We use white fillings aka composite resin restorations for smaller cavities. This is a synthetic plastic material with great esthetics. If they are placed in baby teeth, you have to take great care of them because they could possibly leak underneath and require replacement or more treatment for the same tooth.
Stainless steel crowns
If your child has a larger cavity, they may require a full coverage crown to fix it. One option is a stainless steel (silver) crown made of biologically compatible metal. This is a very strong temporary restoration for a baby tooth. When the new permanent tooth erupts under the crown, the stainless steel crown falls off just like a regular baby tooth.
White crowns aka EZCrowns or Sprig
EZ Pedo crowns are a healthy esthetic alternative to silver crowns for the back teeth, and a stronger alternative to plastic resin crowns for the front teeth. They cannot be used in every case due to their technique sensitivity, size restrictions, and they do not take forces as well as the stainless steel crowns. Dr. Manske will work with you on making the best recommendation for your child. Dr Manske is a Premier Provider of Sprig crowns: she attended a special hands-on class and during this course Sprig representatives checked and approved her work. Learn More
Pulpotomy or nerve treatment
If the cavity goes into the nerve of the tooth or if a tooth breaks all the way to the nerve, a tooth may require a pulpotomy or “baby root canal.” We remove part of the nerve of the tooth and replace it with a medication that heals the tooth. When it is time for the new permanent tooth to replace the baby tooth that has had nerve treatment, it should fall out like any baby tooth. To cover and protect the tooth after we do a baby root canal, the tooth requires full coverage protection by a silver or white crown.
If a baby tooth is infected, badly broken down with a large cavity, or cracked, it may require complete removal or extraction. Infection can happen due to a large cavity or sometimes, if the child injured the tooth.
A sealant is a protective coating that is applied to the chewing surfaces (grooves) of the back teeth. This sealant acts as a barrier to food, plaque and acid, thus protecting the decay-prone areas of the teeth.
Silver Diamine Fluoride or SDF
Use of silver diamine fluoride in pediatric dentistry has some value for our very young patients with untreated decay, or patients who cannot tolerate treatment. SDF is a colorless liquid containing both silver and fluoride ions. When placed on areas of a tooth that have decay, it arrests or stops the cavity from growing. Any decayed area that the SDF grabs on to turns black. The tooth will require re-application of the SDF in 1-3 months and it will need to be checked over time to make sure the cavity is still arrested. More often than not, the tooth will require restorative treatment (filling or crown) at a later date. Your dentist will determine the right timing for the application of SDF, and the restoration.
If a baby tooth requires extraction, it may require a space maintenance appliance to hold the space for the growing permanent tooth underneath. This is so the surrounding teeth do not move into the empty space where the baby tooth once was. Your child still may need orthodontic treatment in the future due to natural crowding or jaw misalignment.
For our patients already with permanent dentition, we have a special tooth whitening program. We gently whiten the teeth with an in office treatment. We follow up with an at- home care program specific for our young patients to help with post operative sensitivity. Our whitening program can also help with “white spots” on your teeth. These are weak spots on the teeth that are either congenital, due to a start of a cavitiy, or decalcification around the brackets after orthodontic treatment. Our program helps even out the color and also strengthen these weaker areas of enamel. Ask about our whitening program for teens and tweens and even parents!
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 given through a small breathing mask which is placed over the child’s nose, allowing them to relax without putting them to sleep. The American Academy of Pediatric Dentistry recognizes this technique as a very safe, effective technique for treating children’s dental needs. The gas is mild, easily taken, and it is quickly eliminated from the body and it is non-addictive. While inhaling nitrous oxide/oxygen, your child remains fully conscious and maintains all of their natural reflexes.
I.V. Sedation is recommended for apprehensive children, very young children, children with a lot of dental restorative treatment needs, children with special needs, or children for whom conscious sedation does not work. Our dentist performs the dental treatment in our office with the child anesthetized under I.V. sedation, which is administered and monitored by a licensed anesthesiologist. If the child has any severe medical conditions, he or she may have to be referred to a hospital setting for treatment under general anesthesia in the hospital. If you have any questions about treatment under IV sedation or general anesthesia, please call our office.