We recommend a topical fluoride treatment after every cleaning in our office. Numerous studies have shown fluoride to be a beneficial, safe, and cost effective preventive treatment. We typically use a sodium fluoride varnish that has a sticky consistency. Patients are allowed to eat and drink immediately after placement. They DO NOT have to wait thirty minutes like they did with the old foam fluoride treatments. However, we do ask that they refrain from chewing any sticky snacks or candies for the day, as they may pull the fluoride off of the teeth and lessen it’s effectiveness.
Dental Radiographs (X-Rays)
Radiographs (X-Rays) are a vital and necessary part of your child’s dental diagnostic process. Without them, certain dental conditions can and will be missed.
Radiographs detect much more than cavities. For example, radiographs may be needed to survey erupting teeth, diagnose bone diseases, evaluate the results of an injury, or plan orthodontic treatment. Radiographs allow us to diagnose and treat health conditions that cannot be detected during a visual clinical examination. If dental problems are found and treated early, dental care is more comfortable for your child and more affordable for you.
The American Academy of Pediatric Dentistry recommends the frequency of radiographs be based on each patient’s risk for getting cavities. For example, a child who has never had a cavity is considered low risk and needs radiographs less frequently than a child who is prone to cavities (high risk).
Our office is utilizing a digital radiographic system that allows us to obtain a better x-ray image while using less radiation than the traditional film based systems. With this system and other contemporary safeguards, the amount of radiation received in a dental x-ray examination is extremely small.
Most cavities can be restored with fillings. We may recommend a tooth colored composite filling or a silver amalgam filling. Both of these are safe, durable, and easily tolerated by children. Several factors affect our choice of material and we can discuss these with you at your treatment planning consultation.
Sometimes a cavity is too large to be restored with a filling. In these instances, we may recommend a crown (or cap). We have traditionally used stainless steel crowns that are mercury free. However, recent improvements in dental materials make it possible to use white zirconium crowns in certain instances. We will discuss these options with you during your treatment planning consultation.
What Is Pulp Therapy?
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 so the tooth is not lost.
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 pediatric dentistry are the pulpotomy and pulpectomy.
A pulpotomy removes the diseased pulp tissue within the crown portion of the tooth. An agent is then 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.
Unfortunately, there are instances when teeth need to be removed, including infection, crowding, or orthodontic considerations. We are skilled at removing primary teeth, as well as many permanent teeth. However, there are certain instances (i.e. a complicated extraction or an extremely anxious patient) when we may refer your child to an oral surgeon in order to make the experience as easy as possible. We will discuss these options with you at your treatment planning consultation.
A sealant is a protective coating that is applied to the chewing surface (grooves) of the permanent molars, where most cavities occur. Sealants will allow for easier cleaning without food getting trapped in the grooves and will decrease the chances of cavity formation.
Space maintainers are appliances that prevent unwanted movement of teeth. They are commonly used following the extraction of a baby tooth to hold the space open for the developing permanent tooth. These appliances can be removed by the dental team but not by the patient. They are designed to remain in place until we determine they are no longer needed (usually when the permanent tooth begins to erupt).
Tooth bleaching is recommended for patients with all of their adult teeth who would like for their teeth to look whiter. Bleaching is accomplished by applying a chemical gel to the tooth surface to lighten it. This gel is held in place by a custom bleaching tray that can be worn at home. Numerous studies have shown this procedure to be safe and effective but it is not always equally effective for all teeth. Results are often individualized and some teeth show no noticeable change.
A common side effect of bleaching is sensitivity to hot and/or cold stimuli. If this occurs, we recommend discontinuing bleaching. The teeth should return to normal after a few days. If you are interested in bleaching, we will be happy to discuss this with you.
Microabrasion is a conservative treatment option for discolored tooth enamel that is not responsive to polishing or bleaching. This process involves applying a chemical agent to the tooth surface followed by polishing with a mildly abrasive paste to remove a microscopic layer of enamel. This "in office" procedure is often recommended for teeth with significant color defects. Many of these color defects are uneven which can make it difficult to obtain completely uniform tooth color. However, the color change is often dramatic and beneficial. When recommending microabrasion we will do our best to predict the level of success that is attainable.