Rainbow Braces

Phase One of Jersey #2's orthodontic treatment has begun.

We are visiting the Orthodontist 5 times in 5 weeks.  What an adventure!

The first visit was for me to take a very large chunk out of our Health Savings Account, and pay a down payment for the treatment.  I will just pause for a moment and Praise God for that HSA!  We started this account two years ago, when The Referee began a job that offered one.  The first year, we did not fund it to the full extent we actually needed, and came up short.  (I think that lesson has plagued us for years---not really realizing the full extent of healthcare expenses we need to budget, and coming up short).  This year, we thought we were much smarter to plan for our expenses.  Not only did we think we had enough money coming out of The Referee's paychecks, and into the HSA, to cover our healthcare expenses, but we thought we had planned for a little extra.  Wrong!  We did not plan for orthodontics to begin this year.  (We also did not plan for me needing a root canal this year---what a VERY EXPENSIVE dental procedure to try to save a tooth!)

Such is life.

...at least for us.

But, we did have that extra in the HSA, so the down payment was made, and the monthly payment plan was set up.  And, the crown I need, myself, will have to wait until January, when it is a new HSA year of funds (an amount that we will be increasing during the next open enrollment).  I have finally learned to not add credit card debt anymore.  (Yes, Dave Ramsey has changed my life!)  

Money matters aside, Jersey #1 also had impressions made during that first visit, and various other measurements taken.  Spacers were fitted between her back teeth, to make some room between her molars to hold the bands that hold the expander.  She was briefed about how she could no longer eat sticky foods (caramel, Starbursts, etc), or else the spacers would be pulled out.

I was briefed that if her spacers came out before the week was up, she needed to return and get them replaced. 

Sure enough, a spacer came out.  She wiggled it out with her tongue.

On a Saturday night.

I just knew this was going to mess up the whole orthodontic schedule.

I was on the phone with the Orthodontist's office when they opened Monday morning.  Jersey #2 was given an appointment to return on Tuesday morning to have the spacer replaced.  Thankfully, her Wednesday appointment would not be affected, and the full schedule could progress.

Of course, every single one of these visits requires a very large dose of Amoxicillin to protect her heart.  (Antibiotic prophylaxis to prevent Endocarditis).  At least I remembered to talk to the Pharmacist in advance, and learned that the bottle could last in the fridge for 14 days, leaving me with plenty on hand for these unplanned dental appointments.    

The Wednesday appointment was a big one.  It was suppose to last 2 hours.  I secured childcare for my youngin's, so I could devote my attention to the appointment with Jersey #2.  This appointment involved more measurements, placing brackets around those molars, taking more impressions for the expander device (with the brackets on the molars), and adding braces on 6 front teeth.  

There was also a big discussion about how teeth cleaning habits had to be modified to accommodate the braces and expander.  Jersey #2 was given a big bag of goodies to get things started right now.  She is to brush her teeth 3 times a day (instead of just 2 times), and for 3 minutes at a time (instead of the previous 2 minutes).  Plus, she is to add a fluoride treatment at night.  The list of banned foods was increased to include hard foods and hard objects (no chewing on pencils), and excessive sugary drinks/foods (no soda or bubble gum).  

The dental assistant informed Jersey #2 that she could pick up to 3 colors of rubber bands for her braces each time she visits.  She knew she was getting 6 braces, so she was planning to pick 6 colors of the rainbow.  Her favorite color is still "rainbow."  So, I asked the assistant if she would be willing to do the rainbow for this first visit only.  I was prepared to throw in the "it's her birthday next week" comment too, but that was not necessary.  The assistant immediately agreed, then leaned in and told Jersey #2 that if she asked nicely, the other assistants would probably be willing to do the rainbow for future visits too.  

The Orthodontist commented that Jersey #2 is a "great patient!"  I found that amusing.  I suggested that she has had a lot of practice being a patient.  He agreed.  I let him know that she was intrigued by his office, and all the new procedures, tools, posters, and gadgets he had all around.  She is a curious child, so she was using any down time to peek around and check things out.  

She has also taken the baton for questions.  Typically, The Referee and I are the ones who ask a slew of questions about every treatment and procedure.  For this Orthodontic treatment plan, Jersey #2 is making the Orthodontist and his assistants explain every single tool and procedure, before they do it.  She is drilling them with questions, and I am just sitting back listening and observing.  She really is a great patient.  She has already learned some skills on advocating for her own health.  She also questions them further if a suggested treatment does not seem necessary to her.  When they went to take an additional impression of her jaw, she made them explain why they needed a 3rd, when she only had 2 jaws.  I don't think they are accustomed to having a child interact with them like that.  I have been totally impressed by the way they take the time to explain everything, with joy.  So far, it seems they are happy to share more details about their job, with their patient who has such an inquisitive mind.  

It turned out that the 2 hour appointment only took 1 hour.  Jersey #2 really is a great patient.  Her cooperation made a big difference in their efficiency.  She left the office smiling from ear to ear with rainbow braces.

 

Toothless

It is official:  Jersey #3 has lost his first tooth (by natural means).

He was showing me that it was barely hanging on, when it fell out of his mouth and landed on the pool deck while we were out swimming.  Fun stuff.

I have to make the disclaimer that this tooth fell out by natural means, because Jersey #3 has already lost 4 teeth by unnatural means.

At one point, he had a full set of teeth....

He was involved in a bicycle accident when he was 4.  He rode his bike down a climbing mountain at a park, and wiped out.

At first the top teeth were only loose.  The dentist was hoping he could save them.

Unfortunately, loose teeth are too much of a temptation for Jersey #3.  He wiggled the first one out quickly.

Others were not far behind.

One tooth managed to secure itself before he had a chance to get it out too.  So, he was left with 1 dangling tooth for a couple years.

That tooth came out last year.

According to the dentist, it is going to take a couple more years before the permanent top teeth are ready to emerge.

Thankfully, Jersey #3 does not seem to mind his unique smile.  It does not seem to touch his confidence the way that I feared it would.

He still can't pronounce the "th" sound.  I suppose teeth are required for that.

It may be interesting to see if he is able to talk and eat well when he actually had a full set of teeth again!

