Restorative Dentistry
Restorative dentistry is performed to treat or replace missing or damaged teeth. Whether your child experienced a dental injury, developed a cavity, or has an aesthetic or functional dental concern, we can effectively restore teeth to ensure a healthy smile and a beautiful appearance. It involves:
Cavity Fillings
The first step is to assess the severity of the decay. This will be done by taking x-rays and/or using a special dental instrument called an explorer to check for cavities. If the decay is found to be in its early stages, a fluoride treatment may be all that is needed. However, dental fillings will be necessary if the decay has progressed to the point where cavities have formed.
The most common dental filling used for children is a composite (tooth-colored) filling. Composite fillings are made of a resin material that can be matched to the color of your child’s teeth. It is made from mixtures of plastic and glass. This type of filling is less noticeable than other types of fillings and can be used on both front and back teeth. We also use fillings made of Glass Ionomer Cement (GIC) that contain fluoride to make teeth more resistant to cavities, making it more suitable for baby teeth that are more prone to decay.
The first step is to anesthetize the area around the tooth so the child will not feel any pain during the procedure. Once the area is numb, the pediatric dentist will remove the decay from the tooth and clean it out. The next step is placing the filling material into the cavity and shaping it. Once the filling is in place, it is hardened with a special light. After the filling is placed, your child may complain about increased sensitivity to hot and cold temperatures for a few days. This is typical and should go away within a week or two.
With appropriate care, dental fillings can last for over five years. Brushing regularly and seeing a children’s dentist for regular checkups are essential, so any problems with the filling can be caught early.
Root Canal Treatment for Baby & Adult Teeth
When a tooth is damaged, the pulp located inside the tooth can become inflamed and infected. If left untreated, the infection can spread to the tooth’s root and form an abscess. The infection is very painful and will not go away without treatment.
The infection within your child’s tooth is undoubtedly causing them severe pain. A root canal procedure, on the other hand, will not. Your child shouldn’t feel any pain during the root canal because of the local anesthetic or sedative. Afterwards, they will feel some discomfort and sensitivity. Ibuprofen and other pain relievers will help your child manage any soreness.
There are three main approaches to Root Canal for children. Depending on the condition of the infection or decay of the tooth, the pediatric dentist will choose the correct approach. The approach will vary from case to case since every child’s problem is unique.
Pulp Therapy: This approach is implemented when there is very little damage to the pulp. Simply put the infection is still in the early stages and has not wreaked havoc on the entire tooth yet. In such a case the dentist for kids will remove the decay without touching the pulp, apply antibiotics inside the tooth and seal it. The direct application of antibiotics on the pulp helps in faster action against the infection.
Pulpotomy: The second approach to a root canal for children is also popularly referred to as a partial root canal or pulpotomy. The pediatric dentist opts for pulpotomy when the X-Ray of the infected tooth shows that the infection is limited to the upper part of the tooth. A Pulpotomy involves removal of only damaged/infected pulp from the tooth while keeping the healthy pulp intact. It also demands disinfecting the tooth with the antibiotic and sealing it properly to ensure full stability and protection to the tooth.
Pulpectomy: A pulpectomy is a full-fledged root canal procedure for children. When the infected tooth is severely damaged the pediatric dentist will opt for a pulpectomy. This is a complex procedure where the pulp tissue will be carefully and completely removed. The dentist will proceed in disinfecting the tooth and shaping the canals. This procedure requires a high level of expertise and precision. The next part is filling the tooth and sealing it properly. In the last stage of the treatment, a crown will be placed on the infected tooth. A common treatment protocol for all approaches is the administration of local anaesthesia before the actual procedure. Local anaesthesia is given to make the child comfortable and keep the procedure pain-free.
Root canals are safe for everyone, including children. These are very common treatments that are straightforward and safe. We have performed hundreds of root canal procedures on patients of all ages! Additionally, deciding not to proceed with a root canal treatment for your child is far more dangerous. Root canals are used to treat severe infections that will not go away on their own. If untreated, the infection can spread and lead to even more serious health issues.
