Pediatric Dentistry Archives | Dental Care at Flint's Crossing

Pediatric Dentist Sent My Child a Bill—What Do I Do with It?

April 30, 2021 by Athena Smiles

This is going to sound weird, but our new pediatric dentist sent my five-year-old son a bill. We’d been back and forth with them quite a bit—there were issues with them getting the insurance verified and them not getting paperwork to me in time. The day of the appointment, they called me and told me and told me that they had just stopped taking our insurance and that the visit would be billed with out-of-network charges. Quite frustrating because I’d booked the appointment a month in advance and had gotten their info from the insurance company.

Anyway, I decided just to go through with the appointment because my son was already prepped for it and the remaining balance would be small. So, we went ahead with the appointment and it didn’t go well. My son was squirmy and the pediatric dentist didn’t get to do the full exam. The “cleaning” was about 30 seconds of them brushing his teeth with a toothbrush. Not exactly what I’d call top-notch clinical work. We got through it, though, and I paid my portion at the end, and we left.

Here we are almost three months later and a letter comes in the mail for my son. It’s not just a bill—it’s a notice that they’re going to send him to collections if he doesn’t pay the remaining portion, which is now pretty much the full amount because apparently there’s no out-of-network coverage.

I’m somewhat tempted to blow it off and let them try. It’s not going to go anywhere and I’m more than a little upset that we wound up with the bill anyway. The whole thing could have been easily prevented if they’d just been on the ball. Can I safely disregard the notice?

Best,

Talia

Dear Talia,

You’re probably not going to like this answer, but you should just pay the bill. No doubt, you signed an agreement saying you’d accept full responsibility for payment even if insurance didn’t pay. Ultimately, it’s your bill to pay since you entered into an agreement with the practice. Sending the bill to your son could give you some wiggle room if it ever came down to it, but that’s really something you’d need to take up with a layer.

Yes, they biffed this one pretty big. It sounds like there were a lot of things they could have done better. It’s hard to say how you could have gotten around it other than to be more familiar with your insurance plan and confirm on your own what the charges will be and what insurance plans to pay beforehand. Granted, that’s not something most people do, and most offices will take care of it for you with a high degree of accuracy too. But, ultimately, any charges accrued are your responsibility.

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

How Do I Make the Pediatric Dentist Take My Concerns Seriously?

March 31, 2021 by Athena Smiles

I took my six-year-old to the pediatric dentist last week and she had cavities again. Two this time. She’s already had four others. Two of those turned into extractions and the other two needed baby root canals.

The thing is, we’ve been vigilant. Seriously vigilant. She doesn’t get juice or soda and I don’t bring anything sugary into the house. Ever since the last round, I’ve done 100% of her brushing for her. Always at least twice per day and I do three when we’re home together on the weekends. Yes, we’re also using fluoridated toothpaste.

This is upsetting as it is. I wanted to know what else we could be doing or why she keeps getting cavities, so I asked the dentist while we were in. Instead of helping, she told me it was my fault for not doing more to take care of my daughter’s teeth. I told her what I was doing and she replied, “Well, your daughter’s cavities say otherwise.” She basically called me a liar.

There must be other things that could be causing this, right? How do I get her to take me seriously and help us find the cause?

Sincerely,

Kim

Dear Kim,

So sorry to hear you are going through all this! Let’s break your question down.

Lots of Things Could Be Causing Your Daughter’s Cavities

She could have a genetic predisposition to have more cavities. She could have some form of structural anomalies or the enamel may not have developed correctly. She could also have an undiagnosed medical condition causing the issue. The bottom line is that you know what you’ve been doing at home and if that isn’t working, then keep being your daughter’s champion until you find a solution or answers.

Get a Second Opinion (And a New Pediatric Dentist)

The pediatric dentist should have taken you more seriously to begin with. Unfortunately, if that’s her nature, there’s not a whole lot you can do to turn her around. Even if you convinced her to keep looking, she wouldn’t have the attitude of someone who cares. She’d go into it to check off boxes.

