Pediatric Dentistry Archives - Dental Care at Flint's Crossing

Why Do Kids Grind Their Teeth in Their Sleep?

Posted on May 16, 2022 by Athena Smiles.

I recently noticed that my youngest child seems to be grinding his teeth at night. He’s five, if that matters. At first, I thought it was a one-off thing or a fluke. He fell asleep in the car on the way home from a family function that ran late, and I caught his jaw moving when I looked back in the rearview mirror. I always pop in and check on him before I go to sleep, so the next few nights I paused to watch for a few minutes and realized he’s doing it all the time. He doesn’t remember doing it and doesn’t seem to be any worse off for it. The pediatric dentist hasn’t said anything while we’ve been in.

So, I’m wondering why do kids grind their teeth in their sleep and is this something he’s going to grow out of? I know it’s a problem for adults—his dad’s a grinder too—but I’ve never heard of children doing it.

Thank you,

Morgan

Dear Morgan,

This is a great question! Teeth grinding, formally known as “bruxism,” in children is more common than you might think. Studies show that up to 50% of kids do it, but that doesn’t necessarily make it a harmless habit. Let’s dig into the details a bit.

Why Do Kids Grind Their Teeth in Their Sleep?

Kids grind their teeth for many of the same reasons adults do.

Familial Links: Studies show teeth grinding tends to run in families, though researchers aren’t sure if it’s a genetic link or an environmental factor that causes it. Boys are more likely to grind their teeth than girls as well.
Stress and Anxiety: Yes! Kids get stressed out too. They worry about tests, things happening with the family, chores, and all sorts of other things.
Mental Health Issues: Grinding is linked to a multitude of sleep disorders as well as issues like ADHD.
Dental Issues: Kids with misaligned teeth, those who wear fixed orthodontic appliances, and those who breathe through their mouth tend to grind their teeth more.
Secondhand Smoke: Even moderate exposure to secondhand smoke increases the risk of grinding for kiddos.

What Happens When Kids Grind Their Teeth in Their Sleep?

Although you didn’t ask about potential complications, it’s important to recognize that sleep grinding isn’t a harmless habit. Kids with bruxism are at risk for a number of complications.

Fractured teeth
Receding gums
Teeth and jaw problems like temporomandibular joint disorder, sometimes referred to as TMJ or TMD (TMJ is actually shorthand for the jaw joint’s name rather than the disorder)
Mental health issues like anxiety and depression
Sleep problems
Eating disorders

Do Kids Grow Out of Teeth Grinding?

Generally speaking, kids do not grow out of bruxism. Remember, there’s an underlying cause, so although a contributing factor may end, and the child may seemingly stop grinding at night, they’ll probably resume if the trigger returns.

You mentioned that the dentist didn’t say anything at your last visit. It may be that it’s so early for your son that there are no outward symptoms yet. You should proactively bring it up so he or she can look specifically for signs of trouble and keep a close eye on your son as he continues to grow.

Treatment for Sleep Bruxism in Kids

Treatment for kids is much like that of adults and may vary depending on the trigger or underlying cause.

Dental Care: If misaligned teeth or other oral health concerns are contributing, the dentist will need to address them. Equally, if a child is displaying signs of grinding, such as broken teeth, the dentist will need to repair them.
Nightguards: Although nightguards don’t prevent grinding, they can protect teeth from damage and often reduce jaw strain.
Stress Relief: Talk to your kiddo to find out if he’s feeling anxious or stressed about anything. Sometimes just talking it out with you will be enough. If not, consider bringing in a mental health professional to help your kiddo learn ways to manage stress.
Bedtime Routines: If bedtime routines are inconsistent or chaotic, stress elevates and sleep issues may develop. Try to incorporate a winddown period before bed and set the stage for sleep by ensuring the room is quiet and dark. Limiting screens, especially close to bedtime, and making sure your child is eating well may help too.

As always, if you have concerns or your child develops symptoms that suggest they’re experiencing pain or discomfort, be sure to get him into the dentist for an evaluation right away.

This blog is sponsored by Auburn, AL dentist, Dr. Raymond Bolt.

Should the Pediatric Dentist Remove My Son’s Baby Teeth?

Posted on April 15, 2022 by Athena Smiles.

