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2 Year Old Having Tooth Decay. On Breast Feeding. What Is The Treatment?

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Posted on Tue, 10 Jul 2012
Question: Hello Doctor,
My daughter is 2yr old and having deay in her frontal teeth. I have not yet shown her to any dentist. But, her pediatrician looked at it and advised that we should stop breast feeding for her(we are any way planning to stop after to 2yrs). I have attached a picture of her teeth.Decay was present only in 2 teeth, but within last two weeks I am seeing decay in 4 teeth. There is one tooth which has black dot on it (not shown in picture).
It looks like there is stain in her teeth but they could not be cleaned by brush If I touch that with my finger my daughter complains of pain(she talks well and knows to complain verablly). we try to brush twice a day, though she does not allow.
1) How bad does it look?
2) Can this be cured?
3) What is the usual treatment/medication for this?

Thanks, XXXXXXX
Bangalore.
doctor
Answered by Dr. Ashu Gupta (20 hours later)
Hi XXXXXXX

Thanks for the query.

I had seen the picture and noted the contents of your query. With the description it appears to be early child hood caries or Nursing bottle caries. This is very rampant amongst children of his age. This kind of caries is characteristically involved on the upper teeth alone. Typically caries is not seen in lower set of teeth because it is naturally cleaned while the child sleeps. Milk on the upper teeth is not cleaned automatically. It involves multiple teeth the description of 4 teeth points towards that.

After physical examination a Pedodontist can do a better staging of this particular problem. Since there is pain and increased sensitivity I think it is progressed to Stage 3 Nursing caries. Stage 1 is reversible with a dental paint. I think your child is beyond this stage now.

In the third stage, the enamel on the teeth is worn off, dentin is still present. The treatment for this particular stage is dental filling. I suggest you to take the child to a Pedodontist in your area. It needs immediate treatment to prevent certain complications. The complications include speech defect in future especially tha, ta, da where the tongue presses the back of the upper teeth. Crowding of the permanent teeth may occur due to loss in space. The child can face cosmetic problems and it is very sensitive issue.

I also suggest the following things from now on:

1. Rub the teeth with wet cotton after each feed.
2. Cheese has anti caries activity.
3. Use straw in case of sweet drinks so that it does not come in contact with teeth.

Let me know if I addressed all your concerns. Please use answer clarification before you close the discussion and rate the answer.

Regards,

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Ashu Gupta (4 hours later)
Helll Dr. XXXXXXX XXXXXXX

Thanks a lot for detailed reply.

How does usually dentist fill tooth?. Do they use anasthesia? I am worried about my daughter for the treatment she has to undergo. She is always afraid of doctors due to vaccination injection.
What is the recovery time after tooth filling? Will there be any pain after that?

She is having fever for last 3 days and pediatrician prescribed antibiotics .I will take her to near by pedodontics once her fever episode is over.

Regards, XXXXXXX
doctor
Answered by Dr. Ashu Gupta (20 hours later)
Hi XXXXXXX

Thanks for the follow up.

It is important for you to XXXXXXX the Pedodontist first. Let the need for filling is suggested by the Pedodontist on examination. If the caries progresses, she may need a root canal treatment as well.

The filling is done using simple instruments. It does not need anesthesia unless the child is not cooperative. The caries is removed and filled with GIC.

The recovery time is immediate and she can take foods within an hour. We do not expect any pain after such filling.

You can take the child after the completion of course of antibiotic.

Regards,
Note: Find out which dental treatment will work best for your teeth. Ask here.

Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
Answered by
Dr.
Dr. Ashu Gupta

Dentist

Practicing since :1996

Answered : 8 Questions

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2 Year Old Having Tooth Decay. On Breast Feeding. What Is The Treatment?

Hi XXXXXXX

Thanks for the query.

I had seen the picture and noted the contents of your query. With the description it appears to be early child hood caries or Nursing bottle caries. This is very rampant amongst children of his age. This kind of caries is characteristically involved on the upper teeth alone. Typically caries is not seen in lower set of teeth because it is naturally cleaned while the child sleeps. Milk on the upper teeth is not cleaned automatically. It involves multiple teeth the description of 4 teeth points towards that.

After physical examination a Pedodontist can do a better staging of this particular problem. Since there is pain and increased sensitivity I think it is progressed to Stage 3 Nursing caries. Stage 1 is reversible with a dental paint. I think your child is beyond this stage now.

In the third stage, the enamel on the teeth is worn off, dentin is still present. The treatment for this particular stage is dental filling. I suggest you to take the child to a Pedodontist in your area. It needs immediate treatment to prevent certain complications. The complications include speech defect in future especially tha, ta, da where the tongue presses the back of the upper teeth. Crowding of the permanent teeth may occur due to loss in space. The child can face cosmetic problems and it is very sensitive issue.

I also suggest the following things from now on:

1. Rub the teeth with wet cotton after each feed.
2. Cheese has anti caries activity.
3. Use straw in case of sweet drinks so that it does not come in contact with teeth.

Let me know if I addressed all your concerns. Please use answer clarification before you close the discussion and rate the answer.

Regards,