Common Procedures
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Regular Exams and Cleanings
Regular exams are an important part of maintaining your child's oral health. During your child's regular exam, we will:
- Check for any problems that may not be seen or felt
- Look for cavities or any other signs of tooth decay
- Inspect the teeth and gums for gingivitis and signs of periodontal disease
- Perform a thorough teeth cleaning
Your child's exam will take about 45 minutes. Each regular exam includes a detailed teeth cleaning, in which we will clean, polish, and rinse the teeth to remove any tartar and plaque that have built up on the tooth's surface.
Visiting our office every six months gives you the chance to talk to the doctor about any questions you may have about your child's oral health. Regular exams are offered by appointment only, so please contact our practice today to schedule your child's next dental exam and teeth cleaning.
Crowns
Children who need baby crowns to restore their teeth often choose to see the pediatric dentists. PDG offers both white or tooth colored pediatric crowns as well as silver, stainless steel crowns for 1st molars and front teeth. For 2nd baby molars, only silver is available. Since the enamel of baby teeth is thinner, cavities tend to spread more easily and usually come to affect a larger area of the tooth. At that point, crowns may be the only way to protect the tooth from premature extraction.
Children who need baby crowns to restore their teeth often choose to see the pediatric dentists. PDG offers both white or tooth colored pediatric crowns as well as silver, stainless steel crowns for 1st molars and front teeth. For 2nd baby molars, only silver is available. Since the enamel of baby teeth is thinner, cavities tend to spread more easily and usually come to affect a larger area of the tooth. At that point, crowns may be the only way to protect the tooth from premature extraction.Why would baby teeth need to be restored by a crown?
Baby teeth that show evidence of extensive decay, with two or more surfaces affected, can sometimes be saved through the use of a crown. Occasionally, especially in esthetic areas, it is possible to use a tooth colored crown. These crowns can be used to protect front teeth when they become cracked or chipped, have undergone root canal therapy, show signs of decay, or are markedly discolored. In particular, if the decay or cavity has spread to different surfaces of the tooth or has reached the pulp of the tooth, a baby root canal may need to be performed. At that point the tooth becomes weaker and is more likely to crack. In these instances, it is important to protect the tooth by using a crown.
Which type of crown (tooth colored or silver) is best for restoring baby teeth?
In general, for front teeth, we recommend using tooth colored crowns with or without a silver coping underneath. These crowns are both esthetic and strong. Tooth colored options are also available for some back teeth but for baby molars that are constantly exposed to chewing and grinding, silver stainless steal crowns may be a better option.
How are baby crowns prepared?
After the child is made completely numb using local anesthesia, all of the affected tooth structure is removed so as to get rid of any decay. Then the tooth is prepared in a certain way so that a prefabricated crown can fit on top. When the pediatric dentist has determined what size crown fits best for the tooth, the crown is then cemented in place.
Are there any precautions that must be taken after having a crown placed on a baby tooth?
Immediately after treatment it is important that the child does not eat anything too hard or sticky. Chips and popcorn pieces can get stuck under the crown, making it uncomfortable. Also, sticky or hard candies, like bubble gum, can displace the crown. If a crown gets displaced, the child should be brought back to the dental office to have it re-cemented. To prevent this from happening however, parents should be careful as to what the child eats after treatment. Often we recommend softer foods. Also, sometimes the gums may become slightly irritated by the new crown. It is important to continue to brush around the gums of these teeth to prevent further irritation.
Extractions
There are times when it is necessary to remove a tooth. Sometimes a baby tooth has misshapen or long roots that prevent it from falling out as it should, and the tooth must be removed to make way for the permanent tooth to erupt. At other times, a tooth may have so much decay that it puts the surrounding teeth at risk of decay, so the doctor may recommend its removal. Infection, orthodontic correction, or problems with a wisdom tooth can also require removal of a tooth.
When it is determined that a tooth needs to be removed, your child's dentist may extract the tooth during a regular checkup or may request another visit for this procedure. The root of each tooth is encased within the jawbone in a “tooth socket”, and the tooth is held in that socket by a ligament. In order to extract a tooth, the dentist must expand the socket and separate the tooth from the ligament holding it in place. While this procedure is typically very quick, it is important to share with the doctor any concerns or preferences for sedation.
Fillings
Traditional dental restoratives, or fillings, may include gold, porcelain, or composite. Newer dental fillings include ceramic and plastic compounds that mimic the appearance of natural teeth. These compounds, often called composite resins, are typically used on the front teeth where a natural appearance is important. There are two different kinds of fillings: direct and indirect. Direct fillings are fillings placed directly into a prepared cavity in a single visit. Indirect fillings generally require two or more visits. These fillings include inlays, and veneers fabricated with ceramics or composites.
Fluoride
Fluoride is effective in preventing cavities and tooth decay and in preventing plaque from building up and hardening on the tooth’s surface. A fluoride treatment in a dentist’s office takes just a few minutes. After the treatment, your child may be asked not to rinse, eat, or drink for at least 30 minutes in order to allow the teeth to absorb the fluoride. Depending on your child's oral health or the doctor’s recommendation, a fluoride treatment may be required every three, six, or 12 months.
