KNOCKED-OUT BABY TOOTH: Due to the risk of damage to the permanent tooth, primary teeth are not re-placed if knocked out.
KNOCKED-OUT PERMANENT TOOTH: Time is of the essence. The goal is to replace the tooth in the socket as soon as possible. Only handle the tooth from the crown; do not touch the root. If dirty, rinse briefly with water and replace immediately. After putting the tooth back in the socket, hold in place by biting on a paper towel or wash cloth, etc. If the tooth cannot be replaced, it must be kept moist to prevent the cells from dying. Place tooth in milk, saliva, or egg yolk and call us as soon as possible. After one hour, it is not advised to replace the tooth.
BROKEN TOOTH: If possible, find the broken fragment and call us as soon as possible. Most of the time, the broken piece can be re-attached.
TOOTHACHE: Rinse with warm salt water. Brush and floss the area to remove trapped food/bacteria. Call us as soon as possible for an evaluation. Over the counter pain medications can be effective until your child can be seen by one of our dentists.
Dental decay affects more children in this country than any other chronic childhood disease, yet many parents assume that cavities can be left untreated because permanent teeth will eventually replace them. Unfortunately, this leads to progressing infections, premature tooth loss, growth and development problems, and needless suffering. Another important fact to keep in mind is that it is nearly impossible to have healthy adult teeth if there is decay present in the primary teeth. This is due to cross-over infection that results during the 6 years of mixed dentition (6 years old-12 years old).
Primary teeth serve many functions, and it is critical that they remain intact until they are lost naturally. They serve to help maintain proper nutrition, allow for good pronunciation and speech habits, and guide the permanent teeth during eruption. Primary teeth also serve as “space holders” for the permanent teeth and this space can be lost with dental caries. Space loss results in crowding and misaligned teeth. Regular dental visits can prevent these complications or minimize the consequences by early recognition and treatment.
Every specialty field of medicine, including dentistry, has a group of doctors, called a Board, that oversees that specialty. The goal of the Board is to ensure that care is provided according to the highest standards, based on sound scientific evidence. A doctor can request to be examined and certified by this board as a knowledgeable doctor who provides treatment according to these standards. After successful completion of this exam, the doctor receives the title of Diplomate in that specialty. The doctor must then keep this designation active by participating in, and reporting on, appropriate continuing education set forth by the Board. By seeing a Dentist who is Board Certified in Pediatric Dentistry, you are ensuring that your child is receiving the best care possible.
Parents have a big influence on how their child perceives a dental check-up. Prior to your first visit, try to be positive when talking with your child about what the dentist will do. Most parents find it helpful to explain that the dentist will simply count and brush his/her teeth, then provide instruction in proper toothbrushing techniques and dental care. If there are older siblings, be careful to instruct the older siblings not to scare their younger siblings before their first dental visit.
Our office has been specially designed to create a warm and friendly atmosphere for all our patients and their parents. We recognize that some children, especially younger (or new) patients, are more comfortable with a parent present during the first visit. The treatment areas, therefore, have been designed so that parents can accompany their children. This usually helps children acclimate to a new or unfamiliar setting. Do not be surprised if your child has to sit in your lap for the first few dental visits. As your child becomes comfortable with our office and staff, he or she will also become comfortable in the dental chair.
We will thoroughly explain each of our procedures in terms that your child can understand. Once your child is comfortable, a full examination of the teeth and supporting structures (gums, bones, etc.) can be performed. Their growth and development will be evaluated, and the teeth will be polished and flossed. Radiographs (x-rays) will only be taken if necessary for diagnostic purposes. We are very conservative about taking x-rays of children and have selected x-ray equipment that provides maximum safety for our patients. See our X-Ray section for how we reduce the exposure of radiation our patients receive.
If needed, we will discuss treatment recommendations with you after the examination. Any questions you may have concerning the plan of treatment can be answered at this time. Please inform us of any special considerations that may help us to provide the best quality dental care for your child.
Fluoride is a natural occurring mineral that strengthens tooth enamel. Eighty years of research have shown there are several ways by which fluoride makes teeth resistant to cavities. First and foremost, it strengthens tooth enamel by turning hydroxyapatite into fluorapatite. Hydroxyapatite is what teeth and bones are made of. Fluorapatite is stronger than hydroxyapatite, thus making the teeth stronger and more resistant to the acid that bacteria living in the mouth produce. An additional benefit of fluoride is it reduces the ability of bacteria to produce acid.
As with any substance, moderation is key. Too much of anything is usually a bad thing, and fluoride is no exception. Our dentists will discuss with you how to ensure your child is receiving the optimal amount to prevent cavities
X-rays are needed to detect cavities forming between the teeth and to monitor your child’s growth and development. Without x-rays, the first sign of a cavity is usually a toothache, requiring extensive treatment when compared to just placing a filling if found early.
New technology has reduced the amount of radiation required (to expose X-rays) to a negligible amount. Radiation exposure is measured in what is called Millirem (mrem). Each year the average person, just through daily living, is exposed to an estimated 620 mrem of radiation. This radiation comes from many different sources, including sunlight, airplanes, power cords, and some foods, etc. A standard dental x-ray will expose an individual to 0.15 mrem.
Because an often-expressed parental concern is regarding radiation exposure and cancer, please note the comparison below, and be reassured your child is safe taking a standard x-ray.
100,000 mrem: Amount of radiation needed to cause cancer (equivalent to 650,000 x-rays)
Silver diamine fluoride, or SDF, is a colorless liquid that contains silver particles. SDF has been used for decades in many parts of the world to treat cavities. It is painless, inexpensive, easy to place, and works 75% of the time with just a single application. There is, however, one significant downside of placing SDF which is, it turns the cavity part of the tooth BLACK. There are many factors to consider when deciding if a child is a good candidate for SDF application including: child’s age and behavior, how long before the tooth will fall out, if the tooth is in the smile zone, and family finances. Your dentist will discuss this option with you, and answer any questions you may have.
