Hello Dr. Katz, I have a now 9 year old son with some bad caries. On 8/6/09, he was taken to dentist for exam by his mother and it says hc-gen-h. plaque, polished, tb on fl.tx, Dr. showed mom areas to watch. On 10/7/10, They left message for check up time. Mother did not take him in. On 4/25/11, He was seen and he had large areas of decay on a mes., 6 dist, i dist, j mes, k dist, l dist, 8 dist, and t dist. Because of the large amount and areas of decay, they immediately sent him to a speciali
Welcome .I will do my best to answer your question.I am not a great typist,be patient and feel free to ask if anything is unclear.The only reason that they sent him to a specialist is because they were either inexperienced dealing with children or they thought that your son might not be cooperative .Most of these teeth are baby teeth,only two of them are permanent ones.I cannot imagine that these areas of decay are that large,number 6 has not even fully erupted yet.We see cases like this daily.One of the most common causes of this type of decay is Coca Cola.Any cola drinks and Dr Pepper,all have phosphoric acid in them.Phosphoric acid is deadly especially to childrens teeth.It does not matter if it is diet or caffeine free.All cola drinks should be avoided by children.As far as decay goes and his treatment,we normally do cases like this in about an hour.Some chose to do it under IV sedation if they are nervous.It is nothing to worry about but the decay should be repaired.Make sure he is using a fluoride toothpaste and if you do not have fluoridated water,have your dentist prescribe a fluoride supplement.If you have any other questions please ask.If I do not respond right away,I am on my way to work.
Thank you for your reply. Instead of 6, I ment A and instead of 8, I meant S. It cut me off before I was done with my rather long question. (I will leave you a good tip.) But the rest of it is: Because of the large amount and areas of decay, they immediately sent him to a specialist where they did a pulpotomy and stainles steel crown on teeth b, i, j, and s, a stainless steel crown on teeth A and k. And an extraction, band loop applia on tooth L. That was done on 5/23/11 and 7/1/11. Prior to this, he had sinusitis show up on a ct scan on 2/22/09 which was never treated and was sick with strep pharyngitis on 3/2/09, 5/8/09, and 10/11/09, Otitis media on 12/16/09, Pharyngitis, headache, leukocytosis on june 24 & 25, 2010, and 9/7/10, evaluated and diagnosed with adhd on Sept., 2010, Had bad hearing test results on 10/1/10, Abdominal pain with acute gastroenteritis on 10/12/10, Throwing up on 10/19&20/10, Pharyngitis, fever, leukocytosis, headache on 10/28&29/10, Rash, leucocytosis, and hyaline casts in urine on 1/19&20/11, Sick again on 2/24/11, 5'ths disease on 5/17/11. In addition, he was sick again on 11/9&10/11, and 12/13/11 but not taken to doctor. He also has had horrible rotten breath through all that untill this day. And the roof of his mouth is white. I feel that he may have had meningitis several times out of those but was not diagnosed or tested for it and if he did, it would have been "partially" treated with anti-biotics. I also feel that the un-treated sinusitis and/or meningitis may have been the cause for possibly the bacteria spreading to his teeth and rotting them out so suddenly. He has no family history of such tooth decay on either side and has always had good dental hygiene. What do you think? And shouldn't someone have noticed before the decay was so bad? I know his mother was trying to put it off as long as possible but shouldn't his doctors or dentists pinpointed a cause for this sudden decay? Ordered testing? Something? There is no mention of any "cause" in any of the records. He presently has numerous neurological problems too many to mention unless you want to know. I thank you for your time.
There can be many factors causing this decay in light of the additional information that you have given.This is not a "normal healthy child.He obviously has multiple medical issues and many times these are genetic.This child has most likely been on multiple medications for a long time.The medications that they give these children frequently cause a dry mouth which would not only be responsible for the decay,but for the bad breath also.The film in his mouth is most likely caused by multiple doses of antibiotics which wipe out the mouth's natural flora causing a yeast infection called Candida.I do not know what his diagnosis is but I am sure that some of the medications that he is taking..in addition to the fact that he is probably mouth breathing at night,is contributing to his rampant decay.Does any of this make any sense to you?
Yes, it makes sense. I forgot to add that mother did not mention ANY of his illnesses to the dentist. I guess that I am concerned about how fast it happened and shouldn't someone have done something sooner? Head trauma is what caused all this. Every bit of it caused by repeated head trauma over and over again since he was just a few months old. Skull fractures, swollen head, ribs, seizures, etc., etc,. But every single person involved runs from child abuse and wants nothing to do with it, therefore he has not been properly diagnosed ever in my opinion. I am going to talk to his dentist today and I want to ask some legitimate questions like: Isn't it odd that mother was shown areas to watch but skips a checkup and doesn't bring him in until 8 teeth are nearly rotted out? If he was sent to a specialist due to "the amount and large areas of decay", wouldn't the specialist want to find what was causing it? If you would have known about all his illnesses and un-treated sinusitis on ct scan, would it have made a difference? Shouldn't a thorough history and possible genetic cause have been explored? Don't you think this is dental neglect?
Are these questions legit, do you think Dr. Katz? And do you think that the decay is possible to be caused by bacteria spreading to the roots of the teeth or not? Thanks again and I will accept after you reply. Much appreciated.
If the child was abused,it would be reasonable to accept that dental neglect was surely occurring on the part of the gaurdian.The dentist should have been asking some questions as to why the child was not brought in for treatment sooner.I do not know the whole history here but the child certainly has been through his share of trauma,and a medical specialist should certainly be involved with this case due to the strong possibility that there was some brain damage caused by the head trauma.The decay does not spread from the roots down..it will come through the actual tooth itself.The roots are protected in the bone and decay does not enter the tooth in that fashion.I do think that any questions that you ask would be legitimate concerning how to get this child back on track.
Dentist and Anesthesiologist for 33 years