The Road to Orthodontia

Jersey #2 had an appointment with an Orthodontist this afternoon.

That was an adventure.

Everything is an adventure with Jersey #2.  You would think that I would be used to it by now.

From the time that Jersey #1 was two years old, I have been told that she will need Orthodontic treatment.  No surprise there.  My sisters and I all had braces.  We have big teeth and small jaws.  It happens.  Jersey #1 also has a couple gum issues that are suppose to be addressed by the Orthodontist as well.  All these years, I have been waiting for the visit when the dentist would announce that it was time for Jersey #1 to go for an Orthodontic consultation.  Much to my surprise, our new pediatric dentist announced that Jersey #2 needs an Orthodontic consultation immediately, and Jersey #1 will most likely be able to wait until around age 12, when all of her permanent teeth have emerged.  I did not see that coming!

In addition to very large adult teeth, and a very small jawbone structure, Jersey #2 has a crossbite.  On one side of her mouth, her top teeth fit over her bottom teeth.  By the time we look at the other side of her mouth, her bottom teeth fit over her top teeth.  

The problem that suggested to the dentist that it was time to meet an Orthodontist, was her severe overcrowding.  On Easter, Jersey #2 lost a tooth that was not suppose to fall out for another couple years.  Her adult teeth are so crowded that they are now pushing baby teeth out of their way.  

Our pediatric dentist gave us a recommendation for an Orthodontist.  I had not taken the time to research Orthodontists yet, so I made a point to inquire with my friends on Facebook.  In the past few years, I have paid attention to Orthodontist threads and conversations, to prepare myself for what to expect.  When I was a young teenager, my Orthodontist pulled the first four molars in my mouth, to make room for my incisors that were growing in front like fangs.  Nowadays, I hear from other parents that pulling teeth is not the preferred method, and expanding the upper jaw is more common, to make room for the teeth.  I have also heard rumors that some Orthodontists push for treatment on young kids, which is twice as expensive because they often also need treatment during the usual young teen time frame, after the permanent teeth are in.  I have observed more 10-12 year olds in braces these days.  I was pleased when my friends assured me that the Orthodontist we were referred to was really good, and quite conservative in his treatments.  A nice guy who doesn't push for treatment, and doesn't charge until treatment actually begins!  When his office staff were extremely sweet on the phone, I was even more encouraged.

The Orthodontist and Jersey #2 hit it off right away.  She said he was "very friendly."  He commented that she was "funny."  When a provider enjoys a visit with Jersey #2, then I know that they really enjoy their work.  Jersey #2 never follows the textbook.  She is always a challenge, that doesn't always make sense.  When the Orthodontist made a point to bring up her need for antibiotics prior to treatment....and to explain which treatments would need the pre-med....I knew we had found the right Orthodontist!  

I almost forgot what it was like to take Jersey #2 somewhere by herself.  She has so much energy, and just climbs the walls.  She explored every detail of the office, from the big couch in the waiting room to the electrical socket in the floor near the chair.  She was up and down and all around the place.  It is amusing to me that she is still this energetic and curious at 8 years old.  

She was this way as a toddler, and it was exhausting.  I was reminded of the time I took her to the urgent care when she was 2 years old, because he was sick and not acting herself.  I told the Doctor that Jersey #2 had much lower energy than usual.  The Doctor had such a puzzled expression on her face as she watched Jersey #2 climb all over the exam table, and jump off it.  She just could not believe me when I said her energy level was much lower than usual.  (Jersey #2 did have an ear infection and a sinus infection at the time, so she was treated anyway, in spite of her "energy" level).

I was internally amused when this "conservative" Orthodontist, who has a reputation for not pushing treatments, especially at younger ages, recommended some pretty heavy-duty treatment for Jersey #2.  I was not surprised (because this is just the way things go for Jersey #2), but I was amused.  There are going to be 2 phases of treatment for her.  By the time she is grown, she will have an 8 thousand dollar smile to go with her multi-million dollar heart!  Praise God for Health Savings Accounts and interest-free payment plans!

Phase 1 pertains to the treatment while she still has baby teeth in her mouth.  Phase 2 will be the normal braces process after all of the adult teeth are in.  The goal of Phase 1 is to expand her upper jaw, and make some room for those big teeth.  Thankfully, her crossbite is not a true crossbite.  It turns out that her teeth do align midline, but she compensates by adjusting her jaw into a crossbite to get her teeth to touch and be more comfortable.  The Orthodontist was able to get her to hold her teeth in proper alignment.  Jersey #2 thought that made her mouth and facial expression look "mad."  So, we started calling it her "growl" face.

    

Even with the expander treatment, there is a big chance that Jersey #2 may need to have some teeth pulled anyway.  The crowding on the bottom jaw is so bad that her permanent incisors are starting to turn sideways under the gums.  It would be a mess if those become impacted.  So, the Orthodontist hopes to monitor them for the next 6 months and see if they will make attempts to come upward.  If not, she may need to have some baby teeth pulled, spacers put in to keep permanent teeth from taking up the space, just to encourage those incisors to come up.  

Jersey #2 is taking it all in stride.  She was excited to hear that she will get braces put on 6 of her top front teeth.  There are many colors of bands that can go on those braces.  Jersey #2 wants to get a band in each color of the rainbow, so 6 braces is a perfect number for her plan!  

I wish I had her spirit to find the rainbow in my life's abnormalities.  

What a heavenly gift she is!

Keeping Dentists Employed

We had a race of the loose teeth this week.  Both Jersey #2 and Jersey #3 were trying to wiggle loose teeth out of their mouths.  Jersey #2 won the race.  Her tooth came out with ease.

Jersey #3 is working on the last remaining top tooth in his mouth.  It is not really time for that tooth to come out.  It wasn't time for the others to come out either, but he took them out with a bicycle accident.  The lone tooth stood its ground for a long time.  But, it appears to be losing footage now.  Jersey #3 wiggled and pulled, but it was just not ready to let go completely.  So, now, he is left with it dangling by a thread on one side, hanging crooked in his mouth...

These jack-o-lantern smiles just crack me up.

