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Pediatric Dentistry

Catering to the dental needs of kids requires a special touch. Children are not little adults. Treating the dental challenges of children requires the patience, skills and expertise that Dr. Sonia provides. Pediatric dentists are specially trained to treat the oral health needs of children, from infancy through their teenage years. This involves in-depth knowledge about children's behavior, as well as their growth and development. Pediatric dental offices are also designed to make kids feel comfortable and relaxed – with plenty of toys, activities and a warm, inviting and fun décor.

Dental Exam

The secret to a bright, healthy smile is actually no secret at all: brush, floss and get a professional dental exam at least once every six months. Professional dental exams are all about prevention – preventing existing problems from getting worse and preventing dental problems from developing in the future. Regular dental exams make it possible to identify and treat a problem in its earliest stage – which is not only good for your child's oral health but also good for your budget!

There's nothing to fear with a dental exam. Your child's teeth will be visually examined for signs of plaque, tartar and tooth decay. Their gums will also be examined for puffiness or discoloration, which are signs of gum disease. A full set of dental X-rays may also be taken during the exam, to enable Dr. Sonia to see below the surfaces of the teeth. Dental exams typically end with a dental cleaning, to remove surface stains and buildup.

 

Dental X-Ray

X-rays are NOT TAKEN AS A MATTER OF ROUTINE in our office.

Dr. Warren believes that they should be used very sparingly, noting that this has been the position of the American Academy of Pediatric Dentistry (AAPD), the American Dental Association (ADA) and the Food and Drug Administration (FDA), with tweaks here and there, since 1987.

The ADA, in fact, has a guiding principal called ALARA (As Low As Reasonably Achievable) regarding responsible radiologic practice, which states that, even once it’s been determined that x-rays are necessary, they should be as minimal as possible to reduce a patient’s exposure.

We  exclusively use digital x-rays, which can lower radiation exposures by around 80 percent.

A dentist’s decision to take x-rays of a kid’s mouth, says Dr. Paul Casamassimo, who is the Director of the AAPD’s Pediatric Oral Health Research and Policy Center, should be based on the following: the child’s assessed risk of tooth decay, any signs of a problem that needs to be further investigated (such as pain, swelling, abnormal development), and how tightly together the baby teeth are spaced. “If we can see between the teeth,” he says, “we don’t expose them to radiation.” If there are spots that can’t be seen or felt, he explains, and x-rays of those teeth are taken and no problems are discovered, then the child can go up to two years without more x-rays. 

Dr. Sonia Remolina Warren practices these "image gently" principles.

 

Teeth Cleaning

No matter how often you brush and floss, plaque and tartar deposits can still build up on your teeth. A professional teeth cleaning is the single most effective way to remove these deposits and prevent them from causing more serious problems in the future. While a traditional teeth cleaning involves manually scraping away these deposits with special dental tools, advances in dental technologies now give you more options for teeth cleanings.

A laser teeth cleaning, also known as an ultrasonic cleaning, is a popular alternative to traditional teeth cleanings. With a laser teeth cleaning, an ultrasonic scaler (rather than a manual probe) is used to remove deposits, kill harmful microbes and eliminate bacteria around the teeth and gums through high-frequency sound waves. Many patients find laser teeth cleanings more comfortable than traditional teeth cleanings because they are quicker, quieter and pain-free.

A deep cleaning may be recommended if excessive plaque and tartar deposits have developed below the gum line. Deep cleanings, also known as scaling and root planing, involve a two-part process: first, the stubborn deposits are removed, and then the root surfaces are smoothened. A deep cleaning helps prevent periodontal disease and restores gum tissues to a healthy state.

Tooth Colored (Composite) Fillings

When considering tooth fillings, one of the options available are composite fillings which are made from durable composite resin that match the natural color of your child's teeth. Because the composite fillings are tooth-colored, they look more natural and are less noticeable compared to other types of fillings.

Another benefit of tooth-colored fillings is that they are compatible with sealants allowing your child’s dentist to perform both procedures in a single sitting preventing further decay. There are other advantages to composite, tooth-colored fillings, most importantly the capability of bonding to tooth structure. Also in many cases they can be repaired by addition of more composite material.
 
Talk to Dr. Sonia to find out which kind of filling is best for your child.
 

Teeth Sealants

Sealants are thin layers of resin that are placed on the pits, fissures, and grooves of molars to prevent decay on these surfaces.
 
The majority of decay on back teeth starts in the grooves and pits of chewing surfaces, especially during the first few years after their eruption. Sealing these surfaces with composite resins prevents this kind of decay.
 
Sealants are one of the most effective methods of preventing decay on the surfaces where they are placed. Although it is still a possibility that decay may develop on surfaces in between teeth, sealants significantly reduce the overall chance of having cavities.

Silver Diamine Fluoride

Silver Diamine Fluoride is an antimicrobial treatment for the infection that causes tooth decay and for the reduction in tooth sensitivity. Silver Diamine Fluoride has been used extensively in numerous countries around the globe for decades and is FDA approved. Click here for more information.

