Services

The best defense against tooth decay, cavities, bad breath, and a host of other dental problems, is a good offense. At 3 Rivers Pediatric Dentistry we constantly provide in depth Oral Hygiene Instruction. Thankfully, the basics of the offensive game plan remain simple, proven, and inexpensive. Investing a little time in establishing and monitoring your child’s good brushing and flossing habits provides years of beneficial returns.

Good oral hygiene requires an understanding of plaque. Plaque is a sticky, colorless layer of bacteria. When you eat carbohydrates (foods made of sugar or starch) you feed this plaque, which in turn produces acids that attack tooth enamel, cause cavities, and develop a hard substance called calculus (tartar). Uninterrupted, the acid attacks can result in tooth decay and gum disease (also known as periodontal disease). If left untreated, gum disease can cause loss of teeth and bone.

By fighting plaque you can keep your teeth for a lifetime. Today’s older adults are keeping their natural teeth longer because of scientific developments and an emphasis on preventative dentistry.

At any age, you can begin the fight with plaque and keep your teeth and gums healthy. It’s really quite easy. Simply:

• Brush your teeth twice a day with a soft-bristled toothbrush and fluoride toothpaste to remove food particles and plaque from the tooth surfaces. While you’re at it, brush the top surface of your tongue to eliminate bad breath and bacteria buildup.
• Clean between your teeth daily with floss or an interdental cleaner. Decay-causing bacteria can linger between teeth where toothbrush bristles can’t reach. Flossing removes plaque and food particles from between the teeth and under the gum line.
• Eat a balanced diet and limit between-meal snacks. If a snack is needed, choose nutritious foods such as raw vegetables, plain yogurt, cheese or a piece of fruit.
• Schedule regular check-ups. Visit the dentist regularly (every 6 months) for professional cleanings and oral exams.
• Ask the doctor about dental sealants, a protective plastic coating that can be applied to the chewing surfaces of the back teeth where decay often starts.
• Wear mouth protection, such as a mouthguard, when you play contact sports or extreme sports.
• Prevent Tooth Decay – Tooth decay (cavity or caries) can develop on any surface of any tooth. Because cavities grow, they are much easier and less expensive to treat when they are small. A decaying tooth may not hurt, so you may have a cavity and not realize it. Our team checks for tooth decay at your child’s regular check-ups and will periodically use digital radiographs (x-rays) to check for decay between teeth. He treats tooth decay by cleaning out the cavity and placing a restoration (filling) in the tooth.

A tooth colored filling is a safer, better looking alternative to the silver-mercury fillings that today’s parents had as children. Tooth colored fillings are made from a composite resin that can be molded and shaded to match your child’s tooth. Unlike mercury-silver fillings, which are wedged into place and require removal of more tooth structure, tooth colored fillings bond to your child’s tooth, creating a seal that helps protect the tooth while keeping more of the natural structure of the tooth.

In the event that decay has progressed to multiple surfaces of the tooth, Dr. Foster or Dr. Ziegler may recommend a pediatric stainless steel crown (silver crown) be placed on the tooth to ensure the most durable and long-lasting restoration. The pediatric stainless steel crowns are placed the same day of the procedure and children often like seeing their new “Iron Man” or “Frozen” crown to keep their tooth healthy and strong.

Every effort is made to keep all of your child’s teeth. However, sometimes it is best to remove a tooth in order to ensure future good health. We may determine that extraction is the best treatment for your child. Rest assured that your child will be comfortable and safe as we take care of the procedure right here at 3 Rivers Pediatric Dentistry. With nitrous oxide and sedation dentistry options, as well as advanced tools and techniques, extractions are easy affairs for your child. Just think of them as an advanced visit from the Tooth Fairy, and a foundational step toward your child’s excellent future dental health.

Space maintainers are metal appliances custom fit for your child’s mouth. When baby teeth are lost too soon due to trauma or decay, the other teeth around that area will start to move and fill in the space left by the missing tooth. This is called “space loss.” If the teeth are not prevented from shifting, there will not be adequate space for the eruption of the permanent tooth. This often leads to the need for extensive orthodontic treatment. The goal of space maintenance is to hold open that space, providing a path for the natural eruption of the developing permanent tooth.

Early Treatment encompasses ages 2 to 6 years. At this young age, we are concerned with underdeveloped dental arches, the premature loss of primary teeth, and harmful habits such as finger or thumb sucking. Treatment initiated in this stage of development is often very successful and many times, though not always, can eliminate the need for future orthodontic/orthopedic treatment.

Mixed Dentition covers the ages of 6 to 12 years, with the eruption of the permanent incisor (front) teeth and 6-year molars. Treatment concerns deal with jaw mal-relationships and dental realignment problems. This is an excellent stage to start treatment, when indicated, as your child’s hard and soft tissues are usually very responsive to orthodontic or orthopedic forces.

Adolescent Dentition deals with the permanent teeth and the development of the final bite relationship.

