First Appointment

Your child can grow up with a healthy mouth free of cavities if you start proper dental care early.

Usually your baby’s first shiny white tooth will appear, typically in the front center of the lower jaw, at about 6 months of age. Your child should see the dentist as soon as the first baby tooth comes in!

This first dental visit does two things:

• It makes your child accustomed to the dental office environment, and makes it a FUN place to go
• It ALSO allows for early examination to make sure that your childs development is within normal limits.

One of the worst things you can do in your childs dental health is waiting to bring your child to the dentist for an evaluation until there is an agonizing problem and the child is already experiencing pain and is afraid. START EARLY and avoid small problems that may be intercepted before they become big ones. Schedule an appointment for your child TODAY!

Prevention

Preventive Dentistry for Your Baby One of the most effective tools for preventing decay in baby’s teeth is the use of fluoride. Fluoride, according to all sources, helps form strong teeth and prevent decay. Because the amount of fluoride needed depends on your baby’s feeding habits and the amount of fluoride in your water supply, be sure and check with your dentist before adding it to your child’s regimen. Combined with sealants, fluoride use can help reduce cavities by up to 90%!

Comprehensive Evaluation

When your child arrives in the treatment room, he or she will have a comprehensive evaluation by our Pediatric Dentist. All conditions will be noted, teeth and other oral structures. Any of your concerns should be pointed out at this time.

During the evaluation, you may be asked to help hold your child. This aids the clinician in restraining your child and making the process safe and comfortable.

If necessary, dental x-rays or other imaging may be required in order to properly diagnose all conditions.

Digital X-Rays

Our offices utilizes the latest in Digital X-ray Technology. A fraction of the radiation exposure is necessary to obtain images of your child’s teeth (both already inside the mouth and also that are still developing under the gumline). These images are usually necessary at their first evaluation, and every 6 month interval.

Caries in children can start very early and spread extremely quickly. Since the enamel layer on childrens teeth is much thinner than on adult teeth, small cavities become root canal problems very quickly.

There is a much greater danger to your childs teeth by NOT taking routine X-rays if a diagnosis is missed due to lack of information.

Diagnodent

As stated earlier, during the comprehensive evaluation all conditions will be noted regarding oral structures and teeth.

Cavities come in two varieties: large ones or small (incipient) caries. We use laser technology in verifying the detection of cavities. A small cavity may either appear to be a pinpoint hole, a dark area on the biting surface of the tooth, or a whitish spot.

The DIAGNODENT allows us to objectively guage the depth and the extent of the cavity without physically drilling into the tooth. This also will let us know if it is possible to remove the decay with our WATERLASE and avoid the use of anesthesia or conventional drills.

Early Childhood Caries

Early Childhood caries is a preventable and treatable disease which affects many children across the country every year. It costs a great deal of time, effort, and money to treat a problem which can be avoided. There are some simple and effective measures of prevention you can follow to prevent this from occurring to your child.

WHAT IS EARLY CHILDHOOD CARIES AND HOW DOES IT HAPPEN?

Early Childhood caries is a disease that can destroy your childs the teeth at a very young age. It can also affect the permanent teeth if it is not treated early enough.

The disease occurs when a child’s teeth are frequently exposed to sugar for long periods of time. In most children, this translates to sleeping with a bottle or ‘sippy cup’. The damage can be caused by milk, breast milk, condensed milk products, formula, fruit juice, soda pop and other sweetened liquids.

When a baby is put to bed with a bottle or ‘sippy’ cup, the liquid collects around the teeth and the sugar ‘bathes’ the teeth throughout the night causes cavitites to start and spread rapidly.

Baby Root Canals

A ‘baby root canal’ is the partial or complete removal of the infected nerve due to caries or trauma. This procedure is indicated when the decay in the tooth is very large and at the level of the nerve.

This procedure often is in conjunction with a major restoration such as a stainless steel crown of white crown. The top portion of the nerve is cleaned and the remainder of the tooth is treated with a medicine that will preserve the integrity of the tooth until it is ready to come out.

Types Of Restorations

As in adult teeth, there are many different types of restorations avaliable. Even though baby teeth will eventually ‘fall out’, the proper treatment of disease is important for your childs health. Often times, a baby cavity may have an infection under the gumline that can affect the permanent tooth from developing normally. It is our objective to treat the problem once with the proper type of restoration and have that restoration in service until the eventual loss of the primary tooth.

Recommendations will be made based on the extent of the problem, and the expected longevity of the tooth and esthetic nature of the restoration.

Options exist that are both very esthetic and quite durable. Cavities on front teeth will always be restored using a white (composite) material. Back teeth with problems requiring a crown to protect against further decay have either the option of silver colored crown or a silver crown with a white facing. The second option while more esthetic may not be as durable and may not be covered by your dental insurance.

Ask your provider to explain treatment options that exist for your child and the expected longevity of each type of restoration.

Extractions And Space Maintenance

In many cases an extraction will be necessary to remove a diseased tooth that cannot be saved with a dental restoration. If this happens before the permanent tooth is expected to erupt, the spacing of the primary and permament teeth will become a problem. Genreally, an extraction of a baby tooth will cause the permanent tooth next to it to drift into that space. This will prevent the unerupted permanent tooth that belongs in this space to fail to erupt or to erupt into a space that is out of position. When this happens, orthodontics are generally needed to correct the spacing problem.

