Pediatric Dental Cleanings, Fillings and Sedation. What I wish I knew!

Recently I took the children to their six month dentist check up/cleaning. It was the first full cleaning for L, who is not quite 3.5 years. And seems old hat for E, who is almost 6.5.
L did well and charmed his way through the process. Chatting it up and cheesing for the camera. He recieved a good report. No cavities!




Sister, true to form was polite, but not all that thrilled with people poking and prodding her. I wasn't surprised when the hygienist mentioned Es sensitive teeth and her reluctance at the process. I purposely stood just outside of her exam room (but within sight and watching) hoping my absence would make it easier for her to comply without asking to be recused.



She was not interested in cheesing for the camera.

Sadly she has three cavities that need to be filled. One is in a front top tooth.  We've been watching it for six months, thinking she might lose the tooth soon. But it is now an issue and can't wait. The other two are between two bottom teeth. The hygenist, dentist and myself discussed with her the importance of brushing and flossing etc etc etc! But they also reminded me some children have weaker enamel and there is only so much prevention we can do. We discussed the plan, got the estimated costs printed out and made an appointment to return in two weeks for the fillings. It felt good to be in a place I trusted and to have a plan. And it reminded me of a dentist appointment last fall that didn't go the same way.

Last fall we visited another dentist in our area. A pediatric dentist, in network for our insurance and someone we had seen previously for multiple check up/cleanings. During our check up last fall, we learned E had cavities, but I was less than thrilled with the way the staff communicated the information, and their ability to answer my questions/concerns about the fillings procedure.  After having almost a year to digest the experience and having recounted it to several friends I feel like there are some valuable take aways. Things I wished I had known before being in the immediate situation.

Pediatric fillings: Red flags. 

1) Discussing costs before discussing the patient. 
During her cleaning the hygienist mentioned she saw a soft spot. And indicated it was probably a cavity. Before the dentist even came to check on my daughter, or discuss it with me, the hygienist was asking me to sign waivers on the filling procedures and financial commitment paperwork.

2) "Upgrading" the filling. 
From across the room the hygienist asked me "Do you want a white or silver filling?" In that moment I was genuinely confused. "Are we doing this today?" I asked. Mind you I still hadn't talked with the dentist. She answered to the effect of "No, but I'm working up the cost estimate".  Side note: I have since learned from another dentist, that white fillings take more time and patience to place and set and are thus not recommended for children unless it is a front facing tooth.

3) Sedation not covered by insurance. 
After I got over my shock (over the process, not the cavities, they are a part of life), talked to the dentist and received her assessment of the cavities, I received a treatment plan/cost estimate. I was still on autopilot. I mean I had two kids at the dentist at 4 p.m. after school trying to keep them from melting down while trying to have a conversation with the staff. Thankfully the $400 cost estimate woke me up. It was my second shock.  "Why is sedation not covered by our insurance?"  I asked. The sedation was 50% of the estimate. "Shouldn't they cover Nitrous Oxide (laughing gas), or a portion of it? Isn't that standard for children?" Me, still assuming we are all on the same page.  Office manager "We don't use laughing gas." Me: 😳

4) Sedation of any kind for children. 
At this point I shook off the autopilot. We were standing in the entry way/counter were they wanted me to sign paperwork and schedule the appointment to have the fillings done. "May I speak to the dentist again...." the play by play gets a bit shaky here,  because a little voice was screaming in my head....  Basic run down, after I played 20 questions with the dentist standing in the foyer of the business.

• They use a liquid cocktail for sedation, based on the child's weight. 
• No they do not have an anesthesiologist on staff. 
• No they don't know what role it could play that my child has an adverse reaction to Benadryl (which she does). 
• No they don't have a back up plan if she won't swallow the meds (and y'all the child HATES liquid meds!). 
• And BTW, we use Fentanyl in our sedation cocktail... um, what? 
• Full stop. FULL STOP YOU GUYS.

I tried to hold myself together long enough to get everyone in the car and drive home. We left, with a polite, "we'll call later to schedule". We did not return to that dentist. So many red flags. I am sure they are fully licensed and reputable. However, for me, Fentanyl was a deal breaker. Not to mention the other items listed above. At the very least I walked away and gave myself time to sleep on it. And thankfully I reminded myself it's ok to turn off autopilot and ask questions (And really that was a red flag too. Why did I have to play 20 questions to get all the pertinent information?). We have since found a dentist we love, in network for our insurance and E had the original fillings completed last fall. Call it Mama sense, or an inner voice, or divine intervention, I'm just happy to call it a closed chapter. This week's dental visit was a much smoother, calm experience for everyone. 

Sewing in a straight line doesn't really matter.

