Is it really necessary to undergo expensive dental work on a 34 mo. child (primary teeth)?

Question

This child (supposedly) has 9 cavities, gingivitis. The estimated dental care will cost nearly $5,000. She will need to be anesthesized and the ped. dentist will need to use the O.R. at the hospital. The hospital charges approx $1250 per hr. for use of their O.R.. It will take approx. 2 hrs, that's about $2500 just for the use of the O.R.. The insurance the parents have will pay very little. These are primary teeth, so, is it really necessary to undergo all this extensive dental work (pulpotomy, caps, etc.). Thus far the parents have only visited one ped. dentist, should they consult with other ped. dentist' before rushing into allowing this particular one to perform the necessary? work? Are there other (more economical) ways of getting this done? Are there any assistance programs to help with the cost' of this? I realize your teeth are very important, but, $5K to fix (possibly) a toddler' teeth is a lot of $ to the people involved here. Realistically, they cannot afford it.

Answer 1

the parents should be charged with child neglect for letting tyhe child's teeth get so bad in the first place

this is pure child abuse

Answer 2

I'd say to get a second opinion, although it is not because I question the proposed treatment. It is only to help the parents feel more comfortable with the need. You can NOT say, "They're only baby teeth. Let them fall out." If you do that, besides subjecting the child to undescribable amount of pain and dangerous infections, you are condemning the arch for of the permanent teeth. The baby teeth serve to hold the position for the permanent teeth.

As far as the dollar amount, it sounds like a lot to me for nine teeth, no matter what they need. If you are in a major metropolitan area, especially in the northeast, the family may not find much difference in fees, though.

It is conceiveable that the dentist might show some consideration in the fees charged. This is amounting to $2,500 per hour in dental fees, which is pretty much the highest I've ever heard. It's true that there is a lot more involved than simply the 2 hours treatment time, but it's still a pretty good remuneration. If I am doing ONE procedure, I really don't have much flex room in the fee, because that's how I personally calculate things. If I am doing two of the same procedure, but true unit cost goes down. If I am doing 9 of the same procedure, it goes down even more. In my office, it is my practice to charge the usual fee for all procedures, unless there are special circumstances AND if I am able to complete the treatment in less time per unit than if I did it all as individual procedures. In other words, I can't charge someone $600 for 4 fillings that took me less than an hour to do. I tend to reduce the fee somewhat to more accurately reflect what I choose to earn per hour. In other words, I charge by the meter and not by the mile. The family MIGHT make some headway if they approach the dentist with this concern.

"Doc, I know that it is worth saving little Johnny's teeth and I can understand how it might cost four or five hundred to do the pulp treatment and crown on one tooth, but I was wondering if you would consider giving us a bulk fee instead of an itemized fee. It's going to be very hard to afford this, but I don't want to let Johnny go without this treatment. Can you help us out?"

Answer 3

Always get a 2nd opinion when skeptical. I would like to point out that it's not necessarily the parents fault. Some people have softer teeth or molars that are deeper and are more likely to get cavities. My mom made sure that my brother and I brushed and flossed regularly. My brother is 32 years old and has never had a cavity, braces, or any type of extensive dental work done. I have fillings in half my teeth, I've had braces, retainers, caps, a root canal. I brush, floss, use mouth wash, follow all of the dentists suggestions. I go to the dentist 3 times a year and my brother goes once every other year. Everyone's teeth are different.

Answer 4

If the parents don't feel it is necessary, then get a second opinion. Primary teeth do not usually start to fall out until the child is in 1st grade, and that is a long time to go if this child already has some badly eroded teeth. U risk infections and abcesses if it is serious enough, not to mention the pain that the child might feel. My son had extensive dental work done when he was 2. They had to put him to sleep, but the work was done in an operating room in the office, which helped keep the cost down. Call some different pedi orthodontists and see if any of them have that kind of facility.

Answer 5

Wow - I have been in medicine 30 years and this is a 1st. It does sound peculiar that so much would be required in a 3 year old. Some children do not produce enamel (the protective layer of the teeth) for their baby teeth. If this is the case - no matter what you do they will 'rot'. The good news is that the permanent or adult teeth usually have normal enamel so the problem is 'out grown'. It these cavities and gingivitis are not producing symptoms I wonder how important this intervention is.

Answer 6

Definately get a 2nd opinion. Also consider dental schools in your area. Even traveling a great distance may be worth saving that much money. It is very important to save baby teeth because they help guide adult teeth. It is very sad that things have gotten this bad for the child. I only hope it was caused by something unforseeable because if it's from lack of dental hygiene, no amount of money will help. All of the work will go down the drain when they continue to neglect the child's mouth.
If the parents do not qualify for CHIPS, have them look into CareCredit.

Answer 7

Anytime a Dr. recomends surgery (or anything expensive), onless it's a Dr. you trust and see regularly, it is always best to get a 2nd opinion. The health of primary teeth is very important, rotting teeth are painful, and that is what will happen if not properly taken care of. Even kids need to brush twice a day. It sounds like the parents could have avoided this expense if they had taken good care of the childs teeth. Maybe they will think of that when they have to take out a loan to pay for the necessary treatment of their child.

Answer 8

Without getting too detailed, I'd go to another dentist. I don't see any reason that this needs to happen. Do the parents have health insurance on the child? If not, get chip. (if they meet income guidelines) It will be covered. But definitely get a 2nd opinion.

Answer 9

Many babies are weaned off of breastmilk or formula and are given cow's milk instead. I don't find that to make any logical sense. I stop feeding my human child human milk and start giving him cow's milk? For what reason? Because he turned a year old? Or because he has teeth? That doesn't make sense to me. Breastmilk has benefits beyond one year, regardless of the number of teeth a child has. There is still nutritional value so as long as mother and child are both okay with it, I see no reason not to breastfeed after baby has a full set of teeth. And what about babies who teethe early? Do you stop breastfeeding at 6 months because your child got their teeth earlier than expected? No, at least I wouldn't. Teeth and breastmilk have no relation in my opinion. And while some still breastfeed for comfort, I see no problem with that either as long as mother and child are both okay with it. As for the pacifier thing...my son is 14 months old and has never taken a pacifier. We offered it when he was a few weeks old and he just spat it out. I've offered it occasionally since then and he never wanted it. He just chews on the nipple. But when he's sleepy, if I nurse him he'll go to sleep. So since that works, and the pacifier obviously doesn't, where's the problem in offering the breast to help him get to sleep? He doesn't require the breast to get to sleep but it does help. We tend to offer our babies a bottle or breast to help them get to sleep, probably since they usually fall asleep on their own during or soon after a feeding. So if that works and I'm comfortable with it, why stop? I have a friend who bottle fed her daughter and she still gives her a bottle to help her get to sleep (she's 13 months). Is that any different because it's a bottle instead of a breast? I don't think so.

Answer 10

Get another opinion before anything is scheduled. You can take the child to another pedodontist and they can usually do the treatment needed in the office and try not to get child to go under any sedation unless they have another option to get this treatment done. I know there are other ways to treat the small children.