The worst first appointment at the dentist for a 4-year old

by Marilia Di Cesare on March 21, 2012

My story about my 4-year old brushing her teeth is bad. I couldn´t get her to brush or let me do it on a regular basis until recently. Given our mainstream diet, DNA and putting her to sleep after breastfeeding for 3 years without brushing teeth – key factors to getting cavities, the result is that she has now dealt with 6 cavities.

As one tooth started to hurt her, I took her to the dentist. She wasn´t keen on the idea, I can only imagine it was media, that made her afraid of the dentist.

There was one Pingu episode that came to my mind (it´s a penguin shivering at the thought of going to the dentist, even though later it all goes well). She saw it far too many times when she was 2-years old. I remember back then how it made me uncomfortable that she was watching it. But back then, when I bought the whole series for her, I needed the electronic babysitter for what I considered ¨just¨ one hour a day.

So I showed her this video (of a 4-year old kid relaxed through a cleaning) and it made her really excited about going. She said it looked like tickling and she wanted to do it.

The local dentist in our town asked me to take Luísa to a specialist – a dentist that works with children – in the city 2 hours away from our town (by bus) and so I did.

I called the specialist and made an appointment. I asked if she could convince 4-year olds to comply to being examined and she said yes.

¨Can you do it with many kids?¨

¨All of them¨.

¨Without force?¨

¨Yes, but you have to cooperate too, if I ask you to wait outside, you do it¨

¨Do you have a TV?¨

¨Yes.¨

I thought that the waiting outside was a bit odd, since I never left Luísa alone with a stranger before, but I wanted to believe it would be all fine.

We went there and the specialist started by bribing Luísa:

¨Luísa, come to watch a movie¨. She had asked me on the phone witch movie Luísa liked. Luísa was happy when she saw Madagascar on the lap top screen. Then Luísa sat on the chair and the specialist said: ¨I´ll give you two gifts if you do as I tell you¨. Luísa agreed.

I wasn´t comfortable with this method at all, but I thought it was ok to bribe her this once. I do it to cut her hair, which happens with a chocolate promise.

The specialist started well, she showed Luísa all the instruments. And she examined Luísa to find 6 cavities. One big one that hurt and 5 tiny.

The specialist told me: ¨Let´s just do the cleaning today¨.

I agreed.

But then, we made a bad decision (our worst decision came at the second appointment), we decided to treat the big cavity, since Luísa was doing so well, even smiling.

So the dentist asked her to close her eyes and then she gave her an injection with the anesthesia. Luísa got scared right away with the pain, but was still cooperating. The specialist gave her another injection that hurt and started working on the tooth. It hurt a lot. Luísa at this point didn´t want to go on, she was crying and scared and wanted to hold me.

I was hating it too. All that was told to Luísa was a painless cleaning and now we were doing the painful work without any warning, just on the assumption that the quickest we did it, the better.

Now the specialist gave Luísa one of the gifts and kept on working.

Things got bad because the anesthesia didn´t work right away. I think she got about 4-5 shots.

Luísa was horrified, didn´t want to be there, wanted to hold me as the specialist started to speak rough to her. The specialist warned me: ¨I´m sorry, I´m going to have to be hard on her¨ and then: ¨We learn this at the university¨ (she meant the coercion practice).

The specialist went on talking about the other gift. Luísa wasn´t having any of it. Luísa said she didn´t want any gift, she just wanted to never see her again.

The specialist asked me to leave the room so she could work. At that point, I knew my presence was making it harder for Luísa to bear everything, but at the thought of me leaving the room, Luísa got REALY scared.

We were in a hurry to make things happen. We had to persuade her, or more accurately intimidate her.

We tried again and nothing. The doctor once again asked me to ¨cooperate¨ by leaving the room and so I did. We went for the full on intimidation tool: taking a child´s mom away.

I felt so crushed. I NEVER left Luísa with a stranger before, (leaving her with someone we recently met for an hour playing at the beach for me to surf is another story). But at that point, I couldn´t do anything else, we had to have that tooth covered.

Once I was out of the room, it only took like 20 seconds for Luísa to ¨cooperate¨ (read: obey).

