New smile

Take a good look at this smile. He's going to get a new one soon. Truman has an abscess in one of his two front teeth. It burst and has caused him a lot of pain. Once the infection is gone, he will have the tooth pulled and a false one put in.

His original dentist missed the abscess at his cleaning in December, but we had noticed some discoloration, but thought it was a typical tooth discoloration issue common among preemies (apparently enamel comes along later in gestation). Then I noticed what looked like a blister on his gums while we were traveling over Christmas. Well, soon after we got home, it burst. We took him to the dentist, who diagnosed the abscess and told us the tooth needed to come out. He also said that we would have to leave a gap because it wasn't safe to put Truman under in order to build the filler tooth. We were concerned about that for cosmetic reasons, but also for speech and feeding reasons. We didn't want to add yet another challenge in that area. Front teeth are kind of important from a functional perspective. After hearing Ben's report about why the first dentist didn't want to put some sort of filler tooth in, I decided that we needed a second opinion.

We found another dentist based on recommendations. The new office is fabulous and super high tech and confirmed my suspicion about Truman's first low-tech dentist. He was just scared of Truman's medical history. I'm guessing he's not the last medical professional we'll have that problem with during Truman's childhood. The newer dentist, who has an pediatric orthodontist and pediatric dental anesthesiologist he works with didn't bat an eye about the process. Truman will have to be put under in some form (I'm not sure if it's conscious sedation because Ben has been handling it) in order to keep him still long enough for the mold for the new tooth to set, but apparently this is common procedure. There is no more risk to Truman than to any other child, and being put to sleep is standard practice for many pediatric dental procedures.

The abscess was most likely caused by trauma to the tooth 8-12 months ago. I do remember a couple of big falls on our tile floor in the kitchen, one of which caused a lot of bleeding and made me worry about a chipped tooth at the time. We had no idea such things can lead to abscess.

I'm also glad about switching to a dentist with an orthodontist in the practice. We already know that with the size of Truman's jaw (due to both genetics and slow growth) and the palate re-shaping caused long-term intubation, he's most likely going to need some serious orthodontic work at some point. In other good dental news, x-rays show he does have all his permanent teeth hiding in his gums--something which is not a given for many preemies.