I’m wondering if I should make an appointment with a pediatric dentist to have my son’s baby teeth removed. He just turned seven and hasn’t lost a single one yet. For a while, I thought the centermost teeth on the bottom were loose, but if they ever were, they’re not now. My sister’s son is six and he’s already lost four, so I’m starting to get concerned.

Thank you,

Mariana

Dear Mariana,

This is a great question! Let’s dig into it a bit.

It’s Normal to the First Baby Teeth Between Ages 6-7

Your son isn’t off track yet. Most kiddos lose their bottom center teeth first somewhere between ages six and seven and then their top middle teeth shortly thereafter. Even though he hasn’t lost any teeth yet, it’s still too soon to say he isn’t developing perfectly normally.

It’s also worth noting that sometimes baby teeth loosen up and then tighten up again. This usually happens because the adult tooth below pushes on the baby tooth enough to stretch the ligaments (make it loose), but then stops, and the ligaments tighten up again. Some kiddos can go through several rounds of on-again, off-again looseness before a baby tooth finally gives in and goes.

But, Staying on Track is Important

There are some things that can stop kids from losing their baby teeth. For example, if no adult tooth is present, people can retain baby teeth. Sometimes a baby tooth can be particularly stubborn and refuse to let go too. In these cases, it can delay the eruption of the adult tooth or the adult tooth will try to come in anyway, but come in behind or in front of the baby tooth.

There are times when it’s beneficial to have baby teeth removed, especially if the latter is true for your son, but he’ll need an exam and probably some x-rays to be sure.

Your Kiddo Should See a Pediatric Dentist Regardless

Even though he might not be experiencing an issue, your son should be on a regular cleaning and checkup schedule now. That way, the dentist can catch potential issues before they become a problem and provide preventative services like fluoride treatments and sealants to help make sure your son’s teeth stay healthy and cavity-free. It’s important to keep up with these visits regardless because they can save a lot of heartache with little ones in the long run, but if you have dental insurance, these kinds of visits are often totally covered, so you probably won’t have to pay anything out-of-pocket for them either.

You can touch base with your dental insurance company for confirmation and a referral or connect with a local family or pediatric dentist and they’ll usually check into your benefits for you as a courtesy prior to your first visit. Best of luck to you and your little guy!

This blog is sponsored by Dr. Raymond Bolt, an Auburn, AL pediatric dental services provider.

Will a Root Canal Make My Son’s Front Tooth Whiter?

Posted on February 28, 2022 by Athena Smiles.

My son almost knocked one of his front teeth out while horseplaying in the pool a few summers ago. Back then, he was seeing a pediatric dentist who suggested we take a “wait and see” approach. She thought it would heal up on its own and it seemed to have, but it’s turning a grayish color now. He graduated to seeing the family dentist who says the next step is getting a root canal because the tooth is dying, and that it’s up to us whether we want to do it right away or wait until the tooth starts hurting. I’ve never heard of a root canal whitening a tooth. Has the process changed over the years?

Thanks,

Tyra

Dear Tyra,

Did the dentist say the tooth was dying or that it was already dead? That’s an important distinction. True, it can take months or years for a tooth to turn gray after trauma. The coloring is a common symptom of the blood flow being cut off or nerve being severed. But, most people do have other symptoms and, for the dentist to indicate the tooth is presently dying with no symptoms beyond a color shift, it’s a bit unusual. You wouldn’t want a root canal if the tooth is vital and not infected and there are other things that can cause gray discolorations. Let’s go over this a bit.

Many Things Can Cause Teeth to Go Gray

While trauma is perhaps the likely culprit here, it’s important to remember there are lots of potential causes of gray teeth. Although some of the following won’t apply to your son, a detailed list is provided below for others following along too.

Decay: Cavities can cut off blood flow just like trauma can.
Dentinogenesis Imperfecta: Although rare, this hereditary disorder weakens teeth and can turn them a bluish-gray color.
Tetracycline: When children under 8 receive this antibiotic or expectant mothers take it, it can turn developing teeth gray.
Restorations: Metal tooth restorations, such as amalgam fillings and crowns, can discolor teeth too.
Aging: Sometimes teeth take on a blue-gray hue as a person ages.
Root Canal Medications and Materials: Certain medications used to disinfect during root canal treatment can turn the tooth a brownish-gray color. Sometimes the inert filling used to fill empty chambers after a root canal, or cement used, can cause discolorations as well.

