General Dentistry
Procedures and Post Appointment Care
Primary Teeth Extraction
Why extract my child’s teeth? – To prevent problems.
If your child’s teeth are crowded, they may erupt and remain positioned too far out toward the lip. This can create a lack of adequate gingival (gum) attachment, and may result in the need for periodontal surgical procedures to correct the soft tissue defect, to prevent ultimate early loss of one or more incisors due to gum disease.
If your child has insufficient space for 4 permanent incisors, upper or lower, his/her primary canines may be extracted. This allows the lateral incisors to erupt, placing them out of the way for the permanent canines, improving the eruption of the canines several years later.
Dental Sealants
What are dental sealants?
Today, most cavities occur on the chewing surface of the back teeth. Dental sealants provide specific protection against that kind of cavity. A dental sealant is shaded plastic material that is painted directly into the grooves on the chewing surfaces of the tooth. The sealant acts as a barrier, protecting the enamel from plaque and acids.
Why seal teeth?
Over the past many years, numerous materials and techniques have been developed to seal the chewing (Occlusal) surfaces of the teeth. Often, these procedures are necessary because some teeth have defective occlusal surfaces when they erupt in the mouth, and food debris and microorganisms penetrate into the grooves on the teeth during eating. Patients cannot clean these areas effectively, and dental decay (caries) occurs frequently.
Do all teeth need to be sealed?
Usually only the back (posterior) teeth require sealing. We cannot tell which teeth individual teeth require sealing, because incomplete fusion of the teeth often leaves a nearly microscopic entry from the enamel outside the tooth into the softer dentin inside. Therefore, we suggest that all suspect posterior teeth be sealed. A few teeth that do not require sealing may be inadvertently sealed because it is impossible to select defective from non-defective teeth at an early age.
Will all decay be prevented?
Sealants placed as close to the eruption time of the teeth as possible prevent the majority of decay on the chewing (Occlusal) surfaces of the teeth. However, brushing, flossing, and routine fluoride therapy are required to prevent decay on other surfaces of the teeth. In the presence of poor oral hygiene, decay may begin between the teeth, since sealants cannot be placed on these surfaces.
Cost?
The cost for sealing a tooth with plastic is about one-third of the cost of filling (restoring) the tooth in the event of decay. Sealants do not require anesthetic or cutting away tooth structure.
How long do sealants last?
Studies show sealants last many years. However, occasional resealing may be required.
Space Maintainers
What are space maintainers?
A space maintainer is needed when a primary molar is missing because the primary tooth roots normally cradle the permanent tooth, guiding its eruption and holding the needed space available for the permanent tooth. If a space maintainer is not placed, other teeth will naturally move forward, taking away space needed for the permanent teeth, due to erupt when your child is 11 or 12 years old.
Your child’s space maintainer:
• Fits on a tooth behind or a tooth in front of the missing tooth.
• Is designed to maintain the necessary space for the permanent tooth to erupt later.
• May be on one side of the mouth or both sides.
• Should stay in place until permanent tooth is erupting.
• Fits until the permanent tooth erupts because growth occurs posterior to (behind) that last tooth in his/her mouth. (No growth changes occur in the area of the missing tooth.
Fluoride Varnish
Fluoride varnish provides relief to sensitive teeth by coating the dental tubules. It is applied by brushing on a very thin coat of varnish to the affected areas. The varnish sets on contact with saliva and will dry within 10 seconds. When dry, any excess varnish may appear “spotty” and may slide off the tooth surface. This will not affect the efficacy of the product as there is still a full layer of varnish on the tooth.
For best results, the varnish should remain on your teeth approximately 4-6 hours for the maximum effect. After the treatment, it is recommended that you only eat soft foods and drink cold liquids for two hours after treatment.
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After Crown and Bridge Appointments
Crowns and bridges usually take two or three appointments to complete. On the first appointment the teeth are prepared. Temporary crowns and bridges are placed to protect the teeth while the custom restoration is being made. After each appointment when anesthetic has been used, your lips, teeth, and tongue may be numb for several hours after the appointment. Avoid chewing until the numbness has completely worn off.
On rare occasions temporary crowns come off. Call us if this happens, and keep the temporary so we can re-cement is. It is very important for the proper fit of your final restoration that temporaries stay in place.
It’s normal to experience some hot, cold, and pressure sensitivity after each appointment. Your gums may be sore for several days. Rinse three times a day with warm salt water (a tsp. of salt in a cup of warm water, rinse-swish-spit). Use medication only as directed.
To help keep your temporary in place, avoid eating sticky foods (especially gum), hard foods, and if possible, chew only on the opposite side of your mouth. It’s important to continue to brush normally, but floss very carefully and remove the floss from the side to prevent removal of the temporary crown.
If your bite feels uneven, if you have persistent pain, or you have any other questions or concerns, please call our office.
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Tooth-Colored Restorations
We have restored one or more of your teeth with tooth-colored materials. The resin (plastic) material used contains small “filler” particles of glass-like material for strength and wear resistance. These restorations will serve you well for several years. They contain the finest and most up-to-date materials available today. Please be aware of the following information about your new restorations:
Chewing:
Avoid chewing excessively hard foods such as hard candy, corn nuts, ice, boned, etc., because the resin material can be broken from the tooth with extreme force. If breakage occurs, replacement of the restoration is not difficult.
Recall Visits:
Professional six-month examinations and cleanings are necessary. Developing problems can be detected at an early stage and repaired easily. Waiting for a longer time may require redoing the entire restoration.
Preventive Procedures:
To provide optimum longevity for your restorations and to prevent future dental decay and supporting tissue breakdown, please use the following preventative procedures:
• Brush with a fluoride-containing toothpaste after meals, and clean your teeth with floss at least once a day.
• Swish vigorously for 30 seconds daily with a fluoride-containing rinse. The best time is immediately before bedtime.
• Use a Water Pik as directed.
• Use a mechanical toothbrush.
The Future:
We expect several years of service from these restorations. However, after a service period of years, we have seen the following situations occur:
• Slight stains may occur at locations around the juncture of the tooth restoration. Often, we can remove these stains.
• Slight chipping at the juncture of the tooth restoration. Usually these chips can be smoothed by us.
• The gums (gingival) may shrink from the restorations, displaying an unfavorable appearance underneath. This condition may require remaking the restoration or modifying the gums.
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