I am hoping that laughter is the best medicine, because I can also see that we will be making quite an investment into braces and orthodontics in our future.

Our family's dental genetics is a dream come true for the dental industry.  I am pretty sure that when my children smile, dentists see dollar signs on those crooked, mismatched, groovy teeth.  When our pediatrician asked if the kids see a dentist regularly, I joked that our family single-handedly funds our dentist's summer vacations.  

Dental Blessings

I took the kids to the dentist this morning. It was time for their every-6-months cleaning.

I am thankful to have found such a wonderful pediatric dentistry to bring my thundering herd. They are sweet, kid-friendly, and provide excellent treatment. They schedule 3 kids at once and 2 kids to follow, so I can take everyone in the same visit. The working environment must be great too, because some of the hygienists, and the office manager, greeted us when we first visited 7 years ago....and are still there each time we visit.

But, I will openly admit that I still feel stress about taking them to the dentist. We have terrible teeth genetics. This is mostly due to my gene pool, for sure. Even though I fully understand that there is a great balance between genetics and environment in any health issue, I still anticipate being accused of poor parenting as the culprit of the numerous cavities.

It is a silly insecurity that is not even founded in truth. My kids teethe on toothbrushes as infants, and brushing is a regular routine in our household. The older children are able to fully explain to the hygienist about their brushing habits, which are always answered with praise. I am confident that I am teaching them good hygiene practices. Yet, I still wait to be accused of failing in this area.

Our pediatric dentist has never suggested that the kids' dental issues are a result of lifestyle or parenting. He actually points out which things are "defects" and which things are genetics. He usually shrugs off most cavities as a result of those "deep grooves." That is the same thing dentists told my parents about my teeth. Apparently, we have groovy teeth.

I sat in the waiting room, watching the kids play, bracing myself for the adventure ahead.

Much to my surprise, this was probably the easiest dental visit I have ever experienced with the children. All 5 of them blessed me with their cooperation. The older 3 were cavity-free! I practically skipped out of the building when we were done, because I was that thrilled.

I was concerned about Jersey #3 because his dental visits have been pretty intense for the past year. He had a stressful experience getting fillings, and followed that up with poor cooperation for his next cleaning. I bought him a battery-operated toothbrush to help mimic the sensations of getting teeth polished at the dentist, in an attempt to help decompress his sensitivities. I had a talk with him yesterday, to try to brace him for the visit and what to expect. I explained that he needed to be still in the chair and not wiggle, and he needed to cooperate instead of yelling. I was amused by his response as he informed me,

"No problem, Mom. I am SO over that now!"

I suggested he could talk to the hygienist and mention when something was bothering him, but that he could not holler. He agreed that he could handle it.

And he did handle it. He talked constantly with the hygienist and asked about every detail of the cleaning. He did not holler. His body language was tense, and it was obvious he had to work extra hard to keep still, but he cooperated. I was so proud of him!

Jersey #1 participated in the cleaning with ease, but still gagged at the attempt at getting bitewing x-rays.

Jersey #4 was nervous, but she was determined to do as well as Jersey #3. She is so stubborn and independent like that. I made her siblings stay back and let her handle herself on her own. She did not want their advice, or them sitting on the chair with her, or anything. She is a big girl too.....even if she did insist on wearing tap shoes with her outfit.

Jersey #5 took it all in stride. He is so mellow. He followed all the instructions, climbed into that big chair, and picked his own toothpaste flavor. He opened his mouth when asked, and was rather still for a 2-year old. He didn't complain or fuss at all.

Jersey #2 was a superstar. She has had 2 heart surgeries, a cardiac MRI, and doctor visits galore....so a dental cleaning was no challenge for her. She laid back in that big chair, completely relaxed, with pig-tails draping to each side. She informed the hygienist about the process, instead of the other way around. Her cleaning was complete in record time. It helps that she is missing a few teeth right now too.

After the cleanings, the Dentist made his rounds from child to child, updating me on their status....

Jersey #1 has a gum defect, which he recommends watching right now, but may require a visit to the periodontist in the future. It appears some of her gum did not attach to the permanent tooth properly as it came in.

Jersey #2 has 4 loose teeth. The tooth fairy will need to stop by the ATM here soon. Her big front tooth is technically "in the range of normal." The dentist said that he would not call it "odd-shaped" (like I called it), and says he is not worried about it at this time.

Jersey #3 has some tartar build-up between his lower front teeth. The dentist went to check it out further, and discovered those teeth are loose. So, instead of treating them, he will let them fall out naturally. That will be a first---natural tooth loss. Jersey #3 has 3 missing teeth from a bike accident. Today I learned that the permanent replacements will take longer to come down. Instead of filling the hole left behind by baby teeth falling out, his permanent teeth will have to break through the healed hole, more like cutting baby teeth. That should be fun.

Jersey #4 has some small cavities in the grooves of her teeth. Not much she could have done about that. She is pretty cooperative, so they expect to be able to fill them with ease.

Jersey #5 has a handful of small cavities, in the grooves of his teeth. I knew this already, as the dentist was waiting to treat until his 2nd molars emerged (so he could fix those too if necessary). I dreaded the suggestion of treating him under general anesthesia due to his young age. I was pleased to hear the dentist say that the cavities were small and should all be fillings (not caps), so he thinks this can be done in-office. Jersey #5 was so cooperative for his cleaning, that the dentist thinks it is worth a try to see if he will cooperate for fillings the same way (with the help of laughing gas). That is great news!

I was full of smiles and relief as the kids picked out their new toothbrushes and goodie bags. That was one dental visit that did not zap my confidence.

Hot Topics: Pacifiers

I was at the dentist the other day....completely on my own, without any children in tow....and happened upon a conversation about pacifiers. The office had a news show on the television, and a segment came up about some celebrity's child who was caught in photographs with a pacifier in her mouth. She was 4. This was apparently newsworthy.

I was appalled. A pacifier at age 4 is national news? Wow. There must not be much going on in the world, if this is the sort of thing that people are getting upset about. Sure enough, experts were brought in to discuss this breaking news topic. One expert was a Mom who never let her children go near a pacifier. One expert was a physician, who was going to give us all the appropriate response to pacifiers. One expert was a Mom who did not think pacifiers were much of a problem. Judging from the way the newscasters were acting about the subject, I knew that last Mom was going to get eaten alive on this program.

