Restorative dentistry has been defined as the repair or replacement of damaged or decayed teeth however restorative therapy includes not only the physical repair process but the preventative process also. The dental industry has and continues to advance and improve the medicaments such as SDF, composite, resin- modified glass ionomer, SSC, Zirconia Crowns and so forth to restore teeth to create a healthy, stable oral environment. With that said, Cherry Orchard Pediatric Dentistry strives to develop an oral health plan that promotes fewer restorative visits and only Recare (cleaning) visits for your child. A healthy smile is a happy smile.
Silver Diamine Fluoride (SDF)
SDF is an alternative, non-invasive preventative treatment for decay. SDF is a liquid material that is applied to the cavitated (decayed) area to arrest and prevent the growth of the cavity. The silver component of SDF acts as an anti-microbial agent killing the bacteria while the fluoride component prevents further demineralization (breaking down) of the tooth structure. This therapy typically consists of 2-3 visits. SDF does not remove decay, it simply prevents and arrests the decay (with good oral hygiene habits) until your child can perform treatment in the office or the tooth exfoliates (falls out naturally).
Composite Restorations (Fillings)
Composite restorations are a resin-based filling material designed for esthetics. Formulated to resemble the color of your natural tooth, composite is often used for filling dental cavities or for dental bonding front teeth. After decay is removed from a tooth and the remaining tooth structure provides enough support for the composite resin(filling), then it can be used to restore the tooth. Typically, the composite resin is hardened using a special UV light which will transform the “playdoh- like material” to a solid material. The tooth is then contoured and adjusted to patient’s comfort.
Stainless Steel Crown (SSC)
Stainless steel crowns have been well utilized in Pediatric dentistry for several years due to their durability and functionality for primary teeth. They are silver in color and are typically used on the posterior(back) teeth for strength. When extensive decay compromises tooth structure or an existing tooth is present with minimal structure, a SSC is indicated to restore the tooth to health. SSC’s may also be indicated due to habits such as chewing toys, chewing ice, severe grinding/bruxism which can easily fracture or break tooth structure. This procedure is typically completed in one visit and is even used to arrest decay via the Hall Technique.
Zirconia crowns are tooth colored ceramic crowns for primary teeth. These crowns evolved in the pediatric industry within the past 5 -7 years. The Zirconia crowns follow the similar guidelines for use as the SSC and present similar strength and durability traits, however there are some restrictions. Zirconia crowns are prepared in a similar manner to a permanent tooth receiving a tooth-colored crown except there is no impression or subsequent visits. Unlike a stainless-steel crown, a zirconia crown cannot be manipulated to fit the child’s tooth, we must make the tooth fit the crown. This procedure is typically completed in one visit.
A pulpotomy is a dental procedure in which the coronal (crown) portion of the nerve (pulp) is removed and the nerve in the root portion remains intact. This procedure is performed when decay penetrates the layers of the tooth near and/ or enters the pulp (nerve chamber). The purpose of a pulpotomy is to protect and preserve the vitality (life) of the remaining root structure and for function such as talking, chewing, natural space maintenance until exfoliation. Typically, this treatment is identified on x-rays and /or can be identified by extensive clinical decay and early signs of discomfort. The procedure is often performed in primary (baby) teeth; however, it may also be performed in developing permanent teeth.
A space maintainer is a metal appliance that is used to preserve space until the permanent teeth erupt or the maintenance period is no longer needed which is determined by the dentist. There are several different space maintainers that we use, some are fabricated at your child’s visit and others are sent off to a lab. The lab fabricated appliances are done via a scan of the oral cavity and then a prescription is filled out for the desired appliance. Typically, a lab will take about 2-3 weeks to deliver the appliance to our office and then your child will be scheduled for the delivery. We recommend the delivery time not exceed 4-5 weeks because teeth can shift and drift, resulting in the fabrication of a new appliance.
**We recommend contacting us immediately if the appliance comes so we can recement if not damaged. **
Extractions (Tooth Removal)
Tooth extractions are typically recommended for orthodontic reasons, infection, and non-restorable teeth. If a tooth is infected, the infection’s ability to spread easily to the facial spaces is the concern; therefore removal/ extraction of the tooth is necessary. Extractions are also indicated for over-retained primary teeth preventing permanent teeth from erupting, supernumerary (additional) teeth, ectopically placed teeth that cannot come into function, ankylosed (anchored) primary teeth and traumatic injury creating vertical fracture.