Kids Dentistry

Dear Parent / Guardian

Dear Parent / Guardian,

Now that you have arranged for your child's first visit to one of our offices, there may be some questions you would like to ask us. We are happy to answer your individual questions at any time. The following are questions that many parents ask. We hope the answers here will be helpful to you and to your child.

1. How may I best prepare my child if this is his/her first visit and what is the procedure at this visit?

You can play a large part in preparing your youngster for his/her first visit to the dentist. Try to act relaxed and at ease. Any anxiety on your part will probably be sensed by your child. Tell your child that we will "count" and "take pictures" of his/her teeth. Do not use any fear provoking works such as "hurt, drill, pull, and needle." Avoid statements like "the doctor will not hurt you." (If I say to you, "Don't think of a banana!" what is the first thing you think of? A banana! It's the same with the word "hurt.")

We will thoroughly explain each of our procedures to your child in terms that he/she can understand before we do it. Depending upon the child's age, we will probably ask you to remain in the reception area so that we can spend time alone with your child. Afterwards, we will invite you to the operative area so that we may review your child's history, diagnosis, or specific problems. Be assured that we will treat your children as gingerly as we treat our own. However, some children will cry as this is a normal response to a strange situation.

At this visit, we will emphasize oral hygiene techniques to be practiced by both you and your child. We will answer any questions you may have. A full examination of the teeth and supporting structures will be done and occlusion (bite) will be evaluated. Radiographs (x-rays) will be taken as necessary (not routinely) to assure a thorough and comprehensive examination. Subsequent appointments for restorations and fluoride treatments may be scheduled, as needed. When treatment has been completed, your child will be placed on a periodic exam schedule and you will receive a reminder phone call when the visit is due.

 

2. What is your philosophy of treatment?

Our emphasis is on "prevention" both in the office and at home. We recommend regular periodic exams and cleanings as well as positive and thorough home care. Home care includes limited sweets, brushing two times a day, and flossing at least once a day, preferably before bedtime, and sometimes a topical application of fluoride. Because the primary teeth form the basis of the adult dentition, we will do everything possible to preserve the integrity of your child's dentition while fostering a healthy and relaxed attitude toward dental care. We offer a full range of dental services for children, adolescents, and the exceptional child, including restorative, preventive dental care, oral sedation, nitrous oxide (laughing gas) and all phases orthodontic treatment by one of our affiliated orthodontists.

 

3. When will the condition of my child's teeth and supporting structures be discussed with me? Who will explain what work is needed and how much it will cost?

At the conclusion of your child's exam the doctor will meet with you to explain what was found and what treatment is recommended. Before you leave the office, our treatment coordinator will discuss the treatment plan again and answer any questions you might have.

 

4. What are your financial options?

We can bill directly to your insurance. All amounts estimated not to be covered by your insurance are due at the time of service. We will gladly submit all dental claims to your insurance for you, but the final determination of payment is a contract between you and your insurance company and you are ultimately responsible for any unpaid amounts.

You may use Visa, Mastercard, and Cash. We also have a contract with an outside financial agent for your convenience.

Your aim as a parent and our aim at as a team of dentists and dental professionals are the same, to keep your child's teeth and mouth in good health and to make the process of doing so a pleasant one for everyone. Our team looks forward to meeting you.

Dr. Mario Ladani B.Sc., D.D.S.
President
7DENTAL Group

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Every Child

Every child should have a beautiful smile and healthy teeth. To achieve this, a child requires proper diet, consistent home care, and regular check-ups beginning at an early age.

The Academy of Pediatric Dentistry recommends the first check-up with a dentist between the age of six to twelve months, with follow-up visits at every six months to monitor dental development and prevent dental disease. During these visits at , we will examine the child, give you updates on their oral health and growth, and show you proper home care.