Your child’s baby teeth will fall out on their own. However, they need to be properly cared for until then. Losing a baby tooth too early can have negative oral health implications for your child. After all, baby teeth have an important role to play. Of course, baby teeth assist with chewing and speaking. They’re also vital for the healthy development of your child’s permanent teeth. Early removal of a baby tooth can cause permanent misalignment of adult teeth and jaw damage. Therefore, it’s important to preserve the baby tooth whenever possible. Root canals are the ideal treatment because they treat infection within the tooth without prematurely removing the baby tooth.
Once the root canal treatment is completed and an appropriate filling/crown is placed over the tooth, we provide all the necessary instructions depending on the case. Your child may be provided with antibiotic and pain killer medication for the next few days, and it is advisable to avoid hard and sticky foods to prevent the filling/crown from getting dislodged.
Dental Crowns for Baby & Adult Teeth
A kids’ dental crown is a dental restoration that entirely covers a damaged, weekend, or decayed tooth. This prevents further damage to the tooth and helps alleviate any discomfort that the child may experience. Dental crowns are fixed, non-removal restorations that are placed in the pediatric dentist’s office. The procedure is relatively non-invasive and does not require a long recovery period.
Dental crowns for kids may be recommended for a multitude of purposes. Keep in mind that the purpose of dental crowns is to protect a tooth that is weak, damaged, or vulnerable in another way. Specifically, dental crowns may be recommended if the child shows signs of one or more of the following:
Chips and cracks
Several dental decay
Tooth Infection
Loose Tooth
Dental crowns are often necessary after a baby root canal procedure or as an alternative to a traditional dental filling. They can also repair most chips and cracks, which helps restore the tooth’s appearance, protects the child’s oral health, and reduces the risk of oral discomfort or sensitivity.
A dental crown can be placed in the dentist’s office in as few as two visits. The first visit allows the dentist to examine the severity of the child’s damaged tooth. If a kids’ dental crown is deemed necessary, the dentist will take an impression of the child’s tooth (or teeth), a temporary crown is placed. The impression is then sent to the lab, where the custom dental crown is created in the appropriate material and sent back to the dentist. Once it arrives at the office, the child returns to have the permanent crown placed.
The various types of dental crowns we use for baby teeth are:
Stainless Steel Crowns: Stainless steel crowns are the most common type of crown used in pediatric dentistry. These are what many people call “silver” crowns. These crowns are covered by most major insurances. They are very durable and are a great option if you aren’t concerned about the cosmetic appearance of baby teeth, being the choice of crown for the back teeth.
Strip Crowns: Strip crowns are celluloid crown forms that are the most effective for use in pediatric patients with extensive caries in the front teeth. These are commonly used crown forms filled with composite and bonded on the tooth.
Bioflx Crowns: These are novel flexible white crowns for the back teeth, a viable option over stainless steel crowns for aesthetic concerns.
Zirconia Crowns: The white zirconia dental crown is a metal-free esthetic crown that is certified biocompatible, extremely esthetic and is one of the most durable material used in dentistry today. These crowns are primarily used in the front teeth (for their enhanced aesthetics) which are chipped, damaged, or broken, are not developing properly, or with areas of decay too large to fill without the risk of breaking a tooth.
Dental crowns are essential for maintaining the proper oral development of the child. Otherwise, the child’s tooth (or teeth) may fall out prematurely. Although it is true that primary teeth are destined to fall out anyway, the early loss of baby teeth may lead to the improper development of the permanent teeth. Additionally, a child with a damaged, decayed, or weakened tooth may experience discomfort until they receive proper treatment.
Parents’ long-term focus should be on the prevention of oral health concerns to reduce the need for their child to get a dental crown (or another type of dental restoration). This can be achieved by the child having a good oral hygiene routine, which primarily takes place at home. This includes brushing and flossing several times a day. Children can also reduce the risk of cavities by limiting their consumption of sugar and other carbs. They can reduce the risk of issues like chips and cracks by wearing a mouthguard during sporting events and at other appropriate times. It is also necessary to visit the dentist for regular cleaning visits every four to six months, as this helps identify any oral health concerns early.
