The dental setup of children is very different from that of adults. Hence, their requirements also differ significantly which must be taken into account when dealing with kids and minors. Usually, going to the pediatric dentist for a check up or a visit can cause anxiety in children; we all know how daunting it can be to visit the dentist as an adult; as a child with not much understanding of dental care, the fear can be even more overwhelming. Therefore, it is important that the pediatric dentist knows how to deal with minors, how to allay their fears and explain any misconceptions about oral health, and in general must make the young patient feel comfortable and at ease.
In the same way that pediatricians are trained to meet a child’s medical needs, pediatric dental specialists are uniquely qualified to protect your child’s oral health using the most advanced techniques, and all in our delightfully friendly open treatment area. Pediatric dentists have an additional three years of training at university after BDS.They learn how to deal with the behavioral aspects of children, how to make them feel comfortable, and to make the experience pleasant. They also are trained and qualified to treat special needs patients.
Stainless Steel Crowns
When there is not enough tooth structure left after decay removal of a tooth to support a typical filling, or if a nerve treatment is performed on a tooth, a stainless steel crown or tooth cap is the restoration of choice. This is a durable, silver-colored crown that fits over the remaining decay free tooth structure and falls out with the tooth itself. Permanent teeth may also need stainless steel crowns. In this case, they are used until the occlusion stabilizes with the eruption of more permanent teeth, and may be eventually replaced by a porcelain crown.
In most cases, a tooth may need to be pulled when other less radical procedures, such as filling or root can treatment, make it impossible or imprudent to save your child's original tooth.
There are different kinds of fillings used to restore teeth after decay is removed:
Composites
Advances in modern dental materials and techniques increasingly offer new ways to create more pleasing, natural-looking smiles. Researchers are continuing their decades-long work developing aesthetic materials, such as ceramic and plastic compounds that mimic the appearance of natural teeth. As a result, dentists and patients today have several choices when it comes to selecting materials used to repair missing, worn, damaged or decayed teeth.
Composite resins are tooth-colored materials that are used both as fillings and to repair defects in the teeth. Because they are tooth-colored, it is difficult to distinguish them from natural teeth. Composites are often used on the front teeth where a natural appearance is important. They can be used on the back teeth as well depending on the location and extent of the tooth decay.
Cements
Ionomers – Glass ionomers are tooth-colored materials made of a mixture of acrylic acids and fine glass powders that are used to fill cavities, particularly those on the root surfaces of teeth. Glass ionomers can release a small amount of fluoride that help patients who are at high risk for decay. Glass ionomers are primarily used as small fillings in areas that need not withstand heavy chewing pressure. Because they have a low resistance to fracture, glass ionomers are mostly used in small nonload-bearing fillings (those between the teeth) or on the roots of teeth. Resin ionomers also are made from glass filler with acrylic acids and acrylic resin. They also are used for nonload-bearing fillings (between the teeth) and they have low to moderate resistance to fracture. Ionomers experience high wear when placed on chewing surfaces. Both glass and resin ionomers mimic natural tooth color but lack the natural translucency of enamel. Both types are well tolerated by patients with only rare occurrences of allergic response.
Porcelain (ceramic) dental materials
All-porcelain (ceramic) dental materials include porcelain, ceramic or glasslike fillings and crowns. They are used as inlays, onlays, crowns, and aesthetic veneers. A veneer is a very thin shell of porcelain that can replace or cover part of the enamel of the tooth. All-porcelain (ceramic) restorations are particularly desirable because their color and translucency mimic natural tooth enamel. All-porcelain restorations require a minimum of two visits and possibly more. Their strength depends on an adequate thickness of porcelain and the ability to be bonded to the underlying tooth. They are highly resistant to wear but the porcelain can quickly wear opposing teeth if the porcelain surface becomes rough.
