FAQ

Are parents allowed back with their child?

Sure! We not only allow parents back for exams, we encourage parents to be a part of their child’s dental experience. While parents have the option of staying in the waiting room, we would like parents to be present so they may observe and learn firsthand of any dental or behavioral concerns we may have. We also allow parents back for most treatment as well. I would like the parents to help show their children that they are in a safe and trusting environment. I also enjoy showing parents what we’re actually doing and how we do it. However, to ensure a safe and positive experience we do have some rules and exceptions:

a) We don’t want parents using any scary words like: shot, needle, hurt, drill, pull, yank etc. We have our own set of words we employ that work very well — as silly as some of them may seem.

b) We don’t mind parents talking to their children to help encourage them, but please refrain from asking the child questions during treatment. This could distract the child, and if the child attempts to answer it could hinder treatment.

c) No other children are allowed in the treatment room. Other children could create a distraction for the staff, scare the child being treated, or become scared themselves.

d) If the parent themselves are anxious or nervous about treatment, then it is probably best the parent wait outside. Kids feed off of their parents’ emotions. If they sense their parents are worried or anxious then they will be too. The best thing you can do for your child is to display a positive happy attitude — even if it’s a fake one.

Do you restrain or papoose children during treatment?

We would like your child (and the parents, staff, and myself) to have a positive, trauma-free experience at our office. Therefore, we do NOT use a papoose board or any other type of immobilization device. If we cannot get the treatment done in a safe, effective manner due to excessive movement by the patient then we will stop and discuss other behavior management options. However, there are rare situations that may require physical restraint of the child for a short period of time, i.e. in emergency situations. We will ONLY restrain the child if the procedure is short and with the parent’s permission, presence, AND assistance. Most often we will ask the parent to hold the child.

What’s the purpose of fluoride? Are there any risks with fluoride use? Is it absolutely necessary to apply fluoride at every visit?

Use of fluoride is a very highly effective way of preventing caries. It works primarily through three mechanisms

a) Increases the strength and density of enamel to help prevent the start of decay

b) If decay has already begun, it can re-mineralize the area and help stop or slow the progression of the decay.

c) It can also disrupt the metabolism of the bacteria that causes tooth decay

If too much fluoride is swallowed as a child this may lead to fluorosis, which is staining and mottling of adult teeth when they erupt. This is more of an esthetic concern and not pathologic. It generally occurs in kids who live in areas where their well water has a high amount of naturally occurring fluoride. The fluoride varnish we apply on your child’s teeth simply does not have enough fluoride and is not applied frequently enough to be considered dangerous to your child or cause fluorosis. Fluorosis is the ONLY documented and proven risk of long-term, excessive fluoride intake. The benefits of fluoride application far outweigh any perceived risks of fluoride. However, if you decide you do not want fluoride placed on your child for personal reasons we will NOT object one single bit.

My child is so young so why do we need radiographs? Are there any risks with taking radiographs on my child?

Radiographs are incredibly helpful and important in diagnosing oral diseases that we cannot see with our eyes. We generally begin attempting to take radiographs around age three. This is usually when the child can cooperate enough for the radiographs and spaces between teeth begin to close. However, we will not force your child if he/she is having a difficult time. By age four it becomes even more important we get the first set of radiographs. We take great effort to significantly minimize the exposure of radiation to you child (lead apron, thyroid collar, high speed digital film, and beam collimation). Future radiographs will be taken based on patient’s risk level. However, if you decide you do not want radiographs taken on your child we will oblige as long as the parent understands and assumes the risks involved.

These are just baby teeth that are going to fall out so why do we need to treat them?

Baby teeth do eventually fall out (exfoliate) and, indeed, sometimes we will not treat decay because the tooth will be exfoliating soon. However, most baby molars fall out between the ages of 10 and 12. We usually begin diagnosing caries on these teeth by age 4 to 8 so there is a large frame of time for caries to progress. This can lead to pain, infection, and premature extraction of teeth, which in turn, can lead to spacing issues and reduced chewing function. In addition, starting at age 6 until age 12, your child will have both baby teeth and permanent teeth in his/her mouth. Dental cavities and the bacteria that cause them could potentially spread to permanent teeth. We will assist you in your decision by going over all risks, benefits, and alternatives of treatment and no treatment.

Are stainless steel crowns the only option for fixing large cavities on back teeth?

In short, yes. Due to the shape and anatomy of a baby tooth, large white fillings do not hold up well (even in adult teeth). They generally break out, fracture, or form more decay around the filling even when placed correctly. Once the decay reaches a certain depth, width, or is on multiple surfaces we generally recommend a SSC. These may not be esthetically pleasing to the eye, but is the most ideal treatment to ensure maximum success until the tooth falls out. SSCs are impenetrable to bacteria and food, and can be easily replaced if it falls off (which is rare). Recently, white crowns have been released onto the market but they still have room for improvement. They have a much higher failure rate. There will sometimes be a gray area where we recommend a SSC, but are willing to try a white restoration, as long as the parents assume and understand the risks involved.