Treatments

Sealants

Normal pits and grooves on the chewing surfaces of back teeth can trap food that can't be removed by brushing or washed out by water or saliva. A sealant is a tough, plastic material designed to bond (stick) to tooth enamel.

The Problem:

  • Protect normal pits and grooves on the chewing surface of back teeth.
  • Stop small amounts of decay from growing larger.

The Solution:

A clear or tooth colored sealants is painted onto the tooth surface to "seal" the pits and grooves and protect against decay. They are generally applied to children's first permanent back teeth. They can also be useful for adults in certain situations.

Advantages

Sealants are an excellent way to protect chewing surfaces of teeth from decay. They are a much better financial investment than treating decay after it has started.

Disadvantages:

Sealants are not permanent. They generally last about five years with normal wear, but can wear off or chip off earlier in certain instances. Also, sealants do not prevent decay between teeth or the onset of gum disease, so regular home care and dental visits are important.

Alternatives:

There are no appropriate alternatives to sealants. If a tooth has decay, it will need a filling or other restoration.

Fillings

An inexpensive way to restore a small amount of tooth decay.

The Problem:

Decay on a small portion of any tooth.

The Solution:

A composite filling is a tooth colored quartz-like material. After tooth decay is removed and cleaned, this tooth colored material is layered into the tooth. Each layer is hardened or cured with highly intense visible light, and the final surface is shaped and polished to match the tooth. The final restoration is virtually invisible.

Advantages:

White Fillings:
Composite fillings are more than just attractive. They require minimal tooth preparation, in other words less healthy tooth structure is removed to restore the tooth. Also, a sealant can be placed over the remaining exposed grooves of the tooth to minimize the risk of decay on another area of the tooth.

Disadvantages:

White Fillings:
Composite fillings can be subject to wear and tear from tooth grinding and from biting into or chewing on hard objects etc.

Alternatives:

In cases of extensive decay or if the baby tooth required a pulpotomy, a crown is the best option. If the decay is not treated, it will most likely increase in size and become a larger problem.

Crowns (Caps)

Protect and keep badly decayed or fractured teeth.

The Problem:

  • Badly decayed teeth.
  • Fractured teeth.
  • Need to protect and strengthen teeth.
  • Tooth has had a baby root canal "pulpotomy".

The Solution:

A crown (often called a cap) covers the tooth and restores it to its original shape and size. Decay is removed and cleaned from the tooth and a preformed crown is placed over the tooth. Unlike adult crowns, in which the crown is made to fit the tooth, which require 2 appointments, baby crowns are placed in one visit, because the tooth is prepared to fit the crown.

Advantages:

Crowns are incredibly strong due to the fact that they are cover the entire tooth. This protects and strengthens the remaining tooth structure. They are the best chance for survival of a tooth that has had a baby root canal.

Disadvantages:

Crowns are excellent restorations and have few disadvantages, however most children's crowns are silver in color.

Alternatives:

Typically there are no good alternatives to crowns. If the tooth has sustained enough damage to require a crown then the best prognosis for the tooth is to receive the crown. Placing a filling on a tooth that should have a crown will likely result in fracture, recurrent decay, and loss of that tooth.

Space Maintainers

The Problem:

Premature loss of your child's baby tooth.

The Solution:

Space maintainer -- a combination of bands and wires designed to hold the remaining teeth in a position that will allow the future permanent tooth to erupt in the proper location.

Advantages:

Prompt placement of a space maintainer will give the permanent tooth the best chance of erupting in the mouth in the correct location. This will minimize orthodontic problems caused by premature loss of a baby tooth.

Disadvantages:

Your child will need to wear the appliance until the permanent tooth erupts. If not kept clean decay can occur under the bands.

Alternatives:

If a space maintainer is not placed, the teeth will shift into the open area, making it difficult or in some cases impossible for the permanent tooth to erupt. This requires orthodontics to remedy.

Pulpotomy, "Baby Root Canal"

The Problem:

Decay that has reached the nerve/pulp of the baby tooth.

The Solution:

Like adult root canals, the dentist will access the nerve chamber of the tooth, and remove some of the nerve/pulp of the tooth. Unlike adult root canals, this is a very short procedure, as only part of the pulp needs to be removed, and does not require the time consuming filing of adult root canals.

Advantages:

  • If the tooth has been symptomatic this procedure will likely alleviate the pain.
  • Allows for the tooth to be preserved until it is ready to fall out naturally.

Disadvantages:

Pulpotomies have a 90% success rate. Occasionally, the nerve of the tooth is so badly damaged that it does not respond to pulp therapy, resulting in the need for extraction of the offending tooth. Certain circumstances increase the likelihood of failure with pulpotomies, your dentist will discuss your child's situation with you during diagnosis.

Alternatives:

The only alternative to a pulpotomy is extraction, and placement of a space maintainer. However, if it is possible to save the baby tooth, this is the best alternative because it preserves the appropriate spacing for the adult dentition.