Instead of pursuing this with her, have a consult with another dentist and touch base with your daughter’s pediatrician too. If there’s going to be a lapse between now and your appointments with them, there’s probably no harm in letting the current dentist take care of these cavities. It sounds like they tend to progress fast with your daughter or the dentist is missing them until they’re large. You don’t want them left untreated for long. Best of luck to the both of you.

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

Will a Pediatric Dentist Whiten My 9-Year-Old’s Teeth?

February 28, 2021 by Athena Smiles

I’m wondering if it makes sense to take my nine-year-old to a pediatric dentist for an evaluation. She’s always been worried about the color of her teeth, but over the past several months, the kids at school have been really unkind to her. The other day a boy in her class told her that wearing a mask was an improvement and she came back home in tears.

We normally all see the same dentist, so I phoned them to ask about doing some teeth whitening. They told me they never do whitening for anyone under age 18 and that no dentist will do it for kids under 16. That doesn’t make any sense to me at all. I’ve had it done and it’s safe. I had no trouble at all.

I’m worried about doing at-home whitening without some kind of dentist supervision, but that’s honestly what we’re going to wind up doing if I can’t find someone who will help. I can’t let her keep going to school and be subjected to this every day. Do pediatric dentists ever do whitening or do we have other options?

Thank you,

Annika

Dear Annika,

Kids can be so cruel. Sorry to hear your daughter is dealing with this. Let’s explore some possible solutions.

Chances Are, Your Daughter’s Teeth Are Normal

A survey of 2,495 children revealed nearly one-third are dissatisfied with the color of their teeth. Less than 20% of parents felt the same and just 9% of dentists felt the kids had an unsatisfactory tooth color. In other words, kids are much harder on themselves and often see an issue when the color of their teeth is perfectly normal and expected for their age group.

The challenge may also be that the structure of primary teeth and permanent teeth are different. Whereas baby teeth have a larger pulp area, adult teeth have more enamel and dentin. The dentin, therefore, shows through on adult teeth a bit more, which can make them seem yellow by comparison.

Your daughter’s likely at a stage where multiple primary and permanent teeth are visible when she smiles, so certainly, some teeth may appear darker or yellower than others. That’s true across the board, even of the kids making unkind remarks. None of this will necessarily help when a child is being bullied, but it may offer your daughter some reassurance.

The Problem with Whitening is Usually Sensitivity

Somewhere between one-third to one-half of people who whiten their teeth experience some degree of sensitivity. Adults generally understand the nature of their sensitivity, can manage it, and know it will pass. Kids don’t always have the same benefit and it can be more traumatic.

Adding to this, kids using at-home whiteners are more prone to abusing them. Understandably, if a child is catching flack at school, whether the kids are correct in their accusations or not, a large proportion of children will whiten more often than they should, keep the whitening gel or strips on longer than they should, or use more than they should, increasing the likelihood that they’ll develop sensitivity and other issues.

That said, a very small portion can develop more severe issues like permanent enamel disintegration and pitting. This is usually only seen when whitening products are misused.

Some Pediatric Dentists Might Offer Whitening

There are reports of kids as young as four whitening their teeth, but it’s generally not done in children under six. Your daughter is within a reasonable age for consideration, though each dentist will have his or her own philosophies on the age in which whitening is appropriate. That in mind, you may wish to speak with a pediatric dentist or someone who specializes in cosmetic dentistry. You’re on the right track with working with a professional on this, but you may have to talk to a few before you find someone who will either do it or explain why whitening is contraindicated for your daughter based on her unique needs rather than age. Best of luck to both of you.

This blog is sponsored by Dr. Raymond Bolt, an Auburn, AL family dentist offering cosmetic and pediatric dental care.

Pediatric Dentist Left Bruises on Son- Normal or Not?

