Scope of treatment

Dental procedures

Our comprehensive procedures offered in age-specified pediatric dentistry include, but not limited to the following:

Sealants, conventional restorative and crowns, pulp therapy and root canals, space management, prevention, sports guard, and dental emergency management.

Sealants

A sealant is a clear or shaded composite material applied to the chewing surfaces (grooves) of the back teeth (premolars and molars), where four out of five cavities in children are found. This sealant acts as a barrier to food, plaque and acid, thus protecting the decay-prone areas of the teeth.

Restorative and crown

When a tooth is cavitated, the area must be cleaned out and then filled. This is known as a restorative treatment or filling. Typically, a white tooth colored substance is used to fill in the area once all decay has been removed. If the teeth are badly decayed, a stainless steel crowns may be used, rather than a filling.

Pulp therapy and root canal

The pulp of a tooth is the inner, central core of the tooth. The pulp contains nerves, blood vessels, connective tissue and reparative cells. The purpose of pulp therapy in Pediatric Dentistry is to maintain the vitality of the affected tooth.

Dental caries (cavities) and traumatic injury are the main reasons for a tooth to require pulp therapy. Pulp therapy is often referred to as a “nerve treatment”, “children’s root canal”, “pulpectomy” or “pulpotomy”. The two common forms of pulp therapy in children’s teeth are the pulpotomy and pulpectomy.

A pulpotomy removes the diseased pulp tissue within the crown portion of the tooth. Next, an agent is placed to prevent bacterial growth and to calm the remaining nerve tissue. This is followed by a final restoration (usually a stainless steel crown).

A pulpectomy is required when the entire pulp is involved (into the root canal(s) of the tooth). During this treatment, the diseased pulp tissue is completely removed from both the crown and root. The canals are cleansed, disinfected and, in the case of primary teeth, filled with a resorbable material. Then, a final restoration is placed. A permanent tooth would be filled with a non-resorbing material.

Space maintainer

A baby tooth stays in place until the permanent tooth, growing underneath, pushes it out and take its place. There are times when the baby tooth comes out too early. When this happens the permanent tooth may not be ready to take the place of the removed baby tooth. A space maintainer is used to hold the space until the permanent tooth is ready to erupt. Space maintainers are appliances made of metal or plastic that are custom fit to your child’s mouth. They are small, unobtrusive and in most cases kids adjust to them within a few days.

Sports guard

When a child begins to participate in recreational activities and organized sports, injuries can occur. A properly fitted sports guard is an important piece of athletic gear that can help protect your child’s smile, and should be used during any activity that could result in a blow to the face or mouth.

Mouth guards help prevent broken teeth, and injuries to the lips, tongue, face or jaw. A properly fitted mouth guard will stay in place while your child wears it, making it easy for them to talk and breathe.

Dental emergency management

Toothache

First rinse the irritated area with warm water (or salt water). Use dental floss to dislodge any food or debris around the irritated area. Place a cold compress on the face if swelling occurs. Give the child acetaminophen for any pain, rather than placing aspirin on the teeth or gums.

Knocked out permanent teeth

The most important thing to do is to remain calm. First find the tooth and second retrieve it. Hold it by the crown versus the root. You can rinse gently with cold water but do not scrub or clean with soap. Attempt to reinsert it back into the socket immediately and hold it there with clean gauze or a wash cloth. If that is not possible put the tooth in a glass of cold milk and take to the dentist.

Chipped or Fractured Permanent tooth

Contact your pediatric dentist as soon as possible. Fast action can save the tooth, prevent infection and reduce the need for extensive dental treatment. Rinse the mouth with warm water. If swelling occurs apply a cold compress. Like with a knocked out permanent tooth put the chip from the tooth in milk and carry with you to the dentist.

Cut or Bitten Tongue, Lip or cheek

To stop bleeding, use firm yet gentle pressure with gauze or a wash cloth. Apply a cold pack/ice to the area to reduce swelling.

Source: American Academy of Pediatric Dentistry. For additional information, please go to www.AAPD.org

Nitrous Oxide (Laughing gas)

Most children are calm, comfortable and confident in a pediatric dental office. Staff members choose to work in a pediatric dental office because they like children and want to cater to their special needs. These elements combined to make your child feel relaxed and special.

Sometimes, however, a child may feel anxious before or during treatment. Nitrous oxide/ oxygen 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.

Q: What is nitrous oxide/oxygen?

Nitrous oxide/oxygen (N2O-O2) is a blend of two gases — oxygen and nitrous oxide. A fitted mask is placed over the nose and, as the patient breathes normally, uptake occurs through the lungs. At the end of treatment, it is eliminated after a short period of breathing oxygen and has no lingering effects.

Q: How will my child feel when breathing nitrous oxide/oxygen?

Your child will smell a faint, sweet aroma and experience a sense of well-being and relaxation. Since it may produce a feeling of giddiness or euphoria, it is often called “laughing gas.” Children sometimes report dreaming and their arms and legs may feel “tingly.” It raises the pain threshold and may even make the time appear to pass quickly. If your child is worried by the sights, sounds or sensations of dental treatment, he or she may respond more positively with the use of nitrous oxide/oxygen.

Q: How safe is nitrous oxide/oxygen?

Very safe. Nitrous oxide/oxygen is perhaps the safest sedative in dentistry. It is well tolerated. It has a rapid onset, is reversible, can be adjusted in various concentrations and is non-allergenic. Your child remains fully conscious — keeps all natural reflexes — when breathing nitrous oxide/oxygen. He/she will be capable of responding to a question or request. Nitrous oxide/oxygen may also be used in combination with other sedative agents.

