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"Holes" in Preschooler's front teeth
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Questions in the Dental Health forum are answered by Dr. Jerome Tsang. Topics covered include bridges, cavities, crowns, and x-rays.

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"Holes" in Preschooler's front teeth

My 4-yr-old had two "holes" in the top of her front two teeth about three mo. ago and had them filled. Now it appears that they have returned again. She has had problems with discoloring, too (enamel problems, I was told). They did clean her teeth, but it has since returned, too. My question is are these "holes" because of decay/enamel problems or did the dentist do a poor job filling them the first time? I'm hesitant to take her back to the same dentist. Thanks!
Jen
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Avatar_dr_m_tn
I can not give you an opinion about the either the quality of the work or if the defects are from decay. I would suggest that your daughter be seen by a pediodontist if she has not been seen already.
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Avatar_m_tn
Recurrent, quickly advancing decay in children is usually the result of inadequate hygiene--ie poor brushing and flossing and plaque control. Either of the other 2 scenarios you mentioned are possible also. I'd bring her back to the dentist who did the work and put the question to him (or her). If you are not satisfied with the answers, then get another opinion from a pediatric dentist.
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Avatar_n_tn
Thanks for the info. and advice. I have often questioned my parenting skills when things like this happen--we've been careful about not putting our children to bed with bottles when they were infants, monitoring their intake of sugary, sticky foods (i.e. fruit snacks, juices), making sure that they brush their teeth every night with supervision, dental check-ups every six months, etc. But, inevitably, even with the best parenting, things can still go wrong. :P

I will probably take her back to the same dentist and see what he says. I just hope that this doesn't continue to be a problem after it's fixed, again.
Jen
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Avatar_m_tn
some kids need intensive homecare and depending upon what they eat shold be brushing 3x per day. remember "brushing" means 2 uninterrupted minutes of brushing. is your 4 year old supervised when he (or she) brushes??? you are right sometimes enamel is not correctly formed and teeth can decay more easily, and sometimes dentistry is performed poorly. BTW does your child take fluoride supplements? Is your city water fluoridated and does your chld drink it??? These things should all be discussed with your dentist.
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173939_tn?1333221450
Jen, you are not alone...I thought I had done a pretty good job with my preschooler`s dental care only to find that decay had evolved between his teeth over a longer period. Most of his molars needed fillings between them. It came as a shock as I know that lots of parents take it a lot easier. If I do not floss between his teeth and don`t take him to dental cleanings every 3 months, the decay just proceeds. And flossing a squirming preschooler`s teeth seems to be the hardest chore ever.
In my family there is hereditary vitamin D malabsorption and many of us had rickets and in general weak bones and teeth. It only learned too late that I should have given my son vitamin D supplements as a breastfed baby. In combination with the heredetary deficiencies, I believe his teeth are just prone to be brittle and all I can do is damage control. I give him daily vitamin D now. This has probably nothing to do with your daughter`s situation but thought I mention it anyway.
When teeth have discoloration, I have heard of of two instances in children. Either they turn darker/yellowish caused by a certain antibiotic that the mother took during pregnancy or they develop white spots due to fluoriosis after too much fluoride intake, however the latter would not show until way after the preschool years as far as I understand.
Do the new holes in your daughter`s teeth appear right beside the fillings or elsewhere? Are the fillings close to the gum line? If it is just beside the previous fillings, the fillings might have some rough edges that nest more bacteria and cause new decay. And if all of this is close to the gum line, you will be amazed how much plaque can be missed during brushing at that edge...
Finally, it helps not to share eating utensils, cups etc. in families to avoid saliva transmission that may re-infect the child`s mouth with caries causing bacteria. Sorry this got so long. Maybe some of it helps. It seems like your regular dentist does not explain a lot. He may be doing a great job but like others said, a paediatric dentist may be more familiar with the full range of childhood dentistry and even parents` anxieties... All the best.
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Jerome Tsang, DDSBlank
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