Dr.Mom
Developmental Enamel Defects
By Lucie B. Amundsen

It would be fair to say that oral hygiene has not been my little guy’s strong point. Milo had always given us static about teeth brushing. While he claimed it “hurt,” his compassionate mom would say something age-appropriate roughly translating to “suck it up.” 

Dentist appointments were always brief. Cringe-worthy behavior, including some biting, did little to charm the office staff and Milo’s exams were little more than a cursory glance. We knew a “real” cleaning was in order and our dentist had talked about us taking him to an oral surgeon to be anesthetized for his next appointment. Another proud maternal moment.

Honestly, we had been dragging our feet in making the call hoping that before the next 6 months passed, Milo would mature enough to handle a standard exam. Somewhere between the pre-surgery fasting, the inherent risks of anesthesia (not to mention the several hundred-dollar price tag), we got bogged down.

But recently my 5-year-old came to us asking for a dental visit. “My teeth hurt, Mom.” The tears running down his face told me he meant it. A trip to Walgreens for Baby Orajel helped us bide the time until the next available appointment, but just barely.

My husband took him to the appointment and called telling me to sit down. Milo had a number of cavities because, as it turns out, his enamel never properly calcified. In essence, he had none. Developmental Enamel Defects (DED) can happen from any number of incidents including premature birth, maternal illness or an early childhood fever. The doctor went to great lengths to repeat that this was not our fault, but it did have me mentally combing over his gestation – a pregnancy with its fair share of oddities – and wondered which one had stolen his good teeth.

Waiting for the surgery date was agony. My kindergartener even erupted into tears at the grocery store after biting into the free kids’ cookie. Though he was on amoxicillin to knock back the attacking bacteria, it didn’t entirely do the trick.

So it was with mostly a sense of relief we accompanied him into the operating theater and submitted to the parental torture of watching a child be “put under.” Just two weeks before we had to put down our family dog and the similarities were not lost on us. I’ll cop to making an involuntary noise when watching his body lose rigor and the sallow coloring replace the apples in his cheeks.

Midway during the procedure the doctor informed us that the damage was more extensive that he’d originally thought. In addition to a handful of fillings and extractions, Milo needed a crown and silver metal bands on his molars. With my baby still on the table, it didn’t seem the time to do anything other than nod.

An hour later and my boy was curled into my lap - still in his doctor-issued jammies - unceremoniously vomiting in the provided receptacle. This was a scene that was repeated for the next few hours and then subsided into an afternoon of mindless television viewing and pudding consumption.

The specimens we were given to place under the pillow were painful to look at it. They were good-sized teeth with the roots still attached and a huge blackened hole all the way through. I wince to think how it must have hurt when I scraped an annoyed toothbrush over those.

Later Milo discovered what he calls his “metal teeth” – the molars with the banding. I don’t know what we were expecting, but I’ll tell you entirely metallic molars was NOT it. They’re reminiscent of the metal-mouth henchman Jaws in the old Bond movies. Fortunately, Milo thinks they look really cool, which is good because he’s going to have those for the next several years. I told him they were very “bad butt,” which he took as a huge compliment.

Milo is not in pain anymore and is much more cooperative with his dental care. I bought everyone in the family electric toothbrushes to make it more fun and have become inflexible about fluoride rinsing. With a bill nearing $2,000 post-insurance, one can say we’re motivated.

Another change we’ve made is tucking a bit of Xylotil candy in the kids school lunchboxes. It’s a natural product out of the Netherlands, Europe and Japan made out of things like birch bark and almond hulls. How it helps teeth is by preventing harmful acids from flooding your mouth after eating. Our dentist told us to watch ingredient lists to ensure that it is the first ingredient and not just traces stuck in there for sneaky marketing purposes.

The candy has been well received, which is good. Because despite all he’s been through, Milo is still a big sweet tooth – even the metal ones.

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