Treatment Procedures

Sealants

Tooth decay has become increasingly prevalent in preschoolers.  Not only is tooth decay unpleasant and painful, it can also lead to more serious problems like premature tooth loss.  Sealants are a thin coating applied to the pits, fissures, and grooves of the chewing surfaces of molars. Tooth structure is NOT removed; rather sealants are added to the teeth. They can be very effective in preventing cavities since chewing surfaces are the areas where food and bacteria can most easily become trapped.  Dental sealants are an important tool in preventing childhood cavities and tooth decay.  Depending on the oral habits of the child, the sealants may last for the life of the primary tooth, or need replacing several times.  Sealants are highly recommended for permanent molars not only because they are more difficult to keep clean for younger children but because they are needed in a healthy condition for decades.  Having sealants placed is elective but can save a patient time, money, and the discomfort associated with having a filling placed in the future.  While sealants can greatly reduce the risk of getting cavities, the patient may still form cavities due to poor oral hygiene or diet. Sealants do not protect against cavities in between teeth or on the smooth surfaces.  Our sealant procedure is easily completed in one office visit, and is entirely painless.

Stainless Steel Crowns (SSCS)

SSCs are the gold standard in treating cavities that are large (wide, deep, or involve multiple surfaces), involve the nerve of the tooth, or in children that are at high risk for having more cavities in the future. They are highly successful in that they are impenetrable by food and bacteria, provide integrity and strength to the compromised tooth, biocompatible with oral tissues, and cemented on using a fluoride-based cement. Although some parents may not like the esthetics of SSCs, they are the best option for reducing the risk of retreatment, and they will eventually fall out when the baby tooth falls out. While very rare, SSCs can be pulled off due to trauma or sticky foods. In most cases, a new SSC can be replaced easily. Generally, when a tooth with a SSC fails, it is most likely due to further degeneration of a compromised nerve and not due to SSC itself.

Composite Fillings

A composite (tooth colored) filling is used to repair and restore a tooth that is affected by a cavity, decay, cracks, fractures, etc.  The decayed or affected portion of the tooth will be removed and then filled with a composite filling.  There are many types of filling materials available, each with their own advantages and disadvantages.  Before your treatment appointment we can discuss the best options for restoring your child’s teeth.  Composite fillings are usually placed in one appointment.  While the tooth is numb, we will remove decay as needed.  The space will then be thoroughly cleaned and carefully prepared before the new filling is placed.  The filling will then be precisely shaped, and polished, restoring the tooth back to its original shape and function.  Because composite fillings are tooth colored, they can be closely matched to the color of existing teeth, and are more aesthetically suited for use in front teeth or more visible areas of the mouth. It is normal to experience sensitivity to hot and cold when composite fillings are first placed, however this will subside shortly after your tooth acclimates to the new filling.   As with most dental restorations, composite fillings are not permanent and may someday have to be replaced.  

Pulpotomy

A pulpotomy is the partial removal of nerve tissue on a baby tooth. We only perform a pulpotomy after much thought and consideration. The only time a pulpotomy is recommend is when the bacteria in the cavity has reached nerve. The pulpotomy will hopefully contribute to the longevity of the tooth. The procedure involves removing the top half of the compromised nerve while preserving the healthy, vital bottom half of the nerve in the root. A medicine is placed on the nerve to hopefully reduce risk of further infection, and a SSC is placed over the tooth to protect and seal it. With proper case selection and correct technique, a pulpotomy is excellent way to prolong the lifespan of a tooth, providing the child with increased chewing function and natural space maintenance. Pulpotomies can fail if the disease process progresses to the lower half of the nerve, but can be a healthier and cheaper alternative to premature extraction of a vital baby molar.

Extractions 

There’s nothing like the excitement of watching your child lose their first tooth; and it helps that most baby teeth come out on their own. But occasionally, baby teeth need a little help to move things along. When teeth are badly decayed or damaged, or when baby teeth start to crowd adult teeth coming in, it may be necessary to consider having your child’s teeth extracted.  Pediatric tooth extractions are common and generally simple. Extraction is only recommended in situations with no other sensible alternatives.  Having a pediatric dentist in charge of the procedure gives many parents peace of mind. Pediatric dentists receive additional training in oral development. They are keenly focused on treating baby teeth, predicting when permanent teeth will come in, and in using anesthesia to aid in an extraction.  Extraction is also commonly recommended to help orthodontic treatment: removing a tooth can reduce crowding and allow your orthodontist to straighten neighboring teeth. We want to do everything possible to keep your child’s mouth healthy, and help those adult teeth arrive in just the right place. 

Appliances

There are an assortment of appliances we use to move or hold teeth or to prevent negative habits. These can be discussed in detail on a case-by- case basis. All benefits and risks of appliance therapy will be discussed in detail so that the parent can make an informed decision. 

If you have any questions or would like to learn more about the procedures offered, please call our office or schedule your appointment today.