/ Preventive Dentistry
Behavior Management Techniques & Sedation /
Age 1 Visits
The American Academy of Pediatric Dentistry recommends
children visit a dentist by the first birthday, and we
whole-heartedly agree with their recommendation. The
American Dental Association (ADA) also endorses the Age 1
visit to establish a "Dental Home". We actually
prefer to see you and your child around 9-12 months so we have
time to reduce any risk factors we may find in our primary
prevention program. Our age 1 visit is for you — the
parents! We provide you with the information you need to
care of your child's smile. We even talk to you about your
mouth and your habits as these have been shown to play a
significant role in your child's future cavity risk. You can
prevent costly dental work in the future by knowing what to
do with your child's diet and hygiene as well as your own.
For children 3 and older, our New Patient visit includes an
orientation to the office, soft tissue examination, oral
scaling and polishing, necessary x-rays, fluoride treatment,
oral hygiene instruction, dental development evaluation,
dietary and nutritional counseling, and patient/parent
education. We encourage mom and dad to be present with their
child during their entire visit. We teach you and your child
how to best care for their teeth, advise on eating habits
and answer any specific questions you may have. We explain
how cavities are caused, what you can do to prevent them and
how your children can help fight gum and tooth disease by
brushing properly. All information is provided in an age
appropriate manner to help nurture and encourage your child.
We pack a lot into this first visit!
Our check up appointments encompass more than "just a
cleaning." We view each check up as an opportunity to
provide you and your child the tools your family needs to
remain cavity free. Take a look at the initial exam to see
the types of services your child will receive at every check
Although check up appointments are a critical component of
your child's dental care, we know that your child's home
care program and habits will more likely influence his or
her ability to stay cavity-free. Therefore, we place a
significant emphasis on education and help identify and
eliminate potentially harmful habits. Please refer to our
FAQ on how cavities
develop and brushing tips and helpful hints for some of our
Back to Top
Sealants protect the grooved and pitted surfaces of the
teeth, especially the chewing surfaces of back teeth where
most cavities in children are found. Made of tooth colored
plastic, sealants are applied to the teeth to help keep them
cavity-free. The application of a sealant is quick and
comfortable. It takes only one visit. The tooth is first
cleaned. It is then conditioned and dried. The sealant is
then flowed onto the grooves of the tooth and hardened with
a special light. Your child will be able to eat right after
When the element
fluoride is used in small amounts on a routine basis it
helps to prevent tooth decay. It encourages "remineralization,"
a strengthening of weak areas on the teeth. These spots are
the beginning of cavity formation. Fluoride occurs naturally
in water and in many different foods, as well as in dental
products such as toothpaste, mouth rinses, gels, varnish and
supplements. Fluoride is effective when combined with a
healthy diet and good oral hygiene.
Athletic mouth guards can prevent serious dental injuries.
We can provide boil and bite mouth guards for children whose
mouths are undergoing a lot of change (such as teeth falling
out, etc). We can construct custom mouth guards
for teenagers that provide the best fit. In addition we make
night guards for teenage patients with teeth grinding or jaw
"I love the
pretty necklaces or bracelets or rings that I get!!"
In all cases our goal is to keep our patients
comfortable. When possible we will use our air abrasion
technique. These micro abrasive particles which are propelled
by a gentle air stream can quickly and
gently remove decay. Many types of cavities can be treated
with air abrasion. If the decay cannot be treated this way,
we will make sure the tooth is thoroughly numb using local
anesthesia and topical
Depending on the size of the filling, we will numb the area
using local anesthesia and place a rubber dam to protect
your child’s airway. We then remove the cavity, clean the
tooth, and fill the tooth with a tooth colored composite
Crowns are used in cases where a cavity has affected so much
tooth structure that filling material cannot be used to
repair the tooth. We offer several types of crowns depending
on the location of the cavity. For the front teeth we have
white crowns. We choose which crown based on the patient’s
bite and the extent of the cavity. For the back teeth we
have stainless steel crowns.
