Severe Bottle Tooth Decay in Children: Treatment Options and Concerns

Severe bottle tooth decay?

My son is 3 years old and has severe bottle caries.
All four of his front teeth are completely decayed, and one of them had a rotten root that was partially emerging from the gums, causing inflammation, and it has already been extracted.
Recently, the upper right tooth also became inflamed, causing his entire face to swell.
The doctor said that none of my son's teeth are healthy.
I have been taking him for dental treatment for almost six months, but he is very resistant to the dentist using machinery to drill his teeth and dislikes water rinsing, so the treatment options are very limited.
Recently, I have noticed that more and more tooth roots are emerging from the gums, appearing white, and he often complains of tooth pain but refuses to cooperate with the treatment.
I am really worried.
The clinic's doctor has suggested that I take him to a hospital for general anesthesia so that a thorough cleaning can be done, and crowns can be placed at the same time.
However, I am very scared at the thought of anesthesia, especially since I heard that he would need to wear a breathing mask to prevent sudden respiratory failure, which is really frightening.
I would like to ask if, given my son's condition, general anesthesia is truly necessary, or if there are other solutions available? If not, which hospital and which doctor in Taipei would be more reliable? Additionally, when he complains of tooth pain, I apply oral gel to his gums while he is sleeping; I wonder if this could have any adverse effects?

Hen danxin de mama, 30~39 year old female. Ask Date: 2006/10/30

Dr. Zeng Guanghui reply Dentistry

In general, if younger children have poor oral health, such as severe bottle caries that make restoration difficult and potentially lead to pulpitis, the treatment becomes more complex and requires more outpatient time.
If the child is also uncooperative, it becomes challenging to achieve thorough treatment.
For uncooperative or fearful children, behavioral guidance can be attempted first, followed by outpatient sedation techniques, such as oral or intravenous sedatives, or nitrous oxide anesthesia to alleviate the child's anxiety.
If these measures do not yield significant results, it is recommended to perform comprehensive treatment under general anesthesia.
This treatment approach, when conducted in larger hospitals with dedicated anesthesiologists and thorough pre-anesthetic evaluations, can minimize risks.
It is advisable to seek treatment at a larger hospital.

Reply Date: 2006/10/30

More Info

Severe bottle tooth decay, also known as early childhood caries, is a significant concern for many parents, especially when it leads to severe dental issues like the ones you've described for your son. Given that he is only three years old and has multiple affected teeth, it is understandable that you are feeling anxious about his treatment options and the potential need for general anesthesia.

In cases of severe bottle tooth decay, especially when there is extensive damage to the teeth and the child is uncooperative during dental procedures, general anesthesia can be a viable option. This approach allows the dentist to perform necessary treatments safely and effectively while the child is completely relaxed and unaware of the procedure. It is particularly useful for children who are very young, have special needs, or have a high level of anxiety about dental visits.
While the thought of general anesthesia can be daunting, it is important to remember that when performed in a controlled hospital environment by qualified professionals, the risks are minimized. Anesthesia providers are trained to monitor the child's vital signs throughout the procedure, and precautions such as using a breathing apparatus are standard practice to ensure safety. The benefits of treating the dental issues comprehensively in one session can outweigh the risks, especially if the child is in pain and has multiple teeth that need attention.

Before proceeding with general anesthesia, it is crucial to have a thorough evaluation by a pediatric dentist who specializes in treating young children. They can assess the extent of the decay, the condition of the remaining teeth, and develop a treatment plan tailored to your son's needs. If you are in Taipei, consider seeking out a pediatric dental clinic or a hospital with a pediatric dentistry department that has experience in handling cases of severe dental decay in young children. Look for recommendations from other parents or consult your pediatrician for referrals to reputable specialists.

Regarding your concern about applying oral gel to your son's gums while he sleeps, it is essential to be cautious. Many topical oral gels contain ingredients that can numb the area, which might provide temporary relief from pain. However, if used excessively or improperly, they can lead to complications such as allergic reactions or toxicity. Always consult with a healthcare professional before using any medication or topical treatment on your child, especially if he is experiencing ongoing dental issues.

In the meantime, to help manage his discomfort and prevent further decay, you can encourage good oral hygiene practices at home. This includes brushing his teeth with fluoride toothpaste (if he is able to tolerate it), reducing sugary snacks and drinks, and ensuring he rinses his mouth after meals. While these measures may not reverse existing decay, they can help prevent further deterioration until he can receive appropriate dental treatment.

In summary, while general anesthesia may seem intimidating, it can be a necessary and effective option for treating severe bottle tooth decay in young children. Ensure you consult with a qualified pediatric dentist to explore all available treatment options and find a reliable facility for your son's care. Your proactive approach to his dental health is commendable, and with the right support, you can help him achieve a healthier smile.

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