Get Clarification from Your Dentist or a Second Opinion

Color alone does not signify the tooth is dead or dying. Find out what he’s seeing beyond the coloration and what condition he thinks the tooth is presently in. It may be a good idea to get a second opinion before starting treatment too.

A Root Canal Will NOT Whiten a Tooth

A root canal is the next step if the tooth’s nerve is dead or the tooth is infected, but that’s only because a dead tooth will eventually develop an infection. Think of it like a stagnant pool of water. Bacteria gets in there and thrives until you have a raging infection. It’s no fun at all! You don’t want to let it get to that point, so if your son has other signs the nerve is no longer vital, it’s best to move forward with the root canal as soon as possible.

With that said, a root canal won’t do anything about the color of the tooth. For that, you’ll want to explore cosmetic options, such as internal bleaching (performed by a dentist) or a veneer. Best of luck to you and yours.

This blog is sponsored by Dr. Raymond Bolt, an Auburn, AL dentist providing pediatric dental services and emergency dental care.

When Should We See a Pediatric Dentist for Two-Year Molar Pain?

Posted on November 15, 2021 by Athena Smiles.

I’m trying to decide if we should visit a pediatric dentist or try to continue treating my kiddo at home. Jake just turned two in August and I’m pretty sure his two-year molars are coming in. He’s normally a cheerful little guy, but lately he’s been grouchy and downright inconsolable at times. We’re seeing issues similar to what happened when he was teething… a bit of drooling, more middle-of-the-night wake-ups, and constant chewing on just about everything. Sometimes he sits around 99.0°F, though a time or two I caught him at a little over 101.0°F. Tylenol always brings it back down and helps him settle in again though.

He isn’t really agreeable when I try to look, but I’m fairly certain I caught a glimpse of white coming in on the bottom left a few days ago. This has been going on for about two weeks at this point, though, so I’m starting to worry. At the same time, the poor little guy is pretty miserable right now. I’d hate to subject him to an exam if it isn’t necessary. Should it be checked out or should I keep treating it at home?

Thanks,

McKenna

Dear McKenna,

You’re probably right in that this is pain related to cutting teeth, but it’s a good idea to book the appointment anyway. Let’s break it down though.

The First Pediatric Dentist Visit Should Happen When a Child’s First Teeth Arrive

Lots of parents don’t realize this unless the pediatrician tells them, but little ones should see a family or pediatric dentist as soon as their first tooth emerges. It’s an opportunity for a professional to assess development and catch any potential issues early, plus give you guidance on what to expect and how to care for your little one’s teeth. The actual exam is typically very quick and kids tolerate it well, especially if Mom or Dad is there and is upbeat. Based on this alone, it’s a good idea for Jake to be seen.

Most of the Symptoms You Describe Sound “Normal”

Lower molars typically make an appearance around 23-31 months and upper molars follow around 25-33 months. Usually, it’s a few days to a week of fussing per tooth, so it’s not abnormal for it to continue a couple of weeks as the lowers are coming in. Common symptoms include:

Irritability
Waking up at night or worsening symptoms at night
Drooling
Chewing on clothing, hands, and objects
Visibly sore or red gums
Low-grade fever of around 99.0°F taken rectally

The Higher Fever is Worrisome

Your kiddo has a higher fever than what’s normally seen when children cut teeth. It may indicate he’s fighting off a viral infection or has something else going on. For that reason, it’s a good idea to touch base with your pediatrician.

You Should Also Be Able to Visually Assess

You absolutely must work with Jake to get a good look at what’s happening in his mouth. Sometimes parents get around contrary kiddos by being silly, singing, making funny noises, sticking out their tongues, etc. to see if the little one will respond in kind. At this stage, you should also be brushing his teeth a couple of times a day for him—you can’t do that effectively if you can’t see. So, that’s something for the two of you to work on together sooner rather than later.

Tips for Teething

Again, you should touch base with a pediatric dentist and pediatrician, but in the meantime, you can continue using traditional teething relief methods such as:

Distracting the child with fun activities
Offering teething rings designed for chewing
Giving the child a washcloth soaked in ice water
Using pain relievers if approved by the doctor

Hope this helps. Best of luck to you and Jake!