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Do's and Don'ts / First Dental Visit

Preparing your child for their first dental visit will help your child to feel more comfortable when they are in our office. At this visit, our experienced team will examine the child’s teeth, give you updates on their oral health and growth, and show you proper home care. There are some things you can do to help this visit be as positive as possible for your child:

Dos

• Try to make dental visits fun for your child
• Tell your child that the dentist at our clinic is a nice doctor who will count their teeth
• Set a good example by brushing and flossing in front of your child daily and by visiting your dentist regularly

Dont's

• Don't use fear provoking words such as “hurt, drill, shot, needle, or pull”
• Don't let your child know that you may have anxiety about going to the dentist
• Don't let siblings or friends tell your child scary stories about going to the dentist
• Don't bribe your child into going to the dentist

 

Brushing

At , we believe proper tooth brushing involves four things:

• a soft toothbrush
• toothpaste with fluoride
• the correct angle of brushing
• and brushing in a pattern

It's important to brush at least twice a day, after breakfast and before bed, using a soft toothbrush. A soft toothbrush also makes it much easier to remove the plaque below the gum line, where periodontal disease starts.

Use a pea-sized amount of toothpaste that contains fluoride. Fluoride hardens the outer enamel of the teeth. It might stop a cavity in its tracks and give you more resistance to future cavities.

Angle the bristles of the brush along the gum line at a 45 degree angle and apply firm pressure so the bristles slide under the gum line. Vibrate the brush while you move it in short back-and -forth stokes and in small circular motions. Brush two or three teeth at a time. Then move to the next teeth, allowing some overlap. Tilt the brush and use the tip to brush the backs of the front teeth. It's fine to brush in any regular pattern you choose, but since the insides of the teeth tend to get less attention, you might start with the insides of the upper teeth, then go to the insides of the lower teeth. Switch to the outsides of the upper teeth, and then the outsides of the lower teeth. Brush the chewing surfaces of the upper teeth, then the lower teeth, and end by gently brushing your tongue and the roof of your mouth. This removes germs and keeps your breath fresh.

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Flossing

Flossing should be started when your child is around 2 to 3 years of age, under the direction of your child's dentist. Prior to this age, flossing is not necessary. Children usually need assistance with flossing until they are 8 to 10 years of age.

The importance of flossing:

Brushing teeth properly and consistently helps to remove most dental plaque, however, brushing alone cannot remove plaque that is located in places that a toothbrush cannot reach, particularly in-between teeth. In addition to removing plaque, flossing also helps to:

• remove debris that adheres to teeth and gums in-between teeth.
• polish tooth surfaces.
• control bad breath.

Flossing should take place at least once a day for two to three minutes each time to be most effective.

Types of dental floss:

Regular, consistent flossing is the single most important weapon against plaque, perhaps more important than the toothbrush. The different types of dental floss include the following:

• waxed and unwaxed
• flavored and unflavored
• wide and regular

Flossing methods:

Your child's dentist or hygienist at can provide a demonstration of any of the following flossing techniques. They include:

• Spool Method (also called the finger-wrap method) - Cut off a piece of floss that is approximately 18 to 20 inches in length. Lightly wrap each side of the piece of floss several times around each middle finger. Next, carefully maneuver the floss in-between the teeth with your index fingers and thumbs in an up and down, not side-to-side motion. It is best to bring the floss up and down making sure to go below the gumline, forming a C on the side of each tooth.
   
• Loop Method (also called the circle method) - Cut off a piece of floss that is approximately 18 inches long, and tie it securely in a circle. Next, place all of the fingers, except the thumb, within the loop. Then, use your index fingers to guide the floss through the lower teeth, and use your thumbs to guide the floss through the upper teeth, making sure to go below the gumline, forming a C on the side of each tooth.

Other flossing techniques:

Flossing tools, such as a prethreaded flosser or floss holder may be helpful for people who are just learning how to floss, individuals with limited dexterity in their arms and/or hands, or persons who are flossing the teeth of someone else (particularly a child or disabled person).

Some parents, find it easier to use a children's dental flosser. These are available in refillable and disposable and can be found at most stores that carry toothbrushes and toothpaste.

The children's flossers are smaller and easier to reach into little mouths.

Irrigating devices, such as water-picks, are not considered a substitute for brushing and flossing. These devices may be effective around orthodontic braces that retain food or in areas a toothbrush cannot reach. However, they do not remove plaque.

If the gums are infected, they'll bleed when you floss, and that's to be expected if you are just beginning to floss. After a week or so of regular flossing, the bleeding should go away.

