DENTAL EXAMS & CLEANINGS / DIGITAL X-RAYS / MOUTHGUARDS / FILLINGS / PRIMARY TOOTH CROWNS / PULP THERAPY / EXTRACTIONS / SPACE MANAGEMENT / SPECIAL NEEDS DENTISTRY 
DENTAL EXAMS & CLEANINGS
Preventing Problems Before They Start
The health of your child’s teeth and mouth is very important to the well-being of his or her entire body. While routine brushing and flossing at home is necessary to keep your child’s smile looking its best, visiting the dentist for a comprehensive exam and cleaning is essential. The American Dental Association recommends your child visit the dentist every six months to ensure his or her teeth stay healthy and the smile stays beautiful.
By routinely seeing us for exams and cleanings, your child can:
- Prevent tooth decay, gum disease, and bad breath
- Avoid costly and extensive dental procedures
- Enjoy white teeth by reducing staining from food and drinks
- Shorten the time spent in the dentist’s office
- Have a smile that will last a lifetime
The Exam
During your little one’s exam, our pediatric dentists will thoroughly examine your child’s teeth and gums for signs of tooth decay, gum disease, and other health problems. The dentist may also want to take X-rays to see what is happening beneath the surface of the teeth and gums. The images captured will help the dentist discover dental issues not visible clinically.
Professional Cleanings
The dental hygienist will begin your child’s cleaning by evaluating their oral hygiene and caries risk. They will identify problem areas and give instruction on how to improve homecare. Then the hygienist will also evaluate your child’s gingiva (gums) to make sure they are healthy. Gum disease in childhood often results in advanced gum disease in adulthood.
Next, the hygienist will carefully clean your child’s teeth with a variety of tools to remove any calculus (tartar) from the teeth. Then, the hygienist will floss your child’s teeth, use a polishing compound, and apply fluoride. Cleanings usually aren’t painful, but if your child has any anxiety about the dental exam, be sure to let the hygienist know.
If Dr. Sloan find tooth decay or gum disease, they will talk to you about changing your child’s dietary, brushing or flossing habits. A treatment plan will be developed and treatment options will be discussed. If your child’s teeth and gums appear to be healthy, we will recommend that your child continue his or her brushing and flossing routine as usual.
DIGITAL X-RAYS
Digital X-rays are better for your child and better for the environment. They require minimal radiation exposure and significantly reduce the time it takes to view and interpret the image. They also allow your pediatric dentists to discuss their findings in an easy to understand manner and allow the parent to see in high digital quality the radiographic findings.
Is a digital X-ray really safer?
Yes! Digital X-rays reduce the amount of radiation exposure by up to 80%. While the amount of radiation used in dental X-rays is very small, the effect is cumulative, so all radiation counts. (An interesting fact: an individual is exposed to more than 8 times the radiation flying from New York to Los Angeles than from a dental X-ray)
What are the advantages of digital X-rays?
- There is no need to wait for the X-ray film to be developed before it can be viewed, so the entire checkup can be a lot shorter.
- The digital images can be enlarged and manipulated, to give the doctor a clear, more detailed look at your child’s teeth.
- Because your child can see the image enlarged on a screen, she can better understand why taking care of her teeth is important.
- It’s better for the earth! There is no need to use harmful chemicals to process film.
Our practice is focused on making your child’s dental experience as comfortable as possible. At your next appointment, we’ll be happy to answer any questions you may have.
MOUTHGUARDS
Protecting your child’s smile while playing sports is essential. Sports-related injuries to the mouth and jaw are among the the most common injuries received by athletes.
Mouthguards help protect teeth and gums from injury. If your child participates in basketball, boxing, hockey, football, gymnastics, lacrosse, martial arts, racquetball, rugby, track and field, skateboarding, skiing and snowboarding, skydiving, soccer, surfing, volleyball, water polo, weightlifting or wrestling, it is recommended by the American Dental Association that a mouthguard is worn.
Types of Mouthguards
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.
When choosing a mouthguard, be sure to pick one that is tear-resistant, comfortable, and well fitted to your child’s mouth, easy to keep clean, and does not prevent him or her from breathing properly. If he/she wears braces or a retainer, it is imperative for him to wear a mouthguard. Dr. Sloan can show your child how to wear a mouthguard properly and how to choose the right mouthguard.
