For most dental procedures, a local anesthetic is used to numb a specific tooth or area of the mouth. The dentist or hygienist will inject the anesthetic prior to the procedure.
Pediatric Dental Associates never uses words that could frighten children, such as “shot” or “needle.” Instead, phrases like “putting the tooth to sleep with sleepy juice” are used.
Distraction and calming techniques are helpful when giving local anesthesia to divert the little patient’s attention from the injection. After the child has received a local anesthetic, he or she is monitored closely to prevent biting of the tongue, lip, or cheek.
A cotton roll is placed in the mouth after the procedure and the parent or guardian is asked to monitor the youngster closely to prevent unnecessary injury to the mouth. It usually takes about two hours for the anesthesia to wear off.
Dental fillings are the most common restorative procedure performed in a dental office. We explain to young children that their tooth will be “washed” to remove “sugar bugs” with a “water whistler” or “tooth tickler.”
After the decay is removed, a filling is placed to restore the form and function of the tooth. Placement of a filling is often referred to as a “painting” or “picture” on the tooth. Pediatric Dental Associates offers white, tooth-colored fillings.
Pulpotomy (Baby Root Canal)
Decay progresses much more quickly in baby teeth and can enter the pulp, or nerve chamber, before the child complains of a toothache. In cases where decay has approximated the pulp of the tooth, a pulpotomy or “baby root canal” is recommended.
The procedure involves the removal of the largest part of the nerve. A medicated material is placed into the nerve chamber of the tooth. The tooth is essentially vital, although all perception of pain or temperature is gone.
Following this procedure, a stainless-steel crown is placed over the top of the tooth. The purpose is to treat the tooth so it will be comfortably maintained until normal exfoliation time.
Baby teeth are not compatible with large fillings. More than 30% of large fillings placed on baby teeth fail within 18 to 20 months of placement. Therefore, stainless-steel crowns are recommended for baby molar teeth with significant decay.
This type of restoration covers the entire tooth and is particularly essential for younger children who need their molars for a number of years. The procedure can be done in one appointment.
The decay is removed and the tooth is prepared so the crown will fit over the top of the tooth. Once the appropriate size is selected for the tooth, the crown is secured to the tooth with adhesive cement. The gums around the tooth may be tender for a few days.
Esthetic Veneered Crown
Large cavities on the front baby teeth of a young child should be restored with full-coverage crowns, the sturdiest restoration for these teeth. Aesthetic veneered crowns are stainless-steel crowns with a white coating on the front to maintain natural aesthetics and normal psychological development. Placement of an aesthetic veneered crown follows the same procedure as a traditional stainless steel crown.
Extractions may need to be performed for such reasons as: severe decay, infection or abscess, trauma, or orthodontic purposes. Children are guided through the procedure by phrases such as “pushing on the tooth” or “wiggling for the tooth fairy.”
After tooth removal, the patient should remain on a soft diet (no crunchy foods) until the extraction site has healed. Also, gentle brushing is encouraged to keep the area clean and promote healing.
A space maintainer is applied when a baby tooth (usually a molar) is lost early due to decay or injury. Adjacent and opposing teeth may move and shift into the space of a prematurely lost baby tooth, which can create problems for the permanent tooth that needs to erupt into that space. A space maintainer helps to preserve the space for the permanent tooth.
There are two types of space maintainers. A band-loop space maintainer is used when space maintenance is needed on only one side or if the permanent molars have not erupted yet.
A loop of wire is attached to either a crown or a band on the tooth adjacent to the space of the prematurely lost baby tooth. The wire extends across the space to “hold” or preserve it.
If the child has permanent molars, a bilateral space maintainer may be recommended, especially if a primary second molar is lost. Bilateral space maintainers are attached to bands on the permanent molars with a wire running behind all of the teeth.
Space maintainers are fixed in the mouth with adhesive cement and are removed when the permanent tooth erupts. It is crucial to keep the appliance clean and avoid sticky foods to prevent loosening of the space maintainer.
Nitrous oxide, commonly known as “laughing gas,” is used to reduce anxiety during dental treatment. Nitrous oxide is given through a small breathing mask that is placed over the child’s nose. With normal breathing, the nitrous oxide enters the lungs and has a mild sedative effect.
The child is still awake but pain and time perception are altered. Nitrous oxide is a very safe and effective technique to use for treating children’s dental needs. The gas is mild, non-allergenic, has a rapid onset, is reversible, and is quickly eliminated from the body.
While inhaling nitrous oxide, the child remains fully conscious and keeps all natural reflexes.