Mouthguards
Whether your child wears braces or not, protecting his or her smile while playing sports is essential. Mouthguards help protect the teeth and gums from injury. If your child participates in any kind of full-contact sport, the American Dental Association recommends that he or she wear a mouthguard. Choosing the right mouthguard is essential. There are three basic types of mouthguards: the pre-made mouthguard, the “boil-and-bite” fitted mouthguard, and a custom-made mouthguard from the dentist. When you choose a mouthguard, be sure to pick one that is tear-resistant, comfortable and well-fitted for your mouth, easy to keep clean, and does not prevent your child from breathing properly. Your dentist can show your child how to wear a mouthguard properly and how to choose the right mouthguard to protect his or her smile.
Nightguards
If your child often wakes up with jaw pain, earaches, or headaches, or if you see your child clenching or grinding his or her teeth, your child may have a common condition called “bruxism”. Many people do not even know that they grind their teeth, as it often occurs when one is sleeping. If not corrected, bruxism can lead to broken teeth, cracked teeth, or even tooth loss.
There is an easy, non-invasive treatment for bruxism: nightguards. Nightguards are an easy way to prevent the wear and damage that teeth-grinding causes over time. Custom-made by a dentist from soft material to fit the teeth, a nightguard is inserted over your child's top or bottom arch and prevents contact with the opposing teeth.
Root Canals
In the past, if your child had a permanent tooth with a diseased nerve, he or she would probably lose that tooth. Today, with a special dental procedure called “root canal treatment”, your child's tooth can be saved. When a tooth is cracked or has a deep cavity, bacteria can enter the pulp tissue and germs can cause an infection inside the tooth. If left untreated, an abscess may form. If the infected tissue is not removed, pain and swelling can result. This can not only injure your child's jawbones, but it is also detrimental to his or her overall health.
Root canal treatment involves one to three visits. During treatment, the dentist will remove the affected tissue. Next, the interior of the tooth will be cleaned and sealed. Finally, the tooth is filled with a dental composite. If the tooth has extensive decay, your doctor may suggest placing a crown to strengthen and protect the tooth from breaking. As long as your child continues to care for his or her teeth and gums with regular brushing, flossing, and checkups, the restored tooth can last a lifetime.
Sealants
Sometimes brushing is not enough, especially when it comes to those hard-to-reach spots in your child's mouth. It is difficult for a toothbrush to get in between the small cracks and grooves on your child's teeth. If left alone, those tiny areas can develop tooth decay. Sealants give your child's teeth extra protection against decay and help prevent cavities.
Dental sealants are a plastic resin that bonds and hardens in the deep grooves on your child's tooth’s surface. When a tooth is sealed, the tiny grooves become smooth and are less likely to harbor plaque. With sealants, brushing your child's teeth becomes easier and more effective against tooth decay.
Sealants are typically applied to children’s teeth as a preventive measure against tooth decay after the permanent teeth have erupted. It is more common to seal “permanent” teeth rather than “baby” teeth, but every patient has unique needs, and your child's dentist will recommend sealants on a case-by-case basis.
Sealants last from three to five years, but it is fairly common to see adults with sealants still intact from their childhood. A dental sealant only provides protection when it is fully intact, so if your child's sealants come off, let your dentist know, and schedule an appointment for your child's teeth to be re-sealed.
Veneers
Your child no longer needs to hide his or her smile because of gaps, chips, stains, or misshapen teeth. With veneers, you can easily correct your child's teeth’s imperfections to help him or her have a more confident, beautiful smile. Veneers are natural in appearance, and they are a perfect option for patients wanting to make minor adjustments to the look and feel of their smile.
Veneers are thin, custom-made shells made from tooth-colored materials (such as porcelain), and they are designed to cover the front side of your child's teeth. To prepare for veneers, the doctor will create a unique model of your child's teeth. This model is sent to the dental technician to create the veneers. Before placing the new veneer, the doctor may need to conservatively prepare the tooth to achieve the desired aesthetic result.
When placed, you’ll be pleased to see that veneers look like your child's natural teeth. While veneers are stain resistant, the doctor may recommend that you avoid coffee, tea, and other staining food and drinks to maintain the beauty of your child's new smile.
Wisdom Teeth
Wisdom teeth are types of molars found in the very back of your child's mouth. These teeth usually appear in late teens or early twenties, but they may become impacted (fail to erupt) due to lack of room in the jaw or angle of entry. When a wisdom tooth is impacted, it may need to be removed. If it is not removed, your child may develop gum tenderness, swelling, or even severe pain. Impacted wisdom teeth that are partially or fully erupted tend to be quite difficult to clean and are susceptible to tooth decay, recurring infections, and even gum disease.
Wisdom teeth are typically removed in the late teens or early twenties because there is a greater chance that the tooth's roots have not fully formed and the bone surrounding the teeth is less dense. These two factors can make extraction easier as well as shorten the recovery time.
In order to remove a wisdom tooth, your child's dentist first needs to numb the area around the tooth with a local anesthetic. Since the impacted tooth may still be under the gums and imbedded in your jaw bone, the dentist will need to remove a portion of the covering bone to extract the tooth. In order to minimize the amount of bone that is removed with the tooth, the dentist will often “section” the wisdom tooth so that each piece can be removed through a small opening in the bone. Once your child's wisdom teeth have been extracted, the healing process begins. Depending on the degree of difficulty related to the extraction, healing time varies. Your child's dentist will share with you what to expect and provide instructions for a comfortable, efficient healing process.