Taking Care of Your Child’s Mouthguard
Similar to a retainer, braces, or any special dental appliance, it is important to take care of your child’s mouthguard by storing it properly and keeping it clean. Here are a few simple ways to keep your son or daughter’s mouthguard clean and working correctly:
- Gently scrub the mouthguard after each use with a toothbrush and toothpaste.
- Store the mouthguard in a protective case.
- Do not leave the mouthguard in the sun or in hot water, because it may melt or become deformed.
- Replace the mouthguard at the beginning of every new sports season. You should also replace your child’s mouthguard if you notice it has become worn and no longer fits properly
- Do not wear a retainer with a mouthguard. If your child wears braces, we will help design a mouthguard to protect the teeth and braces
- Do not chew on or cut pieces off your mouthguard
- Bring the mouthguard to each dental checkup so your child’s dentist can check to make sure it’s still in good shape!
Our goal is to help minimize your child’s chances of a sports-related injury to his smile. Be sure to ask your dentist about mouthguards at your child’s next dental checkup.
DENTAL FILLINGS
Typical dental fillings include silver (i.e., amalgam) and tooth-colored (i.e., composite) fillings. The strength and durability of traditional dental materials continue to make them useful for situations where restored teeth must withstand extreme forces that result from chewing, such as in the back of the mouth.
At South Hills Pediatric Dentistry, we recognize that many people are hesitant to use silver fillings because of cosmetic concerns and worry about mercury exposure. For this reason, we only offer composite (tooth-colored) fillings for basic restorative procedures.
Composite fillings are aesthetic and in most cases are able to last until the primary tooth would normally fall out. Sometimes, though, composites are not recommended due to a number of factors:
- The cooperation level of the child
- The amount of remaining tooth structure
- The chewing load the tooth will have to bear
- The length of time the procedure takes to complete
- The child’s risk for developing future cavities
Before your little one’s treatment begins, the doctor will discuss all the options and help you choose the best restorative option for your son or daughter’s particular situation.
DENTAL CROWNS
Crowns are “cemented” onto an existing tooth and fully cover the portion of the tooth above the gum line. In effect, the crown becomes the tooth’s new outer surface.
There are three types of full coverage crowns we offer at South Hills Pediatric Dentistry:
1. Stainless-Steel Crowns
- Stainless-steel crowns are the most predictable primary tooth restoration and have great longevity. They are silver in color. Stainless-steel crowns are the preferred restoration on back teeth.
2. Composite Strip Crowns
- A tooth-colored front-tooth crown that builds up your child’s tooth with a plastic material, restoring it to normal form and function. Strip crowns are very cosmetic and are ideal if a single front tooth requires full coverage.
3. Zirconia/Porcelain Crowns
- Zirconia Crowns are also tooth colored and very strong. They are premade and cemented onto your child’s tooth.
Full-coverage crowns are intended to save a primary tooth until the permanent tooth can erupt and take its place. Because they are full coverage, they completely encase the tooth and protect all surfaces from future decay. Keeping the primary tooth if at all possible is very important.
A crowned tooth must be brushed and flossed just like other teeth.
PULPOTOMY/PULPECTOMY
If your child’s primary tooth has extensive decay, or has been damaged by trauma, action may be needed to restore its integrity and prevent infection from spreading to surrounding teeth. After a set of X-rays are taken, your dentist will be able to assess the extent of the infection and recommend one of two options: a pulpotomy or a pulpectomy.
Pulpotomy
If the decay or trauma is confined to the crown of the tooth, a pulpotomy may be recommended. When a cavity gets really deep, and close to the pulp of a tooth, or even into the pulp, the pulpal tissue becomes irritated and inflamed. A pulpotomy is when the inflamed pulp chamber, usually on a baby molar, is removed.
Dr. Sloan will remove all the infected material in the pulp of the crown only, and leave the living tooth root intact. After a pulpotomy on a baby molar, the empty space will be filled with dental cement and a stainless-steel crown will be placed to restore the tooth.