Now you know why brushing your teeth is only half the battle. Most cavities and periodontal disease start between the teeth, where your toothbrush simply doesn't reach.

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When you have braces, it's tougher to keep your teeth plaque-free and avoid cavities. Use a soft toothbrush and toothpaste with fluoride, and be sure to brush after every meal. Brush every surface of every tooth, and give extra attention where the brackets and bands meet the tooth and where the tooth meets the gum line.

Some tips on brushing:

1. Brush the front and back of each of your front teeth. Hold the toothbrush at an angle and use slow, circular motions.

2. Work the brush between the wires and brackets of your braces. Go slowly. Make sure you cover each part of the appliance. Gently brush the gums, too.

3. Brush the top and sides of each back tooth. Also brush your tongue and the roof of your mouth. Rinse with water. Then use other rinses or gels as directed.

Make sure you brush in small circular motions, brushing two to three teeth at a time. You must also floss your teeth, because the toothbrush bristles simply can't remove the plaque between your teeth.

Some tips on flossing:

1. Put 1 or 2 feet of floss into a floss threader. Thread the floss between your teeth and the wires of your braces. Remove the threader.

2. Wrap the ends of the floss around your fingers. Pull to make a “V” shape. Rub the floss up to the gums and then down the sides of the teeth. Do this between each tooth.

After you're done, check carefully to see if you've missed any areas, and then rinse thoroughly with a lot of water.

Cutting down on sweets will hep avoid cavities, so avoid sticky sugary foods. Beware of hard foods such as corn nuts and ice. They can damage your braces. Eating softer foods and cutting harder foods into smaller bites is your best bet.

Our professionals at clinics believe watching your eating habits and careful attention to your daily home-care will keep your mouth healthy and keep those teeth looking good!

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Infant Teeth

As soon as your child gets their first teeth you should begin cleaning them with a soft infant toothbrush using water only. No toothpaste is needed until age two or three. When your child is comfortable with a toothbrush, brush their teeth twice a day with an extra soft toothbrush.

Use a pea-sized amount of toothpaste if your child likes toothpaste. Otherwise, it's fine to brush without toothpaste. Gently floss your child's teeth each day and pay particular attention to areas where the teeth are close together. Regularly help your child brush and floss until they're 7-10 year old and able to effectively keep the plaque off their teeth by themselves. After that, check their efforts occasionally. It's a good idea to keep some disclosing tablets on hand. The pink dye in disclosing tablets stains missed plaque red and makes it much easier to see.

Fluoride is an important preventive tool for infants. It's important that we first check the fluoride level of your child's primary source of drinking water. We sometime prescribe fluoride tablets, and generally recommend fluoride toothpaste and fluoride treatments in our offices after cleanings.

The most serious dental problem for young children is called early childhood caries or bottle syndrome. It's caused by the constant presence of milk, formula, or fruit juice in a child's mouth during the night, during breast-feeding, during naps, or for extended periods during the day. Use water at these times to prevent this severe decay of baby teeth, and always clean your child's teeth immediately after each feeding. Our professionals at 7 DENTAL often find that children learn best by imitation, so let them watch you as you brush and floss your teeth. Regular praise of their home-care efforts and a positive example will get your child started down the path of excellent oral hygiene.

Baby Teeth Are Important!

One of the myth's of dentistry is that baby or primary teeth are unimportant because they will eventually be lost away. Normally, some of the primary teeth remain in the mouth until a child is 11 or 12 years old.

During this time they serve as space maintainers and ensure that the permanent teeth are properly aligned as they develop and grow into the mouth.

Our dentists at find early loss of primary teeth often causes misalignment of the permanent teeth and may even alter normal facial development. Expensive orthodontic solutions may be necessary to correct these problems.

Cavities or tooth loss may also make it impossible for a child to eat properly, and this affects a child's overall level of health. Speech development can also be affected by premature tooth loss. In combination, these problems may combine to lower a child's self-esteem during their important formative years.

As you can see, baby teeth are important to your child’s overall health. Children need strong, healthy baby teeth to eat well and a healthy smile builds self-esteem. Primary teeth are critically important for a child's health and development. It's important to catch and treat problems of the primary teeth early and keep them in the mouth as long as possible.

