My Child had Painful Cavities, and I had Options

Ever have a kid with bad teeth? Like lots of cavities, pain from cavities, discoloration, over-crowding…etc. Did the child need some serious dental work, but the thought of going to Children’s and putting them to sleep make you a bit uneasy? Keep reading…

In my last post about our visit to Oak Mountain Pediatric Dentistry, I talked about how my 4 year old daughter needed some dental work done and the different options that OMPD offered. We were relieved to find out OMPD offers an “in-between” option for getting cavities filled in kids that is more than just laughing gas but not a full visit to Children’s of Alabama with putting them to sleep and intubating. (Did you know that is normal protocol for this type of dental work?) The “in-between” option is called PDAA (Pediatric Dental Anesthesia Associates), where they put them to sleep in the office, but it is more like a twilight sleep. OMPD is one of only four dentists in town that offers PDAA.

The PDAA option was good for my daughter, because she has quite a bit of anxiety when visiting the dentist. This can be normal in kids that haven’t been to the dentist much and have a lot of tooth pain (which she did!). We were able to get x-rays and knew she had at least 1 painful cavity, and possibly more. 

Leading Up to the Appointment

In the weeks leading up to our appointment, we received a few calls from the people at PDAA. They require an upfront deposit a couple weeks before, and then the balance a few days before the appointment. After the appointment is over, OMPD provided instructions on how to file the claim with your insurance.

A few days before the appointment, OMPD called to confirm the time of the appointment and what time to be at the office (they usually schedule the patients in order by age, with youngest children going earliest). PDAA calls a few days before the appointment to go over the pre-op instructions. These included making sure they have no solid food after going to bed the night before. (Or eight hours before appointment time, but they clarify this on a case-by-case basis.) Clear liquids can be consumed up to 3 hours before the appointment, but patients shouldn’t drink anything else from that point. They also ask questions about her health. Because my daughter had tubes and an adnoidectamy and has been put to sleep before, I know she wakes up disoriented and crying. This is good for everyone to know! 

Morning of the Appointment

When we got to OMPD, we called and they let us know when to enter the building. This is a COVID protocol so that there are not multiple people waiting together in the waiting room. When we got in, everyone was super friendly and greeted Samantha by name! Even Dr. Jeff Flannery came by to say hello! We were both temp checked and given hand sanitizer, and went ahead and used the bathroom. While Samantha colored, I watched a video on an iPad about her procedure.

Next our nurse Lauren came in and asked several great questions. She asked what Samantha liked to be called, to which she replied ‘Samantha’ (so much for all of the embroidered shirts she has that say ‘Sam’!). Lauren asked Samantha what flavor she wanted in the mask… cotton candy, skittles, bubble gum… Samantha chose bubble gum! Then she asked what Samantha wanted to watch on the iPad. They had Netflix, Disney+ and more so we were well versed in the options! Samantha wanted to watch a show called ‘Victorious’ on Netflix… she loves a good singing/dancing show! 

Next, the anesthesiologist came in. His name is also Dr. Jeff! Easy to remember! (Jeffrey S. Plagenhoef, MD, FASA if you’d like to Google him. He’s a physician anesthesiologist specializing in pediatric dental office anesthesia exclusively.) He explained what was going to happen. Samantha would walk back with Dr. Jeff the anesthesiologist, get to choose a toy from the toy box (she loves a good beany baby), get the iPad with her show choice, and then hold the mask with bubble gum flavor on her face. He checked her breathing and heart beat with a stethoscope. Samantha started getting nervous and a little teary, but she was very brave. She got to take her beloved bunny ‘Bethany’ back with her to the procedure (any comfort really helps!). I prayed with her, and Dr. Jeff carried her back. The anesthesiologist was with her the whole time, monitoring her during the entire procedure. 

One thing that amazed me about PDAA was that they bring to the office all of the standard monitors, drugs, and emergency equipment that you would find in hospitals and surgery centers. It really is amazing how they set this up to allow for anesthesia in a child’s dental office. I know I’m not the only mom who appreciates this option over a hospital visit!

During the Procedure

I was asked to wait in my car during the procedure. I probably waited about a total of 45 minutes, but it didn’t feel that long because they came to give me lots of updates! The nurse came back with paperwork and details on what recovery would look like. She said she should be feeling fine after a few hours, soft foods to start, and let them know if she developed any new symptoms like throwing up or fever.

Then Dr. Jeff Flannery let me know what they ended up doing since we weren’t quite sure if her tooth could be saved or exactly how many cavities she had. They ended up saving the tooth and filling two cavities. They also said Samantha had a chipped tooth; my little sugar monster will need start brushing better! Then the other Dr. Jeff came out to let me know she did great and that I could come get her.

When I came in the room, the sweet nurse Lauren was holding Samantha. They helped me get to the car and made sure we had all the new toys–she got 2, probably because she was nervous! She had a little bit of bleeding around her gums and treatment area, but I was assured that was normal. They gave me the numbers to call in case we needed anything, and we were all set.

Recovery at Home

Next we headed home! My sweet daughter was still drowsy and a little out of it on the ride home. She was a little fussy, kept ‘losing’ her stuffed animal even though it was in her lap. I had a blanket in the car (a recommendation from one of my calls with PDAA), so I covered her up so she would be extra comfy. When we got home I laid her on the couch to rest and watch TV. 

She wanted French fries first thing because she was starving (she hadn’t eaten since dinner the night before). Since no restaurants sell French fries at 10 in the morning, I made her some at home. She ate fine. I’d say she was about back to normal about 2 hours after her procedure. 

Samantha was very excited about her ‘new’ silver tooth! My son says its her lucky tooth and wants to rub it! Ha! It’s interesting to hear all of the thought and planning that goes into crown choices! Dr. Jeff explained that sometimes the space is too tight on back teeth, and silver is a more conservative and better option for the tooth, but white is always used on any tooth that is visible in a child’s smile.

Samantha is doing much better these days! She told me that her mouth doesn’t get cold any more when she drinks water (meaning, her tooth sensitivity is gone). She can eat on both sides of her mouth again. She really has been sleeping better. Before the procedure, she probably got up once to a few times a week with tooth pain requiring meds. She’s still not a great sleeper, but I will I’ll take what I can get! 

If you are worried about your child’s teeth and especially if they need some procedures, I would highly recommend Dr. Jeff and the team at Oak Mountain Pediatric Dentistry. I truly trust them with my heart… my baby girl!