Pulpectomy
If the infection involves tissue in both the tooth crown and the tooth root, a pulpectomy may be the best option. In a pulpectomy, the entire pulp material is removed from both the crown and the roots. After numbing your child’s tooth, the dentist will remove the pulp and nerve tissue from the crown and from the canals of the roots.
Then the pulp chamber and root canals will be thoroughly cleaned and disinfected. Next, the dentist will fill the tooth and tooth roots with a dental cement, and finish with a stainless-steel crown.
EXTRACTIONS
There 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. Other times, a tooth may have so much decay that it puts the surrounding teeth and jaw at risk. Infection, orthodontic correction, or problems with a wisdom tooth can also require removal of a tooth.
If it is determined that your child’s tooth needs to be removed, the pediatric dentist may extract it during a regular checkup or schedule 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 that holds it in place. While this procedure is typically very quick, it is important to share any concerns you might have; we want to make sure your child is as comfortable as possible.
Recommendations after your child’s extraction
- No drinking with straws for two to three days
- No vigorous rinsing and spitting for two to three days
- A soft diet is recommended for seven to ten days; no eating of popcorn, nuts, pretzels, pizza, crackers, chips, or any food with sharp edges
- If your child has any discomfort, administer a children’s dose of Advil® or Tylenol®. The initial dose of pain medicine should be given before the numbing medicine wears off.
- If your child experiences swelling, apply a cold cloth or an ice bag and call our office
SPACE MAINTENANCE
If your child’s tooth has come out too soon because of decay or an accident, it is important to maintain the space to prevent future space loss and dental problems when permanent teeth begin to come in. Without the use of a space maintainer, the teeth that surround the open space can shift, impeding the permanent tooth’s eruption. When that happens, the need for orthodontic treatment may become greater.
Types of Space Maintainers
Space maintainers can be made of stainless steel and/or plastic, and can be removable or fixed (cemented to the teeth).
Removable
A removable space maintainer looks much like a retainer with plastic blocks to fill in where the tooth is missing. If your child is older and can reliably follow directions, a removable space maintainer can be a good option.
Fixed
Fixed space maintainers are the preferred type and come in many designs.
A band-and-loop maintainer is made of stainless-steel wire and held in place by a crown or band on the tooth adjacent to the empty space. The wire is attached to the crown or loop and rests against the side of the tooth on the other end of the space.
A lingual arch is used on the lower teeth when the back teeth on both sides of the jaw are lost. A wire is placed on the lingual (tongue) side of the arch and is attached to the tooth in front of the open space on both sides. This prevents the front teeth from shifting backward into the gap.
In the case of a lost second primary molar prior to the eruption of the first permanent molar, a distal shoe may be recommended. Because the first permanent molar has not come in yet, there is no tooth to hold a band-and-loop space maintainer in place. A distal shoe appliance has a metal wire that is inserted slightly under the gum and will prevent the space from closing.
Caring for Your Child’s Space Maintainer
There are four general rules for taking care of your child’s appliance.
- Your child should avoid sticky foods, including candy and chewing gum.
- Encourage your son or daughter not to push or tug on the space maintainer with the fingers or tongue.
- Keep your child’s space maintainer clean through effective brushing and flossing.
- Your child should continue to see the pediatric dentist for regular dental visits.
SPECIAL NEEDS DENTISTRY
Providing comprehensive preventive and therapeutic dental care to patients who have special healthcare needs is an important aspect of the specialty of pediatric dentistry. We value the unique qualities of each young smile we treat, and seek to ensure maximal health for all, regardless of developmental disability or other healthcare issues.
The American Academy of Pediatric Dentistry defines special healthcare needs as “any physical, developmental, mental, sensory, behavioral, cognitive, or emotional impairment or limiting condition that requires medical management, healthcare intervention, and/or use of specialized services or programs.” Whether your child’s condition is congenital, developmental, or the result of disease or trauma, we can provide guidance and raise awareness of his or her special dental care needs.
Dental care for patients with special needs requires specialized knowledge acquired by additional training, as well as increased awareness and attention, adaptation, and accommodative measures beyond routine treatment. At our office, we have the experience necessary to provide suitable dental care while keeping in mind the unique nature of the children we see.
It is our goal to create a dental home for your child, where treatment can be delivered safely, and ideal dental health can be achieved.
