Kids and tooth fillings

Janko on 22/09/2013 - 17:19

A friend has a 5 year old daughter with that needs a filling - no pain or anything, just a black dot apparently.

Dentist has told her that kids must be put under general anaesthetic to get the filling as kids can't keep still, so she's been told she's up for a day in a private hospital, plus the anaesthetist fee, plus of course the dentists fees.

Is this what other parents normally have to do? I had a filling about that age and some mobile van dentist just did it at school.

Her husband recently left her and I know she mentioned she has some concession card and gets some child care payment to supplement her work income. Does this help if she has to go under general? The father is penniless.

General Discussion

Comments

  • donga100 on 22/09/2013 - 17:36
    +7

    At 5 years old those teeth are not permanent anyway so you could just wait for it to fall out if it's not painful.

    • Whodis on 22/09/2013 - 20:48
      +1

      I would be wary of giving advice like that. If the kid ends up in hospital because of your advice, I don't think you'd be very happy.

      • Janko on 22/09/2013 - 21:32
        +6

        No, I believe it is up to the receiver to show due diligence and I definitely wouldn't pass it on to the mother if she was the type to act solely on advice received on an bargain forum.

        The advice here is appreciated as it will give her something to discuss with dentists and discover more about as she explores her options.

  • kt on 22/09/2013 - 18:46
    +4

    I'm inclined to agree… otherwise in 6mths time if they find another hole, what do they recommend then, going down the whole hospital path again? General anaesethic carries risks as well.

    I went thru it with my son at 5/6yrs of age but he had to have about 7 fillings (don't ask!). For just one I would definitely be getting a second/third opinion. Some dentists are just better with kids than others…

  • maximum on 22/09/2013 - 19:10
    +2

    NSW health has dental health clinics for school age children. No need for health care card etc. There is a waiting list but if the child is in pain ( or you say they are you go up the list). Look up the local area health service in the white pages. My eldest had to have 2 teeth extracted as the result of an accident under general anesthetic day surgery at private hospital but he was only 4 and this was much bigger than a filling. The other advantage of the dental health clinics is they work with kids all day so our local ones know how to get the kids to sit still etc.
    Another tip is to be willing to travel our local clinic was about one year wait but by travelling 20 minutes I got the first appointment in under 3 months.

    • Janko on 22/09/2013 - 19:33

      I like the suggestions of getting a 2nd opinion and just waiting for the teeth to fall out, but I think what you have said will definitely relax her, knowing there's a way in the worst case (as she lives week-to-week on money)

      Very valuable information. Thanks.

      Does this look like what you are referring to? http://www0.health.nsw.gov.au/cohs/health_services.asp#para_…

      So I take it you had the extractions and general at minimal (zero?) cost?

      • Whodis on 22/09/2013 - 20:46
        +1

        Take the kid to the health service clinic. They will attempt to do what is possible, otherwise they will wait list them for GA, bearing in mind the line is quite long.

      • maximum on 23/09/2013 - 00:08

        Unfortunately the ga and private hospital was not under the public clinic after Medicare rebates it was less than $500. That being said when you are living on welfare it might as well be $1 million dollars. Sorry for giving that impression - I only mentioned that incident because that anesthetic was because it was for extraction of two front teeth. Even then the dentist said they could have done it in the chair if we preferred so unless the child is very fidgetty I would assume a filling could be done in the chair.
        Since we have been using the dental clinic my son (who was born without enamel on some teeth so is more prone to decay) as had 2 fillings and has had his teeth fischer sealed all free and the ladies are fanstastic. Don't ignore a filling though even for baby teeth because it can effect the adult teeth underneath as far as I have been told.

  • Whodis on 22/09/2013 - 20:45
    +8

    Coming from the dentist's point of view, recommending GA is not necessarily a crock. Kids who are generally agreeable might turn up to the dentist and freak out. I've seen 5 year olds that are completely cooperative and 12 year olds that are complete chickensh*ts. If the kid has been coddled all their lives/scared to death by their parents about the dentist and panics in the chair, there is little choice but to recommend IV sedation or GA.

    You try working on the mouth of someone that shakes their head left to right in the chair with a sharp diamond tipped drill going at 200000rpm.

    I wouldn't agree with the people saying leave the tooth until it's painful. Multitude of risks ranging from loss of space and subsequent crowding to life threatening or at least very painful abscesses. More often than not you'll end up with a more uncooperative child in pain who will fear the dentist forever after getting that tooth with the little hole pulled at 7. Baby back teeth will NOT be changed till at least 8yrs old, often not till 11 or 12.