At the end, she offered Luísa the second gift and Luísa didn´t want it. I took it myself. She asked Luísa what she would like her to bring as a gift next time and Luísa got more pissed off at the idea of receiving any gifts and of being reminded that she would have to be back there.

The second dentist appointment (can things get worse then this?)

The night before our second appointment to the dentist, Luísa complained of pain in that tooth that was half treated.

Bad sign.

It meant the cavity wasn´t completely taken care of. And we wouldn´t just cover it like it was planned, I knew we would have to open it once again.

I told her right away the truth, that it meant the cavity wasn´t all treated and surely she would have to take an anesthesia to get it open again. I told her I´d be there and she could squeeze my hand and let us know when it hurt, but that she would have to do it.

I won´t bribe her for doctor´s appointments

Luísa had been asking for some dancing shoes too. I told her we could buy them when we went to the dentist at the city. I thought about getting the shoes after the appointment and use it to make her comply, but I don´t want to bribe my daughter to do what she has to do, she is smart enough to see the manipulation going on, so I told her:

¨The shoes have nothing to do with the dentist. They are a gift I want to give you. We will buy them first and then we go and do what we have to do at the dentist.¨

When we arrived at the specialist, I liked her more. She was more businesslike. She wasn´t offering a movie or toys, she was just being a plain dentist.

The only wise thing we did was to start off with one of the small cavities that didn´t hurt at all, so Luísa would see that the little ones were easy to take care of.

Then, the specialist went on to work on the big cavity again. Luísa got some shots, started to cry a bit but was taking it all, even though scared after she spat some blood.

But, now I know, working on the big cavity again knowing that it hurt was a bad decision because it was infected. We should have used antibiotics first and treated her later.

This meant that the anesthetic wasn´t doing much effect, Luísa kept feeling the pain when the drill would touch the bottom of the tooth.

Luísa was so scared that at one point she was trembling. She would scream even when the specialist was touching another tooth.

The specialist seemed more humane this time, though. She would say stuff like ¨I know that this hurts¨. She finally said that it was too much for Luísa to bare and she would use the white thing again to cover it up.

There it came the painful thing again. This time, the specialist accessed more Luísa´s feelings, she at least said:

¨I know this hurts a lot. I´m sorry¨.

The specialist knew that we wouldn´t finish the job that day. She prescribed an antibiothic and antiinflamatory.

Later that day, it started to swell and hurt. The next morning, half of Luísa´s face was swollen and it still hurt.

The following morning, it was even more swollen, Luísa´s eye was almost closed, like if stung by a bee.

I was scared of the swollen face, in fact, when I looked at Luísa, I got up and went to cry outside, before she woke up. I even called my sister in Brazil to vent.

I was not happy about Luísa taking antibiotics (this was her first time in her life), but now I just wanted stronger drugs for my girl.

The specialist prescribed a stronger antibiotic, antiinflamatory and corticoid to be taken in 3 shots. It was another little torture session for Luísa, but after that, in two days she was fine.

The specialist decided that we had pull out that tooth on our next appointment.

I told Luísa that right away. We operate on total honesty here.

She mentioned the ¨Raton Perez¨, which is the local tale about kids leaving their teeth under the pillow for the rat to switch it for a coin.

Third time is a charm

To finish the traumatic experience (she will probably fear dentists for ever), we went for the extraction.

This time, when she sat on the chair, she was very much scared and tears were rolling down. She wouldn´t let the specialist touch her so much and she would try to hug and cling on to me.

The specialist told me to leave the room.

Once more, I was crushed at the waiting room, hearing Luísa complain, but definitely, I heard the silence too and could tell that she was letting the dentist do what was needed.

It was quite fast without me being at her side. And this time it was painless (except for 2 anesthetic shots).

Luísa was not happy about it. She kept saying later:

¨I´m not the same anymore, I want to be like before.¨ and ¨Why did she had to pull my tooth out¿¨

Now I lied too

I hate lying. I almost cannot do it. But this time, Luísa told me the story of the Perez rat leaving a coin under the pillow for the tooth, so I went on with it.

I considered spoiling the fun and not playing the rat, because I couldn´t picture her in the future coming home one day, angry because I´ve been lying all these years about the Perez rat.