This blog is sponsored by Dr. Raymond Bolt, a general dentist providing pediatric dentistry services in Auburn, AL.

Is Pediatric Dentist Right to Blame Fruit Snacks for Cavities?

Posted on October 31, 2021 by Athena Smiles.

I took my six-year-old daughter to the pediatric dentist last week and she discovered three cavities on my daughter’s back teeth. We’re very diligent about brushing in our household. I still do most of the brushing myself. So, I was naturally alarmed and looking for potential causes when I learned what was going on.

The pediatric dentist asked us a few questions about my daughter’s diet and, when I mentioned she sometimes ate fruit snacks, she abruptly stopped me and told me that was what caused it. I couldn’t even get a word in edgewise after that.

I want to be clear that the ones we have at home aren’t just junk—they’re made with real fruit. We don’t even do soda at our house. Is it possible there’s something else going on here?

Thank you,

Justine

Dear Justine,

Great question! You’ve provided lots of details which is very helpful.

The Fruit Snacks Could Be a Problem

It’s not the fruit content (or lack thereof) that’s the problem when it comes to fruit snacks. They’re sticky and compress into grooves of teeth where they tend to sit much longer than other types of food do. That’s probably why your dentist pointed to them as the culprit. You didn’t mention which surfaces of the back teeth developed cavities, but they usually form in the grooves. It makes sense that the fruit snacks would be involved. That doesn’t make them the enemy per se, but, certainly, you’d want to remove that residue as soon as possible after brushing.

Note, this also doesn’t rule out other possible causes, but when it is the biting surfaces of the back teeth like this and other teeth or surfaces aren’t impacted, it’s typically related to diet and hygiene.

Your Daughter Should Have Sealants

What’s perhaps the first red flag here is that you say your daughter is six and is getting cavities on her back teeth. That’s somewhat common with younger kiddos because they’re not great at scrubbing all the way back there. So, usually starting around age six, pediatric dentists start placing sealants on those grooves to prevent cavities from forming. Maybe your kiddo is a young six and this hasn’t come up yet, but it probably should have been discussed by now. Bring it up with the next dentist she sees so you can protect the other teeth.

You Should Still Do the Brushing

It’s good that you’re still doing most of the brushing, but you should probably be doing all of it at this stage. It’s usually not until a child reaches age six that they can start brushing on their own with supervision, but some kiddos develop the skills months or years later. If your daughter can’t tie her shoes yet, she’s probably not ready for solo brushing either.

Your Pediatric Dentist Should Have Heard You Out

The final red flag here is that the dentist wasn’t willing to hear you out. That’s concerning. You’re an involved parent and are trying to provide the best care for your child. If nothing else, she should have taken the time to explain why she felt the fruit snacks were the issue and/or how she ruled out other causes.

There’s also no mention of what she recommended to help prevent more cavities. Did she talk about brushing? Sealants? Fluoride? These are all absent from your note. If she didn’t bring them up, she should have.

All these things combined suggest it’s time to look for a new provider in addition to trying to prevent more cavities.

This blog is sponsored by Dr. Raymond Bolt, a general dentist providing pediatric dentistry services in Auburn, AL.

What’s the Best Way to Come Out to My Pediatric Dentist?

Posted on September 30, 2021 by Athena Smiles.

I’m 14 but my mom still takes me to a dentist for Kids in Auburn. I am trans and use the pronouns he/him and they/them. I came out at the end of last school year. Telling the school was scary but the principal talked to everyone and promised that teachers would use our chosen names and correct pronouns. My friend came out at the same time too so that helped.

Anyway, I’m supposed to see the dentist during fall break and I’m not sure what to do or say. I don’t want them to use my deadname but telling them is terrifying. What if they refuse? Or say something? Or kick me out?

Yes, my mom knows, but she doesn’t say much about it and I’m afraid to ask her to tell them too. What do I do?

-T.

Dear T.,

First off, it was very brave and mature of you to write this letter! You got this!

Talk to Your Mom Again

You were probably expecting this, but your first stop should be a chat with your mom. Maybe start by telling her how much her support and help means to you and then outlining your concerns. If she’s onboard, she’ll be your best advocate with this and so much more going forward.

