Pediatric Dental Services

Below you will find a list of services we provide along with some explanations/definitions that may help answer some questions you may have about the various types of dental treatments available. In addition to providing these services with the utmost quality of care, we strive to do so in a way that will provide children with an experience that is not only comfortable but also pleasant. For more information on Pediatric Dentistry please visit the American Academy of Pediatric Dentistry’s Parent Resource Page at: http://www.aapd.org/resources/parent_resources/

Preventive Dental Care:

The goal of preventive dentistry is to maintain good oral health so that children can have a healthy mouth and a healthy smile. Examinations are performed to check for overall dental health, tooth decay (cavities), gingivitis (gum disease), proper growth and development, signs of trauma and/or infection. Preventive care appointments are recommended every six months and include the following: Diet and oral hygiene counseling, dental cleanings, fluoride treatments, x-rays as needed, and orthodontic evaluations and referrals when necessary.

Infant oral health care:

Examination of infant’s teeth (starting with the eruption of the first tooth or by age one) to ensure the teeth are erupting properly, evaluation of overall oral health, and discussion of diet and feeding habits. This is all in an effort to establish a dental home, promote excellent oral health, and prevent dental problems from arising. This first appointment provides parents with the opportunity to ask questions and aids in allowing the infant to get used to regular dental visits.

Sealants:

An adhesive coating (typically tooth colored) applied to the biting surfaces of the teeth to help prevent cavities. Sealants are most commonly applied to the permanent molars because these teeth have many surface grooves and pits that are difficult to clean and are often susceptible to getting cavities. Sealants do not last forever and occasionally need to be touched up. In addition, they are only effective if they are accompanied by good brushing and flossing habits and a healthy diet.

Restorative Dental Care (Fillings, Crowns):

Fillings: When teeth have small cavities, on one or more surfaces, they can be restored/treated with a composite restoration (tooth colored filling material).

Crowns: If the cavity is fairly large, on multiple surfaces, or if the tooth requires a partial or full root canal treatment, it will most likely need to be restored/treated with a stainless steel (silver) crown. Stainless Steel Crowns are also used as temporary restorations on permanent molars that are either severely broken down or have had root canal treatment. Under these circumstances, they are used until the child has completed growth (usually around 18 years old) and then are replaced by a more permanent Porcelain Crown.

Root Canals (Pulpotomies and Pulpectomies on Primary Teeth (Baby teeth):

In primary (baby) teeth, if the cavity is so deep that it has reached the nerve of the tooth, and if the nerve is still alive, a portion of the nerve is removed and a medicine is placed inside the tooth to help disinfect the remaining nerve tissue. This treatment is known as a Pulpotomy or a partial root canal treatment. If the cavity has reached the nerve, and the nerve is dead, then the entire nerve must be removed and a medicament placed inside the entire root canal system. This treatment is known as a Pulpectomy or a full root canal treatment.

Extractions:

If a tooth is decayed beyond the point to which it can be restored (either with a filling or a crown) and/or if the tooth is so infected that a root canal cannot save it, it must be extracted (pulled).

Space maintainers:

If a primary (baby) tooth (typically a molar) is lost prematurely a space maintainer may be needed to hold the space for the permanent tooth. The space maintainer will help prevent the surrounding teeth from tipping/moving into the space. There are different types of space maintainers available and we always select the type that is best for your child.

Emergency/Trauma Care (24 hours):

In case of an emergency, such as dental trauma, the doctor is on call 24 hours a day and can be reached via her pager. (The pager number is available on our office voice mail at the end of the message).

Adjunctive Services

Although many children enjoy visiting the dentist and are extremely cooperative for their appointments, there are some children, especially the very young ones, who are fearful and anxious and therefore may have a difficult time cooperating. If a child is unable to cooperate due to their young age, fear, and/or anxiety, there are several adjunctive services (listed below) available to help them receive the treatment they need.

Nitrous Oxide/Oxygen Analgesia (Laughing gas):

Nitrous Oxide is a safe and effective gas that is used in combination with oxygen to help decrease anxiety and make dental appointments easier for children who are anxious/nervous/scared. The gas does not put the child to sleep but rather relaxes them to the point that they are more comfortable, less afraid, and able to tolerate treatment. The child must be willing and able to breathe through his/her nose in order for this to work. Not all children require Nitrous Oxide, but for those who do it can be very effective in helping them get through their dental procedure.

Sedation:

In cases where children are not able to tolerate dental treatment on their own, when Nitrous Oxide alone does not work, and when there are limited treatment needs, an oral sedative, such as Valium, can be given to the child to help them relax even more. Under such circumstances, and for your child’s safety, we ask that you arrive one hour early to your appointment so the doctor can administer the medication and monitor your child prior to beginning treatment. In addition to the Valium, the doctor will also use Nitrous Oxide/Oxygen Analgesia and will monitor the child’s vital signs with a pulse oximeter throuhgout the procedure. Valium is a very mild sedative with minimal side effects and does not put children to sleep, but rather relaxes them in an effort to help them tolerate the procedure better.

Treatment under General Anesthesia in a Hospital Setting:

In cases where a child is not able to tolerate dental treatment in the office, with or without the use of Nitrous Oxide and/or Sedation, and when there are extensive treatment needs, treatment in the operating room under general anesthesia may be necessary. This service is typically a two hour surgical procedure in the hospital in which the child is put completely to sleep by a medical anesthesiologist and a breathing tube is placed. The dentist then performs all of the necessary dental treatment while the child is asleep and being monitored by the anesthesiologist. We perform our surgical procedures at the Children’s National Medical Center in Washington, D.C.