Dental Hygiene / Preventive Dentistry / Restorative Dentistry
Behavior Management Techniques & Sedation / Post Operative Instructions

Age 1 Visits
The American Academy of Pediatric Dentistry recommends children visit a dentist by the first birthday, and we whole-heartedly agree with their recommendation. The American Dental Association (ADA) also endorses the Age 1 visit to establish a "Dental Home". We actually prefer to see you and your child around 9-12 months so we have time to reduce any risk factors we may find in our primary prevention program. Our age 1 visit is for you — the parents! We provide you with the information you need to care of your child's smile. We even talk to you about your mouth and your habits as these have been shown to play a significant role in your child's future cavity risk. You can prevent costly dental work in the future by knowing what to do with your child's diet and hygiene as well as your own.

Initial Exam
For children 3 and older, our New Patient visit includes an orientation to the office, soft tissue examination, oral cancer screening, scaling and polishing, necessary x-rays, fluoride treatment, oral hygiene instruction, dental development evaluation, dietary and nutritional counseling, and patient/parent education. We teach you and your child how to best care for their teeth, advise on eating habits and answer any specific questions you may have. We explain how cavities are caused, what you can do to prevent them and how your children can help fight gum and tooth disease by brushing properly. All information is provided in an age appropriate manner to help nurture and encourage your child. We pack a lot into this first visit!

Check up Appointments
Our check up appointments encompass more than "just a cleaning." We view each check up as an opportunity to provide you and your child the tools your family needs to remain cavity free. Take a look at the initial exam to see the types of services your child will receive at every check up appointment.

Dental Education
Although check up appointments are a critical component of your child's dental care, we know that your child's home care program and habits will more likely influence his or her ability to stay cavity-free. Therefore, we place a significant emphasis on education and help identify and eliminate potentially harmful habits. Please refer to our FAQ on how cavities develop and brushing tips and helpful hints for some of our educational favorites.

Preventive Dentistry

Sealants
Sealants protect the grooved and pitted surfaces of the teeth, especially the chewing surfaces of back teeth where most cavities in children are found. Made of tooth colored plastic, sealants are applied to the teeth to help keep them cavity-free. The application of a sealant is quick and comfortable. It takes only one visit. The tooth is first cleaned. It is then conditioned and dried. The sealant is then flowed onto the grooves of the tooth and hardened with a special light. Your child will be able to eat right after the appointment.

Fluoride Treatment
When the element fluoride is used in small amounts on a routine basis it helps to prevent tooth decay. It encourages "remineralization," a strengthening of weak areas on the teeth. These spots are the beginning of cavity formation. Fluoride occurs naturally in water and in many different foods, as well as in dental products such as toothpaste, mouth rinses, gels, varnish and supplements. Fluoride is effective when combined with a healthy diet and good oral hygiene.

Mouth Guards
Athletic mouth guards can prevent serious dental injuries. We can provide boil and bite mouth guards for children whose mouths are undergoing a lot of change (such as teeth falling out, etc). We can construct custom mouth guards for teenagers that provide the best fit. In addition we make night guards for teenage patients with teeth grinding or jaw clenching habits.

Restorative Dentistry

In all cases our goal is to keep our patients comfortable. When possible we will use our air abrasion technique. These micro abrasive particles which are propelled by a gentle air stream can quickly and
gently remove decay. Many types of cavities can be treated with air abrasion. If the decay cannot be treated this way, we will make sure the tooth is thoroughly numb using local anesthesia and topical
anesthesia.

Fillings
Depending on the size of the filling, we will numb the area using local anesthesia and place a rubber dam to protect your child's airway. We then remove the cavity, clean the tooth, and fill the tooth with a tooth colored composite material.

Stainless Steel Crowns
Crowns are used in cases where a cavity has affected so much tooth structure that filling material cannot be used to repair the tooth. We offer several types of crowns depending on the location of the cavity. For the front teeth we have white crowns. We choose which crown based on the patient's bite and the extent of the cavity. For the back teeth we have stainless steel crowns.

