Pediatric Dental Care

At our office we take pride in creating and maintaining beautiful and healthy smiles for our younger patients in an environment that is lighthearted and fun. With an emphasis on establishing oral health habits that last a lifetime, our primary tools are education and a comprehensive preventive care program.

As part of an effort to guard against childhood dental decay we recommend periodic fluoride treatments and dental sealants placed on the biting surfaces of the back teeth.

Space Maintainers

One of the main purposes of primary teeth is to act as a space maintainer for the permanent teeth which will erupt as the child enters adolescence. Occasionally, a primary tooth is absent, lost early or needs to be extracted. In these cases, it is important to maintain the space for the permanent tooth to erupt. In order to preserve the space, we will fabricate a space maintainer for your child. There are two types of space maintainers. One is a "fixed" space maintainer which gets cemented into the patient's mouth and will stay there until the permanent tooth erupts. The second type is a "removable" space maintainer, which resembles a retainer, can be removed from the mouth and should be worn until the permanent tooth erupts.

Interceptive-Orthodontics

Historically, most patients did not commence orthodontic treatment until all of their permanent teeth had erupted and then had a malocclusion diagnosed and addressed at the age of about 12-14. Waiting this long often necessitated the extraction of several permanent teeth in order to create space for orthodontic movement. More extensive movement necessitated the use of headgear and other orthodontic appliances. It was noted that teen cooperation in wearing such appliances was often problematic.

Interceptive orthodontics is a technique and philosophy which was developed to address certain orthodontic problems between the ages of 7-11.This early intervention and phased treatment can result in fewer extracted teeth and better patient compliance.

Some of the techniques used in this interceptive orthodontic phase include arch expansion, which allows more room for permanent teeth and orthopedic growth appliances which enhance jaw growth and make later orthodontic treatment much simpler.

These early interventions act as Phase 1 of a two step orthodontic treatment. Phase 2 will occur closer to the time when standard orthodontics generally takes place. Interceptive orthodontic techniques will allow Phase 2 of the treatment to become simpler, less extensive and less expensive than it otherwise would have been.

Fluoride Varnish

The role of fluoride is especially important for children as it improves the quality of dental enamel in their developing teeth and makes their new teeth more resistant to decay. As part of your child's preventive dental care program at our office, fluoride varnish is applied during their routine checkup appointments and if indicated at regular intervals between these visits.

Fluoride varnish is a topically applied product that is brushed onto all sides of your child's teeth. It is a completely safe and painless procedure that takes just a couple of minutes from start to finish. Once applied and in contact with your child's saliva the fluoride hardens. The fluoride component is now absorbed into the dental enamel and begins its job of strengthening the tooth.

Following the application of the fluoride varnish, your child does not have to wait to eat or drink. The only restriction is that foods are soft and not crunchy for the rest of the day. Brushing and flossing may be postponed for several hours.

While fluoride varnish can help prevent cavities and slow their progression, it is not a guarantee against dental decay. Optimal dental health for your child involves an excellent oral hygiene regimen at home, routine dental care and eating a healthy diet.

Dental Sealants

As part of your child's dental prevention program, dental sealants are often recommended to protect their permanent back teeth from developing dental decay. In fact according to the American Dental Association, dental sealants reduce the risk of cavities in molars by approximately 80%.

While establishing a good oral hygiene regimen, maintaining proper toothbrushing habits, and avoiding sticky sweets are essential for the prevention of dental decay, children's teeth often need more protection. The reason for this is that the deeply grooved chewing surfaces of the back permanent teeth can be difficult for a child to keep free of leftover food and cavity-causing bacteria. Moreover, young children do not always brush their teeth, as often or as thoroughly as they should, making them particularly vulnerable to dental decay.

Dental sealants afford additional protection from dental decay by providing a strong plastic-like protective coating for the chewing surfaces of a child's permanent back teeth. They basically fill in the pits, fissures and grooves on these teeth to seal out harmful bacteria and food particles. Beyond preventing the development of cavities, sealants may also be useful over areas of incipient dental decay to stop further damage from occurring.

Applying dental sealants is a relatively quick and painless process. They are simply brushed on in a series of steps during a child's dental visit and then cured (set) with a light wand. Sealants are strong and durable and can last for several years. The condition of your child's dental sealants will be evaluated at each checkup and reapplied if the need arises.

Dental Fillings

With the advent of the newest technologies in dental science, today's state-of-the-art restorative materials include ceramic and the latest composite materials. These materials are not only strong and durable, but restore the look of natural teeth and are very aesthetically pleasing.

