Common Procedures
Regular exams and cleanings
Regular exams are an important part of maintaining your child’s oral health. During a regular exam, we will:
- Look for cavities or other signs of tooth decay
- Inspect the teeth and gums for gingivitis and signs of periodontal disease
- Perform a thorough teeth cleaning
- Check for any problems that can’t easily be seen or felt
The regular exam will take about 30 minutes. Each regular exam includes a detailed teeth cleaning, during 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 ask doctor 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.
Bonding
Bonding is a conservative way to repair slightly chipped, discolored, or crooked teeth. During dental bonding, a white filling is placed onto the tooth to improve its appearance. The filling “bonds” with the tooth. Because it comes in a variety of tooth-colored shades, it closely matches the appearance of your natural teeth.
Tooth bonding also can be used for tooth fillings instead of amalgam fillings. Many patients prefer bonded fillings because the white color is much less noticeable than the silver amalgam. Bonding fillings can be used on front or back teeth, depending on the location and extent of tooth decay.
Bonding is less expensive than other cosmetic treatments and usually can be completed in one visit to our office. However, it can stain and is easier to break than other cosmetic treatments such as porcelain veneers. If it does break or chip, tell your doctor. The bonding generally can be easily patched or repaired in one visit.
Crowns for Children
Sometimes we find decay on a “baby” tooth that has been there a long time. The decay can destroy a significant amount of tooth structure. When this happens, a filling is not the best choice to restore it. For these cases we have preformed, stainless steel crowns specially designed by 3M for “baby” teeth.
Stainless steel crowns have proven to be a very succesful restoration for large cavities on primary teeth. They’ll last as long as the primary tooth would have lasted and their failure rate is very low.
If an anterior primary tooth needs a crown, we do have aesthetic alternatives. We use Nu-Smile Pediatric Crowns, for patients who have concerns about the social and psychological impact of the “stainless steel smile.”
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 it 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 and jaw at risk, so the doctor may recommend removal and replacement with a bridge or implant. 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, the dentist may extract it during a regular checkup or request another visit for this procedure. The root of each tooth is encased within your jawbone in a “tooth socket,” and your tooth is held in that socket by a ligament. In order to extract a tooth, your 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 us any concerns or preferences for sedation.
Once a tooth has been removed, neighboring teeth may shift, causing problems with chewing or with the jaw joint function. To avoid these complications, the dentist may recommend replacement of the extracted tooth.
Fillings
Traditional dental restoratives, or fillings, may include gold, porcelain, and composite. The strength and durability of traditional dental materials continue to make them useful for situations where restored teeth must withstand extreme forces that result from chewing, such as in the back of the mouth.
Newer dental fillings include ceramic and plastic compounds that mimic the appearance of natural teeth. These compounds, often called composite resins, are usually used on the front teeth where a natural appearance is important, as well as on the back teeth depending on the location and extent of the tooth decay.
What’s right for your child?
Several factors influence the performance, durability, longevity, and expense of dental restorations, including:
- The components in the filling material
- The amount of remaining tooth structure
- Where and how the filling is placed
- The chewing load the tooth will have to bear
- The length and number of visits needed to prepare and adjust the restored tooth
Before your child’s treatment begins, the doctor will discuss all of your options with you, and help you choose the best filling for your child’s particular situation. To help you prepare for this discussion, it may be helpful to understand the two basic types of dental fillings: direct and indirect.
- Direct fillings are placed immediately into a prepared cavity during a single visit. They include glass ionomers, resin ionomers, and composite (resin) fillings. The dentist prepares the tooth, places the filling, and adjusts it in just one appointment.
- Indirect fillings generally require two or more visits. They include inlays, onlays, veneers, crowns, and bridges fabricated with gold, base metal alloys, ceramics, or composites. During the first visit, the dentist prepares the tooth and makes an impression of the area to be restored. The dentist then places a temporary covering over the prepared tooth. The impression is sent to a dental laboratory which creates the dental restoration. At the next appointment, the dentist cements the restoration into the prepared cavity and adjusts it as needed.
