Yep, you heard me. A second one.

See, about a week after his first surgery, I noticed the tiniest of grooves on the other side of his mouth in relatively the same spot as the last one. I kept an eye on it and it seemed to be getting bigger so I brought him to the local dentist. Unfortunately, we didn’t get to see Dr. W and ended up seeing a different dentist who didn’t have the best bed side manner but did know her stuff. She immediately referred us to Dr. P (formerly known as Dr. P², since the original Dr. P is out of the picture).

So Tuesday, we trekked up to Newnan and stayed in a hotel (graciously provided by my in-laws) where we watched Hell’s Kitchen, The Nanny and otherwise enjoyed a short break from home. Since Noah couldn’t have anything to eat or drink after midnight for the procedure the next morning, we were trying to avoid having to drive him up to Newnan while hungry AND tired AND fussy. Noah did relatively well that night, sleeping a solid six hours without wanting to nurse, which is pretty unusual for him. I did pump him full of squash and applesauce before I brushed his teeth and gave him a good nursing and I hope it helped. Whatever did it, he slept through and we got him to the clinic.

When we got there, we waited a good thirty minutes before they got us to the back where one of the dental assistants tried to tell me that a predisposition to cavities just couldn’t be genetic and that it HAD to be the breastmilk that was causing Noah’s teeth to get cavities. While I can say that he doesn’t need to nurse all night or all day long without having his teeth brushed, I can’t say I agree that I should suddenly switch to cow’s milk because someone without a dental degree says so. She also couldn’t get through to her head which tooth had the issue and kept asking if the “filling” (his crown) came out, so I’m sure you can imagine why I am skeptical of anything she had to say to me.

Anyway, when Dr. P saw his teeth, she confirmed that he had two brand new cavities. Thankfully they were pretty small since we had caught them so early (score one for vigilant mommy, finally!) and said he didn’t need the Versed to be sedated for the procedure (so we starved our kid for 8 1/2 hours because…?). Not that I want to put anything into Noah’s body that is unnecessary so we were thankful – at first.

She swore that the papoose board would be the best choice, as it would take longer with Joshua holding him (squirmy) so I went against all of my natural gut instincts, personal fears and intelligent thought and agreed to try it that way. What I didn’t know, until they had already started, was that they weren’t going to give my little baby boy ANY numbing medicine whatsoever! Both fillings were done within five minutes or I would have raised far more hell but I will tell you, I will never. ever. ever subject my son to that again. Parents that are reading this and are debating on using the papoose board on a toddler without sedatives or pain medicine – DON’T! It’s traumatic for the parents and it isn’t easy even for our resilient toddlers who scream for five minutes while a stranger puts them through pain (necessary procedure or not). Since Noah is so young, I don’t expect him to remember any of it and after a nap he was back to his normal, sunny self but I can’t forget the way he was sobbing in my arms after I yanked him out of that stupid papoose board. And I mean yanked – as soon as they scooted back and said they were done, I was ripping the velcro apart and scooping him into my arms.

I trust Dr. P as far as knowing her stuff. I know she did a good job and this visit was a huge contrast with the other one, where he needed a tooth extraction and a crown. With that one (I’ve already written this much so I may as well keep going), we went to Newnan the night before, where Noah woke up every two hours wanting to nurse. I think he fell asleep on the hotel floor three times and I would promptly move him to the bed. That was a fine night…not.

That time they got him in within two minutes, weighed him and then gave him a carefully measured dose of Versed. Within twenty minutes, he was giggling and snuggly and trying to play with his car and ball but not really able to grip well. Within forty-five minutes of being given the dose, he was about to fall asleep and actually did so in the assistant’s arms as we were made to leave the room. They extracted his tooth (I need to get a picture of this posted, actually – yes, I kept the tooth) and put a crown on the tooth next to it to prevent any cavities or weakness. He woke up screaming for mommy (mostly because he was around strangers) and immediately went to nurse. Within a few hours he was back to normal and within 48 hours he was mostly healed up. It was nerve-wracking for me but not traumatic for any of us in the least.

