The Tale of Noah’s Teeth

Last weekend was a huge weekend for us. Huge in the sense that we all had to gear up and prepare for Noah’s first ever procedure where he was sedated. You see, kids with Down syndrome have various medical conditions, some of which require surgery at a very young age. Some have open heart surgery before a year old to ensure that these little rock stars grow up healthy and strong. Noah is lucky that he didn’t have any medical conditions that required surgery. Although he was born with 2 holes in his heart, these closed on their own when Noah turned one. His eyes were good so he doesn’t need glasses (yet). His hearing is good too and the last time we had his thyroid checked, his endocrinologist didn’t prescribe any more medications. However Noah has issues with gaining weight. And that’s what we focused on. This meant giving him milk and feeding him when and if he wants. Noah is a pouch eater (nagbabad ng food) and he drinks milk in the middle of the night pa.

Recipe for dental disaster talaga. Kids with Ds get their milk teeth at a much later stage than typical kids. Most of the time their teeth are tiny, sharp and uneven. Noah’s teeth came in when he was more than a year old and yes his teeth were sharp and tiny. He’s turning 3 next week and his milk teeth are actually not complete yet. Pero the pouch eating and bottle feeding all led to major decay of most of the teeth he has now. Even if Noah’s teeth were brushed at least 2x a day, it was not enough. When we finally took him to the dentist and his teeth and overall oral health were examined, we were presented with a dental plan that included multiple extractions and possible crowning of some teeth that can be saved. Noah also had gingivitis.  The entire procedure(extraction and crowning) will all be done under sedation. The dentist will also include an excision of the fleshy growth underneath Noah’s top lip.

Well to say na naloka ako is an understatement. Naloka ako because I beat myself up that I allowed Noah’s teeth to be so degraded. His gingivitis must also have been so painful already  at that point because his gums would always bleed when we brushed his teeth. Dan and I do not want to risk further infection. . Ang hirap isipin na we could have prevented this but we took so many things for granted because I focused on Noah’s weight gain.

Noah’s dental clinic is at the Children’s Dental Center. Our dentist is Dra. Pedroso. Before we had the procedure, we needed to get clearance from Noah’s pedia and we also got a second opinion from our family dentist who agreed with the extractions and the treatments for Noah.  Our pedia, Dra. Alma Enriquez insisted on a hospital set up and that Noah be sedated under IV and a heplock so that if anything happens it would be easy to stop and/or reverse the medications that Noah was receiving. Phew!!

So Saturday came. Noah was scheduled for a 7 am slot so we drove to Makati as soon as he woke up. He fasted for 8 hours before the procedure but he was asleep naman. The 7 am slot worked really well for our little boy.

The clinic was quiet when we arrived and Dra. Pedroso and one of the staff welcomed us. The anesthesiologist soon came after bringing with him his bag full of emergency supplies. (I totally forgot his name and I forgot to call the clinic, I will update this post next week when I find out who he is, so sorry Doc!! Ang bait pa naman nya!)

I was a nervous wreck and I was really scared. Noah was just his playful self and was waving to the other staff who have already come in for the day. Here he is at the reception area, solong solo nya ang toys hehehe

Then the anesthesiologist approached us, sprayed something on Noah’s hiney and injected a sedative. Knock out si bugoy in less than 30 seconds. He was then placed in the chair that was set up like the one below, complete with padded restraints.

Dra. Pedroso and the anesthesiologist were both cool, calm and collected. I appreciated this very very much. I stayed with Noah all throughout the procedure and the anesthesiologist would always check on me. My hands were in my face kasi. Lukot na lukot mukha ko sa kaba talaga. Noah was not completely asleep, he was in and out but he wasn’t conscious. His vitals were monitored all throughout and his anesthesia was done via IV. For a little boy like Noah, there were 4 professionals who looked after him that morning.

Dra Pedroso extracted 12 teeth and filled in 3 of Noah’s molars. She did not attempt crowning anymore because she did not want to prolong Noah’s sedation. Noah’s Oxygen saturation and breathing were monitored constantly and unfortunately Noah had disruptions with his breathing because of his tongue. The crowning procedure would take at least 30 minutes per teeth. Dra. Pedroso did not risk it anymore.
One extra procedure pa that was done with Noah was that the extra fleshy growth under his upper lip was excised by his doctor. Ang dami lang talagang ginawa kay Noah but I was glad that everything was done in one go too. At least Noah will only experience the sedation and the procedures once.

Before finishing, Dra Pedroso took an x-ray of Noah’s gums as a final check. This level of thoroughness and concern really impressed me. I was still very much worried for Noah though.

Noah woke up from his sedation a few hours after. He still had bleeding and was disoriented the entire day. He woke up really hungry though and so he was fed with cold yogurt and oatmeal. Noah actually fed himself yogurt! He was that hungry!

He’s still on soft diet a week after.  We tried to give him rice but he cried 🙁 Wawa talaga but I am hoping that his wounds would completely heal soon. He also has stitches under his lip kasi. Noah doesn’t complain though although he’s a bit masungit. I wouldn’t blame him really so we let him be.

I realized that I really should not have taken Noah’s dental health for granted. But I am thankful that he was in good hands throughout the procedure. At the back of my mind, I kept going back to this piece of research on Down syndrome and dental care. Ultimately, Noah’s overall health is important. It may come at the cost of this major dental procedure now but I know that we have arrested a possible infection that could affect his heart in the long run.

I summed up everything I learned on that day into 5 points. If you have a young child and you are considering having his/her teeth checked, I really recommend that you don’t delay it. Have their teeth and oral health checked right away!

1) Go to a pedia dentist as soon as your child’s first tooth erupts. And yes a pedia dentist is important so they can properly check your child’s teeth and provide the necessary plan to maintain the health of their teeth and gums. A pedia dentist also knows how to make the experience pleasant and fun. David’s first experience with a dentist is with a pedia dentist. He goes to our family dentist na without any fear and I credit much of that to his fun times at his pedia dentist.

2) Use a toothbrush with flouride right away. Maski isa pa lang ang ngipin ni baby, a thin smear of toothpaste is enough to protect and clean the tooth.
3) Do not gargle right away!! (Applies to us adults too) Wait for 30 minutes the rinse or if kaya naman don’t rinse na. O diba nakakagulat?! But apparently this is the right thing to do.

4) If your kid bottle feeds at night follow-up his milk with lots of water. Or pwede rin that you clean his teeth with a wet gauze wrapped around your finger then clean clean clean. Noah drinks water na lang at night. Ang sama ng tingin sa akin lagi 🙁

5) Go to the dentist regularly. Guilty ako dito, I am long overdue for a prophylaxis!! Noah goes for regular cleaning and flouride/vitamin treatments every 2 weeks. David goes to our family dentist at least once every 2-3 months. Dental health is wealth talaga. I had to learn the hard way with Noah so I hope you guys learn from my experience din.

I also scanned the brochure of Children’s Dental Center which has really helpful FAQs and tips on Pediatric Dentistry (you can click on the pic below to enlarge)

Noah is back to his makulit self. Medyo bungal pero cute na cute pa rin. I am hoping that he could soon eat his favorite buttered rice again. I am hoping that he would soon get his other milk teeth so he could eat and “speak” better. But I am in awe of this kid and his ability to fight and soldier on. I love his brave heart and his ability to bounce back from any set back. Ang galing mo talaga Noah. Mom, Dad and Kuya David are super proud of you! Kain na tayong kanin next week ha! 😀

Children’s Dental Center
G/F 1012 A. Arnaiz Ave, Makati Ciy 1223
846.2780/ 0917.569.3455