January 20, 2021 by Athena Smiles

My six-year-old had to see the pediatric dentist to have two teeth removed yesterday. He was incredibly sore after and overnight. We tried icing it and giving him ibuprofen, but it didn’t really help. By this morning, it looked like he’d been in a boxing ring. I phoned the dentist to find out what happened and they told me there was nothing out of the ordinary about the treatment—just that sometimes this happens. I want to believe them. We have a good relationship with the doctor and all my kids have seen him, so we’ve been patients for probably a decade by now. But, I’ve never seen or heard of anything like this and it’s quite alarming. My son doesn’t remember anything about the treatment. They sedated him during the visit. So, I really don’t have anything but the word of the dental office to go on. Is this normal? Or should I have my son seen somewhere?

Thank you,

Ann

Dear Ann,

As scary as it may look right now, your son is probably experiencing a side-effect of receiving anesthetic and will be just fine in time. However, you should get him checked out by the pediatric dentist or a physician just to be sure.

Hematomas May Occur by Receiving Anesthetic

As Jacqueline J. Freudenthal, RDH, MHE, associate professor and chair of the Department of Dental Hygiene at Idaho State University explains, “A hematoma develops when a blood vessel (artery or vein) is inadvertently injured by the needle. If the injury is minor or the tissue is dense, a hematoma is unlikely to be noticeable extraorally.” She notes that the care team can help diminish the impact by stopping treatment and applying pressure and ice right away and continuing with ice off and on for the next six hours. So, you did the right thing by applying ice at home. However, she also notes that, “ If an artery or vessel is injured in a vascular area, such as the pterygopalatine or infratemporal fossa, a more dramatic response of swelling and bruising may occur.”

Most hematomas heal on their own with no further care needed. However, more serious cases do require additional treatment and follow-up care with the dentist or a physician. This has been observed and studied in children.

Sometimes Bumps Happen During Extractions

It’s also possible your son is more susceptible to bruising or was bumped during the extractions. This doesn’t happen much with baby teeth because they have shorter roots and tend to come out easier than adult teeth, but it’s possible trauma occurred during the extraction too.

Take Him to the Pediatric Dentist or His Pediatrician

It sounds like your instincts are spot-on here. Your son is in pain and has obvious signs of injury. Whether they happened during the course of normal treatment or not, he should be seen right away. Chances are, he’ll be sore for a bit and the marks will dissipate over the next couple weeks. However, if he is experiencing one of the rarer complications, medical intervention could be necessary. Give the pediatric dentist a call back and let them know you’d feel better if the doctor took another look at your son. If they can’t get him seen right away or you have concerns about what may have happened in the treatment room, have him visit his pediatrician or another doctor instead.

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

Pediatric Dentist Recommended Crowns for 4-Year-Old—Is That Normal?

December 10, 2020 by Athena Smiles

My four-year-old had his regular checkup with the pediatric dentist earlier this week and the doctor diagnosed two cavities. I didn’t know they were there before the visit, but once they were pointed out to me, I could kind of see them a little. They’re right in the middle of his two front teeth.

So, I don’t question that they’re there. The problem is, the dentist is recommending tooth-colored crowns as treatment. That seems a bit like overkill to me since the cavities are very, very small and these are his baby teeth.

To be clear, I want to do whatever’s best, but if this is overly aggressive treatment, I also don’t want to put him through all that. Right now, he does pretty well at the dentist and I’m worried having to have crowns done will be traumatic for him. I had a bad experience when I was little and am still afraid of the dentist to this day. I don’t want him to go through the same thing. Is it possible fillings are enough?

Thanks,

Geraldine

Dear Geraldine,

Sorry to hear you had a bad experience. Sometimes those things do stick with people and it’s more than understandable that you’re approaching this with some caution. You’ve asked some good questions too. Let’s break them down.

You Can’t Tell the Full Picture by Looking at the Outside of the Tooth

Sometimes cavities can be misleading. They may appear small on the surface, but still cause a lot of damage within the tooth. Your pediatric dentist probably took x-rays to aid him in the diagnosis. They give a better indication of what’s happening inside the tooth.

Crowns Might Be Warranted

Crowns are usually only done when the decay is extensive or the tooth has other issues and needs a “baby root canal,” otherwise known as a pulpotomy. Since you didn’t mention the latter, it sounds like the dentist believes the decay is extensive and the teeth will need extra support to stay intact.