Very large cavities can result in tooth aches and nerve
irritation or infection. If a cavity has affected the nerve,
we will clean out the infected part of the nerve, place an
antibacterial medicine on the remaining nerve structure and
finally place a protective filling over the nerve. Once a
tooth has had nerve treatment it is weakened and must have a
crown placed over it to protect it.
Back to Top
In the event of tooth fracture, malformed teeth, or tooth
discoloration we are able to repair teeth by using tooth
colored composite material.
Often our teenagers, especially after braces, desire whiter
teeth. We offer at home bleaching kits with custom made
Back to Top
We use this technique on virtually all young
patients. We explain to our patients what we’re going to do.
We show them what we’re going to do. And then we do it.
Voice Control This technique is used to intercept
inappropriate behavior as it begins. The dentist alters
voice tone and volume to interject more authority.
Very young children and some special needs patients are not
able to understand why they need dental treatment. This
technique is used to protect them from harming themselves.
We only use restraints when absolutely necessary and with
Some children are given nitrous oxide/oxygen, or what you
may know as laughing gas, to relax them for their dental
treatment. Nitrous oxide/oxygen is a blend of two gases,
oxygen and nitrous oxide. Nitrous oxide/oxygen is given
through a small breathing mask which is placed over the
child’s nose, allowing them to relax, but without putting
them to sleep. The American Academy of Pediatric Dentistry,
recognizes this technique as a very safe, effective
technique to use for treating children’s dental needs. The
gas is mild, easily taken, then with normal breathing; it is
quickly eliminated from the body. It is non-addictive. While
inhaling nitrous oxide/oxygen, your child remains fully
conscious and keeps all natural reflexes.
Prior to your appointment
Please inform us of
any change to your child’s health and/or medical condition.
Tell us about any respiratory condition that
makes breathing through the nose difficult for your child.
It may limit the effectiveness of the nitrous oxide/oxygen.
Let us know if your child is taking any
medication on the day of the appointment.
Conscious sedation is a management technique that uses
medications to assist the child to cope with fear and
anxiety and cooperate with dental treatment. Conscious
sedation is a good option for children who have a level of
anxiety that prevents good coping skills or are very young
and do not understand how to cope in a cooperative fashion
for the delivery of dental care.
Conscious Sedation is recommended for
apprehensive children, very young children, and children
with special needs. It is used to calm your child and to
reduce the anxiety or discomfort associated with dental
treatments. Your child may be quite drowsy, and may even
fall asleep, but they will not become unconscious.
There are a variety of different medications,
which can be used for conscious sedation. The doctor will
prescribe the medication best suited for your child’s
overall health and dental treatment recommendations. We will
be happy to answer any questions you might have concerning
the specific drugs we plan to give to your child.
Prior to your appointment:
Please notify us of any change in your child’s health and/or
medical condition. Do not bring your child for treatment
with a fever, ear infection or cold. Should your child
become ill, contact us to see if it is necessary to postpone
You must tell the doctor of any drugs that
your child is currently taking and any drug reactions and/or
change in medical history.
Please dress your child in loose fitting,
Please make sure that your child goes to the
bathroom immediately prior to arriving at the office.
Your child should have nothing to eat or
drink after midnight the evening before the sedation
The child’s parent or legal guardian must
remain at the office during the complete procedure.
After the sedation appointment:
Your child will be drowsy and will need to be monitored very
closely. Keep your child away from areas of potential harm.
If your child wants to sleep, place them on
their side with their chin up. Wake your child every hour
and encourage them to have something to drink in order to
prevent dehydration. At first it is best to give your child
sips of clear liquids to prevent nausea. The first meal
should be light and easily digestible.
If your child vomits, help them bend over and
turn their head to the side to insure that they do not
inhale the vomit.
Because we use local anesthetic to numb your
child’s mouth during the procedure, your child may have the
tendency to bite or chew their lips, cheeks, and/or tongue
and/or rub and scratch their face after treatment. Please
observe your child carefully to prevent any injury to these
Please call our office for any questions or
concerns that you might have.
