A few months ago, my four-year-old, Gavin, went for one of his regular dental appointments for cleaning and checkup. The x-rays revealed that he had four cavities. He is too young to understand what was in store for him, but I felt terrible. I felt like I had let him down. After all, his mother and I are solely responsible for his oral health. Each night, I brush his teeth and each morning Mommy brushes his teeth. We do the best we can to maintain good oral hygiene. Regular dental checkups have always been part of our schedule and we try to limit the intake of sugary foods. Sometimes we just let them down. The pediatric dentist reassured us that we were doing all that we needed to do, but sometimes drinking as much apple juice as he drinks simply leads to tooth decay. Still, I felt like it was all my fault.
If you are facing your child’s first filling, here is our experience to help prepare.
First – Relax
When our child’s dentist told us that he had four cavities, I was expecting to get one appointment set and have all of these filled at once. Unfortunately, this was not an option if we wanted it done in the dental office. Pediatric dentists only like to numb and work on one quadrant at a time. Gavin had cavities in each of the top left, top right, bottom left, and bottom right. In this specific instance, they chose to work on the two teeth in the bottom left. If we wanted to have all four teeth treated at once, we would have had to check him into the hospital to be put under general anesthesia. We felt that this was a little more than we wanted to put him through at this point.
The Preparation
Once he got seated in the dental chair, the dental hygienist asked if I consented to using Nitrous Oxide (laughing gas) prior to getting the cavity filled and a dental crown on the second tooth. I was not sure if this was standard practice or not, or what effects it had on a child. The hygienist told me that this was recommended for children his age and that it was just to calm his nerves. Levels of Nitrous Oxide used on children this age is very small and not enough to cause any numbing effects. The hygienist kindly asked him if he wanted a blue or purple mask, to which he requested the blue mask. The mask was placed over his nose, and he was asked to breathe through his nose for about 10 to 15 minutes to relax his nerves while still being fully conscious.
After watching Bluey for a few minutes while allowing the nitrous to take its full effect, the dentist came in and administered the local anesthetic. He took it like a champ. The dentist was very careful not to let Gavin see the needle. It was almost comical watching him trying to use sleight of hand to distract my little guy with one hand and bring the shot into his mouth with the other. Again, we had to watch another 10 minutes or so of Bluey while we waited for his month to numb. The hygienist continually reminded Gavin to keep from trying to chew on his cheek as he tried to get acclimated to the odd feeling in his mouth.
When he was adequately numb, the dentist came back in and got to business. The dental crew dried out his teeth and the surrounding area. A device was put between his top and bottom teeth to help keep his mouth propped open, then a dental dam was put in place. The dental dam is most used when a crown is put in place. This is a rectangular piece of latex with a hole in the center that is placed over the teeth being repaired and held in place with a metallic bracket on the outside of the child’s mouth. The purpose of the dam is twofold. It is important for the area to be kept dry when having a tooth crowned, as well as preventing the child from swallowing any debris from the affected tooth during the filling process.
The Real Work
It felt like what it must be like to be on pit road for the Daytona 500. There were other hygienists coming in and out, mixing cement and resin, preparing tools, and drying out his mouth. The doctor began to drill out the tooth that was being filled, and then removed and reshaped the tooth that was being crowned. Meanwhile, another hygienist mixed the composite resin to be used to fill the cavity. Composite resin creates a tooth-colored fillings that is most used to fill children’s cavities, so you won’t even notice the filling in your child’s smile. A special blue light was used to immediately harden the filling. Once this was done, the crown was put over the top of the second tooth to reshape it and prevent it from cracking further from the existing decay. Obviously once the baby tooth with the dental crown falls out, the permanent tooth will replace it and will not need a crown assuming we can perform enough preventative measures to keep from having to have another crown.
The procedure to fill one tooth and cap another took about 10 minutes tops. As expert pediatric dentistry practitioners, they knew all the tricks to keep Gavin calm and under control. The nitrous may have had a small hand in that too! They were very calm and collected which helped keep his nerves under control. Periodically they would tell him how he was doing such a good job and how brave he was not to complain or cry while he was getting the work done. While cleaning up, the dentist turned the nitrous oxide down and turned up full oxygen into his mask. This gave him about 10 minutes to let the nitrous flush out of his system and allow him to come back to his normal self. All in all, the whole thing took about 40-45 minutes.
All in all, it was a very smooth process. Gavin was visibly nervous while in the waiting room, but the dental staff did a great job keeping him distracted with cartoons and reassuring him that they were going to take good care of him. I could not have been more proud of how well he did with his first cavity filling and receiving his dental crown.
What is Dad’s Role In This Experience?
First and foremost, it is to help keep your child calm and in control of his or her emotions. While we were in the waiting area, I could sense Gavin starting to get nervous. He is currently interested in snakes and spiders, so I asked if he would like to look at pictures of these on my phone. We scrolled through dozens of pictures of each on Google images until he became lost in search of the biggest, coolest, hairiest spiders. He was so intrigued that he did not even hear them call his name to go back. Instead of pictures of spiders, your child may prefer having another sort of comfort item such as a stuffed animal to bring to help prevent this from being an unpleasant experience.
In my opinion, the best way to keep young children calm is to stay calm yourself and have a positive attitude. As you probably know by now, nervous children tend to have a lot of questions in situations like this. Be there to answer questions in kid-friendly terms. If your child asks if they will have to have a shot, your response could use non-scary words such as, “you might feel a little poke.” One of the most important things is that you don’t get frustrated with their questions and concerns. Simply be there for your child’s moral support.
Each child is different, so you will just have to know and read your child as the events unfold. Gavin was content for me to sit close by his side while they were laying him back in the chair and putting on his mask. He did, however, want me to hold both of his hands. The best thing that I could do for him at this point was to show that I was calm and right at his side if he needed anything. Bluey playing on the tv mounted in the ceiling occupied his attention from then on.
Your child will likely be different, but the best thing that the Ultimate Dad can do is know and understand how his child will react to stressful situations. Because you are the Ultimate Dad, you will have previously spent hours and hours of quality time with your child in all situations, thereby knowing your child’s needs and which mental and emotional buttons to push garner the reactions needed in these situations to help him or her cope with the stress in this situation. Help relieve anxiety by creating conversation about his or her favorite topics. Give a few options for him or her to pick from as a treat for doing well during the procedure. Whatever works for your child. Just be calm, cool, and collected and your child will recognize this and both of you will do great.