Thankfully, I missed the rest of the segment, as the dentist approached and was getting ready to work on my teeth. His hygienist could not resist sharing her thoughts on the subject while they got things ready. Her comments made me wonder if she even had any children.....or if she had even been around any children. I know that I knew a whole lot more about parenting before I ever had any children. The more kids I have, the less I know about what is best.

The hygienist began to explain to me that children should not use pacifiers after their teeth come in, because it could move their teeth out of alignment. I stared in awe, wondering if she knew what age teeth arrived in a baby's mouth. That would really limit pacifier use, if the arrival of teeth were the limit. I tried not to laugh as I thought about the number of times I have seen a toddler hold their pacifier to the side of their mouth, using their teeth. Kids can get really creative with the combination of teeth and pacifiers.

I didn't say anything. I just listened. I am really not passionate about pacifiers. Some parents like them, some don't. Some kids like them....some kids REALLY like them....and some kids don't. I really can't see where the world is going to come to an end if a child does or does not take a pacifier, for whatever length of time. There are so many choices that parents have to make for what is best for their children. Adding more rules, fears, and stigmas is not helping grow great parents.

When the hygienist was finished giving me her report on the damage that pacifiers do to teeth, she turned to the dentist for affirmation that she was correct. I really had to work hard to not bust out laughing at his response. This man has been around the block a few times. He has seen it all. He simply said that he has not recalled ever putting a person in braces because they took a pacifier. He knew of some thumb-suckers who moved their teeth. Some. He said that some people have teeth that move easily and some people just have crooked teeth.

Then, he added that if a child was already showing signs of crooked teeth....and already going to need braces....then you may as well let them have the pacifier and enjoy themselves, because that need for braces is in their future regardless.

More Dental Photos

And, for the record, the big kids went to the dentist too...

Jersey #1 is a pro. Except that whole x-ray thing. She has a very strong gag reflex, which makes x-rays a challenge.

Jersey #4 was not going to participate at first. But, after watching her big sister, Jersey #2 make it look like fun, she decided she wanted to get her teeth cleaned too. She also wanted to wear the cool sunglasses...

Jersey #3 cooperates, and then he doesn't. Poor kid. He is over-sensitive, and perceives any strange sensation as pain. He kept wiggling and saying "ouch" when the hygienist was only polishing his teeth. He also breathes through is mouth, which makes dental visits adventurous...

Jersey #2 brings the party with her....even to the dentist. She fully cooperated, inspired her younger siblings, overcame her gag reflex well enough to get x-rays, and also cooperated for a full-mouth panoramic x-ray (now that her 6-year molars are all in).

First Dental Visit

Jersey #5 had his first dental visit this week. He has accompanied his older siblings before, but this was his first visit where his teeth were cleaned and examined too.

Big brother, Jersey #3, showed him how it works. Jersey #5 was more interested in assisting the hygienist with his brother, than participating in his own care.

He gladly accepted a new toothbrush, and decided to take that Big Chair for a spin...

The chair was better used as a jungle gym...

When the time came for his cleaning, he preferred Mommy's lap over the chair...

Much to my surprise, he actually participated in a full cleaning and fluoride treatment...

He is very possessive of that new toothbrush. He shows it off to everyone in the family and says, "MINE."

SMILE

I absolutely adore this stage of childhood: mismatched grins.

The sporadic fun appears with the loss of that first baby tooth, usually somewhere in kindergarten. From there, it is a roller coaster of dental fun....teeth fall out...teeth grow in.

Those permanent teeth are so much bigger than the baby teeth too. At first, it is a shocking sight to see.

The missing two front teeth are my favorite. I love to see those smiles. I love to hear the sound of the air passing through the empty space as the kids talk. I find this whole phase to be quite entertaining.

Down the road, I know it will be important for the kids to have a nice full smile of straight teeth. Braces will most likely be necessary to accomplish this goal.

But for now, I am totally enjoying this time where missing teeth and mangled smiles are C.U.T.E!

Tough Morning at the Dentist

Jersey #3 needed some dental work one morning last week. 3/4 of his mouth was numb in this picture, due to the locations of the cavities. They were small cavities, on his groovy teeth, so the procedure to fill them was expected to be pretty simple.

WRONG!

It turns out that all of my worry and concern over Jersey #4 needing dental work last month was placed on the wrong child. She did great, so I had worried for nothing. Jersey #3, on the other hand, had a very rough time, when I expected him to be cooperative.

I don't know what I was thinking. Cooperative? Jersey #3?

Everything started out well. I prepped him the evening before. We talked about brushing teeth, and sugar bugs, and how the dentist has to fix our teeth if the sugar bugs damage them. I explained how he was not to eat or drink in the morning, and how I would be waking him up early to go to the dentist. Then, I explained that he would get his choice of a treat afterward. He was most concerned about when he would get to eat again, so we covered that topic well. He seemed almost excited about the adventure.

Jersey #3 was very cooperative to not eat or drink, and got himself dressed to go to the dentist. He was in a good mood that morning, and went through the motions of playing in the waiting room, getting his vital signs checked, and taking the sleepy medicine. He happily watched a movie while the meds kicked in. He was pretty loopy by the time it was time to go to the big chair. I had to guide him down the hall so that he did not crash into the walls.

The trouble began when he did not like the mask that had the laughing gas. He is a mouth-breather also, so he wasn't actually breathing the gas. That makes a huge difference. That mouth-breathing is bad for tooth decay too, because the mouth stays dried out all the time. Still, he listened to the hygienist go over everything, and let her put the numbing gel in his mouth. He did well when the dentist arrived and numbed him. He was already showing signs of being wiggly, and not as relaxed, which I am guessing is because he was not breathing the gas as he should.

And then everything fell apart when it was time to start and the dentist held his mouth open with that rubber tool. Yep, that was it for Jersey #3. He could not stand that sensation at all. It did not matter what the dentist was doing at the tooth level, that tool holding his mouth open was the enemy. He managed to wiggle and thrust his tongue to get the tool out on numerous occasions...to which the dentist caught it in mid-air with amazing reflexes. Unfortunately, the tool was necessary in order for his mouth to be open, because he was closing it with every intervention, including painting the sealant on.