You Won’t Be the Pediatric Dentist’s First LGBTQ+ Patient and You Won’t Be the Last

Auburn may a smaller city comparatively, but as you noted things are changing and even the schools are setting new guidelines for inclusivity. That means there are lots of kids like you and your friend and your dentist likely already has some LGBTQ+ patients.

If you decide to move forward with telling them, enlist your mom’s help. She can talk to the practice ahead of time and ask them to notate your records, so the team uses the right name and pronouns when you visit.

The other reason why it’s a good idea to bring your mom into the loop is so that she can feel out the response from the office for you ahead of time. As you noted, there is a possibility that they might not be agreeable or welcoming. If that’s the case, then you and your mom will need to discuss your next steps together. As your parent, your mom obviously gets the final say, but it sounds like you can at least have an open dialogue with her and she’s willing to hear you out. That’s a good start.

If, for some reason, things don’t go well when you talk to your mom, you may want to talk to your school guidance counselor. Oftentimes, a counselor can give you pointers on how to talk with your mom, can help get the dialogue started, or can link you up with some local resources and support.

Hang in there and best of luck to you!

This blog is sponsored by Raymond Bolt, a family dentist providing pediatric dental services in Auburn, AL.

Will Tooth the Pediatric Dentist Damaged Heal on its Own?

Posted on August 30, 2021 by Athena Smiles.

My teen still sees a pediatric dentist, mostly because the office does ortho and she was undergoing treatment until recently. When she successfully completed treatment, they recommended we do a fixed retainer rather than a removable one because they weren’t sure she’d wear the removable one like she should.

Well, she just started back to school and sings in the choir, so almost immediately after classes resumed, she began complaining that the fixed retainer was making it impossible to sing. The pediatric dentist asked her to give it a bit more time to get used to it, but she was coming home crying almost daily, so I pushed him to remove it.

I’m not sure what happened, but while he was removing it, one of my daughter’s lower front teeth was banged. It looks bad. It’s darker now and seems to be out of place. She’s also complaining that doing just about anything hurts.

The dentist took an x-ray and ran some tests. He said he doesn’t see anything wrong with the x-ray, but since the tooth responds to cold, he thinks it’s dying and will need a root canal. He referred us out to a specialist for it.

My questions are, first, isn’t the fact that it’s responding a good sign? Second, since he didn’t see anything on the x-ray, is there still a chance this will heal on its own?

Thank you,

Lynn

Dear Lynn,

There’s a lot to be concerned about here. Let’s break this down.

Dead and Dying Teeth Do Not Heal

When a tooth is diagnosed as dead or dying, it means the pulp inside the tooth is no longer vital, so it’s not capable of fighting off infection. The only fix in these situations is a root canal. Symptoms like responding to cold are signs that a root canal may be necessary, particularly if she’s experiencing a pain response when the tooth is cold. The coloration and clear indications of trauma point in that direction too.

The Pediatric Dentist’s Remarks Are Questionable

It’s worrisome that the dentist isn’t making a diagnosis given everything he’s seeing. It’s equally concerning that the tooth was damaged in what should have been a routine procedure. This is something that he should be covering—if he hasn’t already offered to pay for the follow-up treatment, you should ask him about it. Better yet, get a second opinion. You can take her to your family dentist or to a specialist to confirm the diagnosis. If that dentist sees what you’re describing and feels it needs a root canal, you can also ask his office to send a request for payment to the dentist who injured the tooth. Although some will avoid getting in the middle of these kinds of things, you can sometimes eliminate extra hoops to jump through by having the new treating doctor make the request.

Don’t Delay Treatment

If this is a dead or dying tooth—and it certainly sounds like it is—it’s only going to get worse. Get it checked out before your daughter’s in serious pain. Best to both of you.

This blog is sponsored by Dr. Raymond Bolt, a family dentist providing pediatric dental services in Auburn, AL.

Can a Pediatric Dentist Give My Teen Dental Implants?

Posted on July 15, 2021 by Athena Smiles.

I’m wondering if it’s normal for a pediatric dentist to refuse to do dental implants for a teen. My 13-year-old son took out both of his front teeth in a skateboarding accident last week. He’s mostly fine other than the teeth—he was treated in the ER and released on the same day. However, their doctor said we should discuss the possibility of dental implants with his primary dentist and that’s where we’re getting stuck.

