Wednesday, October 21, 2009

The Tooth Fairy is NOT our Friend

Bright and early this morning I had to take Dear Child to the dentist. Today cost me very little, an hour of my time and about $18. Unfortunately, the real bill is coming soon.

As folks who've been reading for a while know, I have 4 kids. Three of them are adults, the youngest is nearly 7. Children 2 and 3 have your average teeth. A few cavities over the years, a little ortho for one of them, some wisdom teeth extracted, but nothing out of the ordinary. Child 1 and Child 2 on the other hand, are giant dental money pits. All four have been raised basically the same. I nursed each of them extensively, including at night. They started solids around 6 months, they've all eaten their fair share of junk. None of them was particularly OCD about sticking a toothbrush in their mouths after every meal when they were little but none of them ran screaming at the sight of a toothbrush either.

Child 1 (a boy), first developed little brown spots all over his baby teeth at about age 2. We'd go to the pediatric dentist, he'd fill them. Six months later, there would be decay around the fillings. We'd put in bigger ones. They'd decay again and there wouldn't be enough tooth left to fill, so we'd crown it. One of them decayed under the crown and formed a nasty abcess. That tooth had to be pulled and a space maintainer put in because he lost it about 6 years early.

This was 30 years ago and people mostly thought we were insane. "They're just baby teeth." "They're going to fall out anyway." "Why would you pay all that money for a toddler's teeth?" Those were examples of the kinds of questions and comments we got. He also ground his teeth so badly that he could be heard in the living room all the way from his bedroom upstairs. I bought a silicone sports mold for him that took care of that, although that was the one place I cheaped out. I could have paid a few hundred dollars for one "custom-made" by the dentist. Instead I shelled out about $20 for a sports one, stuck it in hot water then had Number 1 Son bite it. Voila, instant "custom-made" mouth guard. It worked like a charm.

He's had continual problems with his teeth as a teen and as a young adult. Over the past couple of years he's had most of them extracted and has a full upper and partial lower plate.

Dear Child (Child 4) also developed brown spots as a toddler and it progressed to "apple core" front teeth as we didn't have a dental plan intitially, although we were doing cleanings, etc. She went from a regular pediatric dentist to a specialist one once I sold my condo and we put about $5k worth of work into her mouth at that point. Ten silver crowns, 2 white ones under anaesthetic in a special facility. Now, her 6 year molars are mostly in and starting to show decay (at least one came with a "factory installed" cavity, which is not unheard of because the decay goes down from the existing teeth to the buds below the gumline). One of her silver crowns is sideways in her mouth because the roots are resorbing into her jaw and, of course, it's one she shouldn't lose until she's 12 so she's going to need a space maintainer there when it either falls out or is pulled.

We had a panoramic x-ray done 3 to 6 months ago and can see that the first 8 permanent incisors are moving into position although she hasn't lost any baby teeth yet (2 are slightly wiggly). We can also see that the new teeth are about half again as wide as the current ones. That's a problem. There isn't room for them. If they try to come into the space they'll have, they will all be crooked and the ortho will be getting involved pretty soon. (I, myself, had orthodontics twice. Once as a teen. Once as an adult. Plus had 4 bicuspids and 4 wisdom teeth extracted. Plus had jaw surgery. I know this road. It's neither fun nor cheap.)

So, what's the plan? Well, we're trying to wait another 3 months for the molars to come in a little more fully. Then the dentist says we need to do surgery again. Pull 8 to 12 of the front teeth so the new 8 front ones will have room to come in straight. Pull the one that's half out and put in a space maintainer that attaches to the molar (why it has to come in more). Then pray.

All in all, it will cost us about $3,000 because the cost of the facility and (I believe) the anaesthetic aren't covered and there's only partial coverage on some of the rest (50% to 80%). Ain't that fun? I know I'm just all warm and fuzzy about it right now.

First there's the little problem of all that money, which we don't have at the moment. Second, that's really major to take half her teeth out at once. Her speech is going to be impaired as well as her ability to eat solid food. I'm worried she'll have that caved-in look around the mouth typical of old grannies who don't wear their "teeth". And I know there will be a rough few weeks recovering while her gums are all soft and sore. But I also know that this is the best chance she's going to get for the teeth to come in straight. And, as the dentist pointed out, if we only did part of it we'd just have to go back and do more in 6 months or so. It would end up costing more in the end and she's already nervous about a second surgery, let alone a third one. Besides, it's best to minimize the number of times a person has to undergo a general anaesthetic.

So, it looks like this is what's in our future. We may have 6 months, but that's probably the maximum timeframe. I'm just glad individual picture day was this Monday! I can't imagine that she'll be smiling for a long time after all the extractions.

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