Preventive Dental Care
Dental decay is a very common and preventable disease. Risk factors for dental decay include frequent consumption of fermentable carbohydrate and the build-up of bacterial plaque on teeth and gums. Age-appropriate fluoride use, good oral hygiene practices and a healthy diet can ensure children remain cavity free. Professional application of fluoride varnish has been shown to be a very effective way to protect teeth from disease.
As part of preventive care for our patients, we like to review a 4-day diet diary to help tailor dietary counselling which is specific to the needs of each child. Parents and patients are taught how to check for plaque on the teeth using an indicator die at home which helps colour the bacteria make it visible. Tooth brushing and flossing instruction are given, and the teeth are cleaned professionally. We place a professional fluoride varnish to the teeth for added protection from decay and acid erosion.
Preventive care helps protect treatment which has been done and stop dental decay from returning after your child’s treatment is complete. Think of it like making the mouth a safe neighbourhood for teeth!
Children develop dental anxiety for many reasons. Young age, fear of the unknown, scary stories from peers, picking up on parental fear and difficult past medical and dental experiences can contribute to this problem. Children with sensory processing challenges are more likely to be fearful in the dental surgery. We help guide parents through how to best prepare children before the first assessment and for subsequent visits after that. Behaviour shaping, desensitisation and acclimatisation use age appropriate explanation and positive reinforcement to help children develop suitable patterns of behaviour required to have their dental care provided safely on the dental chair.
Many children respond well to child friendly explanations and some patience and empathy. Other children benefit from further support using inhalation sedation. This uses a sweet-smelling gas which helps children relax while having their dental treatment completed. Children remain awake throughout this process and can talk and respond to questions. It is very safe and once the treatment is over the effects of this type of sedation are finished. It is suitable for all children but may be less effective if your child is unable to breath through their nose of has limited communication.
General Anaesthetic is provided in a hospital setting as a day case. Patients are put to sleep by a consultant anaesthetist before having their dental work completed. This method of anxiety management is suitable for children with severe anxiety, complex dental treatment needs and those who are too young to cope with dentistry on the dental chair using conventional methods.
New Infant check
Dental decay is a common but preventable disease. The ideal time to learn about safe feeding practices, fluoride use, non-nutritive sucking habits and dental hygiene for infants is when the first tooth appears and not later than 12 months. The examination for infants is done in the knee-to-knee position between clinician and parent. Sometimes infants may have a little cry when they lie back, and this is normal. The teeth and mouth are examined for signs of dental disease. Cleaning instruction is given, and a fluoride varnish is applied. Anticipatory guidance is provided on how to care for the mouth, teeth, and gums appropriate to your child’s age and specific oral health care needs. Studies have shown that the new infant check is an effective way of preventing dental problems develop and maintaining good oral health through childhood.
Fissure sealants are a method of preventing decay. A resin barrier is placed into the grooves in your child’s teeth to prevent food and bacteria lodging in the cracks. Sealants reduce the risk of dental decay by up to 40%. When children have sealants the tooth is dried, cleaned, washed and the sealant placed before being set with an ultraviolet light. We add an additional step to our sealants involving the placement of a bonding agent to increase the retention and success rates of our sealants.
Space maintainers are a type of interceptive orthodontics. When a primary tooth must be removed before its natural exfoliation time, the space for that primary tooth can close meaning that the adult tooth beneath does not have room to grow into. A space maintainer helps keep the gap open to facilitate optimal dental development and to minimise the orthodontic problems created by early loss of primary teeth.
Injuries to children’s teeth have some unique features which make them different to injures in adults. Assessment of the injury needs to consider the potential damage to the developing structures such as immature adult teeth close to the primary tooth and a child’s coping strategies and compliance.
Injury to immature adult teeth have the potential to have lifelong implications. Immature adult teeth have short open-ended roots. The cells around the roots of the teeth are necessary for growth of the bone around the tooth. Injuries can lead to complications arising from the short open-ended root or from failure of the bone surrounding the tooth to grow. Monitoring and management of these kinds of injury is specialised and we follow the latest guidance from the International Association of Dental Traumatology which provides high quality evidence-based recommendations on the best techniques and technologies available to treat these injuries.
Posterior White Crowns
Although silver caps are an excellent approach to the management of decay and other problems with primary molars, some parents and children do not like the idea of silver crowns. Ceramic posterior crowns offer an aesthetic alternative.
Silver Caps/Stainless Steel Crowns
Stainless Steel crowns have a long and reliable track record in the management of children’s teeth where there is deep decay, in molars with pulp therapy or where the enamel of the tooth is weak. They are used at the back of the mouth where aesthetics is not as much of a concern. They are well accepted by children.
When primary teeth become decayed, inflammatory changes may occur in the nerve of the tooth even though the tooth may not be painful. For the tooth to be restored fully, the inflamed portion of the nerve must be removed, and the remainder is medicated. The purpose of the technique is to maintain the vitality of the tooth, prevent pain and infection and the need for extraction of the tooth. This procedure is known as a pulpotomy. When decay is extensive the nerve of the tooth may die and become infected. In this case if there is sufficient tooth left to fix the tooth, the infected part is removed, and the nerve space is filled before the tooth is fixed. This is known as a pulpectomy.
Anterior White Crowns
Front teeth are important for speech, eating, general social development and confidence. Infants can develop aggressive dental disease from drinking liquids at night which contain sugars for example formula, juice, cow’s milk and even breastmilk. Anterior white crowns are made from ceramic are used to restore the appearance of damaged or discoloured front teeth.