Since his reaction was to yell "ouch," the dentist actually stopped at first. He explained to me that he really did not think that Jersey #3 was feeling any pain, but he went ahead and numbed him more anyway. Those cavities were so shallow, that some kids would be able to endure the filling without numbing, so Jersey #3 really should not have been feeling anything. Regardless of the standard logic, for a physically sensitive kid, any dental sensation is going to be a problem.

After the 2nd numbing, the dentist attempted more work, only to be met with more struggle. The dentist was spending more time repositioning the tools than he was spending fixing the teeth, because Jersey #3 was engaging in wiggle battle. At this point, the dentist asked if he could restrain him on a papoose board, because he could not leave the tooth half-done as it was. I agreed, and explained to Jersey #3 what was going to happen.

Much to my surprise, Jersey #3 fully cooperated laying on the papoose board, and having his arms wrapped to his body. He actually relaxed, as if he was an infant being swaddled.

He still was not able to handle the sensations of the tools in his mouth. He clenched and screamed and wiggled. It was impressive. A second hygienist had to be brought in to hold his head still, and I had to help hold his legs still. He is a strong little fella. I was confident he was not in pain, because of the way his struggles ensued. He would immediately calm down as soon as all instruments were out of his mouth....and the dentist was real good about backing off in between working on his teeth, to give him a break. But, as soon as any instrument...even the paintbrush or the UV light (which did not even touch his teeth)...was put in his mouth, he had a screaming fit. Ironically, he was the most calm for the drilling part. I am guessing the sound captured his attention a bit.

I tried to calm him with my voice, and by patting his leg. I would only get minor responses from him. I was no match for the battle over having his mouth held open with a rubber tool.

When all 3 of the cavities were filled, the dentist removed the tools, and unstrapped the restraints immediately. Jersey #3 sat right up, put his arms out to me, and I held him in my lap. He was still crying a bit, and took a few minutes to calm down.....bringing back many memories from his infancy. The dentist was so very apologetic about the restraints. He assured me that he felt it was much better than having to place such shallow fillings in the hospital, under general anesthesia. I totally agreed. No one wants to see their child upset at the dentist, but the lesser intervention was the best method. I tried to reassure the dentist that it was the best choice.

The dental staff were completely shocked by Jersey #3's behavior. I was not. He has always been a high maintenance child. His sensitivities are improving, but clearly there are some stresses that are just going to be challenging, even at age 5. Hopefully, more maturity and understanding will take place before he needs any more dental work.

I praised and encouraged Jersey #3, and he perked right up. He talked cheerfully with the hygienist, and took great interest in the toys he got to pick out for being so brave. He did not like the sensation of having numb cheeks. Thankfully, he napped on the ride home. He was happy to go pick out a Slurpee to drink.

I do not think that this experience is going to cause much trauma over going to the dentist, but time will tell. Jersey #3 seemed fine with the staff and the place on our way out. He seems fine talking about it. He maintains that he yelled because it hurt, and that is that. He simply states that he did not like having his mouth held open like that. He almost shrugs the whole thing off, as if it is justified. His attitude is that he didn't like it, so he screamed, so the dentist wrapped his arms, he screamed more because he didn't like it, and then he was done. He cheerfully agreed to my conclusion that he needs to keep learning how to brush his teeth better, so that he doesn't get anymore sugar bugs damaging his teeth.

It will be interesting to see how he reacts to returning for routine cleaning in a couple months. I am hoping he doesn't need any more fillings for a while. I am not confident that his sensitivities will improve very quickly.

I am going to try a electric toothbrush for him though. I wonder if that sensation will help relax his sensitive response.

This tough morning at the dentist was a big reminder for me to not take this child for granted. I have always said he is the child who humbled me. It appears I've still got quite a bit more growth to endure with him.

Dental Blessings

This is what Jersey #4 looks like following dental work. The left side of her mouth was quite numb.

(My sister jokes that Slurpees must have healing powers for our family....because that is what the kids are often pictured with after medical and dental procedures. It is funny that they all seem to ask for a Slurpee after a procedure where they have had to have empty stomachs. They drink them down quickly, rehydrating, and settling their tummies too.)

Taking Jersey #4 to the dentist this morning was a huge deal.

Huge.

I was very worried about her cooperation.....or, really, her lack of cooperation.

We have a fantastic pediatric dentist. This is a good thing too, because we also have terrible teeth genetics. So, we spend a lot more time with our pediatric dentist than most folks experience. Our pediatric dentist really wants the kids to learn healthy teeth care, in a positive environment. His office is kid-friendly in its design and decor. There are prizes, gifts, and goodies a plenty there. The hygienists are the most patient people I have ever met. They take great care to show the kids all the tools and instruments and sounds before they experience them in the big chair. The hygienists are also very organized. They have every single tool ready to go, so that the dentist can work as efficiently as possible. The level of teamwork among that staff is incredible.

When a very young child needs dental work, our dentist will do the work at a day surgery clinic, with the child under general anesthesia. This is what we have been through with both Jersey #2 and Jersey #3, for different reasons. The benefit is that the child does not remember the procedure, and does not develop a fear of the dentist. For older kids, who can be more cooperative, there are levels of conscious sedation medication to help them relax and be drowsy for procedures.

Jersey #4 was 3 years old when her dental needs were discovered. She had a fairly large cavity that needed attention, as well as a smaller cavity on a different tooth. The good news was that she only had the two problems to deal with, not a whole bunch like her siblings. The bad news was that she was still too nervous to sit in that big chair, even after visiting twice for cleanings.

The dentist recommended attempting to treat her in the office, instead of the surgical option. It is better to avoid general anesthesia if we can help it. Her age and ability to cooperate was there, but her willingness to cooperate was the concern. The dentist hoped that giving her sedation medication prior to the procedure might help with her cooperation. I agreed, because we want the least invasive methods possible.