So, you know, two entirely different experiences and I can say that I preferred the first one, though I preferred the lack of severity of the second (fillings versus extraction). I’m not entirely thrilled with Dr. P’s practice anymore but since we’re leaving, I don’t think it will be an issue. The reason has a lot to do with how she handled the fillings but also that, though she claims she is a “big proponent of breastfeeding”, she did everything she could do get me to wean Noah. First it was about night-weaning. Then it was about weaning during the day. Then it was about sippy cups (we’ve told her he’s already using sippy cups and have done for a year now but she insinuated we must not be).

Her dental assistants also don’t know that breastfeeding is a clear liquid and actually cautioned me against breastfeeding Noah after the first procedure because “dairy would mess up his tummy”. Mind you, I don’t expect dentists to know an excessive amount about breastfeeding but I do expect a pediatric dentist to at least be aware of the current recommendations by the AAP and WHO, as well as the basics in regards to the infants in their care (clear liquids, not dairy, etc).

Maybe my mama bear side has just come out and I’m protective of my son. It’s also no secret that I’m a lactivist at heart…but I just can’t understand why someone would choose to work with infants and young children and not take the time to learn simple facts about other important areas of their health. Maybe I’m wrong to expect that much…but I don’t think so.

Whatever the case may be, I’m just happy Noah is happy and healthy.

I rarely do meta tags or keywords but since this entry may help other parents, I am.
Keywords: toddler teeth, versed, sedation, dental work, pediatric dentistry, papoose board, breastmilk, breastfeeding, sippy cups, cavities, fillings, crowns, weaning, grooves in baby teeth

I called another local office on Monday and told the receptionist that we desperately needed to get Noah in before his surgery. Since Dr. P made us wait almost a month before getting an appointment, I was worried that this office would be the same. She managed to get one set up for the 16th but about two minutes after we hung up, she called me back and said that Dr. W, the owner/dentist at their clinic, was wondering if we could come in that same day. Evidently, he heard “17 months old” and “putting under” and wanted to see him immediately. Of course I took him in!

Noah liked the office. It used to be a house, like many of the places here in town, and he had fun running from room to room. Like always, he was the center of attention as he flirted with every girl in the room. I think the youngest was 7 and the oldest was easily 60!

He really liked Dr. W, too. He was giggling and opening his mouth really wide so Dr. W could get a good look at his teeth. Dr W. took one look and said that it wasn’t a cavity but more than likely a developmental delay in the enamel growing on his teeth. He set us up for a consult in Newnan with Dr. P² on Thursday (yesterday).

I think Dr. W liked Noah quite a bit. He scooped him up to give him a hug and his nurse ended up scolding him because evidently he had been having back pains all day. I told him that if I had known, he wouldn’t have had the chance to pick up my 30 pound chunker! I don’t think he cared though…he gave Noah a big hug and handed him a token so Noah could get a bouncy ball out of the toy machine (you give Noah a choice of a bunch of toys and I guarantee you that he’ll go for the ball). I’m not sure if it was this or the fact that Dr. W just seemed to have an open, refreshing personality, but the feeling was mutual for Noah too. Heck, I liked Dr. W and I don’t like dentists. (Sorry.)

Unfortunately, Dr. W was wrong (he did say that he might be) and it turned out that the tooth is definitely decayed. We went to Newnan yesterday and got to the new clinic about thirty minutes early (when, of course, Noah fell asleep just as we got there). They were very accomodating though and let me fill out the paper work (Which was laminated papers and a Vis-a-Vis! Is this standard now?) and then let me wait in the car with Joshua and Noah while Noah napped. They came out and got us just as Noah woke up…but really, I couldn’t blame them. They probably wanted Noah to nap as much as we did!

That’s when we met Dr. P². She has a very strong personality, but in a good way. She’s the type of person that walks into a room and is the center of attention. However, that’s a good thing for someone in a position of authority…it gave me confidence.

