Preventive dental care is the cornerstone of pediatric dentistry. Pleasant childhood preventive dental visits help keep your child cavity free, help ensure we catch any potential problems early, and help promote the establishment of trust and confidence that will last a lifetime. Most children should be seen for routine preventive dental visits every six months. To help our youngest patients get an early start, we do not charge for well-baby dental visits for children under 24 months of age.
Depending on the age and behavior of the child, at these visits we will:
- Check that their gum tissue and other oral soft tissues are healthy.
- Check their teeth for cavities and any developmental defects.
- Check if their bite (occlusion) is developing normally.
- Clean and polish their teeth to remove any debris that has built up.
- Review home care and oral hygiene instructions.
- Apply fluoride to help strengthen the teeth’s enamel surface.
- Take digital radiographs (x-rays) if indicated.
- Devise a treatment plan to treat any problems found.
- Review everything with you and your child.
Even with good brushing and flossing it is difficult, almost impossible, to clean the pits and grooves on certain teeth, especially first and second permanent molars. Less frequently we may also find these deep crevices on other teeth such as: primary (baby) molars, permanent premolars, and the tongue side of upper front teeth. Food and bacteria can build up in these areas and lead to cavities. Sealants help solve this problem. Sealants are the same type of material as a bonded composite filling, but in a more liquid form. After the tooth is specially cleaned, the sealant is “painted” into any deep grooves and crevices and bonded on. The sealant fills in these areas so that food and bacteria cannot get stuck there, thus lowering the risk of decay.
Unlike some sealants, the brand we use (Ultraseal) is certified by the manufacturer to be BPA free.
We use white, bonded, composite restorations for most of the teeth we restore. This is both a healthy choice for our patients and healthy for the environment as well. Dr. Schneider has made a commitment not to use amalgam (mercury containing) restorations with our patients.
Occasionally a back tooth may be so severely damaged that it requires covering with a stainless steel crown. While these crowns are silver-colored, they do not contain mercury.
If the decay is deep enough that it penetrates to the pulp (nerve) of a primary (baby) tooth we can often still save the tooth with a pulpotomy. This is like a simplified version of root canal therapy. Back teeth that have had pulpotomies are usually restored with stainless steel crowns. Usually the pulpotomy and stainless steel crown can be completed in one treatment visit.
We do not perform root canals on permanent teeth in our office. If your child should need a root canal on a permanent tooth we will refer you to one of the local endodontic specialists that we work closely with.
Most of the time if one of our patients should need either primary and/or permanent teeth extracted Dr. Schneider can do it easily in our office. While we make every reasonable effort to restore decayed and/or traumatized teeth, sometimes the damage is so great that extraction is the best option. Other reasons a tooth might need extraction include: as part of orthodontic treatment, or if a primary tooth doesn’t fall out after the permanent tooth already starts to come in. For situations such as badly abscessed teeth, impacted teeth, and third molars (wisdom teeth) we work closely with several local oral surgeons to whom we can refer you.
Silver Diamine Fluoride
Silver Diamine Fluoride (SDF) is one of the newest tools we have to help prevent the progression of tooth decay. While it does not cure or fill cavities, it can arrest them - stop them in their tracks. Studies show treatment is successful about 80% of the time.
What are the benefits of SDF treatment?
- Can prevent the progression of existing tooth decay
- Easy to apply
- Does not require removal of any tooth structure
- Does not require local anesthesia (getting numb)
- Doesn’t take a lot of time
- Reasonably high success rate
- Relatively inexpensive
What are the down sides of SDF treatment?
- Turns the decay dark black in color – not good for cosmetically sensitive areas
- Cannot be used for very large cavities that are close to the nerve of the tooth
- Not 100% effective
- Requires multiple applications to boost effectiveness
- May not be covered by dental insurance
When do we use SDF?
- For young children with extensive treatment needs - while we are waiting for behavior to allow treatment and/or for appropriate sedation to be arranged.
- For baby teeth with cavities that we expect will fall out within 8-12 months - in order to help avoid the need to fill or extract them.
- For cavities that are just getting started between permanent and/or baby teeth – in order to stop the decay before it progresses far enough to need a restoration.
Local Anesthesia - The Wand
While we are able to restore most cavities on the chewing surfaces without the use of local anesthesia; it is necessary for larger cavities, cavities between teeth, and for extractions. In our offices we use the STA System by Milestone Scientific to administer local anesthesia. Our “Magic Wand” doesn’t look like a “shot”, so our patients are less nervous right from the start. It also allows us to place the local anesthetic more accurately and much more comfortably then the old “traditional style” dental injection. The result is happier patients with less anxiety toward getting “numb".
Monitoring our patients’ developing occlusion (bite) and early detection of any potential problems is an important part of our dental exam. We work closely with several local area orthodontists rather than having a part time orthodontist in our office. This offers several advantages to our patients: we can refer you to the orthodontist whose office is closest to your home; the treating orthodontist has more available office hours; and most importantly we can refer you to the orthodontist who bests fits your child’s personality and orthodontic treatment needs.
Digital Radiographs (X-Rays)
Dr. Schneider is very conservative when it comes to taking radiographs for our patients and he only takes them when he expects they will add important information to your child’s treatment plan. Digital radiographs are a win-win situation. Compared to film based radiographs: they allow us to use less radiation, are easier to share with other specialists via e-mail, and are more environmentally friendly as they don’t require use of toxic developing chemicals.
Nitrous Oxide (Laughing Gas) & In-Office IV Sedation
Our staff is specially trained to help our patients feel comfortable receiving their dental care and we are usually able to comfortably treat most of our patients without any added sedative medications. Sometimes, however, young children and/or especially nervous children may benefit from mild medications to help them relax for restorative treatment.
Nitrous Oxide (Laughing Gas) is the most commonly used sedative in pediatric dentistry and can be used with patients 4-5 years old and older with mild anxiety towards treatment. It has a calming effect that helps phobic and/or anxious patients relax during their dental treatment. Because it is a mild sedative, patients are still conscious and can talk to their dentist during their visit. After treatment, the nitrous is turned off and the patients breaths plain oxygen for 5-10 minutes to flush out any remaining gas. The effects wear off almost immediately. Nitrous oxide rarely has side effects, although some patients may experience minor nausea and constipation.
For young children with extensive treatment needs, or extremely anxious older children, we offer in-office IV Sedation administered by Board Certified Anesthesiologist. Only one child is seen at a time and they are continuously monitored with hospital grade equiptment. This allows us to perform all necessary treatment in one visit and the child has no recollection of treatment being done.
Sometimes children who are medically compromised and/or who have special needs are unable to safely receive sedation in an office setting. When this is the case we can perform their dental treatment safely under general anesthesia at Huntington Hospital. This allows us to perform all necessary treatment in one visit and the child has no recollection of treatment being done. Currently Dr. Schneider is the only pediatric dentist with staff privileges at Huntington Hospital.
- CariVu Trans-illumination
- Emergency Care
- Dental care for children with special needs