Fluoride
Fluoride is effective in preventing cavities and tooth decay. It also prevents plaque from building up and hardening on the tooth’s surface. A fluoride treatment in the dentist’s office takes just a few minutes. After the treatment, patients 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 the oral health or the patient or the doctor’s recommendation, a fluoride treatment may be required every three, six, or 12 months.
Mouthguards
Whether your son or daughter wears braces or not, protecting your child’s smile while playing sports is essential. Sports-related injuries to the mouth and jaw are among the most common injuries received by athletes. Our goal is to help minimize your child’s chances of a sports-related injury.
Mouthguards help protect teeth and gums from injury. The American Dental Association recommends the use of a mouthguard if your child participates in basketball, boxing, hockey, football, gymnastics, lacrosse, martial arts, racquetball, rugby, track and field, skateboarding, skiing and snowboarding, skydiving, soccer, surfing, volleyball, water polo, weightlifting, or wrestling.
Types of mouthguards
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 choosing a mouthguard, be sure to pick one that is tear-resistant, comfortable and well fitted for your child’s mouth, easy to keep clean, and does not prevent him or her from breathing properly.
If your youngster wears braces or a retainer, it is imperative to wear a mouthguard. The dentist can show your child how to wear a mouthguard properly and how to choose the right mouthguard to protect his or her smile.
Taking care of the mouthguard
Similar to a retainer, braces, or any other special dental appliance, it is important to take care of your child’s mouthguard by storing it properly and keeping it clean, as well as knowing when to replace an old mouthguard. Here are a few simple ways to keep your child’s mouthguard clean and working correctly:
- Gently scrub the mouthguard after each use with a toothbrush and toothpaste.
- Store the mouthguard in a protective case.
- Do not leave the mouthguard in the sun or in hot water, because it may melt or become deformed.
- Replace the mouthguard at the beginning of every new sports season. You should also replace your child’s mouthguard if you notice it has become worn and not longer fits properly.
- Do not have your child wear a retainer with a mouthguard. If your child has braces, the dentist will help design a mouthguard to protect the teeth and braces.
- Do not let your child chew on or cut pieces off the mouthguard. Mouthguards come in different shapes and sizes, so ask the dentist which is best for your child.
- Bring the mouthguard to each dental checkup so the dentist can check to make sure it’s still in good shape!
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 between the small cracks and grooves on 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 plastic resins that bond and harden in the deep grooves on the tooth’s surface. When a tooth is sealed, the tiny grooves become smooth, and are less likely to harbor plaque. With sealants, brushing becomes easier and more effective against tooth decay.
Sealants are typically applied to children’s teeth as a preventive measure after the permanent teeth have erupted as a way to prevent tooth decay. It is more common to seal “permanent” teeth rather than “baby” teeth, but every patient has unique needs, and the dentist will recommend sealants on a case-by-case basis.
Sealants last from three to five years, although 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 the dentist know, and schedule an appointment for your child’s teeth to be re-sealed.
Space maintainers
Sometimes a primary tooth is lost before the permanent tooth beneath it is ready to erupt. The most common causes for this are cavities and injuries. If your child loses a tooth prematurely, we may recommend a space maintainer.
A space maintainer is an appliance that holds open the space left by the lost tooth. It helps prevent the nearby teeth from shifting into the vacant space. If that were to happen, when the permanent tooth was ready to erupt it would not not have enough room or might erupt in a wrong position.
Once the spacer is in place, the eruption of the permanent tooth is monitored. When the time is right, the spacer is removed.
Wisdom teeth
Wisdom teeth are molars found in the very back of the mouth. They usually appear in the late teens or early twenties but 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, the person 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 roots have not fully formed and the bone surrounding the teeth is less dense. These two factors can make extraction easier, as well as making the recovery time much shorter.
In order to remove a wisdom tooth, the 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 embedded in the jaw bone, your 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 each piece can be removed through a small opening in the bone.
Once the wisdom teeth have been extracted, the healing process begins. Healing time varies, depending on the degree of difficulty related to the extraction. Your dentist will explain what you or your child can expect and provide instructions for a comfortable, efficient healing process.