Comprehensive oral examination and prophylaxis
Our office provides comprehensive dental treatment for infants and children up to age 18. The comprehensive examination appointment includes tooth cleaning, full mouth examination, assessment of the growth and development of orofacial structures and assessment of the risk for cavities. Our approach to complete dental exam and cleaning depends on the patient’s age and behavior. Our pediatric dentist will discuss with the parents and determine what is best and most comfortable to their children.
Often times, the detection of cavities will require radiograph for thorough diagnoses including cavities in between the teeth, missing teeth, and other pathologies. We only recommend the radiographs as needed according to the latest American Academy of Pediatric Dentistry Guidelines for Prescribing Dental Radiographs.
Dental sealants are resin-based material placed on the tooth structure with deep pit and groove. The deep pit and groove accounts for more than 90 percent of the cavities in posterior teeth and the placement of dental sealants have been shown to reduce the caries incident of more than 80 percent.
We recommend sealants on newly erupted primary and permanent molars with the indicated deep pit and fissure that is susceptible to cavities, and in patients with high risk for cavities. At our office, we use dental sealants that are free of BPA (bisphenol-A).
Evidence-based reviews show that fluoride use for prevention and control of cavities is both safe and highly effective in reducing caries prevalence. At the cleaning visit, we offer the application of 5 percent sodium fluoride varnish or 1.23 percent acidulated phosphate fluoride. After the application, we recommend that the patient refrain from drinking water for approximately 30 minutes.
For systemic fluoride supplement, we recommend in children with high risk for cavities and who drink water with fluoride level less than 0.6 ppm. To find out about the level of fluoride in your drinking water, click here for the California Department of Public health Drinking Water Program 2013 Annual Fluoridation Report.
At our office we also offer Sodium Diamine Fluoride as an option. Our pediatric dentist will determine what would be the best treatment option for each patient based on many factors including age, behavior, and the extent of dental treatment need.
Oral Hygiene instruction
At the oral exam and recall appointment, we review the oral hygiene care at home for your children. We recommend using fluoride toothpaste with appropriate brush size, under supervision of parents, in infants and children. The amount of fluoride toothpaste recommended is smear-size in children less than 3 years of age, and pea-size in children aged 3-6 years old. Flossing is recommended whenever two adjacent teeth are seen touching each other. We also recommend prescription-strength fluoride toothpaste and mouthwash in the children with high risk for cavities.
For the teeth that are restorable with dental fillings, we offer dental restoration with composite resin and glass ionomer cement. We do not use amalgam in our office. For young children who are likely to be anxious during the restorative appointment, the dental restoration is often recommended to be completed in conjunction with the use of laughing gas. We encourage the morning appointment for the restorative procedures for young children.
The cavities that progress past the enamel and dentin into pulp chamber often time causes pain and discomfort. We offer many types of pulp therapy or root canal treatment based on the diagnosis. We always try our best to save the tooth for your child.
Pre-fabricated crowns in baby teeth are indicated when the decay extends to multiple surfaces of the tooth, and/or into the pulp chamber, in such a way that the regular dental restoration cannot hold on the tooth structure. The stainless steel crown is the standard treatment of choice for the posterior teeth due to its durability and functionality, and the white color crowns in the front teeth for esthetic as well as functionality. In certain circumstances when indicated, posterior white crown can also be applied.
Silver Diamine Fluoride
Silver diamine fluoride (SDF) is a topical medicament that has gained attention in recent years for its use in pediatric dentistry. It is a clear liquid composed of silver, water, fluoride, and ammonia. SDF has been found to have several beneficial effects in managing dental caries (tooth decay) in children.
SDF has been shown to effectively arrest or slow down the progression of dental caries in children. It works by killing bacteria that cause tooth decay and forming a protective layer over the affected tooth, which helps prevent further decay.
One significant advantage of SDF is that it is a non-invasive treatment option. It can be applied topically to the affected tooth without the need for drilling or anesthesia, which is particularly useful in managing dental caries in young children who may have difficulty cooperating with invasive procedures.
Treatment of Cavitated and Non-Cavitated Lesions:
SDF can be used to treat both cavitated (cavities) and non-cavitated lesions. For cavitated lesions, SDF can help arrest the decay process and provide temporary relief until a more definitive restoration can be performed. In non-cavitated lesions, SDF can halt the progression of early decay and prevent the need for invasive treatment.
SDF is typically applied to the affected tooth using a microbrush or applicator. It is important to ensure that the tooth is clean and dry before application. The surrounding soft tissues (gums) should be protected with a barrier such as petroleum jelly or a rubber dam to minimize contact with SDF.
One of the notable side effects of SDF is the potential for staining the affected tooth and adjacent tissues black or brown. This staining is a cosmetic concern, particularly when SDF is applied to anterior (front) teeth. However, it is important to note that the staining is superficial and does not cause any harm or structural damage to the tooth.
After the application of SDF, it is important to educate parents and caregivers on proper oral hygiene practices for the child. Regular follow-up visits with the dentist are essential to monitor the progress of the affected tooth and determine the need for additional treatment or restoration.
