Pediatric Dentistry Procedures
New Patient Exam:
Please watch our videos under the “Child Preparation” section :)
What to expect?
- Review medical history in detail
- Review any dental history in detail + concerns
- Oral Exam with Dr. Hernandez or Dr. Soyupak
- Cleaning may or may not include scaling + fluoride (optional)
- X-rays (case by case based on age, findings)
- Discussion of findings and suggested treatment plan
See relevant AAPD guidelines:
https://www.aapd.org/globalassets/media/policies_guidelines/p_prophylaxis.pdf
https://www.aapd.org/globalassets/media/policies_guidelines/p_dentalhome.pdf
Follow Up Check-Up 4-6 Months:
What to expect?
- Review any changes in medical history including new medications, allergies or hospitalizations
- Review any dental concerns parent might have
- Check-up with Dr. Hernandez or Dr. Soyupak
- Cleaning may or may not include scaling + fluoride (optional)
- X-rays (case by case based on age, findings)
- Discussion of findings and suggested treatment plan
See relevant AAPD guidelines:
https://www.aapd.org/globalassets/media/policies_guidelines/p_prophylaxis.pdf
https://www.aapd.org/globalassets/media/policies_guidelines/p_dentalhome.pdf
Sealants:
What are sealants?
Sealants are placed on chewing surfaces of adult molars to reduce chances of them getting cavities. They block the grooves on the teeth, making it easier to keep them clean and less likely to get cavities.
E.g. when Oreos get packed into the chewing surface making them hard to clean
Will my child need anesthesia or drilling for sealants?
No drilling or anesthesia is required to place sealants on teeth.
What else should I know?
Sealants might wear down over time and will need touch ups. It will depend on the chewing and grinding habits of the individual.
Photo obtained from https://oralhealthnc.org/what-are-dental-sealants/
See AAPD guidelines on sealants:
https://www.aapd.org/research/oral-health-policies--recommendations/pit_and_fissure_sealants/
Silver Diamine Fluoride (SDF):
What is SDF?
Silver diamine fluoride (SDF) is a colorless liquid that we use to slow down the cavities from getting bigger. While the silver kills the bacteria, the fluoride strengthens the tooth. It can be applied to both adult and baby teeth for smaller areas of decay (cavities). Research has indicated that with diligent daily oral care the cavity process is slowed. However if the oral care habits are not modified the cavity will grow.
How is SDF applied? Will my child need anesthesia?
The application of SDF is fast, easy and painless. No anesthesia or drilling is required for SDF. It is a liquid that is applied with a brush or floss.
How many treatments will my child need?
It will usually require at least 2 applications 2 to 4 weeks apart. It is strongly recommended that we consider follow up applications in the future.
Will the teeth need more treatment later?
In some cases, this will not be definitive treatment and the tooth may need intervention in the future, although this varies case by case. It is a great alternative in a child who may not be able to tolerate a dental filling.
SDF before and after:
Active cavitated caries lesions before application of SDF SDF-treated lesions with temporary gingival staining
Primary molar teeth before SDF Primary molar teeth after SDF
Photos obtained from https://www.aapd.org/globalassets/media/policy-center/sdf.factsheet.pdf
See AAPD Guidelines on SDF: https://www.aapd.org/media/Policies_Guidelines/R_ChairsideGuide.pdf
Silver Modified Atraumatic Restorative Technique (SMART) Restorations:
What is a SMART restoration?
SMART fillings are placed to slow down or stop cavities using Silver Diamine Fluoride (SDF) and a white filling material that releases fluoride over time. The goal is to slow down the cavity using SDF and seal the tooth using the white filling material to prevent food from getting stuck in the area.
Will my child need anesthesia or drilling for SMART restorations?
Anesthesia is not required, however in some cases minimal drilling can allow to remove part of the cavity. In most cases, the superficial part of the cavity is “scooped out” using hand instruments before applying SDF.
Will these teeth need more treatment later?
In some cases, this will not be definitive treatment and the tooth may need intervention in the future, although this varies case by case. Like SDF, it is a great alternative in a child who may not be able to tolerate a dental filling.
The first image shows a baby tooth with a large cavity,The second image is after SDF application.The last image is after the restoration is finished. Photo obtained from: Aly et al., 2023published in Journal of Dentistry
See AAPD guidelines on restorative dentistry and minimally invasive dentistry:
https://www.aapd.org/globalassets/media/policies_guidelines/bp_restorativedent.pdf
https://www.aapd.org/globalassets/media/policies_guidelines/p_minimallyinvasivedentistry.pdf
ICON
What is ICON?
Icon is a “minimally” invasive technique that allows to reduce appearance of white spots after braces or developmental defects on teeth.
What does the procedure look like?
This procedure does not require any anesthesia or drilling. The teeth are treated with several layers of materials to reduce the discoloration. Several rounds of treatment might be needed for some teeth.
ICON Before & After
See link for studies done on ICON:
See AAPD guidelines on restorative dentistry and minimally invasive dentistry:
https://www.aapd.org/globalassets/media/policies_guidelines/bp_restorativedent.pdf
https://www.aapd.org/globalassets/media/policies_guidelines/p_minimallyinvasivedentistry.pdf
Cosmetic Bonding
Cosmetic bonding can allow us to recreate teeth natural form and function. This can be used to restore front teeth that have fractured due to trauma or closing spaces between teeth.
Here is an example of a case where our patient wanted to close the space between the two front teeth. The space was closed using white filling materials that match the color and shape of adjacent teeth.
Here is an example of an esthetic bonding case after trauma. The fractured tooth was restored to look like the adjacent teeth.
Space Maintainers
What is a space maintainer?
Every baby tooth holds space for an adult one. When a baby tooth is lost early, we use space maintainers to hold the space for the adult tooth until it comes in. Space maintainers can look different based on the location of the tooth that is missing.
What will the process look like?
Once we determine your child needs a space maintainer, we will get a mold or a scan of their mouth and send it to a lab to make a customized space maintainer for your child. We will use a dental cement to seat it in the mouth.
Photo obtained from https://www.bmortholab.com/product/nance-appliance/
Photo obtained fromhttps://www.philadelphia-orthodontics.com/palate-expander
Photo obtained from: https://www.specialtyappliances.com/appliance-categories.php?type=8