Back to Top
Care of the Mouth after Local Anesthetic
- Your child has had local anesthetic for their dental
If the procedure was in the lower jaw - the tongue, teeth,
lip and surrounding tissue will be numb or asleep.
- If the procedure was in the upper jaw - the teeth, lip and
surrounding tissue will be numb or asleep.
Often, children do not understand the effects of local
anesthesia, and may chew, scratch, suck, or play with the
numb lip, tongue, or cheek. These actions can cause minor
irritations or they can be severe enough to cause swelling
and abrasions to the tissue. Please monitor your child
closely for approximately two hours following the
appointment. It is often wise to keep your child on a liquid
or soft diet until the anesthetic has worn off.
Please do not hesitate to call the office if there are any
Care of the Mouth
Please keep the traumatized area as clean as possible. A
soft was cloth often works well during healing to aid the
Watch for darkening of traumatized teeth. This could be an
indication of a dying nerve (pulp).
If the swelling should re-occur, our office needs to see the
patient as-soon-as possible. Ice should be administered
during the first 24 hours to keep the swelling to a minimum.
Watch for infection (gum boils) in the area of trauma. If
infection is noticed - call the office so the patient can be
seen as-soon-as possible.
Maintain a soft diet for two to three days, or until the
child feels comfortable eating normally again.
Avoid sweets or foods that are extremely hot or cold.
If antibiotics or pain medicines are prescribed, be sure to
follow the prescription as directed.
Please do not hesitate to call the office if there are any
Care of the Mouth
Do not scratch, chew, suck, or rub the lips, tongue, or
cheek while they feel numb or asleep. The child should be
watched closely so he/she does not injure his/her lip,
tongue, or cheek before the anesthesia wears off.
Do not rinse the mouth for several hours.
Do not spit excessively
Do not drink a carbonated beverage (Coke, Sprite, etc.) for
the remainder of the day.
Do not drink through a straw.
Keep fingers and tongue away from the extraction area
Bleeding - Some bleeding is to be expected. If unusual or
sustained bleeding occurs, place cotton gauze firmly over
the extraction area and bite down or hold in place for
fifteen minutes. This can also be accomplished with a tea
bag. Repeat if necessary.
Maintain a soft diet for a day or two, or until the child
feels comfortable eating normally again.
Avoid strenuous exercise or physical activity for several
hours after the extraction.
Pain - For discomfort use Children's Tylenol, Advil, or
Motrin as directed for the age of the child. If a medicine
was prescribed, then follow the directions on the bottle.
Please do not hesitate to contact the office if there are
Care of Sealants
By forming a thin covering over the pits and fissures,
sealants keep out plaque and food, thus decreasing the risk
of decay. Since, the covering is only over the biting
surface of the tooth; areas on the side and between teeth
cannot be coated with the sealant. Good oral hygiene and
nutrition are still very important in preventing decay next
to these sealants or in areas unable to be covered.
Your child should refrain from eating ice or hard candy,
which tend to fracture the sealant. Regular dental
appointments are recommended in order for your child's
dentist to be certain the sealants remain in place.
The American Dental Association recognizes that sealants can
play an important role in the prevention of tooth decay.
When properly applied and maintained, they can successfully
protect the chewing surfaces of your child's teeth. A total
prevention program includes regular visits to the dentist,
the use of fluoride, daily brushing and flossing, and
limiting the number of times sugar-rich foods are eaten. If
these measures are followed and sealants are used on the
child's teeth, the risk of decay can be reduced or may even
after a Cleaning
A thorough cleaning can sometimes produce some bleeding and
swelling and may cause some tenderness or discomfort. This
is not due to a "rough cleaning" but, to tender and inflamed
gums from insufficient oral hygiene. We recommend the
following for 2-3 days after cleaning was performed:
1.) A warm salt water rinse 2 - 3 times per day (1 teaspoon
of salt in 1 cup of warm water)
2.) For discomfort use Children's Tylenol, Advil, or Motrin
as directed for the age of the child.
Please do not hesitate to contact the office if the
discomfort persists for more than 7 days or if there are any
Back to Top