Unlike the other two dentists, she had Joshua hold Noah in his lap in a chair, as opposed to the dentist chair, and put Noah’s head in her own lap. She asked us questions about my pregnancy (For those who need to know, fevers in pregnancy, especially during the third trimester, can result in developmental delays in teeth.) and Noah’s health and whatnot. She checked his teeth and confirmed that there was definitely a cavity that needed to be worked on, one that is quite possibly already to the nerve (I’m amazed and terrified of how quickly it grew, as we called a dentist as soon as Dr. Z pointed out we might need to.) and immediately started listing our options.

As she is a pediatric specialist and has an anesthesiologist in office (which is beautifully designed, by the way – I was impressed), she could do the procedure in their clinic as opposed to in a hospital. This also meant that they did not have to do anesthesia by IV but instead, could do sedation (so Noah does not care about the pain or remember the procedure). This carried the lowest amount of risk, as with full anesthesia, Noah would not be breathing on his own but instead, through tubes. (Why Dr. P immediately jumped to this option despite the higher risk of incident, we’ll never know.)

The only hiccup came when she mentioned that 1) Noah would be in a velcro blanket after he’s “schnookered” (her term) and 2) we could not be in the room during the actual procedure. I think I started hyperventilating and when she asked me if it that would be an issue, I started crying as I said yes.

I never used to tell people this but as an adult, I’ve put most of it behind me so I can, but as a child, I had a terrible experience with my pediatric dentist. I won’t go into the gruesome details, but I will say that I am grateful to my parents for being so vigilant and that they really prevented something worse from happening. Unfortunately, I deal with what I am told is called Merinthophobia and the idea of leaving my child with any medical professional unsupervised absolutely terrifies me.

Dr. P² was actually really good about it. She didn’t seem offended, even though I fell all over myself apologizing for crying and having such a negative reaction to the idea. She told us we would need to call around to find another pediatric dentist and see if they could do it with us in the room, as she absolutely could not (I’ve made a note to ask why, mostly out of curiosity). She also said that if we talked about it and decided we were okay with it, she was still happy to do the procedure…but she wanted us to be completely on board. She did mention that she wouldn’t do anything with Noah that she wouldn’t do with her own kids and that we were responsible for his health and we were the ones that had to make the decision.

At first, I wasn’t sure what to do. Noah’s teeth need to be worked on. We left, got out to the car, and then talked about it. There really is no way around the issue. Another dentist might do it with us in the room but that means more time waiting for a consult, more time waiting for an open appointment to do the procedure, possibly not finding a dentist we “synch” with…you know, a lot of issues.

So we made an appointment for July 1st and now we wait. Noah can’t eat or drink anything after midnight the night before, poor little one, so they gave him the first appointment for the day. We were dreading the idea of a 45 minute drive with a hungry, tired Noah right before a (albeit minor) surgery so Joshua’s parents really came through for us. They are going to pay for us to stay in a hotel the night before so we can be about ten minutes away from the clinic. Isn’t that wonderful? I am so grateful…you just have no idea how much.

I’m nervous. I’m scared. Yet I trust Dr. P² and I trust my husband and I trust my instincts. Noah’s tooth needs to be fixed. His other teeth need to be saved. We’re doing our part…we’ve drastically cut out sugar (there is still some, but mostly because I refuse to throw perfectly good food away) and I brush his teeth as much as I can. We’re also working on night weaning, which is a relief for multiple reasons. Dr. P² said that she was a strong proponent of breastfeeding (in those words) but she felt that night weaning was a large part of what caused the issue for Noah. As I’ve said before, I have horrible teeth, and it’s a genetic issue. Therefore, night weaning seems to be the logical step, and considering that Noah is 17 months old (today!), he’s old enough…in our opinion anyway.

I still feel guilty for giving him bad teeth. I feel like I could have done more, though I don’t know what. I guess I could have listened when everyone told me to bring him in when he was two or three but I didn’t…does that give me points?

I just hope it isn’t too late for him and that they can save most of the tooth. I also hope we can establish some good habits with him while he’s young so he never has to deal with what I deal with. *sigh* I just want my little boy to be 100% healthy.

I’m disappointed that Dr. W didn’t really work out. I’m sure we can take Noah back there for smaller things but since dentist visits should be fairly rare once this is squared away, a drive to Newnan to visit Dr. P² shouldn’t be too bad. At least we like both of them!

