Dentist uses Nitrous Oxide?

While I can't advise anything specifically over the internet, the more I
hear of the story, the more I would lean towards sedation.

Best wishes,
Fawks


He rarely eats candy, and doesn't drink soda or take a bottle, to bed or
otherwise.

This child showing up with 5 cavities all at once (about a year after his
critical episode, just when he was turning 4) seems to me to be related to
something other than parental neglect.

I might just be fooling myself, though. The dentist certainly didn't
believe me.

Wendy

Yep, that's a whole different issue. Are these five cavities inbetween
the teeth or on the biting surface? No matter what, a serious illness a
year ago certainly wouldn't help things. It also might have a little to
do with the childs behavior.

Blame at this point is indeed silly. Getting the restorations completed
is the first goal and then you can take actions to make sure that this
isn't a recurrent problem.

Fawks


Some teeth rot due to Design Defects by the Master Designer .......

*
CRACK!!!! (Lightning!!)

ME: "Oh sorry, I did not mean to be disrespectful!"

Joel

I agree fully with the "time-bomb" analogy. I hate it when parents come in
demanding we do all 3-4 filing on a young child at one visit so that the
parent will not be too inconvenienced.

--
=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+
Stephen Mancuso, D.D.S.

~`~`~`~`~`~`~`~`~`~`~`~`~`~`~`~`


"Steven Fawks" wrote in message
...
BTW, working with kids is tough. One minute everything seems perfectly
normal and they are cooperative. The next minute they may be squirming
and whimpering. It's almost like working with a time bomb ticking down
and you can't even see the clock (but you know it's still ticking).
Distractions, gentleness, and speed come in handy (and often nitrous).

Karen wrote to someone regarding the qualities of Nitrous Oxide:

Sorry but I think your child may be spoiled and knows how
to get your attention and avoid situations he doesn't
enjoy. While he may have been anxious, you could have
helped more than you did. Nitrous didn't have anything
to do with this incident.

-Karen

Karen hasn't a clue what she is talking about, neither did the dentist.
I've been an anesthetist for forty years, and Nitrous can indeed make
people cry, laugh, or even violent. I suggest she learn about what she
is talking about before giving such incorrect advise.

Will, CRNA

Wendy Marsden writes:

Why? What is a step in the right direction?

It's strong stuff to give a young child. Indeed, I even have my doubts
about nitrous oxide. You need the ability to provide positive
respiratory support and other resuscitation beyond a certain point, and
most dentist's aren't equipped for that. Anesthesia in children is more
delicate than in adults.

What do you suggest?

Find a pediatric dentist that can deal with the child. If none can be
found, and the dental problems require attention, the child may have to
be fully sedated (asleep), which requires special support. If multiple
dentists cannot deal with the child, maybe the child or his parents
could use some counseling.

--
Transpose hotmail and mxsmanic in my e-mail address to reach me directly.

Cathy Weeks writes:

Disagreed. They MIGHT be (however unlikely) the effects in NO.

If you set the required probability low enough, _anything_ MIGHT be an
effect of nitrous oxide. But normally this isn't.

And though I think avoiding drugs when possible is
a good idea, why is Valium a bad idea?

Because it's a drug, as you point out yourself. Children have to be
watched more closely because dosage and response are more
individualized. Any kind of heavy sedation or general anesthesia
requires equipment for resuscitation, too.

As the daughter of dentists, and the wife of a man who has had a
life-long dental phobia due to horrible frightening experiences when
he was about the OP's son's age, I can say that trying to avoid a
dental phobia, especially when one looks about to start, is a really,
really good idea.

Agreed.

And a good pediatric dentist knows how to treat the little ones
without scaring them.

Agreed. Although in some cases the child may be the problem. See how
the same dentist works with other kids, and ask other parents.

--
Transpose hotmail and mxsmanic in my e-mail address to reach me directly.

Catherine Woodgold wrote:

Our pediatric dentist does most of the fillings on
our children's teeth with no anesthetic. He asks
them to tell him if it hurts. Apparently it doesn't
hurt!! I don't know how he does that. Maybe they're
small, surface fillings or something. My children
like going to the dentist, apparently because they
like getting the little prizes the dentist gives
them at the end of the session. The dentist also
talks to them in a respectful and friendly way,
which I'm sure helps a lot.