The problem is what to do if she refuses to cooperate in the midst of the procedure. If the dentist was already started into the work on her teeth, she would need to be restrained so that he could complete the work. This was something I had to understand and agree to before choosing the in-office procedure.

Restrained. That is the big topic that comes up in any conversation about pediatric dentists. There are a few in town who are known for having parents authorize restraints, even for lack of cooperation for cleanings. The idea of restraining a child to a dentist chair brings up images of torture, as well as a lasting fear and hatred of going to the dentist. I have always advised my Mommy friends to avoid any dentist who does not let you go back with the child for cleanings and procedures. And to avoid any who require you sign a restraint agreement from the beginning of a routine cleaning visit. I have never thought restraining a child at the dentist was a good idea...

...Until I was put in this position of restraint versus general anesthesia, for minimal dental work. Wow. Just when I thought I knew it all, I am always thrown for a loop.

Ultimately, I agreed to attempt the in-office procedure. I agreed to the sedation medication in advance of the procedure. And I agreed to allow Jersey #4 to be restrained, if she refused to cooperate in the midst of the procedure.

I rationalized the decision with the fact that our family has been going to this same pediatric dentist for over 6 years. This is the first restraint recommendation he has ever mentioned to me. I know his goals of the least invasive, least traumatic procedures possible. Trust is already established there. I inquired about the method of restraint, and learned they would use a blanket to wrap Jersey #4 like a papoose, so that her arms could not flail. The hygienist was also quick to point out that they would work very hard to re-earn Jersey #4's trust, so that she did not despise going to the dentist. I was glad they had a plan to help her overcome the trauma of such an experience. Unfortunately for Jersey #4, this decision was being made a month prior to Jersey #2's open-heart surgery, so being swaddled like a papoose in a dentist chair, just did not have as much traumatic weight.

Knowing that Jersey #4 is not a very forgiving child, my biggest fear was that she would develop a hatred for going to the dentist. I did not want that for her. That was the most troubling side effect of the entire decision.

I tried to prepare Jersey #4 in advance. As I went over her teeth...brushing them myself, after she brushes them first....I talked to her about going to the dentist and sitting in the big chair. Three days before her appointment, I started explaining to her that the dentist needed to fix her tooth. I started to prep her for what to expect. I prayed for cooperation from her.

When I woke her up this morning, I told her it was time to get dressed and go to the dentist. I assured her she was a big girl and she was going to do great sitting in that big chair and opening her mouth. She replied, "No, not today."

We are doomed!

As we drove over there, I debated with myself as to how to approach this boundary with her. Do I go the positive, cheerleader, encouraging route? Or do I go the firm, this-is-the-limit-and-you-must-obey route? Jersey #4 is a VERY strong-willed child, so I had to pick my battle carefully and prepare for war. She would pounce on any wishy-washy response from me.

I chose the cheering path. I approached the entire experience from the perspective that I believed she was a big girl and she could handle this. It is the same approach I take with Jersey #2, for all of her medical experiences. It can be hard, because I am sensitive to their fears, and I want to cry for them. But, any catering to their fears gives them the false impression that they can get out of the procedure, so that makes the battle worse. So, I stood firm in my position that Jersey #4 could handle this. I praised her and encouraged her every step of the way.

I took a step back and let Jersey #4 interact with the hygienists first, so that I could gauge her level of cooperation. Much to my surprise, she was a trooper. She answered their questions, and followed their instructions during all the vital signs readings. I praised her for being such a big girl. She picked out a movie to watch, took her medicine (looking at me to make sure she really had to drink all of it), and settled right in. The medicine worked great on her, and she became quite loopy about 10 minutes before they called her back for her procedure.

With her new-found boldness at the dentist, I let her follow the hygienist down the hall, and I walked behind them. I did not direct Jersey #4 at all. She was listening to the hygienist and following all the instructions. She climbed up into that big chair, no problem. I praised her and covered her with her blanket, and handed her the stuffed animal we brought. I scooted my chair close by her side, and patted her leg and told her I would be right beside her the entire time. She relaxed and cooperated just fine.

The hygienist asked me if Jersey #4 was always so polite and cooperative. I nearly fell out of my chair laughing at that description. Um, no, quite the opposite. I shared that this was the first time Jersey #4 had ever even sat in the big chair, so I had been preparing for her to be restrained. The hygienist was as surprised by my answer as I was by her question. Are we even discussing the same child?

Jersey #4 was cooperative for the dentist too. He was very efficient in his work, so it did not take long. All of my worries about restraining her were unnecessary. She didn't even so much as cry or complain, so restraining her was not even considered. There was only one time when she did not respond to the dentist's request. He reached over and turned down her level of laughing gas. She was not responding to him, because she was falling asleep. When the procedure was over, they continued to give her pure oxygen to help wake her up. She took a nap in the chair instead. She even snored. She was quite relaxed. When she woke up more, she picked out a couple prizes. She was still fairly loopy as we were leaving, so I had to hold her hand as we walked out to the van. She has not taken many medications in her 3 years of life, since she is a pretty healthy kid, so those meds had a strong effect on her.

I praised her heavily for how good she did at the dentist. The dentist and all of the hygienists praised her too. She left with a big smile on her face. It was obvious she was mighty proud of herself. I am so proud of her too.

A Matter of Perspective

I often joke that I knew a whole lot more about parenting before I ever had children.

It is easier to form a theory than to put it into practice.

On Facebook yesterday, a handful of my friends happened to post an article about parenting within the same few hours. Each of them posted an article that was positive for their style of parenting. Each article took a very different approach from the others. I was entertained by the timing of the article posts. I also enjoyed reading the articles and the comments of my friends.

I admit, though, that the burst of information shook me up a little. It wasn't the specific information that got me. I have my agreements and disagreements there. I know my friends are loving parents who are seeking the best for their individual families. It was the realization that my motherhood experience just does not seem to fit nicely into those various labels & styles that were posted.

I used to delight in being different like that. I have joked with some of my Mommy friends about how I pick and choose things out of different parenting labels, but I don't really fit into a specific one.

But, what struck me yesterday, and plowed me over this morning, is the realization that my own parenting style keeps changing based on the circumstances in my life. My perspective keeps changing.

