The American Academy of Pediatric Dentistry, American Academy of
Pediatrics, and American Dental Associations recommends children
visit a dentist by their first birthday. Our office is strong
believer in this recommendation and has seen the advantages to
having children seen at this age. Early visits give us time to
identify and reduce any risk factors we may find that could
lead to unhealthy teeth. During this visit, we provide you, the
parent, with the information needed to care of your child's smile.
You can prevent costly dental work in the future by knowing what to
do with your child's diet and hygiene as well as your own. Your
child will also be provided with a toothbrush cleaning and a
fluoride treatment.
New Patients Exams or Check-Up Exams
The pediatric dentist will review your child's
medical and dental history. She will examine your child's teeth,
oral tissues, and jaws. A dental cleaning, necessary x-rays,
fluoride treatment, oral hygiene instructions, dental development
evaluation, dietary and nutritional counseling, and patient/parent
education will be performed. Your pediatric dentist provides an
ongoing assessment of changes in your child's oral health. For
example, your child may need additional fluoride, dietary changes,
or sealants for ideal dental health. The pediatric dentist may
identify orthodontic problems and suggest treatment to guide the
teeth as they emerge in the mouth. If dental treatment is warranted,
your pediatric dentist will have a consultation session to discuss
various treatment options. Your pediatric dentist won't talk just to
you about dental health, she will talk to your child with easily
understandable words, pictures, and ideas. Your child will be
motivated to take responsibility for healthy smile.
Digital Radiographs/X-rays
Since every child is unique, the need for dental X-ray films varies
for each child. X-ray films detect more than cavities. X-rays allow
dentists to diagnose and treat conditions that cannot be detected
during a clinical examination. X-rays may also be needed to survey
erupting teeth, diagnose bone diseases, evaluate the results of an
injury, or plan orthodontic treatment. If dental problems are found
and treated early, dental care is more comfortable and affordable.
Our office uses digital radiographs, which provides a reduction in
radiation usually 70 to 80 percent, and at times even more compared
to conventional radiographs.
Prevention:
Prophylaxis
Cleaning (dental cleaning)
A prophylaxis cleaning
(i.e. dental cleaning) can be performed using toothbrush, rubber
cup, flossing, and/or mechanical instruments. The pediatric dentist
will determine the most appropriate type of prophylaxis for each
patient. During the prophylaxis cleaning, the pediatric dentist will
instruct the caregiver and child or adolescent in proper oral
hygiene techniques; remove microbial plaque and calculus; polish
hard surfaces to minimize the accumulation and retention of plaque
which will result in an introduction of dental procedures to the
young child and apprehensive patient. An individualized prevention
plan will be established for proper oral hygiene methods, techniques,
and removing plaque, stain, calculus, and the factors that influence
their build-up.
Fluoride Treatment
Fluoride occurs naturally in water and in many different foods, as
well as in dental products such as toothpaste, mouth rinses, gels,
varnish and supplements. When the compound fluoride is used in small
amounts on a routine basis, it helps to prevent tooth decay and
encourages "remineralization," a strengthening of weakened areas on
the teeth. Fluoride also affects bacteria that cause cavities;
discouraging acid attacks that break down the tooth. Risk for decay
is reduced even more when fluoride is combined with a healthy diet
and good oral hygiene.
Sealants
Even if your
child brushes and flosses carefully, it is difficult and at times
impossible to clean the tiny grooves and pits on certain teeth. Food
and bacteria build up in these crevices, placing your child in
danger of tooth decay. Sealants “seal out” food and plaque, which
help in reducing the risk of decay. They protect the grooved and
pitted surfaces of the teeth, especially the chewing surfaces of
back teeth where most cavities in children occur. Sealants are made
of clear or shaded plastic and are applied to the teeth to help keep
them cavity-free.
Space Maintainers
A baby tooth usually stays in place until a permanent tooth underneath
develops and pushes it out and takes its place. Unfortunately, some
children lose a baby tooth too soon due to various reasons such as
accidentally knocked out or removed because of dental disease. When
a tooth is lost too early, your pediatric dentist may recommend a
space maintainer to prevent future space loss and dental problems.
Space maintainers are appliances made of metal or plastic which is
custom to fit your child's mouth. They are small and discreet in
appearance. Most children easily adjust to them after the first few days.
A Space maintainer is more affordable, and easier on your child, to
keep teeth in normal positions with a space maintainer than to move
them back in place with orthodontic treatment.
Procedures:
Restorations of primary and permanent teeth
Composite/Fluoride Releasing Fillings (also known as
Tooth Colored Fillings) Tooth-colored fillings are
made from durable plastics called composite resins. There are
also certain tooth color fillings that can release fluoride to
help in prevention of future cavities. Similar in color and
texture to natural teeth, these fillings are less noticeable,
and much more attractive, than other types of fillings. However,
tooth-colored fillings are not for every tooth. They work best
in small restorations and low-stress areas. Talk to your
pediatric dentist. Together you will decide what type of filling
is best for your child.