And your point is?

They also had some
local anesthetic for some more serious work --
similar to the anesthetic I've had at dentists'
offices: where they inject something into your
gums to "freeze" that part of your mouth.
My son also had nitrous oxide at a younger age
with an other dentist; I worry about long-term
effects; I don't think it's possible to prove
something is completely safe.

It's a gas. It has no long lasting consequences.

Someone I know said that when she had a general
anesthetic, she couldn't think clearly for 6 months
afterwards. (That's the kind where you go
unconscious.) I believe there's a significant
risk of death with the kind of anesthetic where
you go unconscious. One in a thousand or something?

Try more like 1 in 50,000.

Besides the doctor or dentist working on you,
there should be an anesthetist constantly monitoring
you until you regain consciousness.

You worry too damned much!

Well, here's my follow-up. My husband brought him back to the dentist
today. I sent my husband because it occurred to me that the [male]
dentist might be one of those people who can't treat women like adults. I
also figured that my husband would have a different demeanor than me and
might be more effective in getting our kid to cooperate.

He didn't even last as long as last time. Their appointment was for
8:30 am and I got a call at 8:38 saying the dentist won't do it.

My husband later said that he thought the dentist was a bit wussy in not
insisting on getting in the mouth when our son got fussy. Apparently he
has no skills in this area because he uses nitrous oxide to knock them
flat during all visits. He did nothing to help our son be less fearful.

DS started to get fearful when the chair was tipped back and then got more
fearful when they put the little pig-snout mask on him and then totally
freaked out after smelling the odd smell. (I had previously asked the
dentist if he could do unscented, apparently he couldn't.)

I conclude now that the freaking out was to the sensation of the mask
experience (and maybe flashbacks to his traumatic hospitalization a year
ago) and not a reaction to the drug itself.

The dentist's two recommendations were to "wait until he's older" (our son
is 51 months) or to schedule hospital dentistry to do all of them at once
under general. Our next course is the obvious thing that the dentist
DIDN'T mention, to try a different dentist. We know we might have to come
back to this one for the hospital dentistry. (He's the only one who does
it that is available to us.)

What's not clear to me is what happens if we don't get these cavities
filled for months or years. One of the five cavities was abscessed in May
and a second one was fairly deep and we discussed whether to restore it or
pull it when we were pulling the abscessed one (which was pulled
promptly.) Nothing has been done with it in three months at this point
and my kid cries everytime we floss there. All of the cavities are
between back teeth, though his teeth are fairly widely spaced. (His front
teeth are all fine.)

We have an introductory meeting set up for Friday with a new dentist.
We've talked this guy up to our kid, explaining that he is our response to
the kid's fear of the other situation.

I'm planning on talking to this dentist about prescribing a sedative to
use before restoration work and NOT using nitrous oxide.

Wendy


In misc.kids Karen DeMent
wrote: Wendy Marsden wrote:

My four year old finally, FINALLY got his dentist visit today, four months
after an x-ray showed a startling five cavities. Our dentist promptly
referred us to a pediatric dentist, saying she wasn't set up to do that
much work on a small kid. The pediatric dentist fit us in for an initial
exam and a teeth cleaning, but couldn't get us an appointment to treat him
until today.

Things started out fine, everyone was cheerful and no one was scared or
anxious. He got in the chair and was laughing and fine. But five minutes
into the nitrous oxide he suddenly started whimpering and curling up and
got clingy and weepy and scared. I wasn't able to figure out what was
causing the anxiety - I really think it was a reaction to the nitrous
oxide. The dentist just thought I had a wimpy boy that I babied - which
wouldn't be a crime if I did, but that doesn't happen to be the case.

The damn dentist threw us out. So much for pediatric dentists knowing
how to work with kids! He offered no solution beyond we'll try again on
Monday. Meanwhile, this dentist is a 45 minute drive from my home, he
isn't a preferred provider in my insurance plan and he thinks I've caused
my son's mouth problems through neglect (which just isn't true.)

