Pediatric Dentistry
Sara Ellen is, to my relief, a willing new dental patient. I called a couple months ago because we were concerned about some brown spots in her molars. We went to our first appointment last Thursday and confirmed our concern. The bad news, she has weak enamel and needs fillings and some fancy-words work to protect her baby teeth from decay. The great news is both Sara Ellen and I love Dr. Maya Vernon and Liz the dental assistant of Collins and Associates Pediatric Dentistry in Annapolis. If you are familiar with the mall area, it is in the same building as Nighttime Pediatrics on Generals Highway across from the mall. And they love Sara Ellen right back!
I wondered how they could make an atmosphere that children would enjoy. It’s a bright, mostly open space. The waiting room has a movie playing, playhouse with books, center table with bead mazes, video games, and a lego table. Before the exam Sara Ellen picked a tigger toothbrush and Thomas dvd to play in our room. When the children cooperate with the dentist or assistant, they get large plastic tub toys and/or small toys from candy machines (which we avoid). The private exam rooms (there is also a larger open space with exam chairs) have average dental chairs in orange but because Sara Ellen is so young she sat on my lap and lay her head on Dr. Vernon’s lap. I was warned that little one’s often cry when their mouth is invaded but Sara Ellen was totally relaxed and watched her video, opening when asked. Her teeth were not really cleaned but brushed a little with the new toothbrush and scraped a little. Dr. Vernon examined the teeth and then we talked. We had to set up an appointment to discuss the problems and treatment options. Sara Ellen received a second tub toy because she lay down a second time to get a flouride treatment. She has been happily ingesting flouride tablets because we drink well water but this only helps strengthen the permanent teeth which are still growing. We were advised to brush her teeth with a sliver of flouride tooth paste and wipe flouride rinse on her teeth with a q-tip.
Today Tim joined me for the consultation. We met primarily with Liz, Dr. Vernon’s assistant because the doctor was the only one in. Sara Ellen got x-rays taken and did beautifully. She sat on Tim’s lap and both wore aprons. Liz demonstrated how the camera would be positioned for each photo, asked her to open wide and chomp down on a small square plate and Sara Ellen followed easily to Liz’s amazement. She and Dr. Vernon said Sara Ellen was responding like a four year old and should be a model for eight year olds. Then we checked out the x-rays while Liz described the problems caused by the weak enamel.
The first photo is her top teeth. If you look at her you can see ridges on the front 2-4 teeth. In the x-ray you can see a lighter spot on the left of the center-right tooth. There is a cavity there. On this photo and the that of her bottom teeth you can see the permanent teeth growing in! 
The light part in the middle of the teeth is the root. If the cavities are allowed to remain, they can get into the root and require a root canal! I love the photo of her molars, it’s that ideal tooth shape. 
We have scheduled two appointments for sedation procedures. The first is next Friday (someone else’s procedure was moved up opening a space) and the second is April 2. I am not worried about the procedure itself, mostly the preparation. The cocktail she will take will not make her sleep but calm her. I guess she will also get local anesthesia. To avoid aspirating or vomiting, she cannot eat or drink anything starting at midnight the same day. The appointment is scheduled until 1pm. It’s hard enough for an adult to go that long, how will a toddler handle it?? They commented on how wonderful she is, but what will happen when her favorite comfort is unavailable? We’ve decided to try to keep her up late into the night and give her a good snack before bed. I will get her up in time for the appointment and put her right into the car. When we wake up in the morning, and often through the night, she likes to nurse but if she is distracted it may not be so hard. Hopefully she will also look forward to the trip to the dentist. She talks about getting her teeth cleaned since Tim prepared her last week the night before we went for the first visit.
If you know of any [nursing] toddler’s who have experienced this, please let me know.
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