Your son, under ordinary circumstances, would probably have those teeth for 2-3 more years, so protecting them is important. If they’re lost prematurely, his other teeth will start to shift to fill the gap, which often necessitates orthodontic treatment down the line. Sometimes kiddos develop issues speaking or with muscle development too.

Your Son Might Be a Candidate for Sedation

Oftentimes, doctors recommend sedation for children of this age when they need more intensive treatment. It helps ensure they stay still throughout the procedure and helps keep the appointment positive. Most kiddos sleep right through it and wake up in good spirits after with little memory of the procedure, itself. If your doctor didn’t mention this and you’re interested, ask him if it’s an option.

Talk to Another Pediatric Dentist if You’re Worried

Without a dentist looking at the x-rays and performing a visual exam, it’s impossible to say whether your son really needs those crowns or if a less invasive treatment will suffice. Moreover, it’s never a bad idea to get a second opinion if you’re unsure of a diagnosis. At the very least, it could help you move forward with treatment with greater confidence. Best of luck to you and your son.

This blog is sponsored by Dr. Raymond Bolt, an Auburn, AL dentist treating kids through adults.

Can a Pediatric Dentist Really Help with Bed-Wetting?!?

October 24, 2020 by Athena Smiles

My sister-in-law says her pediatric dentist helped her nine-year-old son stop wetting the bed at night and told me that I should take my seven-year-old in for the same kind of treatment. I’ve never heard of such a thing and no matter how much I search online, I can’t find anything that relates to what she’s talking about either. I’m starting to think she somehow got her wires crossed, but she’s very adamant about it. Is there a connection here? If so, what did they have done?

Thanks,

Laura

Dear Laura,

This is a great question on a topic that’s rarely discussed in pediatric dentistry. Your sister-in-law is not off her rocker, but her son may be experiencing a somewhat rare condition.

First, Some Quick Stats on Bedwetting by Age

According to research published by Harvard, somewhere around 80-85% of kids are dry throughout the night by age five. The number of kids still wetting the bed decreases about 15% per year after that even when no action is taken. By the time kids reach 15, only about 1% still wet the bed. At your son’s age, he probably “should have” outgrown bed-wetting, but it’s not necessarily a huge cause for concern yet.

There are Many Potential Causes

Developmental: Sometimes kids physically develop slower—it takes a bit longer for them to control over urinary sphincter or to recognize their bladder is full.

Genetic: Harvard researchers point to two genes associated with bedwetting—one on chromosome 12 and another on chromosome 13. Vincent Iannelli, MD of Very Well Family says that if both parents wet the bed, there’s a 77% chance their child will too. If only one did, there’s a 44% chance.

Hormonal: Under ordinary circumstances, hormonal shifts that happen during sleep tell our bodies to make less urine. Some children don’t have the same hormonal shifts, so their bodies keep producing urine just as they would during the day.

Other: Additional factors, such as a “small” bladder can cause the issue too.

Health Issues: It’s worth noting that conditions like urinary tract infections and diabetes can be related to bedwetting too. For this reason, it’s always a good idea to bring the pediatrician into the discussion as well.

Sleep Apnea is an Often-Overlooked Cause

Obstructive sleep apnea (OSA) is the type of sleep apnea where the airway becomes blocked. It’s often caused by obesity, but sometimes people with a small airway or other risk factors can experience it too. Additionally, about half of all people who snore loudly have OSA too, according to the Sleep Foundation. The organization notes that children with “sleep-disordered breathing” often produce more urine and that “OSA may also have an effect on a child’s arousal response, bladder pressure, or urinary hormone secretion, all of which could contribute to nighttime bedwetting.”

OSA comes with a host of other issues well beyond bedwetting. If your son is experiencing it, he needs treatment regardless. However, one thing that can help with lots of cases is an oral sleep apnea device—a pediatric dentist or family dentist can have it made for you. This is likely what your sister-in-law was referencing.