I phoned the pediatric dentist to inquire about the process and they said they don’t do dental implants—that it’s better to wait until they’ve matured and to do something like a flipper until they’re adults. Well, my son isn’t irresponsible. He just had an accident. I don’t want him going around without teeth or getting stuck with obviously fake teeth.

Is it normal for kids dentists to refuse implants? If so, should we try a general dentist or some type of specialist?

Thanks,

Jill

Dear Jill,

Sorry to hear about your son’s accident! It sounds like your dentist could have explained things better. Let’s go over the challenges and your options.

The Jawbone Doesn’t Usually Finish Developing Until Age 18+

It’s unlikely your dental office was referring to emotional maturity or responsibility. The jawbone, itself, doesn’t finish growing until the late teens or so. Every child is different, and boys tend to get there a little slower than girls, but most kids aren’t physically ready for implants until around age 18. Growth is an important factor because, if the implant is placed too soon, it can prevent natural teeth from shifting as they normally would and impact the bite. Smiles can wind up crooked and implants may not be in the right position either.

Flippers Are a Good Choice Until Your Son is Ready for a Dental Implant

While your son is still developing, it’s generally better to use temporary and removable appliances to fill the gap his missing teeth left behind. He may need to have it replaced a time or two to accommodate growth while he’s waiting on the dental implant too.

Be Wary of Pediatric Dentists Offering Dental Implants

While some pediatric dentists have no doubt undergone training to place dental implants and may well do a fine job, it’s not something they usually do simply because kids aren’t ready for implants very often. For that reason, most will refer their patients out if they think it’s a possibility. If, by chance, you happen to find one who is willing to do it, find out how often they perform the procedure. You want someone who is regularly placing implants to handle this, not just someone who does it occasionally.

With that in mind, you may want to look for a family dentist who can take over his care or connect with a specialist, such as a periodontist or oral surgeon, who can monitor his growth and let you know when he’s cleared for the implants.

This blog is sponsored by Dr. Raymond Bolt, a general dentist offering implant dentistry and pediatric dental services in Auburn, Alabama.

How Can I Make Pediatric Dental Visits Easier for Autistic Child?

Posted on June 30, 2021 by Athena Smiles.

My six-year-old daughter was just diagnosed with Autism Spectrum Disorder (ASD). She was five the last time we tried going to the pediatric dentist and it went very poorly to say the least. She was screaming and crying. At the time, we didn’t know what was going on and the dentist treated it as a behavioral problem. He insinuated it was our fault—that we weren’t good parents—and told us not to come back until we could “control our child.”

I look back on that and it just breaks my heart. I knew the dentist was way off base and that something more was going on but I couldn’t place it at the time. Now, trying to get back into things, we not only have to find a pediatric dentist who can work with kids on the spectrum, but also try to make up for a horrific first dental visit. I’m really not sure where to start. Any help would be greatly appreciated.

Thank you,

Kandace

Dear Kandace,

Big hugs to you and your little one, mama! It sounds like you’ve had quite the journey. As you probably know by now, ASD is a broad term and kids on the spectrum can have different symptoms or respond in unique ways to the same stimuli, so what works for one kiddo may not be what works for your kiddo. Because of that, the following will be general tips. You’ll need to consider your daughter’s specific needs and work with her care team to come up with the best solutions.

Find a General or Pediatric Dentist Who Already Works with Kids on the Spectrum

You don’t necessarily need to stick with a pediatric dentist, but you do need to find someone who already works with those diagnosed with ASD—more specifically, kids who are similar to your daughter. Make note of specific behaviors your daughter exhibits—is she sensitive to sounds? Lights? Touch? Changes in routine? How does she behave when she experiences these situations?

Find out how the dentist will handle each situation and make sure the team is prepared prior to bringing your daughter in. You can also request a consultation with just you prior to your daughter’s first appointment, a visual “no touch” appointment, or a tour beforehand. While not all dentists offer these options, they can be incredibly helpful for kids with ASD.

Prepare Your Daughter for the Visit

When you’ve selected a dentist, get a complete walkthrough of what the visit will entail from the moment you walk through the doors. Because many kids on the spectrum struggle with new places and situations, you’ll want to familiarize her with the process and expected behaviors as much as possible beforehand. Some families find it helpful to create a storyboard or book together, while other families like to create a checklist of activities.

