changed some things around, so that office actually accepts Medicaid now!”

What. WHAT?! Why was a letter not sent? Why was I never told I had the option to take him to our local office? I initially scheduled for November and they ended up canceling due to weather, so I spoke with them several times on the phone making this appointment. Why did they not mention any of that info to me?!

Wesley got his annual x-rays, had his cleaning, and then the dentist (the breastfeeding comment guy’s son) came by and very quickly showed me a glimpse of Wesley’s x-rays and pointed out a darkish area underneath a molar and was like, “Welp, looks like that tooth is dead so it’s like a sliver the body is trying to get out and there’s a small infection so we’ll just pull it and put in a spacer to keep the gap open for his permanent tooth and it’ll be a piece of cake okay see you later bye” and hustled us out to reception.

I was extremely stunned and didn’t have any questions because it was all so fast and I really didn’t even know what sort of questions to ask. I dutifully scheduled the appointment for his extraction at our local office since that was apparently an option now, and we left. I felt sick. The appointment was three days before Christmas, and if it was anything like having his caps put on, it would ruin his entire Christmas vacation, not to mention the holiday itself.

After working myself up into a frenzy about it for days, I finally typed up a page-long list of questions I had for the dentist, dropped it off at their office (since it’s approximately a 90 second drive from my house), rescheduled Wesley’s appt for January, and waited for a call back. The dentist called me back and addressed most of my concerns. He kept saying it would be “really easy” and would be “a piece of cake” and it’s “really no big deal.” He interrupted me and talked over me many times, which is a huge pet peeve of mine. He also indicated that “once this is all over, you’ll laugh at how worried you were about it” which I found incredibly condescending. Don’t talk down to me because I’m advocating for my child! And I wouldn’t have to do it if you would just explain things thoroughly the first time around.

The closer we got to his original appointment date, the more he started complaining that his tooth hurt. I decided to attempt to reschedule his extraction and got his original date back, December 22, with only a slight time change. The hygienist tasked with administering his “loopy medicine” (I’m not actually sure what it is, but it makes him a little more relaxed and silly so he’s easier to work with, I guess) got tired of negotiating with him to take it and smushed the Dixie cup up to his face, spilling it all over his cheeks, hair, shirt, pants, and the bench he was sitting on, and then wiped the medicine from his cheeks into his mouth with her hand, smiled at me, and said brightly, “it’s the squeegee method!”

I texted Daniel angrily.

The extraction itself went pretty smoothly; Wesley got a minuscule amount of the loopy meds so he wasn’t very loopy when they did it, but he cooperated okay and they let him pick out two prizes and he got to go home for a day of popsicles and movies.

I felt like he healed just fine. He wasn’t complaining of any pain, the spacer didn’t seem to bother him, and the gums looked pink and healthy.

Until three weeks later when he started complaining that his tongue hurt. It seemed like maybe it was rubbing on the spacer, like what happens when you have braces, so we tried to get him to tough it out. When that didn’t work, he also started saying his cheek hurt. I kept peeking in his mouth but I didn’t see anything out of the ordinary. No redness or swelling, no “rubbed” areas, nothing, except that I could see his bottom 6yr molar coming in, so we assumed it was severe teething pain. We started giving him ibuprofen at night to take away the pain so he could sleep.

After a few days, he started complaining of the pain during the day. This was unusual – he would be fine one second and then would clutch his face and start howling. Friday it happened a few times, and he got up a few times at night because it hurt. Saturday was MISERABLE. He was howling on and off all day, constantly clutching his face, and then he was up every hour all night long. I think he finally slept from 3-5am and that was the longest stretch all night. And this was WITH ibuprofen on board! Something seemed wrong.

I called his pediatrician, who advised that yeah, six year molars can be tough but maybe call his dentist? So I called his terrible dentist and they said it sounded unusual and that I should bring him in.

We went in this past Tuesday. They took an x-ray of the area that hurt, and after the dentist took a look, he informed me that THAT molar was infected, maybe abscessed, possibly dead, and they would need to pull that one too and here’s a prescription for antibiotics your appointment is on Tuesday any questions okay byeeeee

I was too overwhelmed and stunned to think of any questions to ask in the moment – since we were doing this all over again less than a month later I mostly felt like my questions had been answered the last time. He then suggested that perhaps this was a congenital thing and those teeth were just doomed to begin with, which I think is complete BS. As though the caps his office put on had nothing to do with his teeth dying?! Way to absolve yourself of all responsibility, sir. That comment made me furious.