An easy example was how I was so nervous about leaving Jersey #1 overnight when I delivered Jersey #2. I worried about how she would do without me. Well, the joke was on me, because when it was time to take Jersey #2 for heart surgery, I didn't even think twice about Jersey #1 being in my parents' care for 12 days! My worries dissipated as my priorities changed.

Last night, Jersey #5 woke up in the middle of the night, battling congestion. I got up to get him a drink, and he followed me to the kitchen. On the way, we passed by The Referee (who was up battling insomnia), sitting in the recliner, watching a movie, with Jersey #4 asleep in his arms. Jersey #5 immediately went open-arms to his Daddy, and The Referee volunteered to rock him, and let me return to bed. I offered to carry Jersey #4 to her bed...she had woken too, and The Referee rocked her back to sleep. The Referee considered the idea, as he looked down at his two youngest children snuggling in his lap.....but decided he would just rock both of them a while.

Normally, I would have been quick to argue that sleeping children should be moved to their beds, to encourage healthy sleep habits. Last night, I took one look at my husband, cuddling and rocking his young children, and I thought about how holding sleeping children is so therapeutic and calming. Considering the level of stress we are under right now, does it really matter if he holds the kids for the rest of the night? Is it really going to ruin their ability to form healthy sleep habits? No. It is better that we draw closer as a family and hold each other and comfort each other, and combat this stress. So, I tossed a blanket on them, and returned to bed.

I took the older 4 children to the dentist today. Upon exam, the dentist discovered that Jersey #4 has a rather large cavity, on a very small tooth. It needs to be capped. When Jersey #2 and Jersey #3 needed caps on some of their teeth, the dentist recommended the procedure be done under general anesthesia. They were each 2 years old, and required a few different teeth to be capped. Considering Jersey #4 only needs 1 single tooth capped, and she is already 3 years old, the dentist recommended trying the procedure in-office, instead. He would use sedation medication to make her drowsy, but she would be awake. Jersey #4 has not been cooperative about sitting in the big chair for cleanings, so the concern is will they get any better cooperation from her if sedated. If not, they would want to restrain her by wrapping her like a papoose. Of course, I would be by her side the entire time.

In the past, I would have been abhorred by the mere thought of a dentist restraining my child. How inhumane! Wouldn't that just breed a fear of the dentist?

Today, I took the information all in stride. We have been taking our children to this specific dentist for over 6 years now. I am well aware that the staff do their best to make dental visits the most positive experience possible. They go the extra mile to help children feel comfortable. I am so thankful that this dentist seeks the least invasive treatment option each and every time, on a case-by-case basis. I know this because we have dealt with A LOT of dental stuff. A LOT! (We have terrible teeth genetics). To be honest, I am relieved that he is willing to try the in-office procedure in the first place. That is so much safer than general anesthesia. He knows it and I know it. But, we also know that restraining Jersey #4 might upset her to the point of hating the dentist for life. The hygienist took the time to explain ways they work to re-build trust if Jersey #4 holds a grudge.

As I explained the situation to The Referee, I asked him if it is strange that I am not upset about the idea of restraining at the dentist, like I would expect myself to be? I am actually relieved that she doesn't have to go under anesthesia for treatment. He suggested it was a matter of perspective. Right now, we are facing open-heart surgery for one of our children, so the idea of swaddling a child's arms to their body for a dental procedure seems small by comparison. When we compare a procedure that may scare a child, versus general anesthesia which can be life-threatening, restraint is not so horrible.

My perspective has really changed. It is amazing what a massive amount of stress and crisis will do to change my priorities. There are so many child rearing details and parenting choices, that were once gravely important, yet seem so insignificant to me right now.

The part that doesn't seem to change is my calling to love my children unconditionally, and support them through all of these challenges in life, no matter how big, scary, or life-threatening.

Toothless

Jersey #2 lost her first tooth....the natural way

She is so excited. She has watched her older sister lose a bunch of teeth over the last couple years. She has been wondering when it will be her turn. Jersey #1 lost her first tooth on her 6th birthday. So, Jersey #2 has been wondering what is wrong with her teeth, every day since she turned 6. She has been anxious to get a dollar from the tooth fairy Mommy/Daddy.

Jersey #2 was late in cutting teeth as an infant. I wonder if that has any effect on the time line for losing those baby teeth? She didn't cut this bottom tooth until she was 10 months old.

It finally started to turn out of place, then became loose. She then proceeded to wiggle it nonstop until she got it to lay on its side. I am not sure what was keeping it in, but she finally asked me to pull it out, because she could not get it to release.

Sometimes my Mommy job lets me pretend to be a dentist.....and then I get to put on my tooth fairy wings.

Her missing bottom tooth lines up nicely with the top tooth that has been missing since she was 3 years old. That loss was much more traumatic. First, she ran into a metal chair at church and knocked the tooth loose. Then, her little brother (Jersey #3) knocked the tooth half-out by throwing a hard plastic toy in her direction. Due to the nature of the trauma to her gums, and her heart condition, an oral surgeon finished removing the tooth in a much gentler fashion.

I still laugh when I think about that experience. Our pediatric dentist referred her to the oral surgeon, hoping the extraction could be done in-office (instead of under general anesthesia). The oral surgeon typically dealt with adult patients, and he was not prepared for our feisty 3-year old Jersey #2. She had plenty of experience with medical providers, and they did not scare her. His secretary squeezed us in for a same-day appointment. But, Jersey #2 did not appreciate the wait, and informed the dentist....as she climbed up into the big chair....that everyone else in his waiting room got to take a turn before she did. She did not appreciate being last! She left an impression with that dentist, with her personality and also with her quick healing.

Now, she gets to enjoy having her two missing teeth line up with each other...

She also likes the way that air passes through the holes and slurs her speech. The details of life just crack her up.

And, she is already working hard on the bottom tooth beside the missing one, because it is also loose.

Dental Work

When I went for my routine dental cleaning nearly a year ago, my dentist gently suggested I was old. Well, he actually said that the fillings in my teeth were old. He tried to say it nicely. He said, "You know, those fillings have really held up for a LONG time. They don't usually last that long. They are usually only good for about 15-20 years."

Gee, thanks.