 

Baby Tooth Removal

When things go right, baby teeth come out on their own without any special attention. These permanent teeth are right below the gums. They came in directly underneath the baby teeth. As the permanent teeth draw in, the roots of the baby teeth dissolve away. But sometimes permanent teeth don't come in directly under the baby teeth, so the roots of the baby teeth stay strong, instead of dissolving away like they should, and therefore the baby tooth has to be removed.

Other times a baby tooth is so damaged that it has to be removed, even though the permanent tooth isn't ready to come in. Space maintainers are then used to hold the teeth in place until the permanent tooth is in.

Space Maintainers

Normally, as a permanent tooth comes in under a baby tooth, the roots of a baby tooth dissolve away and the permanent tooth replaces the baby tooth. In addition to being important for chewing, the baby tooth holds the adjacent teeth in place.

The best space maintainer is a primary tooth, as you see demonstrated in this. When nature's best space maintainer is lost prematurely, we need to intervene and maintain the space for normal development of the dental arches.

When a baby tooth is lost early, due to decay or injury, the adjacent teeth may drift together, causing loss of space in the dental arch. Fortunately, by placing a space maintainer, this loss of arch space can be prevented.

It generally takes our professionals at clinics only two appointments to complete a space maintainer.

On the first appointment, orthodontic bands are carefully placed and an impression is taken. A duplicate model of the child's mouth is made from this impression so that the dental laboratory can custom make the space maintainer to the exact contours of the mouth.

On the next appointment, the space maintainer is tried in, adjusted, if necessary, and then cemented in place. Space maintainers are used until the permanent teeth begin to break through the gums. While wearing a space maintainer, it is important to avoid chewing gum, sticky candies, and hard foods like corn nuts or ice. Following up with periodic checks of the space maintainer at your clinic, your doctor makes sure it's still functioning properly and keeping all the teeth in their proper position.

This photograph shows an example of a fixed bilateral space maintainer. The patient is four years of age. The appliance is cemented on the two second primary molars and is maintaining the space for the teeth that are lost early on both sides.

 

For More Info:

http://www.ada.org/public/topics/space_maintainers.asp
http://www.aapd.org/publications/brochures/space.asp

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Baby Bottle Tooth-Decay

It is tempting to calm a tired baby witha milk bottle in the evening.
But it may not be the best solution.

Baby Bottle Syndrome, also known as Early Childhood Caries is the severe decay of baby teeth caused by the constant presence of milk, formula or fruit juice in a child's mouth. Baby Bottle Syndrome can cause a lot of damage in a short amount of time.

Every time a child drinks anything containing sugar, bacteria in the mouth produce acids that attack the teeth enamel for at least thirty minutes. The most common source of sugar is a bottle left in the child's mouth for long periods, especially at night or during naps. Then we see a lot of damage. Our professionals at recommend switching to a pacifier or a bottle of plain water at these times in order to avoid the damage and suffering of Baby Bottle Syndrome.

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Ankylosis

Ankylosis is a dental term for a condition where a primary tooth loses its normal ligament connection to the bone and becomes fused directly to the bone. This is a fairly common occurrence and is most often seen with lower first molars.

When a primary tooth becomes ankylosed, three problems result:

• First, when the tooth root fuses to the bone it no longer grows out at a normal rate with the other teeth. Because of this, it appears submerged compared with the other teeth.
  
• Second, the upper teeth need the lower teeth for support. With the tooth submerged, the opposing upper tooth grows out of the socket and also loses its normal alignment.
  
• The third, and most serious problem has to do with the roots of the ankylosed tooth. About 50 percent of the time, the roots of the ankylosed tooth fail to normally dissolve as the permanent tooth grows in, and the permanent tooth is blocked out of position. The solution to these problems is the eventual removal of the ankylosed tooth.
  

Our dentists at will determine if any teeth are ankylosed, and will work with you and your child to determine the best timing for the removal of an ankylosed tooth.

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Mouthguards

Our Spartacat used to have more teeth ...
now he knows the value of mouthguards!

