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Need some help - No 1 - Childs Dentist

Need some help - No 1 - Childs Dentist

Old May 27th 2014, 7:01 pm
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Default Need some help - No 1 - Childs Dentist

Hiya,

I registered both my children with a local dentist a couple of weeks ago, (Tampa, Florida) we had a mailing through our door and as new members of the neighbourhood we were entitled to free consultations and x-rays.

I was keen to get the children checked out as my youngest daughter at 6 still had her baby teeth at the front and on the bottom row her 2nd teeth were starting to show behind.

So I took both my kids, son aged 9 to the dentist to register and gave over our insurance plan number etc, both the children were examined and x-rayed and although my daughter had lost a filling and needed treatment nothing needed to be done about her baby teeth. My son also needed a filling and so two separate appointments were made. I also got a printout of the charge to the insurance company and although we had been offered a free consultation and x-ray it seemed like the dentist was passing on all the charges to the insurance company. At the time I thought thats not right but thought no more of it.

My wife took my daughter to the dentist this morning and after two hours of treatment she has come home with a big stainless steel crown over the tooth that had lost its filling, its on the bottom row at the side but near the front, close enough to notice it when she smiles, I was furious. She is 6 years old and has a silver tooth in her mouth, I rang the dentist and was told the filling was too deep and she needed a crown, well why not a white crown I asked? As its still a baby tooth and only has a few years left a porcelain crown would not have been suitable.

Am I missing something here?

I have never seen a six year old child with a stainless steel crown on a tooth, all through my older children's treatments back in the UK and they have had a lot nothing like this ever happened. Plus despite our insurance we have been charged $260 dollars for this crown.

I am really not happy with this dentist and sorry we went there. Now I am thinking of cancelling my sons appointment and also my own and going somewhere else.

Here is the question, once we have signed on with a dentist can we move to another one if not happy? How does the insurance company view this?

Please give me the benefit of your experience and advice, am I over-reacting?

Thanks
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Old May 27th 2014, 7:31 pm
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Default Re: Need some help - No 1 - Childs Dentist

Apparently stainless steel crowns are used on Milk teeth except on the front since when the tooth falls out, it won't damage the gums.

http://www.myvmc.com/treatments/stai...crowns-ssc/#q2

They should have explained that to you ahead of time.
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Old May 27th 2014, 7:35 pm
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Default Re: Need some help - No 1 - Childs Dentist

To be honest I'm horrified that kids would need all that dental work.
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Old May 27th 2014, 7:38 pm
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Default Re: Need some help - No 1 - Childs Dentist

Just looking for advice on the treatment not judgement of my parenting regarding lollipops etc, which are and have been banned.
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Old May 27th 2014, 7:38 pm
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Default Re: Need some help - No 1 - Childs Dentist

Originally Posted by Sally Redux
To be honest I'm horrified that kids would need all that dental work.
What would be the option if there was a deep decay and the tooth would fall apart other than pulling the tooth which was common with milk teeth in the US prior to the 1970s?
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Old May 27th 2014, 7:40 pm
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Default Re: Need some help - No 1 - Childs Dentist

You will still have to pay towards the crown.

I think you can change dentist as long as they are in network.
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Old May 27th 2014, 8:03 pm
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Default Re: Need some help - No 1 - Childs Dentist

You can change dentist to whatever one you want whenever you want. If you want the best coverage, find one who is in network. Dental insurance is kind of lame. It does help somewhat but it often leaves you with large bills. $260 for a crown seems about right. It also has a yearly cap so make sure you don't exceed it or you'll pay even more.
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Old May 27th 2014, 8:10 pm
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Default Re: Need some help - No 1 - Childs Dentist

Just FYI, if she'd had a porcelain crown your co-pay would be much higher than $260 I would imagine...

Other than that I know nothing about crowns for children, sorry.
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Old May 27th 2014, 8:16 pm
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Default Re: Need some help - No 1 - Childs Dentist

Originally Posted by kins
Just FYI, if she'd had a porcelain crown your co-pay would be much higher than $260 I would imagine...

Other than that I know nothing about crowns for children, sorry.
My daughter had the same thing years ago, a stainless steel crown. She went to a very well regarded pediatric dentist. The point of the crown is to keep the dental area stable so that the permanent teeth come in straight. If she loses the tooth she will have stability problems. I was very pleased with my daughter's crown, and it fell out at the right time. It kept everything as it should be, and she has lovely straight permanent teeth. Dentists know what they are doing.

It's liking breaking your arm and having a cast, it's just something that needs to be done. Not pretty, but goes away with time. Relax.
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Old May 27th 2014, 8:55 pm
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Default Re: Need some help - No 1 - Childs Dentist

Originally Posted by dfrbrowne
Here is the question, once we have signed on with a dentist can we move to another one if not happy? How does the insurance company view this?
Yes and the insurance won't give a toss.
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Old May 27th 2014, 8:58 pm
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Default Re: Need some help - No 1 - Childs Dentist

A stainless steel crown is the standard treatment for a baby tooth with a fair bit of decay.

The reasons:
1 they are ready made and the dentist chooses the most appropriate one for the tooth - this means no laboratory fee and it's fairly quick to do so it's cheaper.
2. They seal the tooth very well and can stop further decay in that tooth.
3. You don't have to cut away lots of good tooth structure to make the correct shape as you would a normal porcelaine crown.
4. The treatment is well tolerated by children. You've no idea how difficult it is for kids to lie there with their mouths open for ages and they have stacks of saliva.