He said it’s sort of unusual for an infection to travel from one tooth to another like that, but I am convinced that it happened because they didn’t prescribe antibiotics the first time around. I know antibiotics are over-prescribed and I don’t like contributing to antibiotic resistance and all that, but this would mark the first time in his life that he’ll have had antibiotics for anything. I even asked, in my page-long list of questions, if we could leave the tooth and treat with antibiotics, but he said that the tooth is like a sliver that the body is trying to work out of itself so we can’t just do antibiotics and leave the tooth. He never mentioned prescribing antibiotics to get rid of the existing infection.

I asked him how we could have possibly missed this the last time around, because we were JUST HERE. He pulled up Wesley’s x-rays and we discovered that the x-ray had taken a picture of the top of the problem tooth, but not anything under the gumline, so there was really no way to tell at our routine appt in December if that tooth was also bad. There’s a chance it could have been infected then too, I guess, but since their x-ray didn’t even show the roots of the tooth there’s no way to tell.

When he was writing the prescription for the antibiotics, he asked if Wesley remembered his last appointment. I was like, “Yes? What do you mean?” and he was like, “Well, I mean does he remember coming in and getting his tooth pulled?” and I was even more flummoxed and was like, “He’s nearly six and not a potted plant. Yes, he remembers coming in here. And every time we come in, it seems like it’s something new and more terrible.” and he was like, “Okay, I’ll prescribe Versed for this next extraction – it takes away your memory so he won’t even remember having it done.” I didn’t really have a response to that, other than shrugging.

I dropped Wesley off at school, filled his prescription, and started freaking the hell out.

He’ll have no left bottom molars for the next four to six years until his 10-year and 12-year permanent molars come in. That seems like a LONG time to be chewing on the other side of your mouth – is that going to mess up his musculature? His bite? Is it going to make his top molars weird or loose or something because they won’t have any pressure on them for six years? Is he going to need expensive orthodonture in the future to fix the problems this plan will create?

WHO KNOWS, BECAUSE THIS DENTIST DOESN’T OFFER INFORMATION TO ME

The next day, I called the other office in town that takes Medicaid. They were sort of helpful and offered an emergency appointment to see him the next morning, but they also indicated that they’d take additional x-rays (versus using the ones he JUST HAD the day before) and that they refer any “special” cases out to Wesley’s terrible dentist anyway – it doesn’t usually go the other way around. They’re kind of the basic level of care and if anything is complex at all we’d be right back at that office.

Based on that info, I declined the emergency appointment. I felt like what I needed was somebody to look at his chart, look at what has been done to him over the last year or so, and tell me if anything hinky is going on. I mean, yeah, bring him in if you need to but it doesn’t need to be another full exam with x-rays – we literally just had that done. Request those records instead!

Another day went by with me freaking the hell out, trying to figure out who to call and what to ask of whom and just feeling sick about the whole thing. This morning, I finally called my dentist (the one that referred us to this terrible place to begin with two years ago) and his office was so reassuring and helpful. The lady on the phone was like oh gosh, yeah, I’ve got his chart here – let me just ask the dentist what he thinks.

They came back and told me no problem, bring him in on Monday for a consultation, we can request his records, and we’ll take a look at them and see what options you have. I quickly asked if they could give me a ballpark estimate on what that might cost because we’d be paying for it out of pocket, and she took a moment and then said the dentist agreed there would be no charge for the consultation.

I am in tears writing this right now, because THEY ARE SO NICE. I have been so stressed out over this dentistry debacle for going on two months now and the fact that they are willing to take a look at Wesley at no cost to me is such a relief that I almost don’t have words for it. I have been going to this practice since I was three years old and even though my dentist has now retired and someone new has taken over, they are just as compassionate as ever and I will happily recommend them to anybody. Therefore, if you’re like me who’s looking for great dental services like teeth cleaning, dental implants, invisalign treatment, etc., then you should really look for reputable family and cosmetic dentistry professionals instead of just settling for a recommendation.

Based on this consultation, we may end up keeping the appointment for the extraction, but at least I will feel like I exercised all my options to figure out if we have any alternatives. Plus, if that recommendation comes from my dentist, who I trust, I can feel confident choosing that plan of action versus being suckered into it by the other guy and not having my questions answered. Or having them answered in a way designed to make me feel weird for asking.

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