Tooth Colored Fillings
Traditional dental restoratives, or fillings, are most often made of silver amalgam. The strength and durability of this traditional dental material makes it useful for situations where restored teeth must withstand extreme forces that result from chewing, often in the back of the mouth.
Tooth colored fillings include ceramic and plastic compounds that mimic the appearance of natural teeth. These compounds, often called composite resins, are usually used on the front teeth where a natural appearance is important, but they can also be used on the back teeth depending on the location and extent of the tooth decay.
There are two different kinds of fillings: direct and indirect. Direct fillings are fillings placed into a prepared cavity in a single visit. They include silver amalgam, glass ionomers, resin ionomers, and composite (resin) fillings. Indirect fillings generally require two or more visits. They include inlays, onlays, and veneers. They are used when a tooth has too much damage to support a filling but not enough to necessitate a crown.
Crowns
As a parent, you do all you can to make sure your child grows up with the best oral health and the happiest possible smile. Even with good home hygiene, decay and traumatic injuries can happen and affect the integrity of a primary tooth. We try to keep your child’s primary teeth intact whenever possible until the permanent teeth erupt, which is when restoring your child’s tooth with a pediatric dental crowns become a good option.
Crowns are a restorative procedure used to improve a tooth’s shape or to strengthen a tooth. Crowns are most often used if your child has a tooth that is broken, worn, or damaged by tooth decay, and too damaged to hold a filling.
White Crowns
A crown is a “cap” cemented onto an existing tooth that usually covers the portion of the tooth above the gum line. In effect, the crown becomes the tooth’s new outer surface. White crowns are made of white powdered ceramic material. White crowns are most often preferred on the front teeth because they mimic the translucency of natural teeth.
Unlike fillings, which are applied directly onto your child’s tooth, a crown is fabricated in a lab and is based on an impression taken of your child’s mouth. We sculpt each crown for your child so that his or her bite and jaw movements function normally once the crown is placed.
Stainless Steel Crowns
Stainless steel dental crowns are considered a good temporary restoration to save a primary tooth until the permanent tooth can erupt and take its place. Keeping the primary tooth if at all possible is very important. A primary tooth can be restored with a stainless steel crown during one appointment.
Pulpotomy
If a primary tooth has extensive decay, or has been damaged by trauma, action may be needed to restore the integrity of the tooth and prevent infection from spreading to surrounding teeth. After a set of X-rays are taken, your doctor will be able to assess the extent of the infection and recommend your treatment options. The less serious of these options is vital pulp therapy, also known as a pulpotomy.
If the decay or trauma is confined to the crown of the tooth, and does not affect the root, a pulpotomy may be recommended. When a cavity gets really deep, close to the pulp of a tooth, or even into the pulp, the pulpal tissue becomes irritated and inflamed. A pulpotomy is when the inflamed pulp chamber, usually on a baby molar, is removed. Your doctor will remove all the infected material in the pulp of the crown only, leaving the living tooth root intact. After a pulpotomy on a baby molar, the empty space will be filled with dental cement and a stainless steel crown will be placed to restore the tooth.
Extractions
There are times when it is necessary to remove a tooth. Sometimes a baby tooth has misshapen or long roots that prevent it from falling out as it should, and the tooth must be removed to make way for the permanent tooth to erupt. At other times, a tooth may have so much decay that it puts the surrounding teeth at risk of decay, so your doctor may recommend removal and replacement with a bridge or implant. Infection, orthodontic correction, or problems with a wisdom tooth can also require removal of a tooth.
When it is determined that a tooth needs to be removed, your dentist may extract the tooth during a regular checkup or may request another visit for this procedure. The root of each tooth is encased within your jawbone in a “tooth socket,” and your tooth is held in that socket by a ligament. In order to extract a tooth, your dentist must expand the socket and separate the tooth from the ligament holding it in place. While this procedure is typically very quick, it is important to share with your doctor any concerns or preferences for sedation.
Once a tooth has been removed, neighboring teeth may shift, causing problems with chewing or with your jaw joint function. To avoid these complications, your dentist may recommend that you replace the extracted tooth.
Space Maintainers
If your child’s tooth has come out too soon because of decay or an accident, it is important to maintain the space to prevent future space loss and dental problems when permanent teeth begin to come in. Without the use of a space maintainer, the teeth that surround the open space can shift, impeding the permanent tooth’s eruption. When that happens, the need for orthodontic treatment may become greater.
Types of Space Maintainers
Space maintainers can be made of stainless steel and/or plastic, and can be removable or fixed (cemented to the teeth).
Removable
A removable space maintainer looks much like a retainer with plastic blocks to fill in where the tooth is missing. If your child is older and can reliably follow directions, a removable space maintainer can be a good option.
Fixed
Fixed space maintainers come in many designs.
A band-and-loop maintainer is made of stainless steel wire and held in place by a crown or band on the tooth adjacent to the empty space. The wire is attached to the crown or loop and rests against the side of the tooth on the other end of the space.
A lingual arch is used on the lower teeth when the back teeth on both sides of the jaw are lost. A wire is placed on the lingual (tongue) side of the arch and is attached to the tooth in front of the open space on both sides. This prevents the front teeth from shifting backwards into the gap.
In the case of a lost second primary molar prior to the eruption of the first permanent molar, a distal shoe may be recommended. Because the first permanent molar has not come in yet, there is no tooth to hold a band-and-loop space maintainer in place. A distal shoe appliance has a metal wire that is inserted slightly under the gum and will prevent the space from closing.
Caring for Your Child’s Space Maintainer
There are four general rules for taking care of your child’s appliance.
- Your child should avoid sticky foods, including candy and chewing gum.
- Encourage your child not to push or tug on the space maintainer with the fingers or tongue.
- Keep your child’s space maintainer clean through effective brushing and flossing.
- Your child should continue to see the pediatric dentist for regular dental visits.
Habit Appliances
A habit appliance is a dental device designed to help children stop harmful oral habits, like thumb-sucking or prolonged pacifier use, that can affect their teeth and jaw development. These habits can lead to problems such as open bite, protruding teeth, or crossbite, which may impact your child’s bite, speech, and jaw growth. A habit appliance works by gently discouraging these habits and encouraging proper oral development. Typically recommended for children ages 4 and older, these appliances can be custom-fitted to help prevent long-term dental issues and
guide the jaws into a healthier position, reducing the need for more extensive orthodontic treatment later on. If you're concerned about your child's habits, consult with us to see if a habit appliance might be right for them.