Teeth

This is the month for teeth around here.  I saw the dentist last week, Anya goes tomorrow, and Reese the following week.  Unfortunately, Anya has to go twice as often as the rest of us, so she is not very happy about tomorrow's appointment.

A year ago, we took her to a pediatric dentist in town, who did a cursory exam and found four cavities.  He immediately started discussing a trip to Children's Hospital to put her under anesthesia to fill them.  I was disheartened, nearly devastated, which may seem silly after everything else she has been through.  Yet, I somehow felt shamed and guilty that my kid could have cavities.  I think of her as a pretty healthy eater, though if you have read this blog, you know she has had gummy bears, donuts, and various other treats. Could that have done it?

I wanted to blame it on the cancer, or, at the very least, chemotherapy.  I contacted her oncologist who said that, yes, chemotherapy can weaken the enamel on teeth, but it would be surprising to see that happen so quickly.  She recommended taking Anya to the dental program at the Children's Hospital.  We did, and they found that she had no cavities, but she did have staining on her molars.  She has been under close watch ever since.  In the meantime, she has to have check-ups every three months, brush her teeth with prescription flouride in addition to regular toothpaste each night, and floss daily.

Three months ago, they found that she has the beginning of two cavities.  Likely, she will need fillings before long, but the goal right now is to prolong that for awhile until she is able to do it without anesthesia. Due to the genetic mutation that Anya carries that predisposes her to secondary cancers, we want to limit radiation as much as possible.  That includes dental x-rays.  I have had to explain this to every dental assistant and dentist that she sees, and it is getting a bit tiring.  One flaw of the dental program at the Children's Hospital is that it is a teaching program, so Anya sees a different intern each visit.  This is challenging for a kid, like Anya, who very much likes to see and connect with people she knows.  She doesn't trust new people immediately.  One plus of that dental program is that they are more familiar than your average dentist with kids who have needs like Anya.  The past three visits, they have used a probe on Anya that can measure the tooth density as opposed to having x-rays.  The intern she saw last, happens to be studying treating kids with lasers and other methods, so he was quite excited to have Anya's case.  We will see him tomorrow, but in another three months he will likely have moved on.

Tomorrow should feel like yet another juggling act of keeping Anya happy, calm, cooperative, and also anticipating possible news of the necessity of more medical care.  Of course, once we are done, she is not going to let me forget that I have promised her a trip to pick out some new lip balm.