Now It's well known that sports mouthguards are mandatory for high-contact sports such as football and hockey, but you may not know that the majority of mouth injuries occur in children between the ages of 7 and 14, often while skateboarding or simply riding a bike. The most common mouth injuries are broken or lost teeth. But accidents may also cause jaw fractures, jaw-joint problems, jaw dislocations, or concussions. It is estimated that each year the use of a mouthguard prevents over 20,000 injuries.

There are three common types of mouthguards: stock, boil-and-bite, and custom made.

• Stock mouthguards are used off the shelf with no modifications and offer little or no protection. Boil-and-bite fit somewhat better protection but are not thick enough to provide the critical support necessary.
   
• Custom-made mouthguards made by our professionals at are by far the best solution. They offer: maximum protection, increased breathing ability, allow easier communication, and they're more durable, which means less frequent replacement.
   
• To fabricate a custom-made mouthguard, on the first appointment, we take impressions. From these impressions we make models, and it's on these models that the our laboratory tech experts fabricate the mouthguard. On the second appointment, we try in and adjust your mouthguard and make sure it's comfortable. Each year more than half a million teeth are knocked out as a result of sports injuries. A custom-made mouthguard is a great way to prevent injury and keep a terrific looking smile.

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Cavities

In science classes, we learn to be very careful with acid. We have to be careful with the natural acids in our mouth too, or we end up getting cavities. The enemy in the fight to prevent cavities is plaque. Plaque is the sticky film of food and bacteria that forms constantly on your teeth. If you don't remove the plaque every day, then the germs in your mouth produce acid that can eventually make a hole in your tooth, and that's what a cavity is: A small hole in the outer layer of your tooth.

The hard outer layer of your tooth is called enamel. Inside the enamel is a softer layer called dentin. Once a cavity gets through the hard outer enamel, and reaches the softer inner dentin, it can really grow quickly.

That's why it's so important to have your regular checkups and cleanings. We can fix your tooth while the cavity is still small and only in the outer enamel layer. We simply remove the decay and replace it with a filling. Fillings are a great solution when you have a cavity, but to prevent future cavities, floss and brush daily to keep all the plaque off your teeth.

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Fillings

No, Not "Feelings" You Silly!

When we do a filling we want the entire procedure to be comfortable for you, so the first thing we do is make sure you're thoroughly numb. Then we remove the decay and shape the tooth with the handpiece. To mold the filling to the shape of your tooth, we first surround it with a thin, flexible band. A small wooden wedge between the teeth holds it snugly in place. We press the filling material very gently into the tooth. White fillings harden when they're exposed to a bright light, while silver fillings harden on their own. Then we check the bite with a colored tape, which shows us where your teeth are touching, and we make sure floss still works. And that's all there is to it!

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Fractured Front Tooth

It's almost always a traumatic experience for both children and parents when a child breaks a front tooth.

Fortunately, new bonding techniques and materials now allow our doctors at to get teeth to be beautifully restored back to nearly new condition.

We first roughen the tooth and a conditioning gel is applied. Tooth-colored material called resin is placed, sculpted to the desired shape, and hardened with a high-intensity light. It's important to watch for symptoms of nerve damage after a tooth has been damaged.

Let us know right away if you see signs of:

• discoloration
• changes in your child's eating or sleeping habits
• any new swelling, looseness or pain
• especially sensitivity to cold
• and any sign of abscesses or gum boils next to the tooth

Bonding is a great way to restore a broken tooth. The final result: a strong restoration and a natural looking tooth.

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Rubber Dam

When it's wet and rainy outside, it's always a good idea to wear a raincoat. Well, when we work on your teeth we sometimes use a special kind of tooth raincoat. It's called a rubber dam. It's made out of stretchy, rubbery material. To put a rubber dam on your tooth, we first put holes in it that match the teeth we're going to work on. Then we put a special metal holder on your tooth. The rubber dam just slips on over the metal holder (we call it a dental clamp). We attach a special frame to hold the rubber dam tight and out of our way. Once the rubber dam is in place, it keeps your tooth dry and keeps anything from falling to the back of your throat. It keeps you more comfortable and lets us do a better job. When we're done, off it comes. Just like your raincoat at home, the rubber dam protects you and keeps things dry.