Nerve Treatment
Very large cavities can result in tooth aches and nerve irritation or infection. If a cavity has affected the nerve, we will clean out the infected part of the nerve, place an antibacterial medicine on the remaining nerve structure and finally place a protective filling over the nerve. Once a tooth has had nerve treatment it is weakened and must have a crown placed over it to protect it.

Behavior Management Techniques and Sedation

Tell Show Do
We use this technique on virtually all young patients. We explain to our patients what we're going to do. We show them what we're going to do. And then we do it.

Voice Control This technique is used to intercept inappropriate behavior as it begins. The dentist alters voice tone and volume to interject more authority.

Restraints
Very young children and some special needs patients are not able to understand why they need dental treatment. This technique is used to protect them from harming themselves. We only use restraints when absolutely necessary and with parents permission.

Nitrous Oxide
Some children are given nitrous oxide/oxygen, or what you may know as laughing gas, to relax them for their dental treatment. Nitrous oxide/oxygen is a blend of two gases, oxygen and nitrous oxide. Nitrous oxide/oxygen is given through a small breathing mask which is placed over the child's nose, allowing them to relax, but without putting them to sleep. The American Academy of Pediatric Dentistry, recognizes this technique as a very safe, effective technique to use for treating children's dental needs. The gas is mild, easily taken, then with normal breathing; it is quickly eliminated from the body. It is non-addictive. While inhaling nitrous oxide/oxygen, your child remains fully conscious and keeps all natural reflexes.

Prior to your appointment
Please inform us of any change to your child's health and/or medical condition.

Tell us about any respiratory condition that makes breathing through the nose difficult for your child. It may limit the effectiveness of the nitrous oxide/oxygen.

Let us know if your child is taking any medication on the day of the appointment.

Conscious Sedation
Conscious sedation is a management technique that uses medications to assist the child to cope with fear and anxiety and cooperate with dental treatment. Conscious sedation is a good option for children who have a level of anxiety that prevents good coping skills or are very young and do not understand how to cope in a cooperative fashion for the delivery of dental care.

Conscious Sedation is recommended for apprehensive children, very young children, and children with special needs. It is used to calm your child and to reduce the anxiety or discomfort associated with dental treatments. Your child may be quite drowsy, and may even fall asleep, but they will not become unconscious.

There are a variety of different medications, which can be used for conscious sedation. The doctor will prescribe the medication best suited for your child's overall health and dental treatment recommendations. We will be happy to answer any questions you might have concerning the specific drugs we plan to give to your child.

Prior to your appointment:
Please notify us of any change in your child's health and/or medical condition. Do not bring your child for treatment with a fever, ear infection or cold. Should your child become ill, contact us to see if it is necessary to postpone the appointment.

You must tell the doctor of any drugs that your child is currently taking and any drug reactions and/or change in medical history.

Please dress your child in loose fitting, comfortable clothing.

Please make sure that your child goes to the bathroom immediately prior to arriving at the office.

Your child should have nothing to eat or drink after midnight the evening before the sedation appointment.

The child's parent or legal guardian must remain at the office during the complete procedure.

After the sedation appointment:
Your child will be drowsy and will need to be monitored very closely. Keep your child away from areas of potential harm.

If your child wants to sleep, place them on their side with their chin up. Wake your child every hour and encourage them to have something to drink in order to prevent dehydration. At first it is best to give your child sips of clear liquids to prevent nausea. The first meal should be light and easily digestible.

If your child vomits, help them bend over and turn their head to the side to insure that they do not inhale the vomit.

Because we use local anesthetic to numb your child's mouth during the procedure, your child may have the tendency to bite or chew their lips, cheeks, and/or tongue and/or rub and scratch their face after treatment. Please observe your child carefully to prevent any injury to these areas.

Please call our office for any questions or concerns that you might have.

