Help me decide what to do.....

My 5 1/2 year old has her first cavity. She is petrified of getting a filling. I've taken her to her usual dentist 3 times and a pediatric dentist and the appointments end the same way. She shuts down and refuses to open her mouth. She has progressively tried new things at each appointment. Opened mouth for a bit, allowed dentist to use hand tools to check, allowed a clean of top teeth only and today they got to the stage of putting the cotton bud in. She freaked cause it tasted bad and she didn't like the splash of water that went down her throat when he used the water pipe thingy. She clamped up and wouldn't go any further.

My dilemma is.. Pediatric dentist wants to put her under general to fill and metallic cap/ crown that tooth. Plus some fissure seals and clean and X-rays. All of which will cost almost $3000 and a bucket load of anxiety for me!

Our usual dentist said it doesn't look like it will require a crown and he's happy to do the filling in the chair. However as she is being difficult due to fear he is happy to try again in 6 months when she's older and developmentally more able to deal with it.

Paediatric dentist said it needs to be done by December!!

What on earth do I do?

Can I ask why she's scared of the dentist? Can you deal with the fear now she's old enough to start to talk about why she feels a certain way? Is it a power/defiance thing or is it that she is genuinely scared and can't cope?

Hmm.. I think it's a bit of both. She is scared of the unfamiliar and also has a strong will and it's almost impossible to reason with her. She has no reason to be scared... She's been having 6 month checks for about 2 years, no mention of needles or pain or anything. We talk about making the tooth healthy again and dentist is there to clean away the gems etc. She has seen her older sister get scared and upset about her own need for treatment over the last year or so but her sister now tells her it's no big deal.

She's mentioned being scared of the tool they use to do a clean and the cotton ball the water (feeling and tasting yuck). The sound of them I think are off putting too. It's very hard for her to fully verbal use her reluctance. She admits she doesn't want the germs there but also doesn't want to do the dentist or hospital option. I'm scared if I take the easy option ( leave it for 6 months) that a) it will worsen and cause pain or infection or bigger bills/ procedures and b) she still won't go through with it in the chair!

Sounds mean, but I always win the "power" battles about health and education. I can't afford to lose one, ever. Neither can my son (now 7.5). So I'd be treating it now and telling her not to be ridiculous about "I don't like the taste of cotton" etc - for crying out loud, she's not eating it, it's a tool to keep her healthy.

A genuine fear or concern, we can work with that. But not when it includes defiance. However, as this is both, I may be asking the normal dentist to see her again in a month and reassess, JIC it does need doing before the end of the year. Then you'll know if you have to fight the battle or not. If she flat-out refuses, then I'd go with it being done earlier as the dentist can't assess her if she's acting up.

I will add, my aim is not to stamp out defiance or boundary testing. Just to let my son know that some things (education and health), the boundaries are close and tight, other things (bedtimes on non-school nights, what we're making for dinner BEFORE we cook it for example) can be negotiated.

Thanks. Believe me, I've have tried being tough and forcing it and it makes the situation worse. There's not much I can do when she closes her mouth shut tight, turns her head from anyone speaking to her and clings onto me!! The dentists seem to give up before I do!!

How can two dentists have such differing opinions on the severity of the need and type of procedure?

What about a dental dam?

What's that Divvy?

Edit* I googled it. Not sure if that would work. It's not an option I've been given.

I've also not been given the option of happy gas. I asked the specialist dentist who didn't want to try it cause she thought she'd be scared of the nasal mask thingy.

It's a great idea div but can be just as daunting, the size alone etc..
We went through the same with my DD at 5, we had to do a GA, luckily I had insurance so didn't cost much, though I feel your pain and anxiety, I wouldn't leave it 6 months, you could face a dying tooth at that point, nerves in kids teeth are very close to surface so decay doesn't need to be deep to kill the nerve. A SS crown sounds extreme unless it's extensive though some just do them, I requested only if absolutely necessary (didn't need them).

I truly feel the crown is over the top especially as normal dentist says it's not needed. He reckons it's a big deal to have a GA for one tooth that's why he said to wait. He also said to come back if it starts to hurt and worse case scenario is it will need to be pulled. My gut instinct tells me not to wait til it comes to that but also that the specialist might be doing a bit of a money grab!

Man, it's difficult!

Could you get a second opinion from another paediatric dentist? It sounds like she has seen her sister get upset and now has the anxiety of the unknown, even though she's been told otherwise, the feelings are hard to contain. It's hard but id be erring on the side of getting it done sooner rather than later as well, as its related to health. I know for me, I would feel guilty if I didn't do it an it got worse. Having said that, six months isn't long. I would be concerned that it just prolongs the inevitable and results in her learning that it's okay to put things off if you are scared. I would probably lean towards her learning that finding an alternative is important to help you manage the anxiety, rather than avoiding it or putting it off.

I reckon a second opinion, well... Third opinion in this case, might be the way to go.

Being a parent is hard work, isn't it?!?!

Yeah I guess I could get a third opinion. I'll have a think about my options. Seriously, kids get fillings every day. Why do my kids have this problem! :-( Yes, parenting sux at times!!

What surface is the cavity? On your treatment plan what does it have, DO, O, MO ??
Can you speak with your GP or dentist about something they can prescribe to relax her.
My DD had a few teeth filled plus fissure seals done whilst under GA so it was worth it, pulling a tooth creates other issues, you'll need to get a spacer due to the teeth either side moving.
My DD hates the suction lol but she's much better now.

It says, adhesive restoration 2 surf- post. Tooth 74. What options are there to relax her? I wouldn't know what to ask for. I'd assume the dentist(s) would have offered if there was something but I hadn't thought of GP.

Ok so it a DO or MO (between teeth and and top), it's not a quick as just the occlusal (top surface)
Speak with dentist and ask if they can prescribe something, they may not. It's tough darl isn't it :(

My dd(6) was similar. Got anxious and upset because she hated the numbing sensation and cardboard in her mouth (to keep the tooth dry) during her filling. We had to push to get it finished (dentist couldn't stop half way/ leave hole unfilled) Unfortunately, her distress meant dentist struggled to get a good dry surface for filling to stick to and it came out weeks later. More trauma for her (and me) having it redone despite best efforts to reassure her things wouldn't hurt etc and persuade her to open her mouth. Long story short more decay got in during this process and she got an abcess and had to have tooth removed under a GA and a 'space saver' put in to leave room for the adult tooth which won't come in for a while yet. I wouldn't wait 6mths- kids' teeth have less enamel than ours and decay moves faster. If your dd can't tolerate a filling in the chair you might need to do the general anesthetic. If not affordable is there a public dental hospital that would do it (without long wait)?

Thank you possum magic. My gut told me not to wait. I'm booking her in. Still nervous but I think it needs to be done sooner rather than later.