Painless Extraction & Space Maintenance
If a baby tooth is extremely decayed, or has developed an infection that the pediatric dentist decides would not heal by a root canal treatment alone, we may opt to go down the extraction and space maintainer route. We have numerous distraction techniques and pain-free needle equipment to ensure the child goes through a painless anesthesia and extraction experience. Following an extraction, a space maintainer may be required.
As an extensive dental procedure there are long term effects to extracting baby teeth. One of the main issues is tooth movement, where a loss of space for the developing adult teeth underneath is reduced. There are solutions to help hold the space open such as inserting space maintainers, or in some cases you can regain that space in the future through orthodontic treatment.
we will first take the appropriate X-rays. This will help to assess the tooth’s roots and bone condition, and to reveal other vital information. Most times, a simple extraction only requires a local anesthetic. We ensure the tooth is completely numb before initiating the extraction. A device, called an elevator, is often used to loosen the tooth before removing it with dental forceps.
Space maintainers are placed to keep gaps between teeth open so that adjacent teeth do not shift and cover the gap, preventing the adult tooth from erupting.
No. Space maintainers are not permanent. They are typically only worn for a couple of years.
Space maintainers are recommended when children prematurely lose their baby teeth. This may be a result of injury or infection, both of which may result in dislodgement or extraction. When the baby teeth are lost too early, the empty space can lead to a shift and the gap can close, which will be a problem later on when the adult tooth grows in.
There is not a set timespan that space maintainers are worn for. Instead, it varies per child depending on how young they are then whey prematurely lose their teeth. In general, space maintainers are worn for a couple of years, until the adult teeth are about to erupt.
While it’s true that baby teeth will fall out between the ages of about 6 to 13, an extensively decayed or traumatised tooth will not necessarily fall out on its own. In fact, sometimes when they become infected they can remain in the mouth long enough to cause localised infection, pain, and eventually affect the developing adult teeth. Naturally it’s important to try and save baby teeth as they help to hold space for the adult teeth to come through, but if a tooth is damaged to the point above, it’s better to be extracted.
As adults, how we communicate with our kids about dental procedures can have an impact on how they cope with it when the time comes. Words create imagery for most children, so the use of expressions like ‘ripping teeth’, ‘extracting teeth’ or ‘needles and injections’ are a big no-no at our practice. Instead, we will talk to our little patients about the process using simple phrases which we refer to as the ‘narrative’. It’s important that you maintain the narrative at home to help your child feel more comfortable and at ease.
Pediatric dentists always do everything they can to ensure the procedure is as comfortable as possible. A patient will most likely still experience some minor swelling or discomfort after an extraction. But there are several things people can do to minimize pain, swelling, and other symptoms. After the procedure, patients should only eat soft foods for a while. Parents should avoid giving their children hot foods for a few hours until the numbness wears off. The area of extraction is usually not brushed for several days following the procedure. Instead, patients may be instructed to rinse with warm salt water for several days. This will not only help with healing but to also keep the area clean. Children should not suck from a straw or spit vigorously for about a week after extraction. These actions may cause the healing area to bleed. When it comes to pain management and swelling, ice packs are often beneficial. A dentist may also recommend medications that can help manage pain and speed up the recovery process.
Space maintainers are important to your child’s oral health because they prevent a number of complications from occurring. This is because your child’s permanent teeth are directly affected by their primary teeth and if these primary teeth are lost too soon, it tends to cause complications with the permanent teeth. These complications can include some or all of the following: A lack of space for the permanent teeth to erupt into Increased risk of teeth becoming impacted or erupting improperly Overcrowding, overlapping, or crooked permanent teeth Speech impediments Malocclusion (misaligned bite) Increased need for orthodontic treatment later down the line
Space maintainers are typically made of metal materials. In some cases, acrylic can be made to create a space maintainer; however, this is much rarer. Metal is a good option because it is thick, durable, and long-lasting, meaning it can weather whatever the oral cavity goes through until the adult tooth erupts.
It is recommended to brush regularly around space maintainers as food can get stuck in or around them. Additionally, it is advised to avoid chewing sticky, hard, or tough foods on the side of the mouth that has a space maintainer. Foods that are not soft in substance can easily damage space maintainers, requiring a replacement to be performed. Lastly, rinsing with salt water or a gentle mouthwash can help to keep food debris from getting left behind.