POST OPERATIVE INSTRUCTIONS

Care of the Mouth after Local Anesthetic
- Your child has had local anesthetic for their dental procedure:
If the procedure was in the lower jaw - the tongue, teeth, lip and surrounding tissue will be numb or asleep.

- If the procedure was in the upper jaw - the teeth, lip and surrounding tissue will be numb or asleep.

Often, children do not understand the effects of local anesthesia, and may chew, scratch, suck, or play with the numb lip, tongue, or cheek. These actions can cause minor irritations or they can be severe enough to cause swelling and abrasions to the tissue. Please monitor your child closely for approximately two hours following the appointment. It is often wise to keep your child on a liquid or soft diet until the anesthetic has worn off.

Please do not hesitate to call the office if there are any questions

Care of the Mouth after Trauma
Please keep the traumatized area as clean as possible. A soft was cloth often works well during healing to aid the process

Watch for darkening of traumatized teeth. This could be an indication of a dying nerve (pulp).

If the swelling should re-occur, our office needs to see the patient as-soon-as possible. Ice should be administered during the first 24 hours to keep the swelling to a minimum.

Watch for infection (gum boils) in the area of trauma. If infection is noticed - call the office so the patient can be seen as-soon-as possible.

Maintain a soft diet for two to three days, or until the child feels comfortable eating normally again.

Avoid sweets or foods that are extremely hot or cold.

If antibiotics or pain medicines are prescribed, be sure to follow the prescription as directed.

Please do not hesitate to call the office if there are any questions.

Care of the Mouth after Extraction
Do not scratch, chew, suck, or rub the lips, tongue, or cheek while they feel numb or asleep. The child should be watched closely so he/she does not injure his/her lip, tongue, or cheek before the anesthesia wears off.

Do not rinse the mouth for several hours.

Do not spit excessively

Do not drink a carbonated beverage (Coke, Sprite, etc.) for the remainder of the day.

Do not drink through a straw.

Keep fingers and tongue away from the extraction area

Bleeding - Some bleeding is to be expected. If unusual or sustained bleeding occurs, place cotton gauze firmly over the extraction area and bite down or hold in place for fifteen minutes. This can also be accomplished with a tea bag. Repeat if necessary.

Maintain a soft diet for a day or two, or until the child feels comfortable eating normally again.

Avoid strenuous exercise or physical activity for several hours after the extraction.

Pain - For discomfort use Children's Tylenol, Advil, or Motrin as directed for the age of the child. If a medicine was prescribed, then follow the directions on the bottle.

Please do not hesitate to contact the office if there are any questions.

Care of Sealants
By forming a thin covering over the pits and fissures, sealants keep out plaque and food, thus decreasing the risk of decay. Since, the covering is only over the biting surface of the tooth; areas on the side and between teeth cannot be coated with the sealant. Good oral hygiene and nutrition are still very important in preventing decay next to these sealants or in areas unable to be covered.

Your child should refrain from eating ice or hard candy, which tend to fracture the sealant. Regular dental appointments are recommended in order for your child's dentist to be certain the sealants remain in place.

The American Dental Association recognizes that sealants can play an important role in the prevention of tooth decay. When properly applied and maintained, they can successfully protect the chewing surfaces of your child's teeth. A total prevention program includes regular visits to the dentist, the use of fluoride, daily brushing and flossing, and limiting the number of times sugar-rich foods are eaten. If these measures are followed and sealants are used on the child's teeth, the risk of decay can be reduced or may even be eliminated!

Oral Discomfort after a Cleaning
A thorough cleaning can sometimes produce some bleeding and swelling and may cause some tenderness or discomfort. This is not due to a "rough cleaning" but, to tender and inflamed gums from insufficient oral hygiene. We recommend the following for 2-3 days after cleaning was performed:

1.) A warm salt water rinse 2 - 3 times per day (1 teaspoon of salt in 1 cup of warm water)

2.) For discomfort use Children's Tylenol, Advil, or Motrin as directed for the age of the child.

Please do not hesitate to contact the office if the discomfort persists for more than 7 days or if there are any questions.