Children’s Dentistry of Charlottesville provides the most comprehensive dental services for the pediatric population in the Charlottesville area. Whether your child visits the dentist for the first time at Children’s Dentistry of Charlottesville, you are seeking care following a recent visit to another practitioner or you seek to establish a new place of service for a child used to regular dental visits, we hope you will call us your dental home. Some of the services provided include:
Dental examinations help to diagnose disease and generally include screenings for oral pathology, evaluation of growth and development, orthodontic needs assessment, gum disease evaluation, visual examination for tooth decay, diagnostic radiographs (xrays) to examine the bone and surrounding structures not visible to the eye, as well as evaluation of any current restorations, concerns or complaints of the patient/parent. Risk factors for disease will be discussed, oral hygiene instruction will be provided and nutritional counseling will also be covered.
More commonly known as a cleaning, this process removes plaque, a sticky substance formed in the mouth from food, saliva and bacteria. If present, the prophylaxis also removes calculus, which is plaque that has hardened on the tooth surface and requires professional instrumentation to remove. In addition, the prophylaxis helps polish the teeth to make them smooth and remove stains from the teeth. In the cooperative patient, a special dental cup and gritty toothpaste are used to achieve these goals.
Following the prophylaxis and flossing procedures, fluoride will be applied to your child’s teeth to help maintain the enamel in its strongest condition. The foods we eat and the things we drink can dissolve some of the mineral content out of the enamel, which is the first stage of a three part process in creating a cavity in a tooth. The fluoride reinforces the tooth structure and can actually reverse a small cavity that is present in only the enamel. The fluoride applied to your child’s teeth does not risk damaging the permanent teeth that are still developing in the bone and is similar to a very strong toothpaste. Fluoride varnish is the treatment of choice in this practice since its effects on the enamel last up to thirty six hours. Varnish is a sticky fluoride application that remains on the tooth throughout the day and is gradually absorbed into the enamel. Because it actually binds to the tooth, the patient can eat or drink immediately following this fluoride application.
Dental xrays are a very important part of the diagnosis of dental disease. They allow the dentist to see portions of the mouth that cannot be seen by the eye. These items include decay in between the teeth, tumors or cysts present in the bone or surrounding undeveloped teeth. The radiographs also determine the presence or absence of permanent teeth and their placement. Modern dental radiographs are very safe and the state-of-the-art digital equipment utilized by Children’s Dentistry of Charlottesville offers much lower radiation exposure than traditional film xrays. The amount of radiation exposure a person receives by living in a brick house all year or on a cross continental airplane flight exceeds the amount of radiation exposure from our equipment.
Sealants are a tough, plastic material designed to stick to the enamel of the tooth in the grooves where food collects. The tooth is prepared with a special cleanser that is quickly applied then rinsed with water. The sealant material is brushed onto the surface of the tooth and dried with a special curing light to make it hard. The process is very similar to applying nail polish to a fingernail and the teeth do not need to be numb. Sealants reduce the risk of cavities forming in these grooves that can be difficult to keep clean. These sealants do not last forever and will need to be replaced as they wear away from the tooth surface. Not all teeth are good candidates for sealants and the doctors will determine which teeth could receive the most benefit from the application.
When dental decay has invaded a tooth, various procedures can be used to treat the disease. Some of the procedures include:
Composite Fillings – A composite filling is a tooth colored material used to fill small cavities on front and back teeth. These fillings match the color of tooth structure and are very attractive. They require the most minimal tooth preparation, so less healthy tooth structure is removed. These fillings are the material of choice in this practice when the decayed tooth meets the proper criteria for their placement. These fillings do require more careful attention to home care (diet and hygiene, particularly flossing) than amalgam fillings (silver) or stainless steel crowns (silver caps). Additionally, many insurance companies do not pay for the increased cost of these fillings and the parent will be responsible for an increased out-of-pocket expense.
Amalgam Fillings – These silver fillings are the long standing restorative material that dentistry has relied on for many years. These fillings are quite durable and provide an excellent choice in restorative procedures. The disadvantages include the silver color, mercury content that some argue can be harmful to overall health (although no research has reliably confirmed this) and the need to remove slightly more tooth structure than for a composite filling.
