Did Pediatric Treatment Do Unnecessary Treatment?
I’m a little worried our pediatric dentist is prescribing unnecessary treatment. We just started with him this past month because our five-year-old didn’t take to the general dentist so well. He noticed what he thought was one cavity starting, but David didn’t sit still and we couldn’t get x-rays either. He did much better with the ped and they did get x-rays, which confirmed the cavity, but found two more. We ended up doing sedation for the actual work. That part was nerve-wracking, but it came out great. David didn’t remember any of it and was back to his normal self pretty soon after.
However, when they called me into the room after, the pediatric dentist informed me that the one we initially thought might have been a “cavity starting” was actually quite large and required something called a pulpotomy and silver crown.
My question is this- if it was that big, why didn’t either dentist catch it beforehand? Is it really possible that something that severe would go unnoticed? I don’t want to think that the ped added in treatment just because he could, but I really don’t know him all that well and something doesn’t seem right.
It is possible, in certain situations, that the depth of decay couldn’t be evaluated well in advance. Let’s explore.
The Family Dentist Had Limited Scope
As you noted, yourself, the doctor you usually see wasn’t able to make a full diagnosis. Your son was wriggly that day, which is quite common for younger children, and that limited what the doctor could do. That’s precisely why he sent you to a pediatric specialist.
X-Rays May Not Have Given the Pediatric Dentist the Full Picture
X-rays are 1-D images of a 3-D world. It’s not always easy to identify the depth of decay until the dentist is actively cleaning it up. Plus, the person having x-rays taken has to sit extremely still in order to get a crisp picture. It doesn’t always work that way with younger kiddos. It’s natural for them to be energetic, their bodies are in constant flux.
The Pulpotomy and Crown Were Probably Necessary
Obviously, no one can say for certain whether the treatment was unnecessary, especially now that the work has been performed, but chances are it was required. A pulpotomy is a child’s version of a root canal treatment. This is required when a child’s tooth is infected, especially a back tooth.
It is especially important for children to keep their back teeth until they are around twelve-years-old when their adult molars come in. If they lose the tooth, the other teeth will crowd into the empty space guaranteeing the need for braces. Sometimes a tooth has to be extracted. If that were to happen, your dentist should place a space maintainer there to hold the spot open.
He Should Have Spoken with You
The real problem here is lack of communication. He or someone on his team should have come to speak with you before they started the additional treatment, in order to get your consent. Make certain you are clear with him that in the future before a different treatment is done, he is to come consult with you and get your approval. If he has a problem with that, you need a different pediatric dentist.
This blog is brought to you by the Cleveland Dentists of Angel Dental Care.