Bring your daughter’s favorite tools with her. If lights bother her, bring a pair of sunglasses along. If noise creates issues, bring along some music and headphones or noise-reduction headphones. Touch may always be a sensitive spot, but you may be able to prepare her for the visit better by acting out events ahead of time. For example, you can roleplay and count each other’s teeth using a toothbrush or mouth mirror from the dental aisle or practice what sitting still in the dental chair will be like.

Be Open to the Idea of Sedation

At the end of the day, your daughter will need to have her teeth professionally checked and cared for. If visits end in chaos or are creating undue stress for her, sedation may be the only route to proper care and can help her maintain a more positive attitude about dental visits in the long run. It’s not right for every child, but if visits are still difficult despite everyone giving it their best, it’s something worth talking to your dentist about. Best of luck to you and yours.

This blog is sponsored by Dr. Raymond Bolt, a family dentist and provider of pediatric dental services in Auburn, AL.

Pediatric Dentist is Billing for Things That Weren’t Done

Posted on May 15, 2021 by Athena Smiles.

I think our pediatric dentist is billing for things that weren’t done. My son started going to this new office about two months ago after our insurance changed. On the first visit, the dentist caught a couple of cavities she said needed to be filled. My son is usually great about brushing. He’s eight, was getting regular checkups at a different office before this one, and never had an issue. I was a little surprised that she found two but I didn’t question it all that much. After all, she’s the doctor.

Anyway, he went in and had those two fillings done and, just the other day, I got a notice from the insurance company. It seemed like the standard post-visit thing that breaks down pricing and what we were responsible for paying, but instead of saying he had a filling, it listed code D2930 and said something about a stainless-steel crown. At first, I thought I was mistaken, but I looked at the work and my son doesn’t have any metal showing in his mouth. So, then I called the office and they gave me a story about how sometimes the insurance company changes the code to allow for al alternative payment.

Does this sound right? If not how should I address it?

Thanks,

Trea

Dear Trea,

You’re correct. Something’s not right here. Either the person who helped you at the pediatric dental office was very confused or there’s something else going on in that office.

Dental Insurance Companies Are Known to Downgrade

Oftentimes, dental insurance companies will pay for the least expensive treatment that will solve the issue. For example, if the dental office had billed for tooth-colored fillings, it wouldn’t be unusual for the insurance company to only pay the price of amalgam (silver) fillings. Dentists rarely use amalgam nowadays because composite fillings allow for more of the natural tooth to be retained and don’t generally have the same kind of leakage and breakage we see with older silver fillings. But, insurance companies see them as an acceptable level of care, and so sometimes they’ll only cover the cost of those rather than white fillings.

When an insurance company downgrades, they make it quite clear that’s what they’re doing. They’ll list the procedure that was billed and note that they’re paying a downgraded fee.

Dental Insurance Companies Don’t Upgrade

What you don’t often see is the inverse—dental insurance companies offering to pay more than the rate the dentist is charging.

There isn’t Much of a Price Difference Between Resin Fillings and Stainless-Steel Crowns

The price for a composite (tooth-colored) filling depends on a few factors, such as whether it’s a front tooth or back tooth and how many surfaces are involved. Generally speaking, a two-surface posterior (back tooth) filling is going to be less than the price of a stainless-steel crown. At three surfaces, the fillings become more expensive. With that in mind, it seems like an odd scheme if an office is intentionally trying to gouge the insurance company. Especially because anyone can look inside your son’s mouth and easily identify if a metal crown is present.

Talk to Your Insurance Company About the Pediatric Dentist

Given how you describe the situation, it doesn’t sound like they’re intentionally up to no good, but they may not be billing accurately. Give your insurance company a call and let them know what your concerns are. They’ll be able to read the documentation sent and any codes submitted to determine what treatment the office is saying was performed. Since it sounds like they have a contract with your dentist, they’re likely to launch an investigation of their own if they have concerns about the validity of the claims being submitted. You may want to ask them to follow up with you to let you know the results. They don’t always do that without a formal request. Best of luck to you and yours.

This blog is sponsored by Dr. Raymond Bolt, a provider of pediatric dentistry services in Auburn, AL.