In sewing, sometimes it is more important for it to LOOK like the line is straight than to actually sew a straight line.  For example, stopping or starting the thread/machine to make sure the line is just right can actually make for a herky jerky line- so sometimes just smoothly bringing the line back or edging it slightly this way or that way to follow the pattern of the fabric is visually more appealing to the eye.

All of this is of course assuming we aren't sewing pants or a fitted garment.  Where the darts and seems need to be JUST right.  I don't do that "KIND" of sewing.  I take my pants to be mended. Yes, I do.  My mom thought that was crazy. But I sew to relieve stress and re-hemming my pants that I bought on sale, from a store I love, pants that they don't make any more, causes stress.  So I pay to have them re-hemmed or lining mended.

I'm a craft sewer. Pillow Cases- Halloween Costumes- Burp Cloths- things that don't need laser precision.  And in that kind of sewing, looking like a straight line is more important than being straight line.

Turns out there are a lot of things in life like that. Looking put together is one of them. Like or not, it is human nature and people actually do treat you differently in stores, banks, restaurants, etc. when you do not look like a hot mess.  And just because I got up early and blew out my hair, does not mean my life is actually any more put together. But isn't that a neat little trick?

Having well behaved children is another.  Having quiet, obedient, and well groomed children is the gold standard for public interactions (or maybe that's my reluctant debutante raising..). We've seen the cute social media posts about "baby's first flight" and parents handing out treat bags to fellow passengers...they aren't asking for college fund donations, they are hoping to "buy" approval if their child cries. Which children do. And children are also not always quiet, obedient, and well groomed in grocery stores, or doctors offices or the DMV (Or of course they are! Right until YOU walked in and of course you missed it! LOL).  Why do parents flying with little ones feel that way? Because they know: It's more important for it to look like a straight line, than it actually be a straight line.

As parents, we see your eye rolls, and sighs, and shifting feet in the check out line. But we aren't trying to sew a fun Halloween costume, we are trying to raise little people, to become big people. Big people that don't eye roll or sigh, or shift their feet when things aren't going their way. Kind people. When things happen and my child is clearly not representing their best selves, I try to reset the mood, by saying what I really feel (especially at the DMV!) "I know sometimes I wish I could cry too" or "I know, I wish I could buy all the things too! That would be so fun!..." Often these comments diffuse others as well, reminding us all that these little people are in fact people and everyone around them is setting examples. And it also helps remind me. This line doesn't need to LOOK straight. It's ok. It can look a HOT DAMN MESS, as long as it turns out kind and caring in 20 years. This isn't my best self on the floor of Target screaming and going limp noodle. This is my two year old, learning how to handle himself. Trying to find his best self. And trying all the tools he has to see if I'll buy him the Paw Patroller trailer. So go him! He is trying every tool he has. And I'm working on mine too (think a combo of trying to find the humor in it, and yoga breathing...).

And why no, my son didn't just turn 2 and 9 months and decide to laugh and smile and LOOK ME IN THE EYE and do *insert whatever I just told him not to do* everywhere we go, including the pediatrician's office, why do you ask?

You don't even know me.

You don't even know me.

It's been almost three years since this incident but I thought about it today and my memory was so clear that my heart raced and the hairs on the back of my neck raised and I wanted to screen "YOU DON'T EVEN KNOW ME, B****!" And of  course include a chest pound and springy jump step for good measure. 

At the time of reminiscing I was alone in Logan airport leaving Boston after a lovely girls weekend (another post, maybe!) my fight response was only *slightly* out of whack. But the memory was interesting and made me really think. 

About three years ago after the birth of E and before I was pregnant with L, I went to a craft/fabric store to buy a few things to finish a diaper wreath I was making for a friend. While there I was drawn to a set of Tervis tumblers on sale in the check out line. I picked out two (We love these cups. We haved used other Tervis' for years. And they were on sale and I had coupons ...and really none of that should matter because I'm a grow ass women and I wanted to buy them with my very own adult money!). 

Two older women behind me in line launched into a conversation about how redicidiulus these cups are and so expensive. Since they made no attempt to have a private conversation I chimed in. Light hearted I said something like "We love these. They really hold up, we've had some more than 5 years and they are in great shape. And don't forget you can use your store coupon on them..." It was my turn to check out. I walked toward the register. They resumed thier conversation and said how this "younger generation" didn't value money the same way! And didn't understand hard work. And were irresponsible with thier money...and that's the problem with America these days. 

I was red in the face. I was shaking. You don't even know me! Irresponsible?! What's wrong with America? I've had a job that required a W-2  since I was 16 and babysat for years before that. I paid for 90% of college on my own (by working!) and bought my first house at 23 instead of continuing to pay rent.

Irresponsible?! At the time my husband and I had paid off both of our student loans and had zero debt outside of one of the two cars and our house. And money not withstanding, we vote! We donate our time talent and treasure. We are a long way from what is wrong with America! How dare she!!!