Silver Diamine Fluoride is an FDA-approved antibiotic liquid clinically applied to control active dental caries and prevent further progression of disease. While the ideal way to treat teeth with decay is by removing the decay and placing a restoration, this alternative treatment allows us to stop decay with noninvasive methods, particularly with young children that have baby teeth. Treatment with Silver Diamine Flouride will not eliminate the need for restorative dentistry to repair function or aesthetics, but has been effective at prevention of further decay. Dental restorations may include but are not limited to dental fillings, root canal therapy and or crowns. Silver Diamine Fluoride is composed of two primary components: silver and fluoride. Silver acts as an anti-microbial agent that simultaneously strengthens the underlying protective layer of your teeth called dentin. Fluoride is the active ingredient that puts a stop to tooth decay and helps prevent additional decay from appearing. During your child’s visit, your dentist will brush and rinse their teeth without paste to prepare for the treatment. Your child’s teeth will then be dried and any debris, such as plaque, will be removed. SDF is applied to the affected teeth with a microbrush and the solution is allowed to cure on the tooth for two minutes. Once the tooth has been treated, we advise patients not to eat or drink or at least an hour to allow it to cure.

When is Silver Diamine Fluoride recommended?

There are several situations in which it may be recommend. Those include, but are not limited to the following:

• Children who may have excessive decay (severe early childhood caries)
• Young children who have difficulty cooperating for treatment
• Special needs patients
• Children with carious lesions that may not all be treated in one visit

Fluoride is a naturally occurring substance found everywhere in soil, air, water, plant, and animal life. Teeth that are developing require minerals that they receive from the bloodstream. It was once believed that fluoride, when ingested and delivered systemically in the form of a supplement, is incorporated into the enamel of the tooth resulting in a mineral structure that is stronger and more cavity resistant. Although some fluoride does get incorporated into your enamel when systemically delivered, it has been shown by modern research that this has a negligible effect on caries resistance. 

Your real benefit is derived from the topical effect. It may seem odd then that studies show that children who drink fluoridated tap water have 50% to 75% less dental disease. The real reason behind that interesting fact is due to the topical effect of the fluoridated drinking water passing through the teeth as it is swallowed or from its use during brushing and rinsing. However, too much ingested fluoride at an early age (particularly between the ages 3 to 6 years) can discolor your child’s developing teeth making them irregular (mottled) in appearance with whitish or brownish stains.

Although you may not realize it, your child may be receiving fluoride from many sources: tap water, infant formulas, reconstituted juices, toothpaste and even the food they eat. The American Academy of Pediatric Dentistry recommends using non-fluoridated bottled water to mix with infant formula if your infant derives nutrition solely from infant formula that’s not ready-made, particularly if your water supply is fluoridated.

Depending upon the level of fluoridation of the water in your area, our dentist may prescribe a fluoride supplement for your child. If so, ensure your child swishes fluoride drops around the mouth with the tongue before swallowing, lets fluoride tablets slowly dissolve in the mouth or chews the tablets and spreads them around the teeth with the tongue. The best time for your child to take fluoride supplements is after brushing the teeth at night, right before bedtime, because the fluoride will coat the teeth and exude its topical effect for a far longer period of time with the greatly diminished saliva flow during sleep. Recommendations for fluoride regimens performed in the dental office have also been updated to take caries risk into consideration:

• Children with moderate caries risk should have 6-month fluoride applications,
• High caries risk patients are recommended to have up to one fluoride application every 3 months, and
• Low caries risk patients may not benefit from in-office fluoride applications at all.

If needed, your child will enjoy up to 6 months of benefits from one application of fluoride varnish – the solely used topical fluoride treatment at 3 Rivers Pediatric Dentistry. Brushing with a pea-size amount of fluoride toothpaste is also important. If your child is very young, from 0-2 years of age, your child should only use a rice-sized amount (smear) of toothpaste twice a day as it is likely they will swallow this minimal amount.

Your child’s first permanent molars appear (erupt) around age 6. These teeth have deep grooves and fissures on the chewing surfaces that can harbor cavity-causing plaque, bacteria and acids that are difficult or impossible for toothbrush bristles to reach. Your child can protect these molars with sealants, a clear composite (plastic) material that is flowed into the grooves and fissures and then instantly hardened with a special light to act as a “shield” to harmful plaque, bacteria and acids. After they are placed, your child’s sealants are checked at each 6 month check-up and touched up if necessary.

Some parents notice chipped or cracked teeth in their children but don’t remember when an injury may have occurred. Those teeth may have been damaged while they were sleeping. Grinding or clenching of your child’s teeth during the night can cause teeth to chip, crack, and even break. That grinding and clenching can also be the cause of otherwise unexplained headaches. To keep from seriously damaging teeth, we sometimes recommend a dental appliance called a night-guard. Our team takes great care in making sure we have a proper fit to prevent pain in jaw joints. Night guards are most often appropriate for children whom have their permanent dentition. Ask our team about having a night-guard custom created.