Friday, September 13, 2013

Kay Kay & His Front Teeth Accident

Date:  Sep 13, 2013

[Updated Sep 17, 2013]

Today, my wife brought Kay Kay back to Dr. Kenneth Lew's dental clinic.

After examination, the healing on the gum actually went pretty well.

The antibiotics did the job too, no fewer.

Except for the following problem.

1.  The two front teeth has been detached out.

2.  One option is to take it out.  But if we go with this option, then, we need to do more things to create space for the Adult teeth to come out in 2 years time.  The solution is to wear retention cap during sleep.  To use some other retention during day time and it will make it very uncomfortable.  As you know Kay Kay is only 4 years old.  How can he wear a retention plastic cap to sleep especially it will create uncomfortable feeling during sleep.  No way.  And this option is out of question.

3.  Of course, after taking out both front teeth, you can leave it as it is.  But the side teeth will start growing into the front teeth space for the next few months, and 2 years later when the Adult teeth decided to come out, there is no space for it to grow.  So, front teeth will go hay wired and grown sideway, inwards or outwards.  Then, 10 years later, we will have to spent more to fix it, wearing bracelet.  So, nope if we have other choice.

4.  Second option is to wait for it to die.  As the front teeth has already jump out of the socket / bones.  The root and nerve cannot properly grow.  So, between the next two months to the next 2 years, the front teeth may die.  So, when it die, the teeth may turn black.  It will loose off one day.  And you're back to square one, where the side teeth will grown inwards to the front teeth location and causing the Adult front teeth has no space to grow.

5.  The front teeth is shaky.  One of it is very shaky.  The other one is alright shaky.

6.  So, the last option is to put a bracelet there.  Dr. Lew suggested to tie against 2 teeth at the side, means 6 teeth together.  Apparently, it is too hard on Kay Kay, for him to sit quietly to let you do it.  

7.  The reason why we need to put a bracelet is the last few days, we have saw Kay Kay's jaw has change a bit.   This is the result of him afraid of biting the front teeth together.  so, his lower jaw is actually moving outside and the shape change.  This will badly affect his facial structure.  THIS IS BAD.  The bottom teeth now is in the front and the upper teeth is at the back.  THIS IS BAD.  So, we will need to use bracelet to correct that.  

8.  Also, the teeth after the knock, has pointed inwards.  This is bad!  the more he bite the front teeth, the more it will pushed into the gum.  That will cause pain.  And it will deform the gum.

9.  In addition, Dr. Lew also temporary put two wax at the bottom back teeth so that he does not bite the from teeth too much.  

10.  So, the mommy decided to put the bracelet in eventually.  As removing the teeth with no space or using retention to maintain space is not an option.

My wife actually uses all her power, all her strength to comfort Kay Kay when Dr. Lew putting the bracelet.  Eventually, Dr. Lew can only put 3 tied together.  But it is good enough for now.  (That is why I like this dentist!!)

(This photo is Kay Kay trying to let Mommy take a good photo, seems like crying though..  hahahaha)

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And his comment on Kay Kay is "Wow.  I have never seen a young kid who has such a high tolerance on pain.  He did not cry much, and did not scream.  The rest of other kids all scream and cry and move here and there…"  This is probably one of his big achievement in putting bracelet onto a 4 year old kid.


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===== Original Posting =====

Mommy is away in US for business.

Jay Jay had just finished his 4 days inline skating camp.

Sep 12 Thursday.

Around 12:30 noon.  I received a call from Lorna Whiston Pre-School.

Kay Kay had an accident in school.  His head bump into another student's shoulder and the teeth is shaky now, and it was bleeding quite bad.

So, I quickly drove to pick him up from school.  Teacher advise me to bring him to see a dentist as soon as possible.

Poor kid.  When I picked him up, his front lips are swollen.  His eyes is full of tears.  Must be very painful indeed.

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When I checked, the upper front teeth gum is bruised.  The two front teeth is shaky.  The gum are swollen too.  Can see lots of blood.

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OK.  I called my dentist at Tanglin Dental but he is on course that day.  

Since I am sending Jay Jay to the BrainFit classroom at Parkway Parade, I quickly google and found NTUC's Unity Denticare @ Parkway Parade.  

I made an appointment.  But later I realise that I forgot to bring my wallet out.  Thanks uncle Shao Yi's help loaning me some money.

Yesterday was a hectic day.

So, we finally made it at the last slot to see the dentist at Unity Denticare.

It was a young lady doctor.  I guess she is still studying for some higher exam or some what, as I can see her text book on the table.  (实习生)

Immediately she asked Kay to do an X-Ray.