The pediatric dentist was talking about scheduling an OR for sometime in
the winter (months and months from now) to do all four fillings at
once. I'm disinclined to put my kid through general anasthesia
again. (Long story, but probably related to why he has such weirdly
horrible teeth: he had a traumatic illness and hospitalization 15 months
ago.)

I'm thinking of finding a dentist that does NOT use nitrous oxide but who
will prescribe a valium before the visit. What do you think?

-- Wendy

Sorry but I think your child may be spoiled and knows how
to get your attention and avoid situations he doesn't
enjoy. While he may have been anxious, you could have
helped more than you did. Nitrous didn't have anything
to do with this incident.

-Karen

Sounds like the child has learned how to avoid the situation altogether.
Most kids are smart enough to do that if given the chance. It is hard to
reason past that behavior for very young children. A guess from a long
distance away is to go to the hospital and get the GA. The child should NOT
remember any of it.

A general suggestion to all parents is to never try to prepare a child for a
dental visit. We have the best of intentions, but invariably end up scaring
the child more by placing new ideas in their heads. Answer all questions as
briefly, but honestly as possible. Just do not offer ANY information. All
too often, parents will place too much importance on a single event (like
visiting the dentist), because it is important to *us*, but we should do the
opposite. I tell parents to treat the visit with the same level of
importance (when in front of the kid), as a trip to the supermarket. If we
tried to explain everything the child would see or experience at the
supermarket prior to their first trip there (at age 3-4), the kid would be
scared to death. Think about a reaction to things the child has not seen
yet by age 3-4, such as automatic doors, HUGE (to the child) metal carts
that they are forced to ride in, but wobble all over the place, all the
strangers everywhere, mountains of boxes, a machine which slices meat,
bright lights, bells going off, and the cash register with its mysterious
moving belt and chirping register.

Most children do not fear the grocery store because, (1) they have been
there since they were weeks old, and (2) no one has given them any reason to
suspect it might be scary. The dental visit should be the same (for the
kid).

Saying things such as "Don't worry it won't hurt", or "don't be scared", or
"don't be frightened of the noises", only plants the thought of fear in
their heads.

I know this advice may be too late for this child. It may not have mattered
in the first place. The important thing is to get the dental problems
sorted out quickly, maintain the child's dental health so that it is not an
issue again, and avoid making the child into a "dentophobic".

The parent will suffer much more from the visit to the hospital for GA than
the child will. Only the parent will remember it a year later. The
hospital will have an entire team ready to administer the anesthetic and get
the treatment done. Don't let the kid live with pain or fear.

It is possible a different dentist may have better luck, but don't count on
it given the history. If you try another dentist, make sure that dentist
has the chance to gain the child's trust prior to trying to fix any teeth.
That often means you get to pay to have the child's teeth cleaned again.
Often it means you get to pay for a whole series of minor little
appointments designed solely to gain the child's trust.

--
~+--~+--~+--~+--~+--
Stephen Mancuso, D.D.S.
Troy, Michigan, USA

{remove first 3 dots for email}
.................................................. ...