Considering that majority of the fillings in my mouth were originally placed around the time I was 5-12 years old, I suppose I can admit that they might be past their prime.

The dentist went on to explain how cavities will form around the old fillings. He also proudly shared the improvements in the dental technology since I was a kid.

What he didn't share was how much easier it was to get fillings as a kid. As an adult, I am finding the process to be rather painful when the numbing medicine wears off. My dentist is has a reputation for being gentle, and helping his clients to relax during their dental visits. I am impressed by the way he can apply the numbing medicine without causing any pain....not even a pinch. He is certainly good at his trade.

It is the recovery that I find to be so painful. I feel as though someone has jogged on my mouth. My jaw is sore. My gums are sore. And my body feels exhausted. I am not sure what is causing this degree of pain and discomfort.

We are addressing one quadrant of my mouth at a time. I've been twice now. Both times have been followed up with me taking Tylenol for the pain and a nap for the weakness. I just don't recall feeling that way when I had dental work as a kid.

Maybe the dentist is right. I might be getting old.

Teeth

Years ago, there was a commercial for some medicine that was supposedly recommended by many doctors....including "Dr. Mom". That idea of Dr. Mom always cracked me up. We used to refer to my Mom that way, because she became so educated in medical matters from all her experience raising children.

Recently, I have had so many experiences with teeth, that I am beginning to wonder if there is an honorary Dentist title for Moms!

Just taking the children to the dentist for exams and cleanings every six months is a big job. In addition to that, Jersey #2 recently had cavities filled.

I've got Jersey #5 cutting teeth....

Jersey #1 had to have a couple baby teeth extracted. The cavities in them were getting too large, and the teeth were about ready to come out anyway...

Her smile currently resembles a jack-o-lantern! She has been losing baby teeth at a high rate. Her permanent teeth in front have been growing in slowly. We have already been advised that she will need braces. Those permanent teeth look so much bigger than the baby teeth! A couple of them are battling for space as it is.

But, the icing on the cake is Jersey #3. While driving down the road the other day, he casually said, "Here Mom. My tooth fell out." I reached my arm back, and he placed one of his front teeth right into my hand. There was no drama, and no blood (so very different from his big sister!).

Lucky for him, I had already spoken to the dentist about this tooth and knew it was on its way out. He had a series of falls and bicycle injuries over the summer, that knocked 2 of his teeth loose. One came out almost immediately. The other was dangling on, and we were trying to keep it for as long as we could. Thankfully, the dentist assured me that his permanent teeth are lined up and ready to come in, so it will be Ok in the end.

He is also credited with knocking out one of Jersey #2's teeth 3 years ago. She did the first injury, by banging her mouth on the back of a metal chair, and knocking the tooth loose. Her little brother finished the job when he threw a hard plastic toy in her direction and hit her square in the mouth! That tooth trauma warranted an emergency visit to the Dentist.

So far, our children have not been able to surprise our actual Dentist, the way that they surprise "Dentist Mom"!

First Trip to the Dentist

I took Jersey #4 to the dentist for her first check-up and cleaning, this week. We have a fantastic pediatric dentist. This is a good thing, because we have terrible teeth genetics. The children accompany their older siblings into the dental office every 6 months, but we don't schedule their own first cleaning until they turn 2.

There are some key requirements I have that helped me choose our pediatric dentist...

• Smart, knowledgeable dentist who knows his field of expertise
• His reputation for working well with cardiologists, because he knows heart patients need good dental care to prevent heart infection
  
• Child-friendly dental office that tries to put the kids at ease and encourage good teeth care for a lifetime
• Involving parents in their child's care...I am allowed/encouraged to accompany my children back to the cleaning bay (and also for procedures)
  
• Dental staff who present their knowledge of teeth care, not their opinions of parenting choices (there is no magic age for ALL children to stop breastfeeding at night, stop using a pacifier/sucking a thumb, or using a regular cup vs sippy cup), and our dentist treats each child like the individuals they are
• Use of sedative medications/gas to relax the kids for advanced procedures, yielding cooperation (instead of holding them down and forcing treatment)

I like that the entire dentist office is child-friendly. The waiting room has colorful toys, chairs, and children's books. The doors have glass windows so we can see down the halls easily. The hygienists are always smiling and friendly. The interior is well-lit, and decorated with colorful pictures. There are 4 dental bays separated by low counters/cabinets and parent seating. I can sit in a chair in one bay, and watch 2 children in side-by-side bays. This is really nice once the kids are old enough to not want me to hold their hands, because I can schedule 2-3 cleanings at the same time and get through the process quicker.

It is important to me to have a pediatric dentist who makes going to the dentist a positive experience. Some of our children have already required advanced dental care, in spite of our best nutrition and teeth brushing habits. There are so many adults who neglect their dental care due to traumatic dental experiences as kids. We want our children to take care of their teeth and build healthy habits for a lifetime. When our 2-year olds first visit the dentist, they are given a tour of the cleaning bay and all of the tools and equipment. They get to spray the air and the water, and feel how the polisher feels on their hand. They climb into the big chair when they are comfortable. The hygienist meets them where they are, and progresses with as much as they will tolerate. She backs off at the first sign of resistance, so that fear is not built. I remember Jersey #3 climbed into the chair, but would not sit on his bottom. So, the hygienist cleaned his teeth with him sitting on his knees, facing her. Jersey #4 never made it into the big chair. Her curiosity was high, but her level of trust was much lower than her siblings.

Here is a picture of Jersey #4 peeking into the next bay to watch Jersey #1 get her teeth cleaned. Since Jersey #1 has such light blue eyes, that are sensitive to light, she requests the sunglasses during her cleanings.

When it was her turn for a cleaning, Jersey #4 observed the tool demonstration from a safe distance...

She had already received her goody bag filled with a new toothbrush, toothpaste, a timer (to brush for 2 minutes), and a toothbrush cover. She refused to climb into the big chair. She did agree to let the hygienist open her new toothbrush, and brush her teeth with that (at arm's length away).

Jersey #5 was eager to climb into the big chair. In this picture, Jersey #4 is trying to push him out, because it is HER TURN! (even though she did not want to sit there herself).