The Silver Baby Tooth
A root canal for a three-year-old? Who knew! Nine months and one silver tooth later, we're happy to have solved the baby tooth mystery.
In the far left corner of my daughter Nella’s brilliant smile is a silver tooth—a shiny little nugget that only appears when she tips her head at the right angle with her widest smile. I’d like to say that little tooth only cost us $10.95—eBay’s going rate for a silver cap (yes, I checked)—but unfortunately we paid upward, the most significant hit—a nice dose of parental guilt. When you take your three-year-old to the dentist and are told she needs a root canal, you feel the clarity of what you’ve suspected many times before: We. Are. Horrible. Parents.
The crazy thing is, I thought I was ahead of the game with Nella’s teeth. When I did her post-birth crash course Down syndrome research, I learned about some dental issues that were common with Down syndrome and immediately made an appointment for her to see the dentist. She was eight months old and had only just sprouted two teeth half the size of a sunflower seed, but I was on top of it. And maybe, like the hare who thought he had a leg up on that tortoise, I slowed down—took a couple years off from the dentist. Because, I mean—who takes their 8-month-old to the dentist? It turns out the American Academy of Pediatric Dentistry recommends getting your baby to the dentist by one year of age, so I guess, what do I know about teeth?
I do know that we treasure our babies’ smiles, and instead of focusing on the guilt of “our three-year-old had a root canal”—or, I’m sorry, a baby root canal as it’s called— I like to acknowledge the fact that we used some good parent problem-solving skills to address what we assumed was pain our daughter was experiencing last summer. I’m so glad we figured it out. It also turns out Nella’s tooth issue had nothing to do with lack of dental care but rather a fluke anomaly—a tooth with pitted enamel since birth.
The hard thing about the littlest dental patients and, in our case, a child with special needs and communication delays is the fact that these children most likely aren’t able to indicate tooth pain. In Nella’s case, we noticed she was crying a lot more, especially when she ate—a sign we mistakenly first attributed to a quirky food phase. “It is always very difficult to know if a nonverbal patient has pain/discomfort,” says Dr. Nikki Kabra at Kid Island Dental. “Difficulty chewing or sensitivity to hot/cold food are tell-tale signs. Also, a patient may only put food in one side of her mouth. Constantly hitting one side of her face may be a sign.”
Our process of elimination skills eventually led us to a great pediatric dentist, and three weeks later the silver tooth was born. The bonus of our experience? Obviously, the greatest reward is that our child received the care she needed and was notably more comfortable and back to her old self after her procedure. But we were also able to find a great pediatric dentist familiar with special needs care—something we needed to establish—and were able to consider the best treatment routes for Nella for the future.
Dr. Kabra adds, “With parent/caregiver’s assistance, most dental care can be facilitated in the office. Protective stabilization may be used if more traditional behavior management techniques aren’t successful. Nitrous oxide sedation may be an option. When all of the above options are not possible, sedation or general anesthesia is the behavioral guidance armamentarium of choice.”
Given the nature of Nella’s procedure, our aim to keep the dentist “a happy place” and our dentist and pediatrician’s recommendations, we decided that the safest, smoothest course was to undergo in-office anesthesia for Nella’s root canal. The procedure was quick and smooth and was combined with x-rays and a cleaning to give us another head start (No hares here! Keeping our head start!).
Obviously, preventative care is the most important tool parents can teach their children dental health, and there are three tiny toothbrushes lined up on our bathroom counter to attest to that. But it took a silver tooth to teach us that sometimes even three-year-olds need a little more. That doesn’t make us horrible parents. It makes a unique smile on a happy kid with healthy teeth. Watch out, Flavor Flav. There’s a new metallic smile up in here.
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