    If the kid has another cavity in 6 months time at the dentist, whose fault is it? The dentist who found the hole, or the parent who has been feeding their kids crap and not making sure they are brushing properly? If you accused me of trying to rip you off by referring to a specialist for GA treatment because your kid is a brat, I'd tell you to go shove it where the sun don't shine.

    My two cents as a general dentist.

    • Janko on 22/09/2013 - 21:49

      Appreciate the information, especially about the risks and future fear.

      Mother said the child is amazingly calm during dentist visits hence really trying to find out if GA is just prescribed for all kids, or just the freakouts.

      • Whodis on 23/09/2013 - 00:06

        Amazingly calm by whose standards? The dentist, or the freaked out mother?
        You'd be amazed at how many people are afraid of the dentist. Having said that, there are dentists out there who will do anything for a buck, as per any profession.

        I'd get a second opinion. Oral sedation, happy gas, or IV sedation are cheaper alternatives if the kid really can't sit still. Also try dentists in lower SES suburbs for a cheaper fee, if money is that tight, hopefully from someone who's been before.
        If the kid really is in pain, call up the community clinic and mention that they're in pain.

    • cannedhams on 23/09/2013 - 12:09
      +2

      Jesus, it seems excessive to put a kid under GA for something like a filling though. Surely all the dental appliance makers can make some kind of restraint, sort of like a Hannibal Lecter/gimp mask that can keep their head and jaw immobile. I'm being serious here, GA is not without risks.

  • p1 ama on 23/09/2013 - 08:47
    +1

    Your best bet is to take her to another dentist to get an opinion. I don't think OzBargain is the best place for medical-type advice, even though I am sure that many people would be knowledgeable. But yeah, I personally don't think it's general practice to put kids under GA, the private hospital will cost a fortune as well.

    Get another dentist's opinion though, that's the best thing you can do by far.

    • Janko on 23/09/2013 - 13:21

      Yeah, I recently got a quote for an knee arthroscopy, the day in private hospital was $2150, anaesthetist $700 and that was for a local. $2850 before the surgeon even gets paid.

  • dannyhc on 23/09/2013 - 08:52
    -2

    Take the child to Thailand on a medical tourist visa, nothing is more overpriced in this world than Australian Dentistry. Malaysia is far better but the price is a little higher.

    If you are on a health Care card you can book in for free dentist treatment at the Royal Dental Hospital but beware, I had a dentist pull out two adult teeth because he thought they were milk teeth, anyone know if I can sue the State Government as this was around 20 years ago?

    • EddieObeid on 23/09/2013 - 17:53
      +2

      Take the child to Thailand on a medical tourist visa,

      I'm from overseas and wouldn't recommend this AT ALL.

      You are just inviting 1 problem after another by doing this… One dentist from a similar low cost country removed the wrong tooth of my wife by mistake and there was nothing we could do about it.

      Yes the dentist offered to remove the correct tooth at a discounted price..

      Danny you are talking about suing the government for something done 20 years ago, how would you go about doing that if that was done overseas.

      • Janko on 23/09/2013 - 18:12

        I think there will always be good and bad anecdotes. For instance, I had root canal in Slovakia, cost me $350 and my Aussie dentist commented on the high quality of the job.

        • Whodis on 23/09/2013 - 19:50
          +1

          I won't say all overseas dentistry is bad, because it's not.

          Taking a child overseas to Thailand for dental work, however, is plain stupid. There are people that will advocate that everything be done in Thailand, again, bringing me back to the problem of cookbooking everything. Get it through your head that not everyone is the same.

          When you're an adult and able to make your own choices, feel free to go get foreign dental work done, you might even get a good result sometimes. Don't subject someone else's child to that sort of harebrained notion that everything is cheaper and better in Thailand dentistry, because it's not. A layperson's definition of good dentistry is very very far from the dentist's point of view 90% of the time. Good luck with your long term dental health.

        • cannedhams on 24/09/2013 - 21:13

          I have been to fifteen (Australian) dentists in my life and all of them have criticised the existing dental work in my mouth from seemingly diametrically opposed points of view.

          Even on basic stuff like resin vs amalgam fillings. I went to a dentist on the north side, she said forget about all this poly composite shit, amalgam is still the best stuff for these back fillings. I said you're the expert and away she went.

          I went to another bloke last month, asked for amalgam and he said he hasn't used it in years, resin is more durable these days and only old school fogeys recommend amalgam.