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Pulpectomy

In primary teeth, when deep cavities are in the nerve, or close to the nerve, it's sometimes necessary to perform a pulpotomy. A pulpotomy is the removal of the irritated part of the pulp while leaving the healthy root canals intact. A pulpotomy usually involves four common steps.

First, we make an opening into the tooth and remove the part of the nerve in the top of the tooth. Next, we place medication to promote healing, and then we may crown the tooth to seal it and protect it. We want the entire procedure to be comfortable for your child, so the first thing we do is make sure they're thoroughly numb. We place a rubber dam around the tooth to isolate it from the rest of the mouth. It protects like a safety net, nothing can fall to the back of the throat. To get at the irritated tissue, we make an opening through the top of the tooth down into the pulp chamber. We carefully clean out the nerve tissue and then place a medicated packing. Sometimes the medicated packing is removed, and sometimes it's left in place.

The last step in the procedure may be a crown; it further helps seal and protect the tooth.

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Stainless Steel Crowns

Small cavities in primary teeth can be fixed with fillings, because there's still plenty of supporting tooth structure. However, large cavities sometimes need to be fixed with crowns. Crowns strengthen a damaged tooth by covering and protecting it. Crowns for primary teeth, unlike crowns for permanent teeth, can be placed in one appointment, are relatively easy for children to take care of, and are much less expensive than adult crowns.

We want the entire procedure to be a comfortable one, so the first thing we do is make sure the tooth is thoroughly numb. Then we remove any decay and shape the tooth with the handpiece. A crown is selected, trimmed and shaped, and adjusted until it precisely fits the tooth.

We then cement the crown in place. After double checking both the fit and the bite, your child will have a new stainless steel crown.

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Nitrous Oxide

We do offer Nitrous Oxide, laughing gas. If you and the doctors determine this is the best treatment for your child, it be used in our office to help to relax your child.

For More Info:

http://www.aapd.org/publications/brochures/nitrous.asp

Oral Sedation

Our offices offer oral sedation. If you and the doctors determine this is the best treatment for your child, we will sedate your child in the office with oral medication. The doctor will monitor your child and the treatment can be done with the child comfortably sedated.

For More Info:

http://www.aapd.org/publications/brochures/sedation.asp

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Toothache

• Clean the area around the sore tooth thoroughly.
   
• Rinse the mouth vigorously with warm salt water or use dental floss to dislodge trapped food or debris.
   
• DO NOT place aspirin on the gum or on the aching tooth.
   
• If face is swollen, apply a cold compress.
   
• Take acetaminophen (Tylenol) for pain and see a dentist as soon as possible.

Cut / Bitten Tongue, Lip or Cheek

Apply ice to bruised areas. If there is bleeding, apply firm but gently pressure with a clean gauze or cloth. If bleeding does not stop after 15 minutes of it cannot be controlled by simple pressure, take the child to a hospital emergency room.

 

Broken Braces and Wires

If a broken appliance can be removed easily, take it out. If it cannot, cover the sharp or protruding portion with cotton balls, gauze, or chewing gum, cheek, or tongue, DO NOT remove it. Take the child to a dentist immediately. Loose or broken appliances which do not bother the child don't usually require emergency attention.

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Cold / Canker Sores

Many children occasionally suffer from "cold" or "canker" sores.

Usually over-the-counter preparations give relief. Because some serious diseases may begin as sores, it is important to have a dental evaluation if these sores persist.

Bleeding after a Baby Tooth Falls Out

1. Fold and pack a clean gauze or cloth over the bleeding area.
    
2. Have the child bite on the gauze with pressure for 15 minutes.
    
3. This may be repeated once; if bleeding persists, see a Dentist.

 

Knocked Out Permanent Tooth

• Find the tooth. Handle the tooth by the top (crown), not the root portion. You may rinse the tooth, but DO NOT clean or handle the tooth unnecessarily.
   
• Try to reinsert it in its socket. Have the child hold the tooth in place by biting on a clean gauze or cloth.
  
  or
   
• If you cannot reinsert the tooth, transport the tooth in a cup containing milk.
  See a dentist IMMEDIATELY! Time is a critical factor in saving the tooth.

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