They had a big aquarium in their waiting room, which was Noah-approved.

The office wasn’t really set up for kids, as Dr. P also takes adult patients (in fact, I believe he primarily takes adult patients) so there weren’t any toys or anything to keep him occupied. I brought a few but because they weren’t brand new, they didn’t hold Noah’s attention long when he could otherwise be exploring! So that’s what he did.

He’s such a ham, really. It’s impossible to be bored around Noah. Not only does he run you ragged but he also thinks making you laugh is hilarious…so he tries (and succeeds) to do so as much as possible. Have I mentioned that I’m blessed?

Anyway, Dr. P came out into the waiting room to speak to us before heading to the back. I actually really appreciated this, as it gave us a chance to talk before Noah was a squirmy little bugger (I think he does this because most kids fuss and scream when they get back there). He did ask us why we were there, in case it was just a case of Paranoid Parent Syndrome, but when I told him Dr. Z recommended that we get Noah seen ASAP and that his tooth was already chipping/crumbling, he nodded and brought us to the back. Of course, Noah wanted to be led to the room by none other than his pretty new friend (ie: the dental assistant), where he continued to flirt with her.

(Don’t you think these two are the handsomest boys around? Because I do.)

Unfortunately, when we got down to business, Dr. P pointed out that Noah not only had a huge cavity and some major decay on the top right tooth (his left), it had spread a little to his three other top teeth. Thankfully, he thinks those are salvageable, especially if Noah is fed no sugar (fruit is okay) and sticks to just water and milk. The fourth tooth, the one that’s been chipping and has been the source of my worry for all these weeks, is probably not. He isn’t entirely sure if the entire tooth has to come out or if it needs to be worked on, and he won’t know until the day of the surgery.

Yup, surgery. You heard me. Well, it’s surgery because he’s being put under anesthesia, where Dr. P is going to attempt to clean and discern what all needs to be done and then do it (with our permission, of course). We have a pre-op to attend with Dr. Z and with the hospital but I really like our local hospital (wonderful maternity ward, seriously) so I am confident that this should go smoothly.

I feel terrible. Even though I brush his teeth and avoid sugar and try to do everything “right”, something still went wrong. I still gave Noah my bad teeth (it’s thought that he may have my weak enamel). *sigh* If it isn’t one thing, it’s another.

Beating myself up isn’t going to help though. All I can do is cut sugar out of his diet, make sure he eats healthy and brush his teeth. Dr. P told me that to save my own teeth, I probably need to cut sugar out of my diet – especially soda. *gulps* I know he has a point. I see his point. I don’t like his point…but I am going to do it anyway. If not for me and the fact that I don’t want to lose half of my teeth by my 25th birthday (which is getting closer and closer…yikes), then for Noah, because the cavity causing bacteria can easily get transferred from me to him (or from Joshua to Noah or Joshua to me to Noah or what have you).

It’s a good thing we’re trying to be healthy anyway, right? Right? And smoothies are made of fruit, so they’re okay…right?

Bleh.

All in all, I think I like Dr. P. He only made mama bear come out once and that was when he seemed completely clueless that people nurse their kids until the age of 2. (What would he have said if I told him about the ones that nurse until 3 or 4 or even 5, I wonder?) I think I surprised him a little when I said the World Health Organization, American Academy of Pediatrics and Dr. Z all think 2 is an excellent weaning minimum. I also flat out said that 2 was my ultimate goal and I would do my best to get there. He seemed to relax when I said that we are focusing on trying to nightwean (for multiple reasons – his teeth and my sanity are neck-in-neck for first place right now) because that’s when the milk pools in Noah’s mouth, causing the rot. (I realize there are naysayers about this but when you have my genetically bad teeth, this is a valid issue.) I did really appreciate how Dr. P was willing to teach me about teeth and growth and milestones as opposed to just telling me what was good for right now.

So, we’ll see how this goes. I pray to God, for Noah’s sake, that this is a relatively easy fix. I hope we can save his teeth for the long run. I hope he doesn’t have my issues. I hope we can raise him healthy.
And I hope this week stops continuing in the same pattern and just gets better already.

