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Pediatric Dentistry

Perinatal & Infant Care

 

An important step for our practice is helping pregnant female patients understand the importance of perinatal care which plays a large role in the oral health of the unborn child. It has long been established that there is link between oral and systemic health in many facets of dentistry. The perinatal period is defined slightly differently depending on the organization it comes from, but it is generally the period of time (usually several weeks) before and after childbirth.

Both Dr. Gary and Dr. Stephen will review your oral health practices related to your hygiene, education, fluoride levels, and caries risk assessment (risk for getting cavities) among other topics. Dental caries is a transmissible and chronic disease of the teeth and our aim is to limit this since failure to do so can result in early childhood caries (abbreviated “ECC”) for the child, which poses a serious problem.

Oral hygiene practices are stressed since periodontal problems can lead to higher bacterial levels of the main causative agent of dental decay that can affect the fetus and placenta. Periodontal disease in the adult patient has been linked to heart disease, diabetes, gastrointestinal diseases and more. Among these most relevant to the pregnant patient is the link between periodontal disease and pre-term birth, high blood pressure (pre-eclampsia), as well as low birth weight. A full list of important factors will be reviewed at your appointment as well as acceptable medications to take during this time.

Preventive & Fluoride

 

  Our goal and philosophy at our practice is to always to try prevent a problem instead of having to treat problems without identifying a cause. Of course, when findings do show up during check ups that require treatment, they will be treated, but the importance of regular exams and preventive services cannot be stressed enough. The use of fluoride has been well documented to decrease the amount of cavities.  Therefore, it is a staple of preventive dental treatment. However, too much of a good thing can have consequences as well, so we will review how much fluoride should be supplemented to your child’s diet.

Regular exam intervals are 6 months, but similar to adults, for certain children this may be more frequent and is ultimately determined by the child’s needs. Dietary counseling will also be reviewed for patients requiring it. It is also our practice philosophy to not routinely take radiographs (x-rays) at every single visit. We will take x-rays only to confirm a diagnosis or problem visible on clinical exam.  Procedures at regular visits can include an exam, cleaning, and placement of sealants when appropriate as described below. Sealants can be thought of as protective varnishes that are bonded to the teeth and help prevent the formation of cavities.

Occlusion & Growth

 

  Proper growth and development is the ultimate goal of pediatrics; to transition in dental and skeletal form to a healthy adult dentition. During your visits we monitor your children for such things including if their baby teeth are falling out and adult teeth are coming in at appropriate times, as well as amount of available space in the arches for this to happen. For certain irregularities, we will either manage or refer to treat these conditions appropriately. Problems that arise during childhood need to be noticed and managed since these will carry into adulthood if not addressed. Often, when treated during childhood, they are easier to treat as the patient gets older.

  There are several stages of development we look for with regards to the teeth. These stages go from the primary (only baby teeth), to mixed (baby + adult teeth),  to adolescent (most adult teeth are in), to adult (complete growth). Not every patient will have enough room in their mouth for all the teeth that want to come in. Teeth may also be congenitally missing and it is our duty to find the best way to treat these conditions. Also, proper management can help when beginning orthodontic treatment if indicated. This is related to their occlusion or essentially their bite and how well their teeth come together. Other things like non-nutritive sucking habits is commonly seen in children and can affect their development; for example, thumb sucking has been shown to lead to a constricted dental arch. We aim to help with these as well.

Restorative

 

  The term ‘restorative’ in dentistry is a general term referring to many procedures including things like fillings, crowns, etc. The benefits of restorative procedures in children which are typically things like fillings and sealants are that they will help to stop the disease progression of dental decay, improving the structural integrity of the tooth and preventing loss of the tooth. Some parents will ask, “If these teeth are going to fall out anyway, why do you need to restore them?” Premature tooth loss in a child can have devastating consequences on their overall dentition and occlusion (bite). For children with malocclusion or growth issues, this can also further complicate future orthodontic treatment. In addition, untreated caries can be painful and caries during childhood is the greatest predictor of having dental decay as an adult.

  For teeth at risk of developing cavities we typically place sealants where reports have shown, with monitoring and recall visits are 90% successful. Repairs or replacements can be determined at your visit but typically they will last a very long time. If we have determined there may be a cavity, there are a variety of filling materials we can use, some of which release fluoride over time. We do not place metal (amalgam) fillings on children.