Tooth extraction and space maintainers
At our office, we offer extraction of baby tooth the has prolonged retention, in other words, when the adult teeth are coming in but the baby teeth are still there. Tooth extraction is also indicated in various circumstances such as unrestorable tooth, orthodontic extraction, and ectopic eruption. To prevent space loss resulting from early loss of baby teeth, we offer fixed appliances which come in many forms including band-and-loop space maintainers, Lingual arch/bar, palatal arch, and pedi-partial for early loss of front teeth.
Dental care for the special needs
Children with special needs are those with impairment in development including physical, mental, behavioral and cognitive impairment. Dental care for children with special needs requires specialized knowledge acquired by additional training, as well as increased awareness and attention, adaptation, and accommodative measures beyond what are considered routine.
When scheduling the first appointment for the special needs, our team will work with the parents for customize care for dental visit to best suit the patient’s condition. We offer many treatment options and various behavioral shaping approaches during the dental visit to maximize the patient’s comfort. For patient with extensive dental decay and require comprehensive dental restorations, we offer the option of comprehensive dental care under general anesthesia/IV sedation.
Our office utilizes the latest technology in digital radiography along with high-speed digital sensors to reduce radiation exposure while producing high quality images for proper diagnosis and thorough detection of cavities and other abnormalities. Our office is fully compliant with the radiation safety requirement according to the State Laws and Regulations. Our staffs are certified with radiation safety certificate. Lead apron and thyroid collars are used in conjunction to further minimize exposure to the radiation.
According to the American Academy of Pediatric Dentistry guideline, during the new patient exam visit, selected periapical radiographs and the interproximal radiographs are recommended when the area in between the teeth cannot be visualized. At our office, we consider many factors to customize the need for each individual child for the radiograph including the child’s age, behavior and his/her risk to have cavity.
Conscious sedation with nitrous oxide
We offer nitrous oxide/oxygen (also known as laughing gas) inhalation for children to relax them during their dental treatment. The American Academy of Pediatric Dentistry recognizes nitrous oxide/oxygen as a safe and effective technique to reduce the child’s anxiety and discomfort. Nitrous oxide also helps reduce gag reflex and increase pain threshold. When administered, 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 child remains fully conscious with all protective reflexes intact.
Prior to the appointment, let us know if there are any changes in your child’s medical history, including new medication, allergies and any difficulty breathing in past few days. Fasting is not required for nitrous oxide administration. We recommend the patient consume a light meal approximately 2 hours prior to appointment.
Outpatient IV sedation/General Anesthesia
When considering age, behavior and dental treatment needs, general anesthesia is an option for apprehensive children, children with special needs that needs comprehensive full mouth rehabilitation. Our office works with board-certified anesthesiologists at Carepoint Anesthesia Care for in-office general anesthesia. Learn more about our anesthesiologist.
Toothache: Clean the area of the affected tooth. Rinse the mouth thoroughly with warm water or use dental floss to dislodge any food that may be impacted. If the pain still exists, contact your child's dentist. Do not place aspirin or heat on the gum or on the aching tooth. If the face is swollen, apply cold compresses and contact your dentist immediately.
Cut or Bitten Tongue, Lip or Cheek: Apply ice to injured areas to help control swelling. If there is bleeding, apply firm but gentle pressure with a gauze or cloth. If bleeding cannot be controlled by simple pressure, call a doctor or visit the hospital emergency room.
Knocked Out Permanent Tooth: If possible, find the tooth. Handle it by the crown, not by the root. You may rinse the tooth with water only. DO NOT clean with soap, scrub or handle the tooth unnecessarily. Inspect the tooth for fractures. If it is sound, try to reinsert it in the socket. Have the patient hold the tooth in place by biting on a gauze or clean cloth. If you cannot reinsert the tooth, transport the tooth in a cup containing the patient’s saliva or milk, NOT water. If the patient is old enough, the tooth may also be carried in the patient’s mouth (beside the cheek). The patient must see a dentist IMMEDIATELY! Time is a critical factor in saving the tooth.
Knocked Out Baby Tooth: Contact your pediatric dentist. Unlike with a permanent tooth, the baby tooth should not be replanted due to possible damage to the developing permanent tooth. In most cases, no treatment is necessary.
Chipped/Fractured Permanent Tooth: Time is a critical factor, contact your pediatric dentist immediately so as to reduce the chance for infection or the need for extensive dental treatment in the future. Rinse the mouth with water and apply a cold compress to reduce swelling. If you can find the broken tooth piece, bring it with you to the dentist.
Chipped/Fractured Baby Tooth: Contact your pediatric dentist.
Severe Blow to the Head: Call 911 immediately or ake your child to the nearest hospital emergency room.
Possible Broken or Fractured Jaw: Keep the jaw from moving and take your child to the nearest hospital emergency room.
Read more about how to prevent dental emergencies during recreational activities and sports with mouth guards.