Pediatric Root Canal

[rae]

My daughter is 4 years old , she went to the dentist for the first time. They were unable to take "pictures" of her teeth yet the dentist stated that she had 3 cavities there could be more. Two of them can be saved but the thirsd she felt needed root canal. Which would be done over 3 visits without sedation. Now these being her baby teeth is it necessary. What other options if any do I have? How tramatic and painful will it be without sedation ?

[Daniel Ravel DDS]

An important function of the back baby teeth is to hold the space for the future adult teeth. If those baby teeth have to be extracted because of dental caries or an abscess, then the remaining baby teeth will shift and probably block out the adult teeth later on.

When I perform a pediatric root canal or a pulpotomy on a four-year-old, I usually suggest sedating the child, because the procedure can be uncomfortable.

In addition, the root canal treated tooth will usually require a metal cap to strengthen it.

Most pediatric dentists will gladly sedate a young child for a procedure.

[Kim]

My daughter who is 8 was scheduled for routine fillings. She had 3 and became "tired" before the 4th one was done. Her appointment was rescheduled. Upon returning for the rescheduled appointment (and after waiting an hour and a half past our appointment time) we were informed that she was scheduled for a root canal (even though a root canal had never been discussed with us prior to this). Upon learning this we rescheduled the appointment and I attempted to get in touch with the dentist (as we were informed of the root canal procedure by office personnel and were not given an opportunity to actually speak with the dentist). I was told rather rudely that I could not speak with the dentist on the phone and would have to wait and speak with him at the appointment. Upon our third visit to the office I went in a couple of hours prior to the appointment in order to try and speak with the dentist. I was then informed that not only was my daughter scheduled for a root canal but for a cap as well. I asked why they couldn't just either a) fill the tooth as originally discussed or b) just pull it as she is losing her baby teeth and a rather quick rate and it will probably just loosen on its own within a year. I was informed that they would not do either of the options (without giving any explanation as to why) and that if I insisted they would inform my insurance carrier that either a filling or an extraction was against their advice and that my insurance carrier would then deny payment. Needless to say I cancelled the appointment (and was subsequently billed for missing the appointment). I am outraged by the actions that this dental office has taken. I would really love to have an explanation as to why an 8 year old child would need to have a root canal done. I can understand it in a young child in order to save the tooth because of spacing problems. But I really don't understand it in a child who is quickly losing her baby teeth. Thank you.
Kim

[Daniel Ravel DDS]

Dear KIm,

There are many issues in your post, but I would prefer to address the question about why it is necessary to have a root canal treatment done on an 8-year-old' baby tooth.

The most important reason for performing a pulpotomy or pulpectomy on an 8-year-old is that the primary tooth in question (probably a first or second primary molar) WILL normally stay in the mouth until age 10 to 12. An 8-year-old is NOT ready to shed a primary molar!

A space maintainer with extraction is a reasonable treatment alternative if money is an issue, however.

Nevetheless: a pulptomy and stainless steel crown is still the treatment of choice for very deep dental caries on a primary molar in an 8-year-old child.

[rae]

I wrote earlier concerning my 4 year old daughter needing root canal without being sedated. I have called several places and one office suggested that i get a second opinion now this was just a receptionist who really could not tell me my options but had stated that they do not do root canal but i should bring her in for a second opinoin and that there were other options. She could not tell me these other options being she was only the receptioist and the dentist could tell me after seeing her. What could be the other options?

[Mom1]

:-[ Today , I too took my 4 year old for a checkup , as she was complaining of tooth pain and to my surprise, the doctor said that she had cavities in 8 teeth and root canal was needed in two of them. I am extremely nervous and would like to know , if there are any options other than root canal. She said there is only going to use Novacane the first time , but if my daughter is uncomfortable , then she is sedate her fully the next time.
If anybody can tell me , if there are any other options.

Thanks.
Mom1

[Rae]

Hi I had writtin before concerning my 4 year old daughter and how they wanted to do root canal on her without sedation i however did go to see another dentist who infact just capped her teeth under sedation and she was absolutly fine she has 2 silver caps and she was in no pain at alll just a little grogy that afternoon and the actual procedure only lasted about and hour if that what they told me the did was save as much as the tooth they could and capped it. The dentist that did the capping informed that infact there are other options then root canal and that this was in his opinion the best option and i totally agree.

