700 South Chester Rd. | Swarthmore, PA 19081 | Phone: 610-627-1199 | Fax: 610-627-1886
X-ray examinations provide us with essential information about your child’s teeth, roots, jaws, and other structures of the head and neck. Some reasons they may be used:
Our office is very sensitive to concerns about exposure to radiation and will reduce your child’s exposure as much as possible. We prescribe x-rays based on the recommendations of the American Academy of Pediatric Dentistry, our clinical expertise, and using the ALARA principle (As Low As Reasonably Allowable). All this being said we will not willfully supervise neglectful care of your child by allowing refusal of x-rays every time they are recommended.
Please ask us why we are taking x-rays or what we are looking for and we will be happy to answer your questions. We reserve the right to dismiss patients from our care who repeatedly refuse to comply with our recommended standards of care. Please note we will not treat dental problems or complete operative procedures without up to date x-rays.
Need for x-rays varies with development and dental health. Children generally require x-rays more often than adults due to a faster rate of development and a higher susceptibility to tooth decay. (For example the average child over the age of 3 gets check up films yearly and a developmental film called a Panoramic x-ray every 3-5 years or ideally at ages 6,11, and 16)
A sealant is a protective coating that is applied to the chewing surfaces (grooves) of the back teeth (premolars and molars), where four out of five permanent tooth cavities in children are found. This sealant acts as a barrier to food, plaque and acid, thus protecting the decay-prone areas of the teeth.
Sealants are primarily recommended for 6 and 12-year-old molars (those generally covered by dental insurances) though may be recommended for other high-risk teeth.
Our sealents are BPA free.
Composite resin or “tooth colored” fillings provide good durability and resistance to fracture in small to mid size fillings that need to withstand moderate pressure. They are chemically bonded and can therefore be used in some instances where amalgam fillings cannot. They do not require a specific depth of material so allow for more conservative prepping in some circumstances. They do require a completely dry environment which in same cases may prove difficult.
*Please ask your dentist if you would like to know which material they feel is best for your child’s tooth. Each instance may be different.
Amalgam fillings (made from an alloy of metals) provide good durability and can be used in areas where moisture control is difficult to achieve. It has widely been studied due to it’s content of trace amounts of mercury. The ADA Council on Scientific Affairs prepared a comprehensive literature review on amalgam safety and reaffirmed at it’s July 2009 meeting that “the scientific evidence supports its valuable, viable, and safe choice for dental patients”
*Please ask your dentist if you would like to know which material they feel is best for your child’s tooth. Each instance may be different.
Stainless steel crowns are indicated for the restoration of baby (and sometimes permanent) molars when the teeth have large cavities or cavities involving multiple surfaces, when pulp/ nerve therapy has been performed, when teeth have fractured, or for patients with severe grinding or dental disorders affecting the enamel of their teeth.
Stainless steel crowns with porcelain facings can be used for front teeth for better esthetics but can chip over time. Patients must take care when biting into hard foods while they are in place. Also these crowns can slightly change the profile of teeth due to a necessity for slightly more bulk of porcelain material. These are not recommended for teeth used for chewing.
The pulp of a tooth is the inner, central core of the tooth. The pulp contains nerves, blood vessels, connective tissue and reparative cells. The purpose of pulp therapy in Pediatric Dentistry is to maintain the vitality of the affected tooth (so the tooth is not lost).
Dental caries (cavities) and traumatic injury are the main reasons for a tooth to require pulp therapy. Pulp therapy is often referred to as a "nerve treatment", "children's root canal", "pulpectomy" or "pulpotomy". The two common forms of pulp therapy in children's teeth are the pulpotomy and pulpectomy.
A pulpotomy removes the diseased pulp tissue within the crown portion of the tooth. Next, an agent is placed to prevent bacterial growth and to calm the remaining nerve tissue. This is followed by a final restoration (usually a stainless steel crown).
A pulpectomy is required when the entire pulp is involved (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. Then, a final restoration is placed. A permanent tooth would be filled with a non-resorbing material.
Removing a tooth that is badly decayed, fractured, infected, or unrestorable.
We try to use this as a last resort treatment in most cases.
