KNOCKED-OUT TOOTH: Primary teeth are not replaced; send directly to the Tooth Fairy. For permanent teeth, time is of the essence. 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. Gently hold in place by biting on a paper towel or wash cloth, etc. If the tooth cannot be replaced, it must be kept moist. Drying will kill the essential cells on the root needed for re-attachment. Place tooth in milk, saliva, or egg yolk and call Anthem Pediatric Dentistry as soon as possible. After one hour, it is not advised to replace the tooth.
BROKEN TOOTH: If possible, find 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 and solution to fix the problem.
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 a child cannot have healthy adult teeth if they have diseased baby teeth. This is due to cross-over infection that results during the 6-year mixed dentition stage.
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. While general dentists can provide dental care to the pediatric population, the pediatric dentist is a specialist who undergoes an additional two years of training to learn about dental issues and psychology specific to children and adolescents. Anthem Pediatric Dentistry specializes in dentistry for children and makes them feel comfortable in a kid-friendly environment. We help children accept dental care more readily with less apprehension.
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 by this board to become “Certified” as a knowledgeable doctor that 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 Pediatric Dentist that 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. The less to-do concerning the visit, the better. Saying too much can create a negative response during this experience. Most parents find it helpful to explain that the dentist will simply “count” and brush his/her teeth and provide instruction in proper toothbrushing techniques and dental care.
Our office has been specially designed to create a warm and friendly atmosphere for all of 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 preschool aged children. This usually will help children acclimate to a new or unfamiliar setting.
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. The occlusal status (or bite) 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.
Following the dental examination of your child, we will discuss treatment recommendations. 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.
There is over a half century of sound scientific data indicating the SAFE reduction of dental cavities by 55-60%. Community water fluoride is the most beneficial and inexpensive method of providing fluoride with the intent to reduce cavities. Not all portions of the tooth benefit the same from fluoride exposure. Exposure of fluoride is reduced in deep pits/fissures of molars, as well as in between the teeth. Good flossing habits and sealants are also critical to help you remain cavity free.
HOW IT WORKS: Bacteria produce acid from sugars and starches that dissolves the hard enamel on our teeth, resulting in tooth decay. This process is called demineralization. In the first step of demineralization, the enamel loses a weakly charged hydroxyl ion in the presence of acid. The hydroxyl ions are like the blocks in the game “Jenga”. The Fluoride ion is the same shape and size as the Jenga block. When the fluoride “block” replaces the hydroxyl “block’ it is equivalent to adding wood glue to the block. It requires an even higher level of acid to be displaced, thereby helping the enamel (Jenga stack) to remain intact.
X-rays are often needed to detect cavities forming between the teeth. If left undiagnosed, these cavities have a tendency to burrow toward the pulp cavities (nerve) undetected. 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 ubiquitous radiation comes from many different sources, including sunlight, airplanes, power cords, some foods, etc. A standard dental x-ray will expose an individual to 0.15 mrem. Following are some common numbers to compare with:
5 mrem: Round trip flight from New York to California (equivalent to 33 x-rays)
35 mrem: Annual sunlight exposure (equivalent to 230 x-rays)
230 mrem: Breathing natural occurring radioactive elements in air (equiv. to 1500 x-rays)
100,000 mrem: Amount of radiation needed to cause cancer (equivalent to 650,000 x-rays)
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. They prevent 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, every 6 months. Placement of a sealant only takes several minutes per tooth and does not require anesthetic to be placed.
Dental fillings are used to replace missing tooth structure after a cavity is removed. Fillings, and the cavities they replace, weaken the tooth. Dentists classify cavities by the number of tooth surfaces involved. The more surfaces involved, the larger the filling will be. Therefore, there is a limit on how big a filling can get without compromising the strength of the tooth. 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. Therefore, it is recommended that teeth with large cavities have a crown placed to restore the strength of the tooth, permitting it 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 to fit over the entire tooth. Once cemented in place, the crown will remain until the tooth is naturally lost. 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. We can discuss with you the WHITE crown limitations and determine if they will work well for your child.
When a cavity encroaches on the pulp chamber of a tooth, there is a chance that the pulp chamber may become exposed to the bacteria while removing the cavity. When this occurs, it is necessary to surgically remove the nerve in the pulp chamber of the tooth and place a disinfecting medication. A material that seals out bacteria from the pulp chamber is then placed 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 in unwanted directions. These space maintainers are well tolerated by the majority of children and will be removed when the new tooth appears, usually 4-7 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 warms and security. It creates euphoria and enhances communication between the patient and dentist. It is an 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 affect is variable and depends on a patient’s response to various drugs.
Sedations at Anthem Pediatric Dentistry are called “Twilight” or “Conscious” sedations, meaning that your child will be awake and responsive during the procedure. Our goal with a sedation 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 sedations consist 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 commonly referred to as “Sleep Dentistry”. General anesthesia is an accepted standard of care with situations involving children who have limited comprehension, have extensive dental treatment needs, or children who are extremely uncooperative and require 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 8 front teeth, 4 on the bottom and 4 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 8 teeth to accommodate these new 8 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. A child should also be reminded to brush their teeth after eating sticky sweet foods.