Common Treatments

Fluoride

Your child brushes twice a day, flosses regularly, and visits the dentist every six months. But did you know that rinsing with fluoride – a mineral that helps prevent cavities and tooth decay – also helps keep teeth healthy and strong? Fluoride is effective in preventing cavities and tooth decay by coating teeth and preventing plaque from building up and hardening on the tooth’s surface.

Fluoride comes in two varieties, systemic and topical:

• Systemic fluoride is ingested, usually through a public water supply. While teeth are forming under the gums, the fluoride strengthens tooth enamel, making it stronger and more resistant to cavities.
• Fluoride can also be applied topically to help prevent caries (cavities) on teeth present in the mouth. It is delivered through toothpaste, mouthwash, and professional fluoride applications. Professional application of topical fluoride foam and varnishes is also a valuable tool in cavity prevention.

Receiving a fluoride treatment from your dentist

A fluoride treatment in the dentist’s office takes just a few minutes. After the treatment, patients may be asked to not 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 your doctor’s recommendation, your child may be required to have a fluoride treatment every three, six, or 12 months. Your doctor may also prescribe at-home fluoride products such as mouthwash, gels, or antibacterial rinses.

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 reach 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 after their permanent teeth have erupted as a preventive measure against 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 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.

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. Other times, a tooth may have so much decay that it puts the surrounding teeth and jaw at risk. Infection, orthodontic correction, or problems with a wisdom tooth can also require removal of a tooth.

If it is determined that your child’s tooth needs to be removed, your pediatric dentist may extract the tooth during a regular checkup or may schedule 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 your dentist any concerns or preferences for sedation; we want to make sure your child is as comfortable as possible.

The day after your child’s extraction:

• No drinking with straws
• No vigorous rinsing and spitting
• A soft diet is recommended; no eating of popcorn, pretzels, pizza, crackers, or any food with sharp edges
• If your child has any discomfort, give a children’s dose of Advil® or Tylenol®
• If your child experiences swelling, apply a cold cloth or an ice bag and call our office

Crowns

Crowns are a restorative procedure used to improve a tooth’s shape or to strengthen a tooth. Crowns are most often used if your child has a tooth that is broken, worn, or damaged by tooth decay, and too damaged to hold a filling.

A crown is a “cap” cemented onto an existing tooth that usually covers the portion of the tooth above the gum line. In effect, the crown becomes the tooth’s new outer surface. Crowns can be made of porcelain, metal, or both. Porcelain crowns are most often preferred on the front teeth because they mimic the translucency of natural teeth, while metal or a porcelain-fused metal (PFM) crowns are best on back teeth because of their strength.

Unlike fillings, which are applied directly onto your child’s tooth, a crown is fabricated in our lab and is based on an impression taken of your child’s mouth. We sculpt each crown for your child so that his or her bite and jaw movements function normally once the crown is placed.

Stainless Steel Crowns

Stainless steel dental crowns are considered a good temporary restoration to save a primary tooth until the permanent tooth can erupt and take its place. Keeping the primary tooth if at all possible is very important. A primary tooth can be restored with a stainless steel crown during one appointment.

Zirconia Crowns

Zirconia dental crowns are made from zirconium dioxide, a white powdered ceramic material. When milled from a solid block, zirconia is more durable and stronger than other types of ceramic crowns. The smoothness of zirconia also minimizes wear and tear on the adjacent teeth.

The strength of zirconia not only helps it last longer, it also means the crown can be thinner than a traditional crown and require less removal of the healthy tooth structure below it for placement. It is always best to keep as much natural tooth as possible, both for longevity of the crown and the tooth itself.

EZCrowns™ All-Ceramic Zirconia Crowns

EZCrowns by Sprig Oral Health are the world’s first tooth-colored, prefabricated zirconia crowns especially designed for children’s primary teeth. They are created from a solid block of zirconia, much like highly aesthetic crowns made for adults.

• Safe: EZCrowns are 100% biocompatible—free of all metals, including nickel, which is commonly used in stainless steel crowns—to eliminate adverse allergic reactions or side effects.
• Aesthetic: EZCrowns have a realistic color that allows them to visually blend in with surrounding natural teeth. Each crown is glazed with a hint of natural color, making them very smooth, shiny, and resistant to staining and plaque buildup.
• Strong: EZCrowns are made of solid, monolithic Zirconia, a ceramic material time-tested for its strength and durability in adult dentistry.

Space Maintenance 

If your child’s tooth has come out too soon because of decay or an accident, it is important to maintain the space to prevent future space loss and dental problems when permanent teeth begin to come in. Without the use of a space maintainer, the teeth that surround the open space can shift, impeding the permanent tooth’s eruption. When that happens, the need for orthodontic treatment may become greater.

Types of Space Maintainers

Space maintainers can be made of stainless steel and/or plastic, and can be removable or fixed (cemented to the teeth).

• Removable - A removable space maintainer looks much like a retainer with plastic blocks to fill in where the tooth is missing. If your child is older and can reliably follow directions, a removable space maintainer can be a good option.

• Fixed - Fixed space maintainers come in many designs.

A band-and-loop maintainer is made of stainless steel wire and held in place by a crown or band on the tooth adjacent to the empty space. The wire is attached to the crown or loop and rests against the side of the tooth on the other end of the space.

A lingual arch is used on the lower teeth when the back teeth on both sides of the jaw are lost. A wire is placed on the lingual (tongue) side of the arch and is attached to the tooth in front of the open space on both sides. This prevents the front teeth from shifting backwards into the gap.

In the case of a lost second primary molar prior to the eruption of the first permanent molar, a distal shoe may be recommended. Because the first permanent molar has not come in yet, there is no tooth to hold a band-and-loop space maintainer in place. A distal shoe appliance has a metal wire that is inserted slightly under the gum and will prevent the space from closing.

Caring for Your Child’s Space Maintainer

There are four general rules for taking care of your child’s appliance.

• Your child should avoid sticky foods, including candy and chewing gum.
• Encourage your child not to push or tug on the space maintainer with the fingers or tongue.
• Keep your child’s space maintainer clean through effective brushing and flossing.
• Your child should continue to see the pediatric dentist for regular dental visits.