Get it Checked Out

There’s no need to panic at this point, but be diligent with this and get it checked out in case there is a medical condition contributing—an infection, diabetes, or sleep apnea should all be treated. Your pediatrician can walk you through other options to help your son sleep better and feel better too. Best of luck to you and yours.

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

Do Pediatric Dentists Do Surgery?

September 15, 2020 by Athena Smiles

I’m wondering if pediatric dentists normally do surgery. Our 11-year old has been seeing the same dentist since she was a baby and normally does well, but this last time she went in, they told us she had a bad cavity and told us we needed to take her to another dentist for root canal surgery, saying they don’t treat kids her age there. That’s not true. I’ve seen teenagers in there.

I didn’t want to call them liars or start a fight over this. If they don’t want our business, fine. But, I still can’t help but wonder if there’s something we might have done that made them turn us away. I’ve been wracking my brain trying to come up with a logical reason they’d oust us and I can’t come up with one. So, I’m back to square one. Is this normal?

Thanks,

Ousted from the Pediatric Dentist in Auburn

Dear Ousted,

It probably wasn’t you or your daughter and they were probably telling the total truth. We’ll break it down.

Pediatric Dentists Do Common Surgeries

It’s common for pediatric dentists to do just about anything that has to do with baby teeth, including common minor surgeries, like tooth extractions. When a primary (baby) tooth becomes infected or has a large cavity that reaches the pulp or comes close to it, it’s not usually a “surgery” that needs to be done in a traditional sense. The procedure is called a pulpotomy. It’s similar to a root canal and many offices even call it a “baby root canal” because people are more familiar with the term. Most offices will perform pulpotomies and even place a silver crown on top of a baby tooth too.

They Often Refer Out for Complex Work or Repairs on Adult Teeth

Given your daughter’s age and your description, it sounds like it’s one of her permanent (adult) teeth that requires treatment, in which case, a traditional root canal is necessary. A dentist who specializes in helping kids might not do that kind of repair on an adult tooth, especially if he or she feels it needs a permanent tooth-colored crown on top after for added strength.

In these cases, they’ll often refer a patient to a family dentist for a root canal and crown or, at the very least, will refer the patient to a root canal specialist, known as an endodontist.

You May Be Happier with a Family Dentist

It doesn’t sound like they’re giving you the boot—not if they didn’t formally inform you that you’re not welcomed back to the practice after this tooth is repaired. However, if you want to ensure continuity of treatment and prefer to keep your daughter with the same doctor as much as possible, you’ll probably be happier transferring her to your family dentist.

This blog is sponsored by Dr. Raymond Bolt, an Auburn, AL dentist that provides comprehensive care for the entire family.

Can a Pediatric Dentist Help Us with “Mask Breath?”

August 24, 2020 by Athena Smiles

I don’t want to waste our pediatric dentist’s time, but I’m kind of at a loss for what to do. I’ve had no choice but to keep my six-year-old son in private daycare despite the pandemic. I’m a single mom and I have to work. The lady he stays with is very diligent about sanitation and requires that all the kids wear facemasks, so my son has his on for several hours per day. Shortly after she started her mask policy, my son started complaining about a bad smell in his mask. I thought it was the mask at first and we tried a few different kinds but nothing helped. Eventually, I look a look in his mouth and, although I don’t see anything wrong, his breath really does smell bad after he’s been wearing the mask. Is this worth a visit to the pediatric dentist or should I just set him up with mouthwash or something?

Thanks,

Pamela

Dear Pamela,

Generally speaking, masks don’t cause bad breath, clinically referred to as halitosis. However, now that people are wearing facemasks, they’re becoming more aware of what their breath already smells like.

Common causes of mask breath in people of any age include:

Failure to brush and floss adequately.
Eating foods like onions and garlic that create an intrinsic odor.
The development of oral issues such as cavities, gum disease, and infections.
Dry mouth, otherwise known as xerostomia, is typically seen in older people, but can affect people of any age. Without adequate saliva, food doesn’t get rinsed away, the mouth becomes more acidic, and issues like gum disease and cavities are more common.
Other health conditions like allergies, acid reflux, and certain cancers.