I really don´t understand why parents come up with the Santa Claus farce, and the rat is just the same shit.

But I prepared myself for that day already. I´ll explain to her that in that moment, the fantasy really served well to alleviate her pain and worries because she was too little to go through so much.

At night, I was the rat, and the next morning, Luísa was thrilled to find a coin.

The fourth visit went smoothly with the specialist taking care of the last 3 small cavities without anesthesia. I could stay by Luísa´s side this time, since she was threatened from the beginning about ¨behaving well, or mama would have to wait outside¨. She decided to ¨behave¨.

We ¨only¨ have to go twice again. One time to put a space maintainer and another to check if it´s alright.

For the parents out there who think pulling out a milk tooth is no big deal, know that it´s not like that. Without the milk tooth in place, the permanent tooth might come down in a wrong position, thus making the child´s teeth bad aligned and probably needing to use braces later on.

And if you read this far (thank you), let me give you two pieces of advice if you haven´t taken your child to the dentist yet:

1. Take your child to do a cleaning way before you can suspect of cavities, so she will have a fun first experience. If she is scared of doing that, try showing you tube videos with small children doing it.

2. If your child needs the dentist and has a dad, let him take her. If not, try another close caregiver that is not the mom. It was clear that my presence was not helping at all. Children can sense the mother´s feelings (and possibly the thoughts too), and I was just as scared or even more scared than Luísa.

Now, just out curiosity, if you see private dentist, could you share here how much you spend on it in dollars? This is a hell of a privileged thing.

In Puerto Viejo de Talamanca – Costa Rica, the dentist charges US$40 per cavity and US$40 per cleaning.

In Limón – Costa Rica, the dentists we saw, charges US$50 per cavity and US$30 per cleaning.

**UPDATE** I forgot to publish right away a link worth looking with this story. Here it goes: How I healed my child´s cavity

Photo Credit



{ 19 comments… read them below or add one }

Catherine Forest March 21, 2012 at 7:11 pm

Oh, Marilia, what a tough experience for Luisa and you! I am glad to here all is well now… In Canada (Quebec), the clean-up is $70 (but covered by the government for children) and a cavity is about $130.

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Liz Botts March 22, 2012 at 8:19 pm

Ugh…dentists.

We didn’t take our oldest until he was five (just recently actually) and he had five cavities so we were referred to a pediatric dentist. While I had lukewarm feelings about the regular dentist we were lucky to find the best pediatric dentist ever. The people who work there know how to make kids feel happy. And the dentist himself is just so good with kids.

My son had no problems thankfully. And we took our three year old too. I agree with your advice about taking kids early.

We have dental insurance (I live in the US) but we still have to pay a ton. Just this last time we paid US$61 just for the anesthesia. We still owe US$120 for part of the cavities.

You are a good mom and I love following your journey.

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Tanya Brown March 26, 2012 at 10:44 am

Its expensive, but no doubt the best thing to start young and be persistent about cleanings. My mother brought me young, and was diligent about regular cleanings and because of that I do not fear the dentist, and have had ONLY 2 cavities in my life!!! Now for Malu the same thing, I brought her for her first cleaning at exactly 3, and she was so very happy to be there and loved it, we will continue to go to regular cleanings. Its soo important. We do pay quite a bit, but thankfully Max has great insurance so it covers it all. I think its 85.00 for the cleaning and maybe 175.00 for the cavity (?) not too sure on that, just guessing, but I know its pricey! Sucks you had to go through that with Luisa, what a bad introduction to the dentist :(

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Stacey March 26, 2012 at 12:07 pm

Cleanings are a lot more expensive where I’m from (US) and cavities too. In Bulgaria where we live, though, its social health /dental (unless you prefer private care, and its still not as expensive as in the States – but I’d blindly assume its similar to the costs you’re paying now, because most of the expenses I’ve researched in Costa Rica have been pretty similar to here).
Hey! I do have good news though, you can knock one of those reasons for cavities right off your list, because breastfeeding before sleep had nothing to do with it.
Here’s an article : http://mothering.com/health/big-bad-cavities-breastfeeding-is-not-the-cause

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Marilia March 27, 2012 at 11:39 am

Stacey, thank you for the link, but I still think that breastfeeding might have something to do with it. It´s the fact that she would go to sleep with some milk in her mouth.