Fluoride is an element, which has been shown to be beneficial to teeth. However, too little or too much fluoride can be detrimental to the teeth. Little or no fluoride will not strengthen the teeth to help them resist cavities. Excessive fluoride ingestion by preschool-aged children can lead to dental fluorosis, which is a chalky white to even brown discoloration of the permanent teeth. Many children often get more fluoride than their parents realize. Being aware of a child's potential sources of fluoride can help parents prevent the possibility of dental fluorosis.
Some of these sources are:
Two and three year olds may not be able to expectorate (spit out) fluoride-containing toothpaste when brushing. As a result, these youngsters may ingest an excessive amount of fluoride during tooth brushing. Toothpaste ingestion during this critical period of permanent tooth development is the greatest risk factor in the development of fluorosis. Excessive and inappropriate intake of fluoride supplements may also contribute to fluorosis. Fluoride drops and tablets, as well as fluoride fortified vitamins should not be given to infants younger than six months of age. After that time, fluoride supplements should only be given to children after all of the sources of ingested fluoride have been accounted for and upon the recommendation of your pediatrician or pediatric dentist.
Certain foods contain high levels of fluoride, especially powdered concentrate infant formula, soy-based infant formula, infant dry cereals, creamed spinach, and infant chicken products. Please read the label or contact the manufacturer. Some beverages also contain high levels of fluoride, especially decaffeinated teas, white grape juices, and juice drinks manufactured in fluoridated cities. Parents can take the following steps to decrease the risk of fluorosis in their children's teeth:
What are mouth guards?
Athletic mouth protectors are comprised of soft plastic. They come in standard or custom fit to adapt comfortably to the upper teeth.
Why are mouth guards important?
Mouth guards protect the teeth from possible sport injuries. They not only protect the teeth, but the lips, cheeks, tongue and jaw bone as well. They can contribute to the protection of a child from head and neck injuries such as concussions. Most injuries occur to the mouth and head area when a child is not wearing a mouth guard.
When should my child wear a mouth guard?
They should be worn during any sports based activity where there is risk of head, face or neck injury. Such sports include hockey, soccer, karate, basketball, baseball, skating, skateboarding, as well as many other sports.
Most oral injuries occur when children play basketball, baseball and soccer.
How do I select a mouth guard for my child?
Choose a mouth guard that your child feels is comfortable. If a mouth guard feels bulky or interferes with speech to a great degree, it is probably not appropriate for your child.
There are many options in mouth guards. Most guards are found in athletic stores. These vary in comfort, protection as well as cost. The least expensive tend to be the least effective in preventing oral injuries. Customized mouth guards can be provided through our practice. They may be a bit more expensive, but they are much more comfortable and shock absorbent.
Orthodontics is the branch of dentistry that specializes in the diagnosis, prevention and treatment of dental and facial irregularities. The technical term for these problems is "malocclusion," which means "bad bite."
The results of orthodontic treatment can be dramatic — beautiful smiles, improved dental health and an enhanced quality of life for people of all ages. Orthodontic problems must be diagnosed before treatment begins. Proper diagnosis involves careful study of photographs, x-rays, and dental impressions. Treatment typically lasts from six to thirty months, depending on age, and the severity of the orthodontic problem.
What's the right age for Orthodontic Treatment?
All children should receive their first orthodontic evaluation by age seven. This allows early identification of potential problems. Certain orthodontic conditions are also best treated at this age. Full braces are placed after most of the permanent teeth erupt, generally age ten to twelve.
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 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.
What are sealants?
Tooth sealants refer to a plastic which bonds into the grooves of the chewing surface of a tooth as a means of helping to prevent the formation of tooth decay.
How do sealants work?
In many cases, it is near impossible for children to clean the tiny deep and narrow grooves on the chewing surface of their teeth. When a sealant is applied, the surface of the tooth is somewhat flatter and smoother. There are no longer any places on the chewing part of the tooth that the bristles of a toothbrush can't reach and clean. Since plaque can be removed more easily and effectively, there is much less chance that decay will start.