          I had two dentists IN THE SAME PRACTICE tip shit on each others fillings in my mouth. The second one motioned his assistant over and said "here this is why you don't do tunnel fillings like that other idiot does. Were going to rip it out and replace it with a traditional filling." And so he did.

          The one time I did go to an overseas dentist, he seemed like a decent bloke and also had his girl apply fluoride varnish to my teeth for free, because he said my teeth were fairly worn for my age and I should look after them better. I'd happily go back to him if I ever was in the area again.

        • Whodis on 24/09/2013 - 23:35
          +1

          Many ways to skin a cat, not all of them correct, LOL.

          I did accidentally shit on a colleague the other day, slipped up, oops.
          Thing is, a lot of dentists are built in such a way that they like to cookbook everything. I personally take issue against that sort of approach that X situation needs Y procedure exactly as per textbook. However, a lot of my colleagues seem to think that their way is the only way, and that's where you get a shitload of different opinions that as equal, only some are more equal than others.

          You also hear stories of holistic dentists shitcanning root canal therapies as poisonous and what not, and a vast majority of normally trained dentists saying they're a perfectly valid and safe way of treating a painful tooth. There is a bucketload of quackery in dentistry, as there is in any other profession. The problem is dentists are fighting a losing battle all the time, in that patients are mostly hateful of the dentist and there is very little regard for the profession in the public opinion, and a lot of dentists are going out of their way to destroy what little regard the public has left for us as well.

        • cannedhams on 25/09/2013 - 12:05

          I remember a story in Readers Digest (way back, years ago). They took a guy who needed a tiny fissure seal (got a bunch of senior dentists to say that it wasnt much of a problem at all), and sent him to twenty GP dentists to see what they would all say. Some of them said yeah you've got a small problem here, lets put in a seal, but there were a huge range of responses from the other dentists.

          Some dentists told him to rip out his amalgam fillings because they were poisoning him. Some said the tooth needed extraction and replacement with an implant. Some said he needed root canal work. Some wanted to put in a traditional filling. Etc etc.

          The problem with dentistry I suppose is that shit work is set in stone and there for all to see, whereas for other types of surgery its always difficult to prove that someone stuffed up (believe me, I have the med neg files to prove it).

        • Whodis on 25/09/2013 - 14:33

          It's not always shit work though. At times it's also lazy patients and just a very difficult situation to deal with. Can't always get a good result if the patient doesn't cooperate.

    • Janko on 23/09/2013 - 18:06

      Sounds like you're in Vic, but in NSW back then you had 6 years to commence proceedings.

      • cannedhams on 25/09/2013 - 12:09

        Wrongo. I'm not going to set out what the limitation dates are, because the person really does need to go and get legal advice, but the limits are different for personal injuries actions and actions for monetary loss. There are also different provisions dealing with limits when the person injured was a child. Dannyhc, please go and get legal advice, you should be able to go and see a neighbourhood legal centre for free.

  • baycie on 23/09/2013 - 09:35

    Our kids are fine at the dentist, but our dentist is very child friendly, they have a tv on the roof and you can bring in their favourite DVD which they will play for them. Our 4 year old had a filling done while watching a movie, no needles required either as small fillings don't hurt. I would get a second opinion and find a child friendly dentist.

  • Luckyduck on 23/09/2013 - 10:23

    My middle daughter has particularly bad teeth & has regularly had fillings done since she was about 3 years old & has never gone under for them. She actually had a tooth extracted 2 weeks ago & was fine throughout (though she is 8 now). We go to the school dentist & she is fantastic with children, my kids love the dentist! Treatment costs around $30 per visit without a health care card & free with one (I'm in Vic). There is a wait though, sometimes up to 2 months. My other 2 children have fantastic teeth & have never needed anything done, much to their disappointment, but look forward to their check ups.

    • Janko on 23/09/2013 - 18:17

      That's good to hear—I too like the dentist, especially the sensation when getting a filling polished off!

  • Geekomatic on 23/09/2013 - 11:08
    +1

    It's unfortunate that we humans have to have teeth worked on- never pleasant for any of us.

    5 is a good time to teach them that there are just these absolutes in the world & be very "matter-of-fact" about it with them. I have a son & a daughter. I handled it this way with both of them. No fuss, no muss…we have to get that seen to because it will get worse. End of.

    I've used both private & school dentists & I prefer the school. I think because they "only" work on kids, they get to know how to handle the whole thing.

    FYI, my son had fillings & my daughter has had fillings + a broken tooth "replaced"/fixed at school & they've done a wonderful job.

