Common Procedures


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exams and cleanings

Regular Exams and Cleanings | Stainless Steel Crowns | White Faced Crowns | Zirconia Crowns | Extractions | Space Maintaniers | Fillings | Fluoride | Mouthguards | Nightguards | Root Canals | Sealants | Wisdom Teeth

Regular Exams and Cleanings

Regular exams are an important part of maintaining your child's oral health. During your child’s regular exam, we will:

  • Check for any problems that may not be seen or felt
  • Look for cavities or any other signs of tooth decay
  • Inspect the teeth and gums for gingivitis and signs of periodontal disease
  • Perform a thorough teeth cleaning

Your child’s exam will take about 45 minutes. Each regular exam includes a detailed teeth cleaning, in which we will clean, polish, and rinse the teeth to remove any tartar and plaque that have built up on the tooth’s surface.

Visiting our office every six months gives you the chance to talk to the doctor about any questions you may have about your child’s oral health. Regular exams are offered by appointment only, so please contact our practice today to schedule your child’s next dental exam and teeth cleaning.

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Stainless Steel Crowns

A crown is also known as a cap. It sits on the tooth as a protective cover to prevent a tooth from chipping or breaking when chewing. A crown extends the life of the tooth.

Primary crowns are typically placed when a patient is at high risk for decay due to poor oral hygiene or rampant decay or when more than 2 teeth with two or more surfaces that need treatment. Primary crowns are routinely placed as the treatment of choice in these patients as guidelines from the American Academy of Pediatric Dentistry indicated. Stainless Steel Crowns can also be placed on permanent teeth as well.

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White Faced Stainless Steel Crowns

To make the stainless steel crowns look more esthetic, especially on the front teeth, stainless steel crowns are available with a pre-veneered plastic facing. These crowns look better because from the front they look “white.” In order for the white facing to adhere to the metal, extra bulk must be added, making these crowns look bulbous or rounded. The white facing also has a tendency to chip off over time, exposing the silver crown underneath. Chipping can occur when children grind their teeth or as a result of chewing forces on back teeth.

It is important to note that the cement used for this procedure is Fugi Glass Ionomer.
A thick mix of cement is mixed by the dental assistant using 1 drop of powder and 1 drop of the liquid.

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Zirconia Crowns

Anterior crowns for primary teeth can be white in color, so they are very hard and esthetically beautiful. The procedure and indications are very similar to stainless steel crowns. White crowns take longer to prepare, require more reduction of the tooth, are more expensive, and typically are only used on the front 6 teeth, and are not covered by Medicaid.

Pediatric zirconia crowns, like stainless steel crowns, come premade in six or seven different sizes for each tooth and are supplied in kits. To place the crowns, the caries is removed and the tooth prepared with occlusal and circumferential reduction to a gingival featheredge. An appropriately sized crown is then tried onto the preparation. If the crown does not fit, either another size is tried or more tooth reduction is done until a crown is passively seated onto the preparation.

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extractionsThere 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. At other times, a tooth may have so much decay that it puts the surrounding teeth at risk of decay, so the doctor may recommend its removal. Infection, orthodontic correction, or problems with a wisdom tooth can also require removal of a tooth.

When it is determined that a tooth needs to be removed, your child’s dentist may extract the tooth during a regular checkup or may request 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 the doctor any concerns or preferences for sedation.

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Space Maintaniers

An empty space in the mouth due to a missing tooth is an unhealthy condition. If left untreated, empty spaces will eventually result in the loss of more teeth or crowding.

In our office when a tooth is missing or has to be extracted, a space maintainer is recommended. Space maintainers are appliances made of metal that are custom fit to the mouth or tooth. They are small and unobtrusive in appearance. Most children easily adjust to them after the first few days.

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Almost everyone has had a cavity at some point in his or her life, mostly during childhood. This office uses both amalgam (or silver fillings) and composite (or white filling) material when restoring cavities.

A cavity is a hole in the tooth resulting from decay. It usually comes from food matter on the tooth that has not been removed. This food matter then eats away the tooth. A cavity can be very big or as tiny as a pinhole. No matter the size, once a hole is there, it must be filled or it will only get bigger.

Our office recommends amalgam fillings in most scenarios. An amalgam restoration can last 15 or more years and a composite usually lasts about 5 to 7 years with regular dental visits. After this time, the material starts wearing down and may become “leaky” (meaning, that saliva and plaque begins seeping through the filling and decaying the tooth underneath the filling). This occurrence is not unusual and happens to almost everyone. The treatment is to remove the old filling and place a new one.

At first, fillings may be sensitive to cold or hard food items. This sensitivity is normal. The tooth is simply adjusting to the filling. Depending on the size of the filling, the sensitivity may last 5 – 6 months. However, if a patient complains of pain when chewing on the tooth, the doctor needs to see the patient. The new filling may be too high: thereby, causing pain when chewing. This is quickly and easily corrected by the dentist (usually in about 1 minute) by removing high spots on the filling with a handpiece and finishing burr.