What is the life expectancy of tooth sealants?
The longevity of sealants can vary. Sealants which have remained in place for three to five years would be considered successful; however, sealants can last much longer. It is not uncommon to see sealants placed during childhood still intact on the teeth of adults.
Our clinic will check your child's sealants during routine dental visits and will recommend repair or reapplication when necessary.
Which teeth should be sealed?
Any tooth that has characteristics, which a sealant can correct, and thus place the tooth at less risk for developing decay, should be sealed. The most common teeth for a dentist to seal are a child's "back" teeth, and of these teeth the molars are the most common teeth on which dental sealants are placed. The recommendation for sealants should be considered on a case-by-case basis.
What is the procedure for placing sealants?
Generally the procedure takes just one visit. Placing dental sealants can be a very easy process. The tooth is cleaned, conditioned and dried. The sealant is then flowed onto the grooves of the tooth where it is hardened with a special blue light. All normal activities can occur directly after the appointment.
How important is brushing and flossing after sealants are applied?
It is just as important for your child to brush and floss their teeth. Sealants are only one part of the defensive plan against tooth decay.
Facts about Sedation Dentistry
Common Questions
Will I feel any pain?
No. You will feel nothing!
Will I be unconscious?
No, you are in a deeply relaxed state, you are responsive.
Will I be monitored?
Yes, one of our team is always with you and your vital signs are monitored during the entire visit. You are never alone.
How long will I be relaxing?
Depending on your needs, from two to six hours.
Who Is a Candidate For Conscious Sedation?
People who have . . .
- high fear
- had traumatic dental experiences
- difficulty getting numb
- a bad gag reflex
- very sensitive teeth
- limited time to complete their dental care
- complex dental problems
People who . . .
- hate needles and shots!
- hate the noises, smells and tastes associated with dental care
- are afraid or embarrassed about their teeth
Guidance eruption is a method used to create enough room for crowded lower permanent incisors. Crowding can often be seen with the eruption of the permanent teeth of the lower jaw at 6 to 7 years old. The permanent incisors will usually compensate for this crowding by erupting behind the primary teeth. If this happens, both sets of teeth may be apparent at the same time.
Additional room for a permanent lower incisor can be achieved through either the extraction of a primary tooth, or the discing away of portion of the primary tooth. If enough room is provided, the permanent lower incisors usually glide into a straight orientation without further intervention.
Guidance eruption may reduce the need for future orthodontic movement of the permanent lower incisors. Guidance eruption may also reduce the risk of future gingival recession and periodontal concerns of the lower front incisors, however, it will not gain any room for future permanent tooth eruption. Because more crowding may be encountered at about 9 years old, the need for space maintenance or future orthodontic treatment may be warranted.
There are two types of tooth stains – intrinsic (internal stain) and extrinsic (external stain).
Intrinsic stains occur from within the tooth, and cannot be removed by brushing and flossing; bleaching may also not be effective. Some causes of intrinsic staining occur from tooth injury, certain medications such as tetracycline, or an excess fluoride ingested during the formation of teeth.
Extrinsic stains usually only involve the tooth surface and are typically caused by ingestion of stain-causing foods and beverages. This type of staining can sometimes be removed by good oral hygiene or professional cleaning.
Teeth whitening can restore your child's teeth to their earlier brightness. There are a number of options today.
Whitening toothpastes can help remove surface stains through the action of mild abrasives. Some whitening toothpastes have special chemical or polishing agents that provide additional stain removal, but unlike bleaches, don`t change the color of your teeth. Whiteners may not correct all types of discoloration. For example, yellow teeth will probably bleach well, while brownish-colored teeth may bleach less well, and greyish teeth may not bleach well at all. In addition, bleaching or whitening may not be effective if you have had bonding or tooth-colored fillings placed in your front teeth. In such cases, you may want to consider porcelain veneers or dental bonding.