All this helps to keep the tooth in place until it falls out at the correct time.

Aesthetically, they are not brilliant at the front of the mouth -as you've pointed out. You could ask the dentist to stick a bit of tooth coloured filling material on the cheek side, this often helps with aesthetics.

Dentists wouldn't normally make a porcelain crown for a childs tooth. I would think in most cases, the tooth would be extracted. I think what the dentist has done is a good standard for what you've said about the situation.

Would be good to get the caries under control though. I would strongly suggest a few regular visits to the hygienist for dietary and toothbrushing/flossing advice.

HTH
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Old May 27th 2014, 9:01 pm
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Default Re: Need some help - No 1 - Childs Dentist

Yes, I've heard that the stainless steel caps are the standard option for crowning milk teeth. And we pay $230, I think, as the 20% copay for crowns.

My daughter too had her adult teeth come in behind her baby ones on the bottom front, so that for a while she looked like a double-rowed shark. It all worked out fine - the baby ones fell out, and the adult ones moved forward into just the right place.

By the by, for those judgingly horrified at small kids and dental work: my daughter had almost ALL her milk teeth repaired under a general anaesthetic when she'd just turned 5. This is despite my then 9 yr old never having had a filling in his entire life, and feeding them both the same ridiculously educated middle-class diet of no soda, small amounts of juice, only water between meals, snacks of veggies, tiny bag of sweets once a week as a Friday treat, etc etc. Some kids just have really c**p tooth enamel, usually due to some minor maternal cold or similar infection in utero. Our dentist in Switzerland was jaw-droppingly astonished how much her teeth could decay from one six month visit to the next; he joked that he could put a tooth in a glass of Coke for the same time, and see less damage.

Luckily her adult teeth seem much stronger, and she hasn't had to have a filling now for a couple of years.
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Old May 27th 2014, 9:08 pm
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Default Re: Need some help - No 1 - Childs Dentist

Hi Kodokan,
I had the same issues with my son's teeth and I'm in the business!

You are correct, some kids have very poor enamel coverage on their teeth and it just seems to dissolve before your eyes!

There are links to other diseases in cases like this - the poor enamel coverage can be one of the symptoms, so it is always a good idea to press your case if you know diet is reasonably good. It is becoming more and more known about in dental circles these days and you can be referred to a pediatric dental specialist for investigations and certainly be given more detailed advice about diet.
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Old May 27th 2014, 9:17 pm
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Default Re: Need some help - No 1 - Childs Dentist

Originally Posted by petitefrancaise
Hi Kodokan,
I had the same issues with my son's teeth and I'm in the business!

You are correct, some kids have very poor enamel coverage on their teeth and it just seems to dissolve before your eyes!

There are links to other diseases in cases like this - the poor enamel coverage can be one of the symptoms, so it is always a good idea to press your case if you know diet is reasonably good. It is becoming more and more known about in dental circles these days and you can be referred to a pediatric dental specialist for investigations and certainly be given more detailed advice about diet.
Thanks - various diagnoses were discussed at the time (there was a long one begininning with 'a', I think, but she didn't have the discolouration typical with that). It was concluded her enamel was just wafer-thin and rubbishly porous. As her adult teeth are much better, it seems to have been 'one of those things'.

Incidentally, she's also been very early on adult tooth development, losing her first ones at just turned 4, and having all her milk teeth replaced by the age of 9. Apparently that can be somehow connected..? Sorry, bit vague - this was all in French (I learnt a LOT of new vocab that month!), and since it's not an ongoing problem I haven't bothered to research it properly in English.

Our family dentist was lovely about it, but the dentist that did the procedure at the hospital was incredibly judgemental and gave me the full speech about Cokes and lollipops whilst I spluttered indignantly about knowing all the rules, that she NEVER fell asleep with a bottle in her mouth, and pointing at my caries-free older child. And he was about half my age. 'Twas most annoying.
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Old May 27th 2014, 9:32 pm
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Default Re: Need some help - No 1 - Childs Dentist

Originally Posted by kodokan
Thanks - various diagnoses were discussed at the time (there was a long one begininning with 'a', I think, but she didn't have the discolouration typical with that). It was concluded her enamel was just wafer-thin and rubbishly porous. As her adult teeth are much better, it seems to have been 'one of those things'.

Incidentally, she's also been very early on adult tooth development, losing her first ones at just turned 4, and having all her milk teeth replaced by the age of 9. Apparently that can be somehow connected..? Sorry, bit vague - this was all in French (I learnt a LOT of new vocab that month!), and since it's not an ongoing problem I haven't bothered to research it properly in English.

Our family dentist was lovely about it, but the dentist that did the procedure at the hospital was incredibly judgemental and gave me the full speech about Cokes and lollipops whilst I spluttered indignantly about knowing all the rules, that she NEVER fell asleep with a bottle in her mouth, and pointing at my caries-free older child. And he was about half my age. 'Twas most annoying.
It sounds like dentists have changed significantly in Switzerland since the early 1970s when I was living there. My ex had regular check ups and each time, all they did was polish her teeth. When we came to the states, she went for a check up and the dentist started to scale her teeth (she never had that done before) and couldn't stand the pain so they had to do it with with Novocain. The x-rays revealed 6 small cavities and she had pretty severe Periodontal disease. The cavities were filled and Periodontal surgery was performed.
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