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Fluoride is effective in preventing cavities and tooth decay and in preventing plaque from building up and hardening on the tooth’s surface. A fluoride treatment in a dentist’s office takes just a few minutes. After the treatment, your child may be asked not to 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 the doctor’s recommendation, a fluoride treatment may be required every three, six, or 12 months.

Please click here for more information and consent for Silver Diamine Fluoride with Fluoride Varnish Therapy to Arrest Decay - PDF

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Whether your child wears braces or not, protecting his or her smile while playing sports is essential. Mouthguards help protect the teeth and gums from injury. If your child participates in any kind of full-contact sport, the American Dental Association recommends that he or she wear a mouthguard. Choosing the right mouthguard is essential. There are three basic types of mouthguards: the pre-made mouthguard, the “boil-and-bite” fitted mouthguard, and a custom-made mouthguard from the dentist. When you choose a mouthguard, be sure to pick one that is tear-resistant, comfortable and well-fitted for your mouth, easy to keep clean, and does not prevent your child from breathing properly. Your dentist can show your child how to wear a mouthguard properly and how to choose the right mouthguard to protect his or her smile.

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If your child often wakes up with jaw pain, earaches, or headaches, or if you see your child clenching or grinding his or her teeth, your child may have a common condition called “bruxism”. Many people do not even know that they grind their teeth, as it often occurs when one is sleeping. If not corrected, bruxism can lead to broken teeth, cracked teeth, or even tooth loss.

There is an easy, non-invasive treatment for bruxism: nightguards. Nightguards are an easy way to prevent the wear and damage that teeth-grinding causes over time. Custom-made by a dentist from soft material to fit the teeth, a nightguard is inserted over your child’s top or bottom arch and prevents contact with the opposing teeth.

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Root Canals

root canals

In the past, if your child had a permanent tooth with a diseased nerve, he or she would probably lose that tooth. Today, with a special dental procedure called “root canal treatment”, your child’s tooth can be saved. When a tooth is cracked or has a deep cavity, bacteria can enter the pulp tissue and germs can cause an infection inside the tooth. If left untreated, an abscess may form. If the infected tissue is not removed, pain and swelling can result. This can not only injure your child’s jawbones, but it is also detrimental to his or her overall health.

Root canal treatment involves one to three visits. During treatment, the dentist will remove the affected tissue. Next, the interior of the tooth will be cleaned and sealed. Finally, the tooth is filled with a dental composite. If the tooth has extensive decay, your doctor may suggest placing a crown to strengthen and protect the tooth from breaking. As long as your child continues to care for his or her teeth and gums with regular brushing, flossing, and checkups, the restored tooth can last a lifetime.

Please click here for information on endodontic treatment and consent:

Endodontic Information and Consent Form - PDF

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sealantsSometimes 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 get in between the small cracks and grooves on your child’s 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 a plastic resin that bonds and hardens in the deep grooves on your child’s tooth’s surface. When a tooth is sealed, the tiny grooves become smooth and are less likely to harbor plaque. With sealants, brushing your child's teeth becomes easier and more effective against tooth decay.

Sealants are typically applied to children’s teeth as a preventive measure against tooth decay after the permanent teeth have erupted. It is more common to seal “permanent” teeth rather than “baby” teeth, but every patient has unique needs, and your child’s dentist will recommend sealants on a case-by-case basis.

Sealants last from three to five years, but it is fairly common to see adults with sealants still intact from their childhood. A dental sealant only provides protection when it is fully intact, so if your child’s sealants come off, let your dentist know, and schedule an appointment for your child's teeth to be re-sealed.

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Wisdom Teeth

wisdom teethWisdom teeth are types of molars found in the very back of your child’s mouth. These teeth usually appear in late teens or early 20s, but they may become impacted (fail to erupt) due to lack of room in the jaw or angle of entry. When a wisdom tooth is impacted, it may need to be removed. If it is not removed, your child may develop gum tenderness, swelling, or even severe pain. Impacted wisdom teeth that are partially or fully erupted tend to be quite difficult to clean and are susceptible to tooth decay, recurring infections, and even gum disease.

Wisdom teeth are typically removed in the late teens or early twenties because there is a greater chance that the tooth’s roots have not fully formed and the bone surrounding the teeth is less dense. These two factors can make extraction easier as well as shorten the recovery time.

In order to remove a wisdom tooth, your child’s dentist first needs to numb the area around the tooth with a local anesthetic. Since the impacted tooth may still be under the gums and embedded in your jaw bone, the dentist will need to remove a portion of the covering bone to extract the tooth. In order to minimize the amount of bone that is removed with the tooth, the dentist will often “section” the wisdom tooth so that each piece can be removed through a small opening in the bone. Once your child’s wisdom teeth have been extracted, the healing process begins. Depending on the degree of difficulty related to the extraction, healing time varies. Your child's dentist will share with you what to expect and provide instructions for a comfortable, efficient healing process.

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