Q: Are there any special instructions for nitrous oxide/oxygen?

First, give your child little or no food in the two hours preceding the dental visit (occasionally, nausea or vomiting occurs when a child has a full stomach). Second, tell your pediatric dentist about any respiratory condition that makes breathing through the nose difficult for your child, as it may limit the effectiveness of nitrous oxide/oxygen. Third, tell your pediatric dentist if your child is taking any medication on the day of the appointment.

Q: Will nitrous oxide/oxygen work for all children?

Pediatric dentists know that all children are not alike. Every service is tailored to your child as an individual. Nitrous oxide/oxygen may not be effective for some children, especially those who have severe anxiety, nasal congestion, or discomfort wearing a nasal mask. Your pediatric dentist will review your child’s medical history, level of anxiety, and dental treatment needs and inform you if nitrous oxide/oxygen is recommended for your child. Pediatric dentists have comprehensive specialty training and can offer other sedation methods that are right for your child.

Conscious Sedation/Oral sedation

Oral sedation is one of the techniques often used in pediatric dentistry to help patients who experience anxiety and dental fears, receive the proper dental health care. Oral sedation is also referred as oral conscious sedation because the patient remains conscious throughout the dental treatment but in a relaxed and anxiety-free condition.

Oral sedation involves in the administration of sedative agents taken from the mouth in the form of a pill or liquid, to achieve a state of relaxation. It is a great tool for dentists to relax anxious patients and increases the level of co-operation of patients with dental fears, and prevents them from neglecting their dental health.

Preparing for your oral sedation appointment:

✎Your child must be on an empty stomach from 12am the night before your appointment. A tiny bit of clear fluids are allowed up to 3 hours prior to your appointment.

✎If your child has a cold, fever or ear infection, please inform us the day before for evaluation whether to reschedule your appointment is deemed necessary.

Please dress your child in loose fitting and comfortable clothing.

✎Parent or caregiver is advised not to leave our office while the child is receiving dental treatment.

✎Keep our office up to date with any drugs your child is taking currently and/or any drug reactions and change of medical history.

After the sedation appointment:

✎Your child will not be able to resume normal daily activities and will require constant supervision for the remainder of the day, after their appointment.

✎Your child will be drowsy and will need to be monitored very closely. They cannot go back to school/camp or attend any activities or parties.

✎It is not unusual for your child to sleep for several hours after their sedation visit.

✎The first meal should be light and easily digestible, please keep your child away from dairy products until the day following your appointment.

If local anesthesia is used:

Local anesthetic sometimes is used to numb your child’s mouth during the procedure; your child may have the tendency to bite or chew their lips, cheeks, and/or tongue and/or rub and scratch their face after treatment. Please observe your child carefully to prevent any injury to these areas. You may need to continuously remind the child to leave the area alone until the area is no longer numb to avoid irritation. As always, Please call our office with any questions or concerns that you might have.

Special health care needs

Q: Do children with special health care needs have special dental needs?

A: Studies indicate that some children with disabilities are more susceptible to tooth decay, gum disease or oral trauma. In addition, they may require medication, special diets, or possess oral habits detrimental to dental health. If dental care is started early and followed conscientiously, every child can enjoy a healthy smile.

Q: How can I prevent dental problems for my special child?

A: A first dental visit by age one will be the beginning to a lifetime of good dental health. We will obtain a full medical history, perform an examination of your child’s teeth and gums, and then develop a preventive care plan specifically designed for your child’s needs. Your child will benefit from the preventive approach recommended for all childreneffective daily brushing and flossing, moderation of snacking and proper amounts of fluoride. Regular dental exams, professional cleanings and fluoride treatments will allow prevention of dental problems and help catch problems early if they should arise.

Q: Is your office prepared to care for special children?

A: Our doctors’ specialty education provided additional training that focused specifically on care for children with special needs. Furthermore, our office is designed to be physically accessible for special patients. Pediatric dentists, because of their expertise, are often the clinicians of choice for adults with special health care needs as well.

Q: Will my child need special care during dental treatment?

A: Each child requires a customized plan of treatment specifically designed for their needs. Some special children might require some form of restraint or even sedation or general anesthesia. We will choose a plan of care specifically designed for your child and then discuss the benefits, limits and risks of that plan with you.

General anesthesia

Younger children are often very frightened of the dentist. Most of the times kids don’t actually feel the pain, but the sounds they hear from the dental drill and the feeling of pressure that they feel, can make them go into hysterics. Moreover, some children need to have a great amount of dental work completed on multiple teeth. Therefore, it is often best to put the child completely to sleep and finish all procedures in one, stress-free visit.

How do we put a child under general anesthesia?

We perform general anesthesia either in-house or go to hospitals nearby. The anesthesiologist we work with will give the child some oral medication that helps make them drowsy. The anesthesiologist will start an IV and give the right dosage of drugs to completely put the child to sleep shortly after. The anesthesiologist will continue to monitor the child’s breathing and vital signs throughout, while the pediatric dentist provides all necessary treatment.

Advantages and disadvantages of general anesthesia

One of the major advantages of general anesthesia is that children will not be traumatized by the dental work rendered. Some of the medications used actually help kids forget what happened during treatment. Once the child is completely asleep, all treatment, including radiographs, fillings, crowns, and cleanings can all be done at once in a timely fashion and not traumatic or scary for the child.

Although the risks are very low, some parents have reservations having their little ones completely put to sleep. The biggest disadvantage of general anesthesia, however, is the cost. Most insurances do not cover the treatment, and anesthesiologist will charge a set amount for the medications and materials used. Ask our front staff about Care Credit if you wish to apply for financial plan.

Preparing for your general anesthesia appointment: