The chewing surfaces of children’s teeth are the most susceptible to cavities and least benefited by fluorides. Sealants are applied to the tops or chewing surfaces of back teeth and are highly effective in preventing tooth decay. Sealant acts as a barrier to food, plaque and acid, thus protecting the decay-prone areas of the teeth. Sealant’s commonly last 3-4 years. Dietary habits such as chewing ice or hard candy can shorten the life expectancy of a sealant. No numbing is required to place them.
Before Sealant Applied
After Sealant Applied
Restorative Treatment (Fillings)
Restorative options mainly include tooth colored fillings, silver fillings, and full coverage stainless steel crowns for back teeth where the tooth is too badly decayed to hold a white filling or silver filling.
Space maintainers are used when a primary tooth has been prematurely lost to hold space for the permanent tooth. If space is not maintained, teeth on either side of the extraction site can drift into the space and prevent the permanent tooth from erupting normally.
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 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 reduce inflammation in 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 (usually a stainless steel crown).
Some children are anxious before dental appointments and are given nitrous oxide/oxygen, or what you may know as laughing gas, to help them relax for their dental treatment. Nitrous oxide/oxygen is a blend of two gases, oxygen and nitrous oxide. Nitrous oxide/oxygen is given through a small breathing mask which is placed over the child’s nose, allowing them to relax, but without putting them to sleep. The American Academy of Pediatric Dentistry, recognizes this technique as a very safe, effective technique to use for treating children’s dental needs. The gas is mild, easily taken, and quickly eliminated from the body. It is non-addictive, and while inhaling nitrous oxide/oxygen, your child remains fully conscious and keeps all natural reflexes. For safety reasons, we will be unable to use nitrous oxide on children with severe respiratory disorders or concerns.
Conscious Sedation is recommended for apprehensive children and very young children. It is used to calm your child and to reduce the anxiety or discomfort associated with dental treatment. Medications are administered orally. Your child may be quite drowsy, and may even fall asleep, but they will not become unconscious. Conscious Sedation works best for 2 to 5 year-old children with minor treatment needs that can be completed in one or two visits. Restraint (hand holding and/or Papoose Board) may still be required to safely complete treatment. Sometimes the sedation will not be effective and we may recommend that your child be treated with general anesthetic in a hospital setting. Oral sedation of healthy children has an excellent safety record: however, there are still risks whenever a child receives sedation medications. All children treated with sedation must have a physical examination form completed by a physician prior to their treatment.
There are a variety of different medications, which can be used for conscious sedation. The doctor will prescribe the medication best suited for your child’s overall health and dental treatment recommendations. During your new patient visit, we will explore conscious sedation options based on your child’s age, level of anxiety, amount of dental work required, and the number of necessary appointments. We will be happy to answer any questions you might have concerning the specific drugs used or the sedation treatment process in general. Please call our office for any questions or concerns that you might have.
Hospital General Anesthesia
Outpatient General Anesthesia is recommended for apprehensive children, very young children, children with many carious teeth, and children with special needs that would not work well under conscious sedation. Treatment is performed in a hospital operating room while they are completely asleep. This would be the same as if he/she was having their tonsils removed, ear tubes, hernia repaired, or any other surgical procedure. This is performed in a hospital or outpatient setting only. All of their dental treatment needs can be completed in one visit. Administrating general anesthesia has risk ranging from and including but not limited to sore throat, puffy lips, abnormal breathing, or even death. The rate of serious reactions is estimated to be between 1 in 25,000 to 1 in 250,000 in children managed with general anesthesia. Like oral sedation, your child will need a physical examination prior to treatment and you may need to meet with the anesthesiologist.
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.