Stainless Steel Crowns – A crown covers the tooth completely and restores it to its original shape and size. Crowns are incredibly strong and provide the necessary protection for any baby tooth that has needed root canal therapy. Additionally, when cavities cover more than one third of the tooth structure or a patient is very young, the crown is the restorative material of choice. The disadvantages of this material are the silver color and the irritation these crowns sometimes cause around the gumline of the covered teeth.
Pulpotomy - When decay reaches the nerve of a baby tooth, the infected portion of the nerve needs to be removed. This procedure is called a pulpotomy and is best described as a “mini” root canal treatment. This procedure is performed to help prevent the tooth from abscessing, which would require additional therapy or extraction of the tooth. This procedure is much quicker than root canal therapy performed on permanent teeth and will be completed during the same appointment a stainless steel crown is placed on the tooth. This treatment prevents abscess of the tooth approximately 90% of the time.
Space Maintenance – When baby teeth in the back of the mouth are lost to decay or abscess more than a few months before they should be lost naturally, the space for the permanent tooth will be lost to the adjacent teeth unless an appliance is placed to keep the space open. This space maintainer is a combination of steel wires and rings that fit appropriate teeth in the area of the lost tooth to maintain the space the permanent tooth will need. This appliance will be fit and cemented into your child’s mouth when necessary and removed as the permanent teeth erupt into position. This appliance requires strict attention to diet to avoid sticky foods and may need to be replaced several times until your child no longer needs it.
Regular return visits to the office are vitally important for keeping healthy teeth. Dental decay progresses very rapidly in primary (baby) teeth. The sooner a problem can be diagnosed, the sooner it can be treated and the less invasive the treatment will need to be. Our goal is to catch as many problems in the earliest stage as possible so that the solution is easier for the patient to tolerate. A new examination will be completed in this visit, as well as prophylaxis, flossing, nutrition counseling, oral hygiene instruction and fluoride application.
Straight teeth help an individual to effectively bite, chew and speak. Straight teeth contribute to healthy teeth and gums. Properly aligned teeth and jaws may alleviate or prevent physical health problems. An attractive smile is a pleasant “side effect” of orthodontic treatment (braces).
An attractive smile contributes to self-esteem, self-confidence and self-image, important qualities at every age. A pleasing appearance is a vital component of self-confidence. A person's self-esteem often improves as orthodontic treatment brings teeth, lips and face into proportion. In this way, orthodontic treatment can benefit social and career success, as well as improve a person’s general attitude toward life.
SPORTS INJURY PROTECTION
Athletic mouth guards can help prevent serious dental injuries if your child participates in contact sports. Custom mouth guards can be fabricated once your child loses all of their primary teeth, which provide the best fit. When primary teeth still exist in your child’s mouth, various options can be used and can be discussed at your examination appointment.
NITROUS OXIDE/OXYGEN ANALGESIA
Commonly known as “laughing gas,” nitrous oxide and oxygen administered in combination help some patients overcome the anxiety associated with a dental visit. This technique works well in a patient that understands the need to complete dental work and merely has concerns about the smells, sounds, tastes or time required to sit still. Your child will be fully conscious and will breathe the gases in through a small mask placed over his/her nose. This treatment modality serves to help relax the patient but will not cause them to sleep or alter their state of consciousness.
When a patient is unable to cope with the various aspects of dental treatment or cannot successfully relax with nitrous oxide/oxygen analgesia, sedation is a management technique that uses medications to help your child through the necessary procedures. Mild or moderate sedation is recommended for apprehensive patients, patients unwilling to maintain the nasal mask for nitrous oxide/oxygen analgesia or patients too young to understand the process of restorative treatments. There are a variety of different medications which can be used and will be dispensed based upon your child’s particular needs. These medications will help relax your child. Some children fall asleep or get very drowsy which diminishes their consciousness, but they do not lose consciousness completely and can respond to requests to interact with the dental personnel.
General anesthesia is recommended when other treatment modalities fail or your child’s level of apprehension is deemed too high to be successfully treated with nitrous oxide/oxygen analgesia or conscious sedation. Additionally if your child has an extensive treatment plan, is very young or has extenuating circumstances, general anesthesia will be an option. General anesthesia renders your child completely unconscious and the dental treatment will be rendered after your child is completely asleep. General anesthesia procedures require the services of an additional practitioner to administer the anesthesia medications while the dentistry is completed.