PEDIATRIC FILLINGS 

​

The pediatric dentist at Top Smile often recommend composite resin or tooth color fillings. These pediatric fillings are generally strong and resistant to the daily pressures that a tooth may be subjected to, making it an ideal material for this purpose. During the dental exam, your child’s dentist may identify cavities. The digital x-rays used in our office, along with a tooth by tooth exam with a dental explorer can help uncover areas of decay. As long as the decay is not too large, in which case it would need a root canal, the tooth can be treated with a simple filling.

For the most part, there are two types of direct pediatric dental fillings that are done in our pediatric dental clinics. These are either composite (white fillings) or amalgam (silver fillings). While amalgam fillings are often stronger, composite fillings are more aesthetic. Composite, or tooth colored fillings, match the color and physical appearance of our natural teeth closely and is preferred by most pediatric dentists for restorations made in aesthetic areas. They are also used successfully on molars or other chewing surfaces, as long as the fillings are relatively small. For larger fillings, or those that go in between the teeth (interproximal decay), silver fillings may be recommended. However, for the most part, both types are filling material, be it composite or amalgam, can be used to restore teeth that have been affected by decay. Before placing any pediatric filling, children are made to feel comfortable in the dental setting. Sometimes this is achieved by using techniques in pediatric oral sedation or nitrous oxide. The tooth affected is made numb using local anesthesia, and the decay is removed. The preparation in the tooth is then exposed to acid etch and a resin bonding material before the composite is placed onto the tooth. Once the filling is in place, a blue light is placed on the filling, making it hard. Finally, adjustments are made so that the child is comfortable biting. After the initial process of making the child numb, the child no longer feels pain while getting a pediatric filling placed. Nevertheless, throughout the preparation process, the child may feel the cold water that is sprayed on the tooth and may also feel pressure. Overall, the process is completed fairly quickly and is mostly painless. After the filling is placed, it is common for some children to experience sensitivity on the tooth. This sensitivity could last up to two weeks, but it dies down with time. After having the fillings placed, it is very important for children to maintain good oral habits by brushing and flossing two times a day. This way they can prevent recurrent decay from happening and can keep their pediatric fillings strong.

​

 

PEDIATRIC CROWNS

​

A crown is a type of dental restoration that completely covers and encircles a tooth. Stainless steel crowns (silver) as well as tooth colored (white) crowns can be provided. Our pediatric dentist can speak with you about which type of crown will be best for your child. At Top Smile, we provide individualized care for our pediatric patients,  and when a patient presents with the following signs, a crown may be recommended:

• If nerve treatment is needed (pulpotomy or pulpectomy)

• The tooth has developmental defects (formed incorrectly)

• Trauma resulting in a fractured tooth

• Large area of decay where a white filling may fail

Does the crown have to be silver? The answer is; it depends. It depends on where the crown is needed and what tooth needs the treatment. Stainless steel crowns are very durable, safe, typically less expensive than white crowns, and have been used for decades. The goal of providing a stainless steel crown, or any crown, is to prevent retreating a tooth; we want your child to keep the baby molar until the permanent tooth is ready to come through the gums. Children typically hold on to their baby molars until they are 10-12 years of age, which is why it is so important to protect them when decay is found at an early age. White crowns for the baby molars have now become more popular due to their esthetic appearance, improvement in ease of application and increased durability; however, they are more expensive and are not ideal for every tooth. The doctor can provide both stainless steel and white crowns for baby molars and will be able to talk about the advantages and disadvantages of each. Crowns needed on front teeth are typically due to trauma as well as extensive decay. We provide white crowns for teeth in the front or anterior area as this is the most esthetic treatment option for these teeth. To enhance the longevity of crowns for front teeth, it is important to avoid habits such as nail biting as this can lead to early deterioration of the crown. Our staff will review how to take care of these types of crowns, if needed, at your child’s visit.

​

​

PEDIATRIC PULPOTOMIES

​

Pulpotomies are performed to remove the diseased pulp tissue within the crown portion of a tooth. The pulp tissue is located in the central core of the tooth and contains nerves, blood vessels, connective tissue, and reparative cells. A pulpotomy is most commonly performed to maintain the life and vitality of the affected tooth to prevent loss of the tooth. Dental cavities and traumatic injury are the main reasons for a child’s tooth to require pulp therapy. Pediatric Pulpotomies are often referred to as a “nerve treatment”, “children’s root canal”, “pulpectomy”, or “pulp therapy”.  During the procedure the diseased pulp is removed and then a preventative agent is placed to stop bacterial growth and to calm the remaining nerve tissue. This is followed by a final restoration which is usually a stainless steel crown. The two common forms of pulp therapy in children’s teeth are the Pulpotomy and Pulpectomy.

A Pulpectomy is required when the entire pulp is involved and goes into the root canal(s) of the tooth. During this treatment, the diseased pulp tissue is completely removed from both the crown and root. The canals are cleansed, disinfected and, in the case of primary teeth, filled with a resorbable material.  If this is performed with a permanent tooth, it would be filled with a non-resorbing material. The procedure is finished with a final restoration, again usually a crown. Here at Top Smile, we offer different sedation methods (Nitrous, Oral Sedation and General Anesthesia) for pediatric pulpotomies and pulpectomies to help calm your child’s anxiety.  You can also expect your child expect to receive a local anesthetic as well to prevent the child from feeling any pain at all. After the procedure, the child can expect to feel numbness on their cheek or lip. This feeling should subside after an hour. It is encouraged to limit any physical activity and hard foods for the remainder of the day. The patient may resume oral hygiene and rinse with warm salt water 24 hours after the procedure every 3-4 hours. This will help to prevent infection. If your child feels any pain, sensitivity, or discomfort 24 hours after the procedure, please call our office.

​

​

PEDIATRIC TOOTH EXTRACTIONS

​

At Top Smile, we do all that we can to keep your child at ease and to help teach children and parent’s how to maintain good oral health. Sometimes removing a tooth is the best option for restoring the health of the patient’s mouth. The doctor may recommend a pediatric tooth extraction when a tooth is:

• Infected by periodontal (gum) disease

• Significantly damaged or decayed

• Impacted (stuck) in the mouth

• Complications from trauma

• Delayed exfoliation

• Orthodontic request

Pediatric tooth extractions are fairly easy and do not take much time at all. A parent may choose a form of sedation (Nitrous, Oral Sedation or General Anesthesia) to help ease your child’s anxiety. The child can also expect to receive a local anesthetic near the troubled tooth, as this will help prevent the child from feeling any pain at all.

After the pediatric tooth extraction has been completed, the doctor will apply gauze to the affected site to soak up any remaining fluid and should be held on the site for at least an hour, or until no fluids are seen. It is also recommended to apply ice to the site to help prevent any swelling.  We also suggest eating soft foods, limit sucking, and limit any physical activity for the remainder of the day.

Your child can resume all day-to-day activities 24 hours after the procedure. Our doctor recommends brushing and flossing as normal to help prevent any infections and to maintain good oral health.

The Doctor and staff here will do everything in our power to ensure that your child is comfortable during the treatment, we offer different types of sedation methods to help ease your child’s anxiety if needed.