Pulpotomy/Pulpectomy (also known as Baby Root
Canals) Very large cavities can result in
toothaches, nerve irritation, and/or infection. If a cavity has
affected the nerve, we will clean out the infected part of the
nerve, place an antibacterial medicine on the remaining nerve
structure and finally place a protective filling over the nerve.
Once a tooth has had nerve treatment it is weakened and must
have a crown placed over it to protect it.
Stainless Steel Crowns or White Crowns (also known
as Caps) Crowns are used in cases where a cavity has
affected so much tooth structure that filling material cannot be
used to repair the tooth. We offer several types of crowns
depending on the location of the cavity. For the front teeth we
have white crowns and silver crowns with a white facing. We
choose which crown based on the patient’s bite and the extent of
the cavity. For the back teeth we have stainless steel crowns.
Extractions
At times, the decay of the tooth has become so involved to the nerve of
the tooth that an infection has developed. This can be of a serious
concern due to the fact that it can do damage to the permanent
tooth. At times, infected teeth can cause severe infections of the
face, head, and neck. In order to resolve the infection and the best
prognosis warrannted; therefore, it is important to restore baby teeth as soon as decay is first
detected.
Behavioral Management:
Tell-Show-Do:
Pediatric dentists are trained in many methods to help children feel
comfortable with dental treatment. The behavioral management
technique of Tell-Show-Do is when a pediatric dentist might name a
dental instrument, demonstrate the instrument by using it to count
your child's fingers, then apply the instrument in treatment. This
can be effective in calming the patient who may be nervous for
treatment.
Positive Reinforcement:
In the process of establishing desirable patient behavior, it is
essential to give appropriate feedback. Positive reinforcement is an
effective technique to reward desired behaviors. This will result in
strengthening the recurrence of those behaviors. Social reinforcers
include positive voice modulation, facial expression, verbal praise,
and appropriate physical demonstrations of affection by all members
of the dental team. Nonsocial positive reinforcers used in the
office include stickers, toys, balloons and even sugar-free ice
cream.
Protective Stabilization:
Very young children and some special needs patients are not able to
understand why they need dental treatment. Partial or complete
stabilization of the patient is used to protect them from harming
themselves as well as to protect the safety of the practitioner,
staff, and parent while providing dental care. The dentist, staff,
or parent can perform protective stabilization. We only use
restraints when absolutely necessary and with parent's permission.
Sedation Dentistry:
Nitrous Oxide:
Nitrous oxide/oxygen (also known as laughing
gas) is a safe, effective sedative agent used to calm a child’s fear
of the dental visit and enhance effective communication.
Additionally, it works well for children whose gag reflex interferes
with dental treatment. Nitrous oxide/oxygen is given through a
fitted mask, which is placed over the child’s nose, allowing them to
relax, but without putting them to sleep. The gas is mild, easily
taken up through the lungs with normal breathing. While inhaling
nitrous oxide/oxygen, your child remains fully conscious and keeps
all natural reflexes. Once treatment is completed, it is quickly
eliminated from the body after a short period of breathing oxygen
with no lingering effects. The American Academy of Pediatric
Dentistry recognizes this technique as a very safe, effective
technique to use for treating children’s dental needs.
Oral Sedation:
Oral sedation is a good option for children who have a level of fear
or anxiety whom basic behavior guidance techniques have not been
successful. This is also used for children who do no have good
coping skills or are very young and do not understand how to cope
cooperatively for the delivery of dental care. This management
technique uses medications to calm your child and to reduce the
anxiety or discomfort associated with dental treatments. Your child
may be quite drowsy, and may even fall asleep, but they will not
become unconscious. The doctor will prescribe the medication best
suited for your child’s overall health and dental treatment
recommendations. We will be happy to answer any questions you might
have concerning the specific drugs we plan to give to your child.
General Anesthesia:
General anesthesia is a controlled state of unconsciousness that
eliminates awareness, movement and discomfort during dental
treatment. This is conducted on an outpatient basis at a surgery center which is a facility that has the appropriate staff and physicians who are trained to monitor your child and manage complications.
Precautions are taken to protect your child during general
anesthesia for their dental care. This would be the same as if
he/she was having their tonsils removed, ear tubes, or hernia
repaired. This type of behavioral management is recommended for
apprehensive children, very young children, and children with
special needs who are in need of extensive dental treatment. While
the assumed risks are greater than that of other treatment options,
if this is suggested for your child, the benefits of treatment this
way have been deemed to outweigh the risks. Most pediatric medical
literature places the risk of a serious reaction in the range of 1
in 25,000 to 1 in 200,000, far better than the assumed risk of even
driving a car daily. The inherent risks if this is not chosen are
multiple appointments, potential for physical restraint to complete
treatment and possible emotional and/or physical injury to your
child in order to complete their dental treatment. The risks of NO
treatment include tooth pain, infection, swelling, the spread of new
decay, damage to their developing adult teeth and possible life
threatening hospitalization from a dental infection. Your pediatric
dentist will discuss the benefits and risks of general anesthesia
and why it is recommended for your child.
