Most children are anxious about having any medical procedure performed. We frequently use nitrous oxide (laughing gas), to lower anxiety and help make the procedure a more positive experience for your child.
Nitrous oxide is a mild, quick acting sedative administered as a gas. It is breathed in by your child through a nose mask and mixed with oxygen. Nitrous oxide will cause relaxation without putting your child to sleep. The American Academy of Pediatric Dentistry recognizes nitrous as a safe, effective technique.
Conscious Sedation is the use of liquid medication that your child drinks and will cause him/her to become drowsy. It is often combined with nitrous oxide/oxygen gas in order to achieve a deeper level of relaxation for your child. This is indicated for young or anxious children as well as for more extensive procedures.
During conscious sedation, Dr. Jessica will constantly monitor your child with a pulse oximiter that tells the level of oxygen saturation in the blood. Most children will become very relaxed and may even fall asleep.
The concentration of drugs used for conscious sedation is calculated based on the weight of your child. However, every child's body is different and therefore their level of sedation may not be enough overcome their anxiety and to perform the dentistry that needs to be done. In these cases Dr. Jessica may recommend an I.V. sedation.
I.V. Sedation is recommended for apprehensive children, very young children, and children with special needs that would not work well under conscious sedation. This causes a deep level of sedation where the child is completely asleep for the entire procedure.
During the procedure, an anesthesiologist provides the sedation and monitors your child.
(reproduced from American Academy of Pediatric Dentistry Parent Resource Center)
Q: What should I do if my child's baby tooth is knocked out?
A: Contact your pediatric dentist as soon as possible. The baby tooth should not be replanted because of the potential for subsequent damage to the developing permanent tooth.
Q: What should I do if my child's permanent tooth is knocked out?
A: Find the tooth and rinse it gently in cool water. (Do not scrub or clean it with soap -- use only water!) If possible, replace the tooth in the socket immediately and hold it there with clean gauze or a wash cloth. If you can't put the tooth back in the socket, place the tooth in a clean container with cold milk, saliva or water. Get to the pediatric dental office immediately. (Call the emergency number if it's after hours.) The faster you act, the better your chances of saving the tooth.
Q: What if a tooth is chipped or fractured?
A: Contact your pediatric dentist immediately. Quick action can save the tooth, prevent infection and reduce the need for extensive dental treatment. Rinse the mouth with water and apply cold compresses to reduce swelling if the lip also was injured. If you can find the broken tooth fragment, place it in cold milk or water and bring it with you to the dental office.
Q: What about a severe blow to the head or jaw fracture?
A: You need immediate medical attention. A severe head injury can be life-threatening. Keep in mind that an emergency medical team might be able to reach you faster than you can get to the hospital.
Q: What if my child has a toothache?
A: Call your pediatric dentist and visit the office promptly. To comfort your child, rinse the mouth with water. Over-the-counter children's pain medication, dosed according to your child's weight and age, might ease the symptoms. You may apply a cold compress or ice wrapped in a cloth to the face in the area of the pain, but do not put heat or aspirin on the sore area.
Q: Can dental injuries be prevented?
A: Your child's risk for dental injuries can be reduced greatly by following a few simple suggestions. First, reduce risk for severe oral injury in sports by wearing protective gear, including a mouthguard. Second, always use a car seat for young children and require seat belts for everyone else in the car. Third, child-proof your home to prevent falls and electrical injuries. Regular dental check-ups provide your dentist an opportunity to discuss additional age-appropriate preventive strategies with your child.
What is Pulp Therapy?
The pulp of a tooth is the innermost layer that is commonly referred to as the "nerve" of the tooth. When cavities become deep enough they can injure or infect the pulp of the tooth. This will lead to pus forming within the pulp of the baby tooth, causing to pain, swelling, and ultimately tooth loss and future orthodontic problems.
To address large cavities on baby teeth we perform a pulpotomy and crown. The pulpotomy involves removing the infected part of the pulp. To seal off the pulp chamber we use a dental laser instead of chemicals such as formocresol.
What is Space Loss and why does my child need a Space Maintainer?
Many people believe that cavities on baby teeth are not significant because the baby teeth will eventually fall out. In reality, the presence of baby teeth is very important for your child's health.
Beyond helping your child to eat and properly chew their food, baby teeth serve to keep enough room for the permanent teeth. When a baby tooth is lost prematurely the space where the tooth used to be is not kept open, the permanent teeth drift forward and cause crowding and other othodontic issues that will become a problem in the future.
This is why Dr. Jessica may recommend a space maintainer. It is a small metal bracket that takes the place of the missing baby tooth so that dental development proceeds normally.
Sometimes children have thumb sucking or other habits that may cause flaring or malposition of the teeth. To address this Dr. Jessica may recommend an appliance to help remind the child not to engage in their habit.