All that said, the vast majority of cases—perhaps as much as 90%—relate to oral hygiene, especially when referring to such a young person.

Sometimes people switch to mouth breathing while wearing a mask too

Although masks do not obstruct oxygen, sometimes people switch over to breathing through their mouth rather than their nose simply because the mask feels unnatural. This can lead to dry mouth too, which, again, can contribute to bad breath.

Start by addressing hygiene

If your son isn’t expressing any discomfort and you don’t see any signs of cavities or infections, start by making sure he’s brushing thoroughly at least twice per day and flossing. He may need some pointers or help. For now, you may want to hold off on using any kind of mouthwash. The alcohol-based kind can dry out tissues and any variety may just mask the scent rather than address the root cause. You can also watch how he’s breathing while wearing the mask—if you see the mask bellowing inward, he’s probably breathing through his mouth and might need some coaching and reminders to focus on nose breathing.

If better cleaning doesn’t solve it, visit the pediatric dentist

Your dentist will be able to help you determine if your son is still missing spots or if there’s another underlying cause that needs to be addressed. If you’re already established with a pediatric dentist, have him go where he’s already comfortable. However, you can also have him see your family dentist as well.

This blog is sponsored by Dr. Raymond Bolt, an Auburn family dentist offering comprehensive care for children and adults.

Thumb Sucking

July 31, 2020 by writeradmin

My five-year-old is still sucking her thumb. I am growing very worried she’s going to need braces if this keeps up. Plus she is starting school soon. What can I do to stop this?

Lydia

Dear Lydia,

We worry about everything when it comes to our children, don’t we? Here’s the good news. While she is still with baby teeth there will be no permanent damage to her bite. When children end up needing braces is when they suck their thumb well into their older childhood years and their permanent teeth are in.

As a dentist who has treated children for years, I’ve noticed that most of the time if parents don’t make a big deal out of the child needing to stop sucking their thumb, they usually do it on their own. For those who don’t, going to school and experiencing some mild peer pressure usually does the trick.

Occasionally, you’ll get a child who has the habit so engrained they have a hard time quitting even when they want to. If that is something you run into with your daughter, you can try something called Thum. It is a liquid you can put on her thumb that tastes quite nasty. If a child is ready to quit, this will help.

This blog is brought to you by Auburn Family Dentist Dr. Raymond Bolt.

Can a Tooth Infection Cause a Fever?

May 21, 2020 by writeradmin

I’m confused by something. My son’s dentist said that a tooth infection cannot cause a fever, but isn’t fever a sign of an infection. He’s been getting in a lot of teeth and now he has a fever. I’m wondering if one of those teeth has somehow gotten infected.

Missy

Dear Missy,

I’m hoping your dentist didn’t understand your question. It’s possible he meant that not every tooth infection develops a fever. In the early stages, especially, an infection is confined inside the tooth. Often that will not contribute to a fever. However, if it is left unrecognized and untreated it will begin to leak out of the tooth, often in the form of an abscess, which looks like a pimple on the gums.

Your bodies defenses kick in and one of those defenses is a fever. Any infection can present with a fever. Though some dentists say it isn’t true, most parents will say that some children develop a low-grade fever while they are teething. That doesn’t mean there is an infection. It’s just his body’s response to his pain.

If he’s teething and the fever is minor, I would start with some Orajel on his gums and children’s Tylenol for the pain.

That being said, if his fever is higher and there is reasons to suspect decay, you will need to see a pediatric dentist or a general dentist who treats children. Even during the COVID-19 quarantine, he can be seen for urgent dental needs.

Tooth infections are considered dental emergencies. This is because if they are left untreated, they will spread into the bone, which in your son’s case can damage his adult teeth, or they can spread to the heart, lungs, or brain.

Don’t panic over that. It would be an obvious infection to get that far. You are not in that stage, nor have you any indication of decay. He’s likely just teething or teething and fighting off something else.

Treat his pain and keep an eye on him.
This blog is brought to you by Auburn, AL Dentist Dr. Raymond Bolt.