He does far better than I expected him to, as well. I kind of expected him to eat the crayon (not out of the picture, either, because I fully expect him to get curious if orange actually tastes like orange) or hold it awkwardly and therefore not be able to actually draw. Instead, he’ll adjust it in his hands (or ask me to do it), then he’ll make marks on the paper that get better each time he tries. I’m pretty impressed, to be honest, because I don’t have much hand-to-eye coordination. In fact, I’m a bit of a klutz, and have been since I was a child.

Anyway, the slight problem with the fact that he likes to color is that anything white is his canvas. We live in an apartment, where we can’t paint our walls. You see where I’m going with this, right?

Yeah. He totally colored on our bedroom door when I wasn’t looking. It has a gorgeous red scribble about 6 inches below the doorknob and he seems really proud of it. I took the crayon away like a good mother (albeit a bit delayed) and so he grabbed his baby carrot, which looks suspiciously like an orange crayon, and tried to color with that! And yet, how could I be angry? My son saw something that looked like a really big piece of paper and he thought he should fill it up. I’m actually kind of proud.

As for the lease and apartment rules…well, they’ll have to paint anyway, so I’m not all that worried about it. We’ll probably be here for a few more years and it wouldn’t surprise me if a couple more slip ups happened but at least I learned my lesson – supervise those crayons! I have a little artist on my hands. ;-)

This entry is definitely a lot more upbeat than I thought it would be though. See, I was born hearing impaired. There was fluid in my ears and I had ear infections constantly as a child. Eventually I got tubes put in my ears and my hearing improved drastically, but I still read lips on occasion and have to use closed captioning/subtitles on the TV or a movie.

Apparently, this is hereditary, and Noah has been showing signs of not being able to hear to his full potential. You can sneak up behind him and he won’t acknowledge you until he sees you. You can call his name and you might as well shoot yourself in the foot for all the good it’s going to do you. He babbles and won’t talk often (he says 5 words sporadically) which is sometimes – sometimes – a sign of hearing impairment. My Mommy Radar isn’t going off at all, but I did notice every now and then that Noah just wasn’t hearing my words. Then his Nana mentioned it and, well, you know.

However… we (Geek Dad and I) took him to his doctor and he agrees with us that Noah may just be too “busy” to hear. He will respond sometimes by grinning when he thinks you can’t see him and then continuing to ignore you. This means he can most likely hear and just gets too absorbed into what he’s doing or just flat out feels like he’s too busy to give you the light of day. This is excellent news, and I feel like it’s really the most likely possibility. Besides, Noah loves music more than any kid I’ve ever met. This kid dances to birds chirping outside at sunrise or because someone taps their pen in the right rhythym. You can’t tell me that it’s the vibration every single time.

Regardless, we’re taking him for an appointment to an ENT that specializes in pediatrics just to be safe. His appointment is on June 10th and it’s in North Atlanta…yes, alllll the way through Atlanta, as far away in Atlanta as is possible from us. I’m hoping to find another, more local, doctor that also works with toddlers because even though I will drive as far as I need to in order to make sure my son is okay, I’d really rather not have to.

And if it turns out that Noah does have a hearing impairment then I guess we’ll deal. We’ll coach ourselves to talk louder. See what options there are for restoring his hearing. Etcetera etcetera. He’s fortunate in the fact that he has a mother who fully understands the burden that being hearing impaired places on your shoulders. It’s not easy growing up, explaining to people that you didn’t turn close captioning or subtitles on to piss them off; you just want to enjoy the movie too. It’s not easy explaining to people that they need to face you when they talk or else you can’t hear what they’re saying or read their lips. It’s not easy explaining to most people what the difference between being hearing impaired and being deaf is – most people think you can either hear or you can’t and that there is no middle ground.

Unfortunately, it’s also not easy knowing that you may have passed that burden on to your innocent child, so I hope for his sake and my guilt-riddled heart that he is perfectly fine and just being silly old Noah. I’m supposed to make life easier, not harder.

Well look at that. Somehow this entry became about me. Typical. ;-)