And the conclusion is:

1.  It is really bad.

2.  Both the teeth got knocked out of the socket.  And it is detached from the "bones".  

3.  It is very shaky.  Both teeth can loose and come up any time.

4.  She wrote a referral letter for me to see Pediatric Dental at SGH.  She advised to "walk in" the next day immediately.  She cannot do anything today.

5.  Cannot wait!  Must do tomorrow.

6.  It may be painful.  So, make sure I go down buy some Children Panadol for him.

7.  There is a slight chance of teeth dropping during his sleep.  I was like HUH?  What if he swallow it during the sleep.  She said, it is very small, don't worry.

8.  Please do not wait.  Must bring him to see tomorrow.

9.  There are chances that he has to extract both teeth.

10. There are also chances that they can tie two wire to stablize the teeth.  But the nerve will die soon.  So, it will fell off too.

11. I have to warn you that next time he will need to wear bracelet.  Because the adult teeth is still way inside, and the rest of the teeth are too crowded.

12. …. etc.

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Wow, that was bad.  But I have not given up.  I decided to see Dr. Kenneth Lew (my dentist) for a second opinion, instead of bringing the referral letter to see the Pediatic Dentist.

But one comment… it is very cheap to see this doctor.  WOW.  Too bad, I don't trust them.  hahaha So, I decided to seek for second opinion the next day.

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Next few days, Kay Kay will have to be on soft food.

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So, today, early in the morning, I brought Kay Kay to see Dr. Kenneth Lew.   This morning, when he wake up, his whole mouth is blood.  hahah must be while he sleep, his front teeth get itchy touch each other.  But the whole night, he sleep well.  No crying, no complaining on any pain.  Most importantly, no fever.  Also, no waking up.

Gum is still swollen a bit.  But I guess it is OK.

Let's see what Dr. Lew has to say.  We always like to come here, because the Doctor will always say "Hello, good morning to my self" (we have the same name). haha

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He is still very happy before the examination.  Take a look at the gum.  Yeak!

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I love my boy.  Strong in character.  No shouting, no pain.

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Of course we love Dr. Lew too.  Very patient, and very gentle.

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Time to do X-ray.

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Aiyooo… two X-ray in two days, immune systems sure go down.  HaHaHa… He is so brave.

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Dr. Lew has better Xray and this is in real distant.  So, he can measure accurately the adult tooth and his baby tooth.

So, after examine it, Dr. Lew said not a big deal.  Later I will summarise what he said.

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When you have a 4 year old seeing a dentist, you will need to have iPad support.

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And we are playing Mickey Mouse on Mars.

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This will keep him busy.

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He is quite comfortable indeed.

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OK, let's get to work!  Shields up!

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And the work begun.

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2-3 minutes later.  Done.

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OK.  Let's take a nice photo.

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Here is the verdict from Dr. Kenneth Lew.

1.  Small deal.  I seen this all the time.  Trauma.  Yeap.  He can actually name it "Trauma" for this injury.  I have to look up dictionary to figure out what he is talking.

2.  No need to extract any teeth today. 

3.  But he is more worry about infection.  So, ask me details about where and how he fall down.  I assure him that he fall on to his friend shoulder.  But to be on the safe side. he say must take some antibiotics.  OK.  Here is the different.  The doctor yesterday did not ask me all these, and does not seems to worry about infection.

4.  Here is my personal mobile.  If during weekend, he has fever or another knock or something bad.  Call me immediately.  (see the different?)

5.  He says let the gum heal.  Seems to have lots of internal bleeding.  So, have to let it heal.

6.  What about the shaking teeth.  Once the gum heal it will stabilise it there.

7.  So, he applied some anti-septic, and wash about his teeth.  That's it.

8.  So, Kay have to wash his mouth with this.

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9.  After washing, apply this.

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10.  Every day for 5 days, 3 times, eat antibiotics.

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11.  don't worry.  Those ang moh and Japanese kids are much worst then this.  Seldom the kid can knock other people and knock their teeth out.  Should be OK.

12.  But Tuesday bring him back to take a look.  See how is the progress.

Immediately, my heart start to stablize.  Yesterday I was a bit worry about him, may have fever.  So I slept besides him.  After hearing what Dr. Lew said, I am relieve now.  HaHaHaHa...

 So, I cooked him a nice Organic Beef porridge.

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It is tasty and of course, he likes it.  

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So, remember, if sometimes your dentist does not give you good feeling, go look for another one to have a second opinion.  In my case, the first dentist is inexperience, and does not dare to comment more, wants me to see Pedictric Dental immediately.  My second dentist who is my family dentist, gives a much comfortable answers and treatment.

YEAH.  For now no need to remove the teeth.  And I am especially proud of Kay Kay for being strong and has high tolerance of pain.  He is brave and it is like his brother like that.

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Don't I look cool?  hahaha

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