Fortuitously, Siena and Thalia had a dentist appointment this morning. This meant we could get the dentist’s opinion on Siena’s loose teeth and the big adult tooth coming in behind them.

They took a panoramic X-ray of her entire set of teeth, which we all got to see. Siena was a real champ through this, as the process require her to bite down on a little plastic rod and have her chin positioned just so, with plastic barriers on either side of her head. She got to wear a big lead shawl, and had to stand there all alone while the grown-ups fled to safety. She managed this all with no complaints, and in fact did great for the entire cleaning, polishing, flossing, and prodding. (Thalia did wonderfully, as well.)

The dentist said that the four bottom middle baby teeth all will need to come out about two months from now. The permanent incisors are coming in too early and are just too big, and they’ll need to make room for them sooner rather than later in order to allow the grown-up teeth to have the proper pathway to their final position. The incisors appear to be coming up behind the baby teeth, which is OK since apparently the tongue does the heavy lifting of getting the teeth pushed forward, but it means the permanent teeth are not helping as much at pushing the baby teeth out of the mouth, and they need to be able to get where they are going.

So either Siena and we can get her teeth wiggled enough to fall out in the next two months, or she’ll be going in for the nitrous. Our bet is that the two loose middle ones will come out by then, but the next pair on either side won’t.

This raises an interesting ethical, and financial, dilemma. Our dental insurance won’t cover all of the extractions, or any of the nitrous oxide, and we’ll hit our yearly maximum if all four teeth need to be extracted at the office. Basically, there’s a cost for each of the four teeth that stays in the mouth, and a fixed cost if any one of them stays in the mouth. So I have these two questions:

• Can we incentivise Siena to get these teeth out on her own? We could buy her some pretty nice things at even half the cost of the dentist’s estimate.
• Should we enlist someone else’s help? String + slammable door + basic understanding of tying knots = extracted tooth. That’s a lot cheaper than paying for gas, assistants, and malpractice insurance.

An interesting puzzle, and the clock is ticking.

As for the shark reference…In the panoramic X-ray, Siena’s got so many teeth in her mouth, what with all the permanent teeth starting to bud in her jaw, that she looks like one. And Shark Week is just a few days away!