If a primary molar is removed prematurely, the placement of a space maintainer is usually recommended to preserve space for the permanent replacement
Teeth may also be extracted for orthodontic reasons.
Used when a primary tooth has been prematurely lost to hold space for the permanent replacement. Otherwise teeth adjacent to and even in the opposing arch can drift into the space and prevent proper eruption or cause impaction of the permanent replacement. This can lead to costly and extensive orthodontic needs in the future.
Generally we take impressions/ models of the child’s mouth and send them out to a lab to make a custom fit appliance. In some cases we may be able to make a band and loop type (single tooth replacement) space maintainer on the spot.
Silver Diamine Fluoride is a conservative approach for arrest of active tooth decay in cases where access to tooth decay is easily achievable and behavior or age of patient does not allow for conventional dental treatment.
To be noted:
Ask your dentist if your child is a candidate for SDF therapy
Nitrous Oxide Analgesia or “laughing gas” is very helpful in relaxing apprehensive patients, relieving gag reflexes, and aiding young children though numbing procedures pain free and with ease. It’s given through a small breathing mask placed over a child’s nose. It’s a mild gas that is quickly uptaken and quickly eliminated from the body. Your child will remain fully conscious with all airways and reflexes intact. The American Academy of Pediatric Dentistry recognizes this as a safe and effective technique for treating children.
Not every child is alike and as with all treatment modalities it does not work for everyone- especially those with severe anxiety, those with extensive needs, those with certain medical conditions/ special needs, or those at a pre-cooperative age. Talk to your dentist about what treatment modalities she recommends for your child.
Some general policies:
General Anesthesia is a way to provide comprehensive dental care to your child while he/she is asleep/unconscious.
***Dr. Annie does not take lightly the decision to recommend general anesthesia to your child. She usually will only do so when she feels it is in the best interest of their dental health/ overall health and there is no other way to safely achieve this result without traumatizing his her developing psyche.
It’s usually recommended for patient’s of pre-cooperative age, those with extensive treatment needs, those with severe anxiety or behavior issues, those with certain special needs, or those with whom other treatment modalities have not succeeded.
Please feel free to ask questions or set up a consult appointment with Dr. Annie to further discuss this treatment method.
Toothache: Clean the area of the affected tooth. Rinse the mouth thoroughly with warm water or use dental floss to dislodge any food that may be impacted. If the pain still exists, contact your child's dentist. Do not place aspirin or heat on the gum or on the aching tooth. If the face is swollen, apply cold compresses and contact your dentist immediately.
Cut or Bitten Tongue, Lip or Cheek: Apply ice to injured areas to help control swelling. If there is bleeding, apply firm but gentle pressure with a gauze or cloth. If bleeding cannot be controlled by simple pressure, call your dentist or visit the hospital emergency room.
Knocked Out Permanent Tooth: If possible, find the tooth. Handle it by the crown, not by the root. You may rinse the tooth with water only. DO NOT clean with soap, scrub or handle the tooth unnecessarily. Inspect the tooth for fractures. If it is sound, try to reinsert it in the socket. Have the patient hold the tooth in place by biting on a gauze. If you cannot reinsert the tooth, transport the tooth in a cup containing the patient's saliva or milk. If the patient is old enough, the tooth may also be carried in the patient's mouth (beside the cheek). The patient must see a dentist IMMEDIATELY! Time is a critical factor in saving the tooth.
Knocked Out Baby Tooth: Contact your pediatric dentist during business hours. This is not usually an emergency, and in most cases, no treatment is necessary.
Chipped or Fractured Permanent Tooth: Contact your pediatric dentist immediately. Quick action can save the tooth, prevent infection and reduce the need for extensive dental treatment. Rinse the mouth with water and apply cold compresses to reduce swelling. If possible, locate and save any broken tooth fragments and bring them with you to the dentist.
Chipped or Fractured Baby Tooth: Contact your pediatric dentist.
Severe Blow to the Head: Take your child to the nearest hospital emergency room immediately.
Possible Broken or Fractured Jaw: Keep the jaw from moving and take your child to the nearest hospital emergency room.