Sealants
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.
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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.
Dental Fillings
Composites are a dental restoration that is made of a non-toxic substance. This durable material is primarily made or quartz, ceramic, or silica and are often referred to as tooth-colored fillings. They provide good durability and resistance to fractures in small to mid-size fillings that need to withstand moderate pressure from the constant stress of chewing. Composites can be used on either front or back teeth. They are a good choice for patients who prefer that their fillings look more natural.
Composite fillings require the tooth be kept clean and dry while the cavity is being filled. Tooth-colored fillings are now used more often than silver or gold fillings. Some tooth-colored fillings contain materials that release fluoride, protecting them from further risk to caries. In a society focused on a white, bright smile, patients tend to want fillings that blend with the natural color of their teeth.
Ultimately, the best dental filling is no dental filling. Prevention is the best medicine. You can dramatically decrease your risk of cavities and other dental diseases simply by:
• Brushing twice a day with a fluoridated toothpaste
• Flossing daily
• Eating a balanced diet and limit snacking
• Scheduling a dental visit every 6 months
Space Maintainers
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.
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 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).
Tooth Extractions
In the event a tooth is badly damaged and can’t be repaired with traditional methods, your child may need to have the tooth pulled or extracted.
A dental extraction is the removal of teeth from the socket in the alveolar bone. Extractions are performed for a wide variety of reasons, but most commonly to remove teeth which can no longer be restored due to tooth decay, periodontal disease, dental trauma or orthodontic needs.
After an extraction, it is most important to stop the bleeding. The most effective recommendation is positive pressure. This can be accomplished by having the child bite tightly on a piece of cotton gauze for 15-30 minutes. If your child is too young to do this, hold the gauze tightly against the extraction site with your finger for the same length of time. Even after long pressure, the extraction site may bleed slightly for several hours and may even stop and start again. Further pressure will usually solve the problem.
Normally, only slight discomfort will be experienced after an extraction unless the child bites the tongue or cheek while numb. If pain is present, we recommend Tylenol or Motrin in the appropriate dose for the size of your child rather than aspirin. If the pain is severe, call the office for guidance.
Avoid straws and any sucking action on the first day. Crunchy foods (peanuts, pretzels, potato chips, etc.) should be avoided for the first day or two. Warm salt water rinses, 3 to 4 times a day, are encouraged to help healing on the first day after the extraction.