Orthodontics

A healthy, functional and attractive smile requires teeth that are straight and jaws that are well aligned. The goal of orthodontic treatment is to correct the cosmetic and functional problems associated with teeth that are either overcrowded, have spaces between them, or that have shifted over time due to extractions, habits, or abnormal bite patterns. Orthodontics can also address skeletal discrepancies between the upper and lower jaws.

Orthodontic treatment can range from the minor movement of a few teeth to the alignment of an entire bite. It may also be used in some cases to align teeth both before and after the surgical correction of severe jaw discrepancies.

Orthodontics utilizes the principles of physics to slowly move teeth into their proper positions. This is performed by using a selection of corrective appliances, including braces, clear aligners, and retainers. Designed to apply incremental and controlled forces to move the teeth in the desired direction, these appliances are adjusted on a regular basis throughout the course of care. Once a malocclusion is corrected and the teeth are completely aligned, retainers are often placed to help ensure that the result remains stable.

Orthodontic treatment time depends on the patient's age, the severity of the malocclusion and the unique needs of each particular case. Some corrections can be accomplished in a few months while others can take a few years. However, for many malocclusions the average length of orthodontic treatment time is 24 months.

Dental Emergencies

Toothaches

A "toothache" is pain typically around a tooth, teeth or jaws. In most instances, toothaches are caused by a dental problem, such as a dental cavity, a cracked or fractured tooth, an exposed tooth root, or gum disease. Sometimes diseases of the jaw joint (temporomandibular joint), or spasms of the muscles used for chewing can cause toothache like symptoms.

The severity of a toothache can range from chronic and mild to sharp and excruciating. It can be a dull ache or intense. The pain may be aggravated by chewing or by thermal foods and liquids which are cold or hot. A thorough oral examination by Dr. Jennifer Rubin, proper tooth testing and evaluation, along with appropriate dental x-rays, can help determine the cause. What we want to know is whether the toothache is really coming from a tooth or somewhere else.

Traumatic Dental Injuries

Dislodged Teeth

Injuries to the mouth can cause teeth to be pushed back into their sockets. If the tooth is pushed partially out of the socket, your dentist may re-position and stabilize your tooth. If the pulp remains healthy, then no other treatment is necessary. However, if the pulp becomes damaged or infected, root canal treatment will be required. Root canal treatment is usually started within a few weeks of the injury and a medication, such as calcium hydroxide, will be placed inside the tooth. Eventually, a permanent root canal filling will be placed and the canal will be sealed.

Avulsed Teeth

If an injury causes a tooth to be completely knocked out of your mouth, it is important that you seek treatment immediately! It is important to keep the avulsed tooth moist. If possible, put it back into the socket. A tooth can be saved if it remains moist. You can even put the tooth in milk or a glass of water (add a pinch of salt). Root canal treatment may be necessary based upon the stage of root development. The length of time the tooth was out of your mouth and the way the tooth was stored may influence the type of treatment you receive and how successful the outcome.

Pulpotomy

Inside of every baby (deciduous) and permanent adult tooth is a central chamber that contains connective tissue, a nerve supply, and blood vessels. Collectively these core tissues, known as the dental pulp, help the tooth to grow and mature before it emerges into the mouth. Once your tooth is in place, the dental pulp provides nourishment, keeps the tooth vital, and alerts you of problems.

Unfortunately, cavities and dental trauma can damage the dental pulp inside of a tooth. When one of these factors has involved the dental pulp of a primary or deciduous tooth and there is no evidence of an infection at the root of the tooth, a procedure known as a pulpotomy may be performed. The purpose of a pulpotomy on a "baby" tooth is to maintain it until its permanent successor tooth erupts. This is because deciduous that are lost prematurely can result in space loss for the permanent tooth and other consequences. During a pulpotomy procedure the exposed or affected pulp tissue within the crown of the deciduous tooth (the visible portion of the tooth) is carefully removed and a special medication to disinfect the area and calm the remaining nerve tissue is placed. Once the procedure is complete, the baby tooth is then restored. Depending on the amount of tooth structure remaining and how much time is left before the baby tooth is to fall out, the type of restoration is selected. Typically, the most effective restoration to seal the tooth and restore function, is a stainless steel crown.

Stainless Steel Crowns

Stainless steel crowns are durable restorations that are typically used as a means of restoring primary molar teeth that have been compromised by decay, trauma, or that have had a pulpotomy procedure. These strong metal caps are permanently cemented in place, protecting what remains of the underlying tooth and preventing it from decaying further. Stainless steel crowns are individually sized and fitted to cover and seal off the affected tooth. As they have a smooth and polished surface, they are easy to clean and maintain. Until the baby tooth is lost, the stainless steel crown allows some level of tooth function and can successfully maintain the space for the coming permanent tooth.