Dental Crowns

A dental crown may not make you feel like royalty, but it is one of the premiere treatments for teeth with extensive decay or damage. Dental crowns can also used to hold a dental bridge in place, cover misshapen or severely discolored teeth, or cover a tooth after a root canal procedure. Made of either porcelain-fused-to-metal, ceramic or gold, dental crowns are placed during a multi-step process and sometimes require more than one dental visit. The first step is a dental impression. A temporary crown is then placed to protect the tooth while the impression is sent to an offsite laboratory to create the final restoration. In some cases, same-day crowns are possible, so be sure to inquire. With good oral hygiene and minimal wear and tear, your child's beautiful new dental crowns can last up to 15 years.

Space Maintainers

Primary teeth stay in place until a permanent tooth comes in from underneath its position and pushes it out, taking its place in the mouth. Some children lose their primary teeth too early due to accidents or dental disease. When this is the case, a space maintainer may be recommended by Dr. Sonia to prevent space loss and future dental problems. It is important to remember the fact that some teeth are not replaced until a child is 12 or 14 years old.
 
Space maintainers are appliances made of metal or plastic that are custom fit to your child’s mouth. Most children adjust to them quickly. Without a maintainer, the teeth can tilt toward the empty space and cause permanent teeth to come in crooked.
 
With empty space, the teeth beside the gap may tilt or shift into the empty space. When adjacent teeth shift into the empty space, they create crowding in the permanent teeth and they come in crooked. If left untreated, the condition may require future orthodontic treatment. Space maintainers hold open the empty space left by a lost tooth. They steady the remaining teeth, preventing movement until the permanent tooth takes its natural position. It is more affordable to keep teeth in their normal positions with a space maintainer than to move them back in place with orthodontic treatment.

Pulp Therapy (for baby teeth)

The pulp of a tooth is the inner, central core of the tooth and contains blood vessels and nerves. Dental caries (cavities) and trauma to the tooth are the primary reasons for children to undergo pulp therapy.
 
Your child may need pulp therapy if he/she has:
 
  • Tooth pain for no apparent reason
  • A tooth that is sensitive to temperature changes
  • A broken tooth
 
The main purpose of pulp therapy is that the tooth is not lost. Primary teeth are needed for chewing and speaking and serve as space savers for permanent teeth. Without the primary teeth to guide them, existing neighboring teeth can crowd in, causing permanent teeth to grow in crooked or tilted.
 
The two forms of pulp therapy for children's teeth are: vital pulp therapy for primary teeth (pulpotomy) and non-vital pulp therapy for primary teeth (pulpectomy).
 
Vital Pulp Therapy for Primary (Baby) Teeth
 
Vital pulp therapy is for cases in which the tooth’s pulp may be salvaged. The main purpose is to maintain and protect existing healthy pulp by removing the diseased pulp tissue within the crown portion of the tooth. Next, an agent is placed to prevent bacterial growth and to calm the remaining nerve tissue. This is followed by a final restoration (usually a stainless steel crown).
 
Non-Vital Pulp Therapy for Primary (Baby) Teeth
 
Non-vital pulp therapy is required when the entire pulp is diseased (into the root canal(s) of the tooth). During this treatment, the diseased pulp tissue is completely removed from all parts of the tooth. The canals are cleansed and filled with a special material meant to be naturally absorbed by the body while the root prepares for the primary tooth to fall out and be replaced by a permanent tooth. A crown is placed on the tooth to prevent fractures.
 
If the pulp is severely damaged then your doctor may recommend removing the tooth entirely. If this is a case ask if space maintainers are necessary for future development.
 
If you suspect your child is in need of pulp therapy, contact our office or schedule an appointment for a consultation today.

Oral Sedation

Another alternative for helping nervous children relax at the dentist’s office is the use of sedation. When your child becomes so anxious that cooperating becomes difficult for them, sedation is an option. Sedation is a method in which medications are used to help your child relax during the dental visit and allow the doctor to effectively treat your child. Sedations tend to produce feelings of drowsiness and relaxation and are not meant to make your child unconscious.
 
Sedation is also a way to for the dentist to provide more effective treatment along with preventing that may result from uncontrolled movements in an anxious, uncooperative child.
 
When administered according to the sedation guidelines of the American Academy of Pediatric Dentistry by a pediatric dentist, sedation is a safe, effective option. If you are interested in learning more about the use of sedation during your child’s visits please contact our office to answer any of your questions or schedule an appointment to find out if sedation is a suitable option for your child.

Nitrous Gas

Most children feel comfortable when visiting the dentist. Early exposure to the dentist helps younger patients to associate the dental office with feeling of relaxation. Some children however, may feel nervous before their visit or while sitting in the dental chair. Sometimes they need more than gentle care to feel relaxed. Nitrous gas is a safe sedative used to help your child relax during the dental visit while allowing the doctor to effectively treat your child.
 
Nitrous gas is a blend of oxygen and nitrous oxide. Before the procedure a fitted mask is placed over your child’s nose and as they breathe, the blend is absorbed through the lungs. At the end of the treatment, the nitrous gas is removed and has no lingering effects. One of the side effects during treatment is a sense of contentment and relaxation one of the reasons why nitrous gas is also known as “laughing gas.”
 
The use of nitrous gas is very safe as it is rapidly absorbed, is reversible, and can be adjusted in concentration. Your child is fully conscious and keeps all of their natural reflexes while absorbing the nitrous gas. If you are interested in learning more about the use of nitrous gas during your child’s visits, or in other alternatives, please contact our office to answer any of your questions or schedule an appointment to find out if nitrous gas is a suitable option for your child. a suitable option for your child.