They continued talking. I was standing right there! After checking out, I turned and said something like "Your comments are offensive to me. You don't even know me or what I'm like with my money." 

The primary woman was genuinely shocked. Blown away that I was offended. I was shaking so badly I couldn't even continue a conversation. I walked out of the store. 

I paced in the parking lot, thinking of all the things I should have said, how I shoud have educated her about the "younger generation". But I calmed down and got in my car. I had other places to be.  

And today 3 years later I honestly don't know what made me think of that. A glance form a stranger? A dismissal from a shop manager while we wondered in Boston this weekend? Does it even matter. Clearly my fight response from the memory indicates I HAVE ISSUES with being or being perceived irresponsible. It's me. Not her. Not you. I was mad that she made assumptions about me. Mad she judged me without knowing me. Mad she didn't even know me. Mad. I was mad. Those are my feelings to work through. 

The next time you make a quick assessment of someone, remember you don't even know them. And I'll try to remember, you don't even know me. How could you, I barely know myself. 

I'm still working on it. 

Coloring in the lines

My daughter (3.5 years old) loves to color and create art. Crayons, markers, paint, you name it. During the week it is normal for us to have an hour of art time at the kitchen table AFTER she has attended a full day of preschool.

We pull out paper, stickers, markers, pipe cleaners in all colors, googley eyes. (Hit up the Dollar Store- more economical than Target/Walmart and for this "level" of creating just as effective), and go to town. Each time I try to get out a different combination of the supplies to keep things fresh.

Some days I make an example or idea piece. Draw a horse, or cut out a bat. More than anything this is to give her idea of what is possible.  I don't really ask her, or even encourage her to re-create what I made. I encourage her to make her own creation.

Lately these projects have tended to be more about drawing/coloring. By her choice.  I love to let her create and I ask after the fact for her to explain what she has drawn. We talk about why she chose certain colors for items and I remind her that water doesn't have to be blue and the sun doesn't have to be yellow (or orange! if you are from "that" camp). Sometimes I bring up the book The Day the Crayons Quit (a great read) as a discussion item. But I have never said "You are doing a such good job coloring in the lines!"

Why do we say that? Every time I hear it, it just sucks the creativity out of me. And I'm 34! An adult with a reasonably developed sense of self. It makes me want to pack up all the art supplies and watch tv.

Yet people say it. ALL. THE. TIME. Grandparents. Teachers. Other parents. MY SPOUSE, father of my children. Why do we care if they color in the lines? Because it shows some sense they are conforming to our norms? Because we think it is a sign of "progress" which as parents sometimes is hard to see between the endless laundry and meal prep and potty accidents. Or because it is good fine motor skills development? Yep. All of these things.

There are a MILLION other ways to help them develop fine motor control. Without sucking the creativity out of everything. Without telling them the ONLY acceptable way to interact with a project is to fill in someone else's lines, ideas, plans for the world.  When they are little and learning not just how to control their tiny fingers, but their minds…let's not box them in.

Next time you are with a child coloring. Consider these conversation starters instead:

• I love what you have done. Tell me about your picture.
• Ohhh…I've never seen a purple Elephant, what else could we draw using purple?
• You choose green for the water! Awesome, looks like the ocean. Do you know what letter green starts with? 

And my favorite…

What a great job coloring in the water and boat in this picture. What else could you add to it. Birds? Another boat? Pirates? Humm…a treasure map?!

Looking for ways to help develop fine motor control? Try these!

• Practicing writing letters.
• Eating with utensils.
• Painting finger nails (of course in the bathroom with the room sealed off with 500 yards of plastic). 
• Threading ribbon into cereal or cardboard with holes punched out. 
• Popping packing bubbles.
• Gluing dry beans to paper to make designs. 
• Cutting canned green beans with a plastic knife. 

I met a blogger. Go me.

One a recent family flight across country with two children (Yes, two! I told you I was terrible about updating this blasted blog….) I sat next to a full time mommy blogger. Actually talked to her. Exchanged stories. Made her laugh with my stories. That may the closest I ever get to becoming a blogger. Time will tell.

Tye Dye with a side of Pinterest

Dusting off the cob webs.  Maybe one of these days I'll have time to type all the posts that currently reside in the voice memos app on my phone.

Tonight I'm looking up tye dye techniques for my daughter's tye dye event at school.  Have I mentioned that she isn't even two yet?  And we have 1) school, and 2) an actual tye dye event to be concerned about.

I wonder if the power of the internet < insert, FB, Pinterest, Blogs, etc, is actually making us smarter more engaged, and better informed parents, or just making us more neurotic and Martha Stewart obsessed that our parents ever dreamed about being? Wait don't answer that.

I'm not sure, but I'll tell you what, my daughter is going to "make" the best tie dye shirt tomorrow.  And I'm only going to "help" a little bit.  *wink