Silver compounds have been used for their medical properties for centuries and, in dentistry, for more than a century. Clinical evidence has demonstrated that silver compounds are effective at stopping cavities by interfering with bacteria reproduction. Silver diamine fluoride is a colorless liquid made up of fluoride and silver ions that has been shown to be 70-90 percent effective in stopping cavities. One down side to treating cavities with Silver diamine fluoride is that it turns the cavity (not tooth) black. Therefore, if the cavities are in the front teeth, these black spots may be visible when you smile. This discoloration can be removed when the child is old enough to receive dental treatment in a cooperate manner.
A dental sealant is a plastic material that is placed on the chewing surface of the tooth. This prevents accumulation of food in the pits and fissures of the teeth where cavities are most likely to form. They can reduce your risk of developing cavities up to 85%! To be effective, sealants should be checked and touched up as needed, preferably every six months. Placement of a sealant only takes several minutes per tooth, does not require anesthetic, and is typically covered by insurance. If your child is anxious or gags easily, nitrous oxide can be used to help your child get through the appointment.
Dental fillings are used to replace missing tooth structure after a cavity is removed. Dentists classify cavities by the number of tooth surfaces involved. The more surfaces involved, the larger the filling will be. There is a limit on how big a filling can get without compromising the strength of the tooth. Therefore, at a certain point, a filling will no longer do the job and a crown is indicated to restore the strength of the tooth.
Large cavities weaken teeth and do not retain fillings well, especially in small baby teeth. When this happens, it is recommended to place a crown to restore the strength of the tooth. This, in turn permits the tooth to stay in the mouth until it falls out naturally.
Placement of a crown involves reducing the size of the tooth to accommodate the crown fitting over the entire tooth. Once cemented in place, the crown will remain until the tooth is lost naturally. Crowns can be made of several different materials, including stainless-steel (silver), zirconia (white), and composite resin (white). Although white crowns are desirable, inherent disadvantages still make the stainless-steel crown the most successful and dependable option. Typically, white crowns are not an option on baby molars, although they work well on front baby teeth. We can discuss with you the WHITE crown limitations and determine if they will work well for your child.
When a cavity is large enough to be close to, or extend into, the pulp chamber of a tooth, the pulp chamber may become exposed to bacteria while removing the cavity. When this occurs, it is necessary to surgically remove the nerve of the tooth and place a disinfecting medication. A material is then placed in the pulp chamber that seals out bacteria, and the tooth is restored with a crown.
Premature loss of a primary tooth will lead to crowding in the permanent teeth. To prevent this, an appliance called a space maintainer is recommended to prevent the teeth from shifting. Space maintainers are well-tolerated by the majority of children and are removed when the new tooth appears, usually in a few years.
Nitrous oxide is a colorless and virtually odorless gas with a faint, sweet smell. It is effective at reducing anxiety, discomfort, and pain, while giving a feeling of warmth and security. It creates euphoria and enhances communication between the patient and dentist. It is extremely safe, as it has little effect on the respiratory system. During administration, patients respond normally and their vital signs are stable. There is no significant risk of losing protective reflexes and the patient is able to return to pre-administration condition quickly. Although it works on the majority of the population, its effect is variable and depends on a patient’s response to various drugs. The most common negative side effect we see is an upset stomach, so please follow our guidelines on eating and drinking, if nitrous oxide is to be used.
At Anthem Pediatric Dentistry, we administer medication to cause a “Twilight” or “Conscious” sedation. This means your child will be awake and responsive, but also relaxed and sedated during the procedure. Our goal is not to have your child sleep through the procedure, but to help reduce anxiety and create an environment where dental care can be delivered in a safe and effective manner. Our sedation procedure consists of a mixture of medications taken by mouth. Although these medications work very well for the majority of patients, they are NOT 100% EFFECTIVE with every child. Occasionally, general anesthesia is required to complete treatment when sedation proves ineffective. The dentist will make a determination whether sedation is a viable option for your child. A child receiving sedative medications must not have anything to eat or drink for eight (8) hours before the procedure.
General anesthesia is typically delivered in a hospital or surgical center and involves a child being completely asleep for the entire dental procedure. General anesthesia is an accepted standard of care when the situation involves a child who has limited comprehension, extensive dental treatment needs, or is extremely uncooperative and requires dental care that is technically difficult.
General anesthesia is recognized and supported by the American Academy of Pediatric Dentistry, the American Dental Association, the American Medical Association, and the US Department of Health and Human Services as a safe and effective way to provide dental care to these patients.
Kids lose their primary teeth during two different time periods. The eight front teeth, four on the bottom and four on the top, fall out between 6 ½-8 ½ years old. If moderate to severe crowding is present, a child may lose more than eight teeth to accommodate these new eight teeth. If so, an early examination by an orthodontist is indicated. Teeth found to be on an inappropriate eruption path as well as narrow jaws-resulting in teeth biting on the wrong side of the arch- is another indication for an early referral. Otherwise, kids are okay to wait until all primary teeth have fallen out before seeing the orthodontist. Our pediatric dentists will evaluate your child for proper timing of a referral to the orthodontist if needed.
Healthy snacks contain very low amounts of carbohydrate and little to no sugar. Frequency of snacking is also an important factor. Children that “graze” are at a much higher risk for developing cavities than a child that eats healthy meals and only snacks once or twice a day.
Note: A child should also be reminded to brush their teeth after eating sticky sweet foods.