As the article you give cites La Leche Legue there are ¨ different mechanisms of nursing at the breast [with the nipple at the back of the mouth, not allowing for breastmilk to pool around the teeth]¨ and I never used any technique to make sure the milk wouldn´t pool around the teeth.

I also remember a mother who would put her baby to sleep after breastfeeding and she would brush her baby´s teeth while she slept. That can probably solve the issue of keeping milk in the mouth too.

I keep advocating extended breastfeeding for sure, but there are more precautions to think about than I thought of, like learning the adequate way to do it at night.

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Ashlee March 26, 2012 at 4:50 pm

It is pretty expensive to go to a pediatric dentist here in the US. It is about $200 for the cleaning, x-rays and exam. Thankfully my son doesn’t have any cavities, but I know those can cost about $100 or more each. I have taken my son since his first tooth came in when he was 4 months old. He loves the dentist and he wants to go there all the time, but only because they bribe him with toys, which I don’t like, but better than being afraid I guess. I am so scared of the dentist myself because I was actually tied down to the chair when I was 8 years old after breaking my teeth.

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Heather in WA State April 3, 2012 at 10:10 am

Oh, I’m so sorry for Luisa! My daughter went through a similar torture with a root canal, after she fell on her face on hard cement while running, dislodging her permanent front tooth. I’ve made many mistakes as a mom, but this one, the root canal without any sedation (the doctor accidentally turned it off), was my biggest fail ever. I really didn’t advocate well for her, and I regret it still.

If you want a horror story, here it is:

http://kandas-adventures.typepad.com/kandas_adventures/2011/01/root-canal-warning-graphic-details.html

And we paid over $1,000. for this. The insurance company didn’t want to pay their portion because it happened on school property, and they thought the school should pay. I didn’t feel it was ethical to sue to school (even though a lot of parents encouraged me too, failing to see that doing so would take educational dollars away from their own kids). A kid can trip and fall anywhere. It wasn’t the school’s fault, there wasn’t anything that they were negligent about that caused it. She collied with another kid playing tag outside. Because most American parents would and do file lawsuits over the smallest things, perhaps that is why healthcare is so outrageously expensive here in the US. Too many lawyers and insurance adjusters involved!

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Marilia April 5, 2012 at 10:34 am

Oh Heather, I read the story, it´s too bad we have to go through these things with our little ones, and feel bad for not having prevented the worse.

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Eugeniya Hilzinger (Health Essentials LLC.) April 2, 2013 at 11:50 pm

Moms, being a mother or a parent, is the hardest job in the world! Please do not blame yourselves for mistakes you’ve made. They are painful memories, and most likely, no parent is perfect.
The main thing to remember is that you did not mean to hurt your children. Forgive yourselves – no-one loves your children more than you. And I am sure your children don’t blame you.
Maybe we should all ask our children to forgive us and cry it all out. Being responsible for little ones, and then, even harder, for teenagers, is not easy!

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nina April 24, 2012 at 9:17 pm

Hi. I just recently took my son to the dentist for the first time’s . He had tw two adult teeth coming in behind his baby teeth and I was afraid it would mess up his mouth. I should have taken him sooner but, well, I didn’t. He had two cavitties. I deliberately picked a pediatric dentist…they know how to bribe the kids! Which doesn’t bother me if my son is less stressed because since having lots of health issues since birth he’s been to lots of doctors. He cried the minute we walked in the dentist’s door! Laying down stresses him out, etc. So the first visit we just checked out the teeth and took xrays which is way easy here. They watch a movie in a screen above their head. They get a balloon. They get a new toothbrush and toothpaste AND the dentist gives them a gold coin they put in a machine for a prize. Ande the lobby has tons of tvs w video games. Heck if it gets so my son’s mind off his worry and even better excited for the dentist I am all for it.

