Dental sealants are plastic resins that bond and harden in the deep grooves on the tooth’s surface. When a tooth is sealed, the tiny grooves become smooth, and are less likely to harbor plaque. With sealants, brushing becomes easier and more effective against tooth decay.
Sealants are typically applied to children’s teeth after their permanent teeth have erupted as a preventive measure against tooth decay. It is more common to seal “permanent” teeth rather than “baby” teeth, but every patient has unique needs, and the dentist will recommend sealants on a case-by-case basis.
Traditional dental restoratives, or fillings, may include gold, porcelain, and composite. Newer dental 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, as well as on the back teeth depending on the location and extent of the tooth decay. We also offer fluoride-releasing fillings like glass ionomers.
Fluoride is effective in preventing cavities and tooth decay by coating teeth and preventing plaque from building up and hardening on the tooth’s surface.
Fluoride comes in two varieties, systemic and topical:
- Systemic fluoride is ingested, usually through a public water supply. However, the public water on Long Island is not fluoridated, so we recommend a fluoride supplement. One of our doctors can prescribe a fluoride vitamin or you can ask your child’s pediatrician. While teeth are forming under the gums, fluoride strengthens tooth enamel, making it stronger and more resistant to cavities.
- Fluoride can also be applied topically to help prevent caries (cavities) on teeth present in the mouth. It is delivered through toothpaste, mouthwash, and professional fluoride applications. Professional application of topical fluoride foam and varnishes is also a valuable tool in cavity prevention.
Receiving a fluoride treatment from your dentist
A fluoride treatment in the dentist’s office takes just a few minutes. After the treatment, patients may be asked to not rinse, eat, or drink for at least 30 minutes in order to allow the teeth to absorb the fluoride. Depending on your child’s oral health or your doctor’s recommendation, your child may be required to have a fluoride treatment every three, six, or 12 months. Your doctor may also prescribe at-home fluoride products such as mouthwash, gels, or antibacterial rinses.
Silver Diamine Fluoride
Silver Diamine Fluoride (SDF) is an FDA-approved topical solution that treats and prevents dental caries and reduces tooth sensitivity. It is made with two acting ingredients: the silver component is an anti-microbial agent that kills bacteria and prevents the formation of new biofilm, and the fluoride prevents further demineralization (softening) of the tooth structure.
Treatment with SDF does not eliminate the need for restorative dentistry (fillings, crowns, etc.) to repair function or aesthetics, but is effective at preventing further decay.
Why use SDF?
We recommend using SDF in several situations, including:
- Children who have extreme decay (severe early childhood caries)
- Young children who have difficulty sitting still for treatment
- Special needs patients
- Children with carious lesions (cavities) that need to be treated over several visits
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. 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.
Types of Crowns
- 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.
- Composite Strip Crowns - are a clear plastic-like shell that is filled with tooth-colored composite material and then fitted over the damaged tooth, usually used for aesthetics or trauma.
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. Other times, a tooth may have so much decay that it puts the surrounding teeth and jaw at risk. Infection, orthodontic correction, or problems with a wisdom tooth can also require removal of a tooth.
If it is determined that your child’s tooth needs to be removed, your pediatric dentist may extract the tooth during a regular checkup or may schedule another visit for this procedure. The root of each tooth is encased within the jawbone in a “tooth socket,” and the tooth is held in that socket by a ligament. In order to extract a tooth, the 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 dentist any concerns or preferences for sedation; we want to make sure your child is as comfortable as possible.
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
- 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 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.