[Becky]

So, did your 4yr old go to a children's hospital for the sedation?

My son is 3.5 and has three cavities plus one major cavity requiring a silver cap (maybe a root canal, not sure at this point). We learned about the large cavity on his 2yr visit, but the dentist said to wait til my son matured more. (he did get a temp filling in there to help slow the decay)

So, this weekend, my son chipped the decayed tooth. I am calling in the morning..but I already know the drill (no pun intended). They WILL NOT attempt to fill major cavities or do root canal or capping w/ the child awake.

I'm scared because dentistry seems so tame, yet the idea of anesthia scares me.

Is there any cause for concern and does this seem to be reasonable care?

TIA!
Becky

[Rae]

Hey , nny daughter did not got to children's hospital they did in right there in the dentist office they gave her a very smalll amount maybe a sip or two of what they call sleepy juice and then they put us in a room with a movie on and in about a half hour or so she was asleep and after the procedure she was alert just a bit groggy like i said she did not have root canal done just capped what they could save on the tooth and my dentist would not reccomend root canal - ;D not on a child.

[Becky]

Thank you. Unfortunately, our pediatric dentist, plus the second opinion (and our personal dentist) feel that we need to use anesthia, not just sedation. We did try that route last year when it was just a cavity, but the "sleepy juice - vicadin/benadryl" never really worked. Now that the tooth decay is worse and the tooth chipped over the weekend, we have no alternative..so it'll be capped and the rest of his teeth checked/filled as needed/sealed. At least it's at a hospital rather than in the dentist's office.

[Rae]

I am sure all will go well as you said with the sleepy juice if it did not work well then the next option would be sedation in the hospital same as my dentist stated but lucky for us the sleepy juice worked well enough so Good Luck and Im sure all will go well it is alot better then root canal im sure!

[Becky]

Well, it was a mess for us! My son's tooth started hurting badly - woke him up several times even w/motrin.

Took him in to the dentist - got the sleepy juice (a thingytail of vicadin, demoral, and phenergan). He got groggy, but not more. He was too upset about the mask for nitrous oxide. We were at a loss on what to do..had 3 choices:
1. antibiotic til next Wed - pray it didn't hurt more, but it would probably abcess (HUGE HOLE in tooth, with some bone loss)
2. oral sugeon to extract tooth, then still Wednesday for the other smaller cavities and sealant
3. extraction right then and there - and still Wednesday, etc.

We opted for extraction right then. My son wouldn't take the mask, but he was ok w/the novacaine shot. The poor dentist had to use the speed of Superman with great certainty and grace! He did it! One fell swoop - the tooth was out.

We (husband and I) did have to hold my son down to steady him so he didn't flinch during the shot or extraction, but he was good. I was a wreck!

So, he's sleeping (of course now!) it off and won't remember all of it. Our job is to only focus on the good (tooth no longer hurts, tooth fairy, etc) and play things down.

Wednesday, we'll be in the surgery center. But, at leasta we won't be in the position as today again. Wednesday's visit should take care of the situation for several years..except the regular checkups.

[Becky]

I gather a mixed drink (which got renamed thingy tail) is a "no no" word on this forum. just didn't want you to think I wrote thingytail on my own.

[Mom1]

My 4 yr old got one of her tooth extracted yesterday. It was horrible. The doctor asked me to stay outside and I could hear her screamming. After the shot , the dr. came outside and said she had 2 options,either to sedate her and get all the work done at once or wrap her in a blanket like thing to get the work done.

We opted for the sedation next month. However, now I am worried. Hope there is no side effects and hopefully she is fully asleep to get all the work done.

Do you think it is a correct decision , we made.

[Dena]

Hello
My daughter who is 8 had a Pediatric root canal done three weeks ago. They first drilled it out and then placed a solution soaked piece of material and then sealed it off. We came back a week later and they took off the seal cleaned it up and placed the white filling over it. Now three weeks later my daughter has an very big soft lump on the out side of that tooth in the gum.

My daughter has had a virus that has caused her to break out in a rash. I am not sure if this is part of the virus. It just struck me as odd it being right near the Pediatric root canal.. I don't want to send my daughter back there if this Dr is no good. Please advise

Also she had one tooth removed during her first appointment. And they would not give her the tooth. Is that normal?