This posting is intended for informational or conversational purposes only.
Always seek the opinion of a licensed dental professional before acting on
the advice or opinion expressed here. Only a dentist who has examined you
in person can diagnose your problems and make decisions which will affect
your health.
.......................
Please ignore j..d...
~~~~``````````#####----

"Wendy Marsden" wrote in message
...
Well, here's my follow-up. My husband brought him back to the dentist
today. I sent my husband because it occurred to me that the [male]
dentist might be one of those people who can't treat women like adults. I
also figured that my husband would have a different demeanor than me and
might be more effective in getting our kid to cooperate.

He didn't even last as long as last time. Their appointment was for
8:30 am and I got a call at 8:38 saying the dentist won't do it.

My husband later said that he thought the dentist was a bit wussy in not
insisting on getting in the mouth when our son got fussy. Apparently he
has no skills in this area because he uses nitrous oxide to knock them
flat during all visits. He did nothing to help our son be less fearful.

DS started to get fearful when the chair was tipped back and then got more
fearful when they put the little pig-snout mask on him and then totally
freaked out after smelling the odd smell. (I had previously asked the
dentist if he could do unscented, apparently he couldn't.)

I conclude now that the freaking out was to the sensation of the mask
experience (and maybe flashbacks to his traumatic hospitalization a year
ago) and not a reaction to the drug itself.

The dentist's two recommendations were to "wait until he's older" (our son
is 51 months) or to schedule hospital dentistry to do all of them at once
under general. Our next course is the obvious thing that the dentist
DIDN'T mention, to try a different dentist. We know we might have to come
back to this one for the hospital dentistry. (He's the only one who does
it that is available to us.)

What's not clear to me is what happens if we don't get these cavities
filled for months or years. One of the five cavities was abscessed in May
and a second one was fairly deep and we discussed whether to restore it or
pull it when we were pulling the abscessed one (which was pulled
promptly.) Nothing has been done with it in three months at this point
and my kid cries everytime we floss there. All of the cavities are
between back teeth, though his teeth are fairly widely spaced. (His front
teeth are all fine.)

We have an introductory meeting set up for Friday with a new dentist.
We've talked this guy up to our kid, explaining that he is our response to
the kid's fear of the other situation.

I'm planning on talking to this dentist about prescribing a sedative to
use before restoration work and NOT using nitrous oxide.

Wendy


In misc.kids Karen DeMent
wrote: Wendy Marsden wrote:

My four year old finally, FINALLY got his dentist visit today, four
months
after an x-ray showed a startling five cavities. Our dentist promptly
referred us to a pediatric dentist, saying she wasn't set up to do that
much work on a small kid. The pediatric dentist fit us in for an
initial
exam and a teeth cleaning, but couldn't get us an appointment to treat
him
until today.

Things started out fine, everyone was cheerful and no one was scared or
anxious. He got in the chair and was laughing and fine. But five
minutes
into the nitrous oxide he suddenly started whimpering and curling up
and
got clingy and weepy and scared. I wasn't able to figure out what was
causing the anxiety - I really think it was a reaction to the nitrous
oxide. The dentist just thought I had a wimpy boy that I babied -
which
wouldn't be a crime if I did, but that doesn't happen to be the case.

The damn dentist threw us out. So much for pediatric dentists knowing
how to work with kids! He offered no solution beyond we'll try again
on
Monday. Meanwhile, this dentist is a 45 minute drive from my home, he
isn't a preferred provider in my insurance plan and he thinks I've
caused
my son's mouth problems through neglect (which just isn't true.)

The pediatric dentist was talking about scheduling an OR for sometime
in
the winter (months and months from now) to do all four fillings at
once. I'm disinclined to put my kid through general anasthesia
again. (Long story, but probably related to why he has such weirdly
horrible teeth: he had a traumatic illness and hospitalization 15
months
ago.)

I'm thinking of finding a dentist that does NOT use nitrous oxide but
who
will prescribe a valium before the visit. What do you think?

-- Wendy

Sorry but I think your child may be spoiled and knows how
to get your attention and avoid situations he doesn't
enjoy. While he may have been anxious, you could have
helped more than you did. Nitrous didn't have anything
to do with this incident.

-Karen

Mary Elliott wrote:

It's a gas. It has no long lasting consequences.

It does if not given with enough oxygen . . . another "anesthetist"
without a clue, aren't you Mary.

I believe there's a significant
risk of death with the kind of anesthetic where
you go unconscious. One in a thousand or something?


Try more like 1 in 50,000. ( Mary's reply . . . incorect )

Oh, it's much higher than that . . . I've been an anesthetist for
forty years, and never killed anybody.


Besides the doctor or dentist working on you,
there should be an anesthetist constantly monitoring
you until you regain consciousness.

You worry too damned much! ( Mary's reply . . . typical )

The writer above is 100 % correct. Dentisty being performed is a one
man or woman job. So is anesthesia. Trouble is, too many dentists do
both, and they have left a long trail of dead patients behind them. The
patient should be monitored by a qualified and licensed anesthetist, not
the office assistant.

Will, crna