My son is 3.5 years old. We took him to a pediatric dentist and was told he had 11 teeth with cavities in them. They want to use general anesthesia at a hospital and fill all of the teeth. This would cost $2000 for the dentist and $2500 for the hospital - quite a lot of money. We don't have dental insurance.

So, we decided to get a 2nd opinion. The 2nd pediatric dentist said he had 13 teeth with cavities and wants to put crowns on 10 of them. $3600 for the dentist, $2500 for the hospital.

I am absolutely sick to my stomach. We are pretty strict parents when it comes to eating. The kids never have soda, have not gone to bed with bottles, eat candy only on special occasions (holidays etc... ). Admittedly, we didn't realize how bad fruit snacks, raisins etc.. Are - but I can't believe he has 13 teeth with cavities because of this.

Anyway, my question is why are the two opinions so drastically different? Should we get a 3rd opinion? And I suppose we really need to treat this (right?) - but I'm not sure how much we can change in our diet to prevent this from happening in the future (and to our younger kids).

Obviously, cut out the fruit snacks and make them brush 3 times a day. I just don't understand. As a kid, I wasn't the best brusher - and I've never had a cavity in my life. What else can we do?

Unfortunately this happens. You definitely want to cut out the sticky treats - raisins are one of the worst snacks. I know we all feel that they are better than candy but they really aren't.

If you want to give your children sweets, give it to them as a dessert and have the brush right after eating. Better snacks are things like fresh fruit, raw veggies, popcorn, pretzels, cheese. You have to be careful with bread type snacks too... as the carbohydrates break down into sugar.

Children have deep pits and grooves in their teeth and this is where the sticky foods sit until brushed away. Some children also have tight spaces between their teeth and need their teeth flossed every day just like adults do.

Something else you need to remember is that milk and juice have sugars in them too. They should never been given to children in a bottle at nap/bedtime (water is the best choice) as the sugary liquid sits on their teeth the whole time they sleep.

Boys generally need parental help with their home dental care until they are 11 or 12. Girls until they are about 10. This all has to do with manual dexterity and how effective they are in removing all the bacteria off their teeth every day. I usually suggest to my patients that they make sure the parent does the brushing and flossing especially at bedtime.

You could ask your dentist about putting pit and fissure sealants on your children's baby teeth if warranted and for sure on the adult teeth as they erupt. This creates a nice smooth biting surface so sticky foods don't get trapped when brushing. The teeth will still need to be flossed!

Are there any anaesthetic dentists in your area who specialize in putting patients under general anaesthetic in their office which will reduce the expense of needing a specialist to administer the anaesthetic?

The fees aren't out of line for the dental portion. I do wonder why the 2nd DDS want to crown so many teeth. Is he talking front teeth? That would be an option for aesthetics only.

It IS important to restore the back teeth as they have to hold the places for the adult teeth to come in (usually all are in by age 12 or 13). This will help prevent the expense of braces later on!

Thanks for your response! The second DDS wants to crown 6 of the back teeth and the top four front teeth. He said 3 of them need crowns because they have more than one cavity on them and the fourth should be done because it will look silly next to the three others.

He also told me that sealants cannot be applied to baby teeth. They can only be applied to adult teeth. I did ask about the sealants, and it seems that he preferred to crown the teeth instead.

Are crowns a better option than just filling a tooth if it has more than one cavity in it?

It depends how big the cavities are. They must be huge to need crowns! Did the DDS say whether any of the teeth would need pulpectomies (nerve treatment)?

As for the top front teeth, as I said, to crown them would be for esthetics only. The other option is to remove them. The adult teeth should start to erupt in 1.5 - 2yrs. These spaces don't have to be held as long as the back teeth would need to be.

I hope the DDS took x-rays to see how the nerves of the teeth look and positioning of the adult front teeth.

I hope this answers your question.

The cavities are not very large - there just happen to be small cavities on three sides of some of the back teeth. There is absolutely no nerve damage. I've seen the X-Rays - the cavities are all on the surface. It seemed that he was going to crown them as a preventative measure.

Maybe that's why the first dentist just planned on filling them rather than crowning them. We are going to get a 3rd opinion, just to sort out the differences in the diagnosis.

Thank you so much for your input. I'll be able to make a much more educated decision now.

One point you must understand is that this may be a gentic problem. He may have week enamel. I would not cut fruit out of his diet. Remember what rickets are. Anyway due to the severity of the problem hospitalization is required. If you are in ny I have a grea pediatric dentist. Let me know and I'll give you his name. Just be aware this needs to be taken care of. It can became a child welfare situation.

If the cavities aren't really big, fillings will be sufficient, no crowns for sure! General aneasthetic is definitely the way to go.. get all done at once and very little bad memory for future dental visitis.

I'll be anxious to hear how things go.