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nina April 24, 2012 at 9:26 pm

So we had to schedule the fillings a month out. We had also scheduled extractions but thankfully the baby teeth fell out on their own. They did the cleaning at the same time. The dentist suggested an awake sedation since my boy is so nervous. Said it would erase his short term memory of the day. It did NOT! And he could not stop puking from the sedative and almost had to get an iv. Did it help him relax? Yes. So id probably do it qgain if he gets as stressed as he does w doctors and dentists. Now id just know to get the antinaseaua suppository before the procedure rather then picking it up on the way home w him dry heaving in the back. And id know its at least 5 hours at the dentist. An hr before, 20 min for the procedures and 4 hours after. My son is 4.5. He nursed till age 4 so its not just that but genetic and such too. Hope next time goes better! Each extraction would be 100USD and each filling was 89USD and the sedation QapPUSD. At some age depending on the tooth they don’t need a filler because the other will come in soon enough. He did get his adult teeth early but also got his baby teeth early. In the us they rec taking kids to the dentist when the first teeth start coming in or by age 2

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Marilia April 25, 2012 at 9:27 am

I wish we had the TV in the seilling here too. And here in Costa Rica and in Brazil, I didn´t hear of sedating kids at the dentist. I´d go for it, I guess. Thanks for your comments Nina.

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Eugeniya Hilzinger (Health Essentials LLC.) April 2, 2013 at 11:44 pm

The easiest thing to do is to use high quality therapeutic grade essential oils – I would see though which one works best for your son. For example, Valerian therapeutic grade essential oil might put him to sleep within minutes. Other oils will just calm him down. Clove will numb.
My husband had a really bad experience after anesthesia. I would be very careful.

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Jamie April 27, 2012 at 5:16 pm

So sorry to read about your daughter’s experience. My daughter turns 3 in 2 months and is still breastfeeding to sleep and I too worry about her getting cavities. We’ve been to the dentist twice so far and so far so good. Where I live in southern california, a pediatric dentist cleaning is 150.00 (this price is without insurance) and they want us to go every 6 months. At first I thought that was crazy, but now after reading your post I think I’ll continue on this schedule so we can nip any cavities in the bud. It is expensive but hopefully will eliminate the fear of dentists in the future.

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Eugeniya Hilzinger (Health Essentials LLC.) April 2, 2013 at 11:39 pm

I breastfed my son for 3 years too – he has no cavities, and he is 15 now.

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Gillian January 23, 2013 at 5:05 am

I cam across this story whilst searching about children with cavities. I don’t like the dentist but I know that my four year old teeth are not the best. I waned to fix them. Is has horrified me! I liked the story about fixing the cavities from the other website but I am glad you shared your experience. I hope your daughter isn’t scarred for life.

In the uk the dentist is free for under 16s regardless of what needs doing. But we have recently moved to Australia and the dentist visits the school here and primary aged children get dental for free through school.

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Eugeniya Hilzinger (Health Essentials LLC.) April 2, 2013 at 11:37 pm

I am sorry, I could not finish reading this – I don’t even know how you got through all this.

When I was a child, my mom took me to a dentist who started cutting my gum without any anesthesia!

If you don’t mind, I would like to share my knowledge and experience with you about holistic method.

I already saved 2 of my teeth – and I did not use antibiotics. I don’t know if your daughter would have done what I did, but at least, maybe going forward, you could use some information on my site and blog for your teeth.

Here is the post about my last tooth I saved:
http://eugeniyamusic.blogspot.com/2013/02/i-did-it-again-tying-it-all-together.html

By the way, I only use holistic dentists.
Not all the dentists are good at giving shots. When my dentist gives me a shot, I don’t even feel the needle.
If you use clove to numb the tooth before you do anything, you will not feel pain that much.
Good luck!

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Eugeniya Hilzinger (Health Essentials LLC.) April 3, 2013 at 12:45 am

Another advice for prevention – brush or rinse teeth every time after you eat. Your children might like using Hydrofloss.

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Ladan Zinati November 24, 2013 at 11:54 pm

Hi Marilia, as a mother like you I can imagine the scary feelings you experienced with your little one at the dentist, treating 6 cavities. It is really a horrible experience especially on your 2nd and third appointment for your child but I am glad it finally settled on your last visit. It will take time for your little girl to overcome that fear of the dentist experience and she will need another tricky strategy to encourage her in this situation as you did before seeing the dentist. She will overcome this after having a couple of more better experiences. It really helps by talking to her and making her feel comfortable.

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