Sweet Life With Mary

I had mentioned that I will be posting eveyday for the month of July and it will be about food.

Though this post is not exactly about food, it is somehow related.

Today, Mary had her last dental appointment.  She went on a series of them as she had a lot of cavities that we did not take care of when we were in the States.

When she first had one cavity, about a year ago, a “regular” dentist tried fixing it.  Mary sat down on the chair, the dentist puts in a cotton plug and sets our to rub her gums with Novocaine and as soon as she had a whiff of that sickly sweetish strawberry scent, she decided that the plug is also very uncomfortable, pushed the dentist’s hand away, took out the cotton, got off the dentist chair and high-tailed it out of the room.  She almost made it to the front door by the time I caught up with her and no amount of talking would persuade to go back.  The dentist did not even want to try coaxing her since he did not want to further traumatize her and thus ruin her dental experience forever.  So, he gave us a referral to a dental clinic that specialized in children, where they would probably suggest sedation for her.

We got the estimate for one such visit, Mary sedated so we can get one tooth filled— $700.00.  We were apprehensive about Mary getting such a treatment at a young age so we thought we’d wait a few months.

Then, life intervened and next thing we knew, we were moving and taking this trip to the Philippines.

Jack suggested getting her dental work done in the Philippines.

While life was happening, the bacteria in Mary’s mouth did its job and a lot more cavities developed.  My best friend from high school is a dentist, graduated from the University of the Philippines, have great equipment in her dental office and up to par with all the latest techniques, very good but alas not a specialized pediatric dentist.  We were able to get Mary’s teeth cleaned and one tooth extracted by her on our first visit. (After a lot of screaming and holding down and eventual calming once the local anaethetic took effect. I wished Jack was holding her down instead of me, it is heart-breaking to see my daughter struggling so.) We scheduled another appointment and though we were braced for another trying time and were able to get the local anaesthesia injected, Mary had enough of the drilling and the water and keeping her mouth open for the longest time and no amount of threatening or cajoling would get us to do any more work on her teeth.  So, we were referred to a pediatric dentist as Mary would probably need sedation.

Prior to seeing this pediatric dentist, we were sent to get a panoramic X-ray of Mary’s mouth. Price for this X-ray, Php 600- about $13.

The pediatric dentist took a look at the X-ray and all the other X-rays that were done by the first dentist and outlined a treatment plan for Mary. We discussed sedation options and was given the list of the things to be done as well as pricing. The list included 2 more extractions, 5 fillings, a pulpotomy (root canal for kids) and stainless steel crown, 9 sealants, 3 space maintainers and sedation for at least, 2 sessions. Treatment will be done in 3-4 sessions. If all of the options are done, it would cost us about $600 without the discount that this dentist would be extending me. I think, 1 sealant cost about $40 in Colorado, just the sealants alone would have cost us already $360.

We were going to try to do one session, the easier quadrant (a couple of fillings and 3 sealants), without sedation and see how Mary would perform with the new dentist.

That first visit went ok, they got the job done but Mary struggled and had fits of crying and screaming—- it was a trying time for the dentist, her dentist assistant (who is also a board-certified dentist), Mary and me. I did not enjoy seeing Mary suffer.

As the next things to be done involved a lot more— the pulpotomy and application of the crown, an extraction and sealant— we agreed on trying sedation with dormicum, recommended by the dentist as it is a tablet that is water soluble and tasteless (will be easy to administer, mixed in some juice), faster onset of action- about 30 minutes with shorter duration of action about 30 minutes. Mary would experience some anterograde amnesia, where she would not remember much from when she was sedated.

I was quite apprehensive about getting Mary sedated butit had to be done so I had to be brave about it and just be there to support her.

Mary reacted beautifully to the drug. She got “drunk” about 10 minutes after taking it, was half-awake for most of the session. Mary was strapped into the dentist chair on a flat cushioned board, looked like a big papoose to me, her wrists were strapped first and then a couple of very wide straps wrapped her torso and legs. Even though she is sedated, she could make sudden movements or even try to get out of the chair. I paid a close watch on her and looked straight on while she was getting anaesthesia injections, getting drilled, things I would rather have turned away from. The dentists were thrilled with Mary’s reaction, saying that she was one of the best patients they have had. 

Mary was still groggy after the session, though she would try to walk by herself on legs that would not entirely support her yet. It would take another hour before she would be able to stand up on her own and would need careful observation for the next 24 hours for any adverse reactions.

We needed at least another session, possibly 2 more. I decided that the next one would be a session under sedation again. What a difference it made for everyone involved, especially Mary.

Today was that second session and the dentist were able to do an extraction, 2 fillings and 4 sealants.  We were going to get her fitted for space maintainers (stainless steel appliances to be put into the spaces left by the extracted teeth) but decided against getting them done. I just had to promise to get Mary’s teeth looked at in 6 months.  The dentist had also already foreseen that Mary would have overlapping teeth and suggested getting permanent teeth that would be in the way, extracted as soon as they come out — instead of getting them extracted later and getting braces to pull back the other teeth.

Jack and I would have to be extra vigilant about Mary’s oral hygiene, brushing after every meal as well as flossing at least twice a day. 

I am so relieved we are done with the dentist.  For now.

July 8th, 2008 | Category: Daily | Subscribe to comments | Leave a comment | Trackback URL