Mouthguards

What are mouthguards?

Athletic mouth protectors are comprised of soft plastic. They come in standard or custom fit to adapt comfortably to the upper teeth.

Why are mouth guards important?

Mouth guards protect the teeth from possible sport injuries. They not only protect the teeth, but the lips, cheeks, tongue and jaw bone as well. They can contribute to the protection of a child from head and neck injuries such as concussions. Most injuries occur to the mouth and head area when a child is not wearing a mouth guard.

When should my child wear a mouth guard?

During any sports based activity where there is risk of head, face or neck injury. Such sports include Hockey, Soccer, Karate, Basketball, Baseball, Skating, Skateboarding, as well as many other sports. Most oral injuries occur when children play basketball, baseball and soccer.

How do I select a mouth guard for my child?

Choose a mouth guard that your child feels is comfortable. If a mouth guard feels bulky or interferes with speech to a great degree, it is probably not appropriate for your child.

There are many options in mouth guards. Most guards are found in athletic stores. These vary in comfort, protection as well as cost. The least expensive tend to be the least effective in preventing oral injuries. Customized mouth guards can be provided through our practice.

Orthodontic Treatment

Orthodontics is the branch of dentistry that specializes in the diagnosis, prevention and treatment of dental and facial irregularities. The technical term for these problems is "malocclusion," which means "poor bite."

The outcome of orthodontic treatment can be dramatic - beautiful smiles, improved dental health and an enhanced quality of life for people of all ages. Orthodontic problems must be diagnosed before treatment begins. Proper diagnosis involves careful study of photographs, x-rays, and dental impressions.

Pediatric dentists are trained to monitor and evaluate growth and development of the teeth and supporting bone structure. As your child grows we will determine when orthodontic intervention is necessary.

What Is the Right Age for Orthodontic Treatment

Every child is different and has different needs. Some children are in need of early orthodontic treatment (phase I) to help modify growth and development. Phase I can include retainers, expanders and headgear. Other children can wait for traditional braces (phase II) when they have all their permanent teeth.

What is Crossbite?

One or more of the upper teeth biting on the inside of the lower teeth characterizes a crossbite. Crossbite can occur in the front and/or the sides of the mouth. Early correction of a crossbite is recommended.

What is Openbite?

Your child has an openbite if you ask him/her to bite their teeth together and they are unable to touch the top front teeth to the bottom front teeth. An openbite can be caused by oral habits such as tongue thrust, digit sucking, or when the upper and lower jaws do not grow evenly.

What is Overbite?

Overbite is a measure of the vertical overlap of the upper and lower front teeth. Excessive overbite may be caused by disproportionate eruption of front teeth, or over development of the bone that supports the teeth. Excessive overbite is commonly seen in conjunction with a Class II relationship (see below). Overbite is also known as a deep bite.

What is Overjet?

Overjet is measure of the horizontal relationship of the upper and lower front teeth. It is often called "buck teeth", and is commonly confused with overbite. Excessive overjet may be caused by improper alignment of the molars (Class II relationship); a skeletal imbalance of the upper and lower jaw(s); flared upper incisors; missing lower teeth; crowded or tipped back lower teeth, or a combination of all the above. In addition, oral habits such as thumb or finger sucking or tongue thrusting can exacerbate the condition.

What is Underbite?

The lower teeth biting in front of the upper teeth characterize an underbite. An underbite is usually caused by undergrowth of the upper jaw, overgrowth of the lower jaw, or a combination of the two (Class III Relationship). Underbite can also be caused by tipped back upper incisors, flared lower incisors, missing upper teeth or a combination of all the above. Early correction of underbite is recommended.

What are Impacted Teeth?

An impacted tooth is one that has failed to erupt normally into the mouth and remains partially or totally covered by the gums and/or bone. Impactions can be caused by improper position of the developing tooth bud, premature loss of primary teeth, and crowding. Wisdom teeth are the most commonly impacted teeth, but canines and premolars are also commonly impacted.

Missing Teeth

Missing teeth can be the result of congenital absence (the tooth fails to develop), trauma, or dental extractions.

Crowding of the Teeth

Crowding is the lack of space for all the teeth to fit normally within the jaws. The teeth may be rotated or displaced. Crowding occurs when there is disharmony in the tooth to jaw size relationship, or when the teeth are larger than the available space. Crowding can be caused by early or late loss of primary teeth, improper eruption of teeth, or a genetic imbalance between jaw and tooth size.

Spacing of the Teeth

Spacing, the opposite of crowding, is an excess of available space, resulting in gaps between the teeth. This generally occurs when the teeth are smaller than the available space. Protrusive teeth, missing or impacted teeth, or abnormal gum tissue attachments can also cause spacing.

Spacing in primary teeth is good to see because the permanent teeth are always bigger than the primary teeth. The extra space allows for the new teeth to have room to erupt.