Our team specializes in keeping your children’s mouths healthy, from their very first baby tooth all the way through their wisdom teeth. Protecting and caring for your child’s mouth helps set them up for long-term good oral health as they age, and our team of pediatric dentists, hygienists, and clinicians have specialty training treating little patients with little mouths to provide specialty care to your family.
Prevention is the best treatment! Your child’s permanent molars will start erupting when they are still very young, around age 6. Permanent molars typically have deeper grooves on the chewing surface of the tooth that make it very easy for food to stick and grow bacteria, no matter how thoroughly you brush and floss at home. Sealants are a protective coating applied to the chewing surface of the teeth to fill in those deep groves, making it harder for bacteria to get in, and easier for your child to brush any food out before it can stick.
To help prevent decay in the teeth your child will have for the rest of their life, we recommend applying dental sealants to those permanent molars as soon as they come in, at age 6 and later at age 12. Reapplication may be needed if the sealants wear off, but even with a reapplication they are an affordable investment to avoid more costly dental work down the line.
DECAY AND FILLINGS
The most common treatment our patients need are dental fillings. Fillings are needed when bacteria develop in the tooth and cause decay, and the decay is deep enough in the tooth to necessitate treatment. Even though baby teeth eventually fall out, if they develop decay they will still need to be treated, as decay can spread to adjacent adult teeth (these are called “kissing cavities”) and even impact the tooth structure of erupting adult teeth below the cavity.
Cavities are treated by cleaning out the decayed tooth structure, and then adding filling material in the shape of the original tooth to replace what was removed. Our office fills all cavities with a composite resin, which is a tooth-colored material to match the shade of the rest of the tooth, and is completely hardened by the time your child leaves the office. Easy peasy!
STAINLESS STEEL CROWNS
For decay on a baby tooth that is too deep to be resolved with a filling, the best protective treatment is a stainless steel crown. As with a filling, our team cleans out the decayed part of the tooth to protect as much of the original tooth structure as possible. Then, a stainless steel cap is placed on top of the tooth, like the porcelain crowns you might see on adult teeth. The main benefit of the crown being steel instead of porcelain is that steel is much harder to distort or chip than porcelain, so it does a better job protecting the teeth while your child is too young to think about their own dental care.
As steel retains more flexibility than porcelain, a stainless steel crown will also naturally adjust to accommodate your child’s changing bite as their mouth grows and develops. By keeping this cap on the tooth, your child can still use this tooth to chew and speak as they normally would, and retain space for their adult tooth to erupt once it is fully developed. As the adult tooth comes in and the baby tooth falls out, the cap will come right out with it, leaving a beautiful, healthy permanent tooth in its place.
Sometimes, a tooth will need to be extracted, typically due to extensive decay or trauma, or when recommended by an orthodontist. Our team is very experienced at extracting teeth while keeping children comfortable and relaxed, so a tooth extraction does not need to be more stressful than any other dental visit! We always refer to an extraction as “wiggling out the tooth”, so your child will feel that it is the same thing they would do at home with any loose teeth, and to this end we recommend using the same words when you discuss it with them.
Depending on the stage of dental development your child is in, they may also need an appliance placed called a space maintainer, which is a stainless steel ring that sits in the space left behind by the extracted tooth. The space maintainer prevents other teeth from shifting into that empty space, so that by the time their adult tooth begins to erupt, there is plenty of space for it to come in healthy and straight.
SILVER DIAMINE FLUORIDE
When our team is able to catch decay on baby teeth in the earliest stage while it is still in the enamel of the tooth, we can apply silver diamine fluoride to the teeth to arrest the decay before it can develop further into the more sensitive dentin or need a filling. Silver diamine fluoride, or SDF, is a silver-based fluoride solution that we apply by flossing between the teeth on the spots of decay. Silver diamine fluoride is also a great temporary alternative to treatment for younger children who are unable to sit through more extensive treatment, as it is quickly applied and non-invasive. As the silver incorporates to arrest any areas of decay, the liquid leaves a permanent black stain to indicate that it is working, which is why it is only recommended for treatment on baby teeth, or parts of teeth that cannot be seen - for instance, in between two back molars.
Surprisingly, children often handle dental work a lot better than parents anticipate, if they are prepared appropriately. Our team is easygoing and friendly, and treats dentistry as a normal part of daily life rather than something to be afraid of. For younger or more apprehensive children, or those who have particularly strong gag reflexes, we offer nitrous oxide to help reduce anxiety in the dental chair. Nitrous oxide is a safe, odorless, breathable gas that produces a light, floating, relaxed sensation for as long as it is inhaled. With nitrous oxide, your child stays awake, aware, and conscious for the entire procedure - just more distracted than usual, and more open to new sounds and sensations. Not every child benefits from nitrous oxide, but for those who do, it can make dental work a lot easier and more approachable to set the stage for a long and successful relationship.