    Tell your friend to go to the school dentist & to assure the child it'll all be fine- because it will.

  • voiletmay on 23/09/2013 - 13:42

    Holy.. that is insane. School dentist will do it for free. They can do kids fillings (in baby teeth) in a few minutes.

    My son at 3 years old (autistic) was sedated once but needed 10 or so fillings (he loved apples as a youngster and would eat them continually and all the front teeth that you use to bite into an apple had to be filled). That was free through the school dentist too.

    I would be trying another dentist (just ring up and see if they will do small fillings on 5 years olds).

  • [Deactivated] on 23/09/2013 - 16:46

    Pull the tooth? General anaesthetic?

  • Whodis on 23/09/2013 - 19:42

    Am I the only one that knows nothing about the school dentist in NSW?

    AFAIK, NSW schools don't provide much in the way of dental care, and they most usually do not have a schools dentist, and if there is anyone most likely it is an oral health therapist. Nothing wrong with oral health therapists at all, but sucks to be the consumer when you can't tell the difference between a specialist, a dentist and a hygienist and oral health therapist.

    Also what really irks me is when everyone drags out their anecdotal experiences and applies them across the board eg "my son/daughter had x done at y, therefore you can take z to a to do b." if it was that simple we wouldn't need sedation and we also wouldn't need specialist paediatric dentists.

    I had a 4 year old boy today, first dental visit, took 5 minutes to get him into the chair, would barely let me look, and the mum insisted that I do a filling when I could barely get him to sit still. I got something in there after about 20 minutes of to-ing and fro-ing, but it was far from ideal and the mum knows it. Not every kid is equal, especially not the ones that their parents call "princess" or "treasure" or whatever else is in fashion. For god's sake don't coddle the children.

    • cannedhams on 24/09/2013 - 21:19

      Is it true that oral health therapists are able to do fillings now? Someone at cqu told me that something like that was in the pipeline?

      • Whodis on 24/09/2013 - 23:27
        +1

        Scope of practice changes, internal dental politics. Therapists are able to do fillings on under 18s, they're trying to get more scope to do stuff on over 18s without supervision from dentists. Dentists getting upset, and rightly so, given the extra time we had to do in comparison and all the other mumbo jumbo. All up in the air, may go through and put a lot of dentists and the huge influx of new graduate dentists out of work in the coming years if it does go through. Lots of new graduates struggling to get more than 1 day a week of work in many greater metro areas at the moment. Just not worth it for practice owners to keep extra dentists on in this current environment. At the end of the day, dentistry is a small business as much as it is a health service, and no income from personal services = no point working to break even.

        • cannedhams on 25/09/2013 - 13:17

          Really? I thought the Commonwealth was begging the dentistry schools to pump out more graduates. And then they have that Public Sector Dental Workplace Scheme to try and incentivise migrant dentists to come over here and do a couple of years in the bush where there there are still shortages.

          Dont get me wrong, times are tough and things are hard, but there are still dentists around who are refusing to take on new patients because their appointment books are full. Believe me, there are very few professions these days where people can afford to do that.

          About 400 lawyers graduate per quarter from QUT's graduate program alone. These people are having trouble getting work in the bush, greater metro areas be damned. I do feel sorry for these kids, the sad truth is that most of them will simply not get jobs in the law.

        • Whodis on 25/09/2013 - 14:35

          That's old news from a year ago when the Medicare scheme was still in place. Hard pressed to find many practices where books aren't a bit sparse now and then these days.

  • [Deactivated] on 23/09/2013 - 20:07

    I don't think ALL teeth are replaced by secondary ones when the first comes out. Secondly, one of our children has no secondary teeth beneath two of their "originals". They're not always there. (As seen on an X-ray.)

  • Whodis on 23/09/2013 - 21:00

    5year old child expect 20 teeth, decay most common in the spaces between the first and second deciduous molars or on the biting surfaces of the molars themselves. On occasion the adult teeth, most commonly premolars, which are the successors to the baby molars do not form for one reason or another and so there are no adult teeth to follow.
    Count from the midline, 1-5 will get replaced most of the time, 6-8 are the first molar, second molar and wisdom teeth . Things people would know if they actually googled for once rather than relying on anecdotal evidence.

  • dwei0420 on 24/09/2013 - 20:59

    I agree with Splathowa, all these anecdotal stories are good for parties etc, but everyones case is different. Kids can be temperamental and parents may be mislead by internet information and advices. Maybe its a better idea to listen to someone who has been through dental school, rigorous training and practice, Im pretty sure they know what they are diong

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