To prevent space loss after an extraction, ‘SPACE MAINTAINERS’ are indicated. Examples are shown to the left and include single tooth space maintenence, and multiple (cross-arch) space maintainers. These appliances are necessary until the eruption of the permanenet teeth fills the space that exists due to the extraction. When front teeth are lost prematurely, a parent may choose to make a ‘PEDO PARTIAL’ demonstrated on the left. This appliance is very esthetic and will allow your child to look and function normally until the front teeth erupt.

Pedo Partial

When front teeth are lost prematurely, a parent may choose to make a ‘PEDO PARTIAL’. This appliance is very esthetic and will allow your child to look and function normally until the front teeth erupt.

Orthodontic Treatment

When describing orthodontics, most people just refer to braces. While the majority of orthodontic cases involve braces, there are also appliances that may be needed before braces and retainers that are use afterwards to keep the teeth straight.

THE BENEFITS OF ORTHODONTICS

1)Reduce the risk of injury – prominent teeth are more prone to trauma
2)Reduce the risk of decay – crooked teeth are harder to clean
3)Reduce the risk of developing TMJ problems
4)Eliminate the excessive wear on your teeth that can be caused by a poorly aligned bite
5)Correcting abnormal tooth alignment can help prevent certain speech problems
6)Straight teeth provide a healthier, more attractive smile
7)A beautiful smile increases confidence and self-esteem

Teething

There is some minor discomfort associated with teething, and some of the symptoms you will see include grouchiness or fussiness, sore or inflamed gums, excessive drooling, loss of appetite, a change in eating habits or difficulty in sleeping. These should not cause alarm and are to be expected. However, if your baby experiences other problems during the teething process such as rash, fever or vomiting, something else may be wrong. Consult with your pediatrician in those cases, and do not make the assumption it is due to teething.

The best thing to do to aid discomfort is to clean your baby’s mouth with a damp gauze pad two or three times daily, and giving your baby a cool teething ring to chew on.

CARING FOR YOUR BABY’S TEETH

Good dental habits begin early, and by caring for your baby’s mouth and teeth as early as you can, you will help baby develop good dental habits.

You should actually begin cleaning your baby’s mouth with the first day of life. Wipe out the mouth with a damp gauze pad wrapped around your finger or a damp washcloth gently and massage the gums pads after each feeding and before bedtime . Hold your baby so that their head rests comfortably in your lap, this will aid stability and provide better visibility.

Begin cleaning baby’s first teeth as soon as they appear through the gum. Continue to use a gauze wrapped finger or you may use a very soft bristled child-sized toothbrush. At this point in their life, it is not necessary to use toothpaste. Sometime after the first tooth comes in, and preferably not later than 1 year old, you should schedule your child for their first dental visit.

Growth And Development

Periodic evaluation is necessary to gague the development of your child’s teeth. Panoramic X-rays should be taken at age 6 to determine the development of permanent teeth underneath the primary teeth. This examination allows the Pediatric Specialist to determine wheter the development is within ‘Normal Limits’.

It is only with this evaluation that interceptive orthodontics may be utilized.

Nitrous Oxide

NITROUS OXIDE (Laughing Gas)

Nitrous oxide, also known as laughing gas, is most often used for children who are slightly nervous. It is a gas that is delivered with oxygen to help your child relax and receive treatment comfortably and safely. Nitrous oxide is administered by placing a small mask over your child’s nose. Your child will be asked to breathe through his or her nose and not through the mouth. As the gas begins to work, the child becomes calm, although he or she is still awake and can talk with the dentist. When the gas is turned off, the effects of sedation wear off almost immediately. Nitrous oxide is always delivered mixed with oxygen.

When the treatment has been completed, the nitrous oxide is turned off and pure oxygen is delivered for 5 to 10 minutes to help flush the child’s body of the gas. The effects of nitrous oxide should disappear as oxygen is breathed in.

Sedation Dentistry

There are two types of in-office sedation avaliable to patients:

ORAL SEDATION

Children who are more anxious may need an oral medication that is stronger than nitrous oxide to effectively calm their anxiety and allow them to tolerate treatment. With oral sedation, your child may be sleepy but can be awakened if necessary and can respond to simple commands.

Prior to the adminstration of oral sedation, the child cannot have any food or liquid for up to 6 hours before the treatment to allow the medication to work effectively and to prevent side effects such as vomiting.

After the sedation your child will be groggy for a few hours and will require some rest that day until the effects of the medication have worn off.

This method is the most widely-used in order to make the visit more comfortable for the patient.

INTRAVENOUS SEDATION

IV Sedation, also known as Deep Conscious Sedation is commonly used by dentist to achieve a deeper level of sedation by giving the medication directly into the blood stream through an IV. With IV Sedation the medication can be adjusted to achieve the optimal level of sedation as needed throughout the treatment. The amnesia with this is greater and so is the sedation level, leading to a more comfortable and tolerable procedure for the patient.

This method is useful when the patient is very anxious, and would like to be ‘sleeping’ during the procedure. Little to nothing is remembered after the procedure is completed. Please be advised that a DENTAL ANESTHESIOLOGIST, and may incur additional fees.

General Anesthesia

Although it is always our primary intention to treat your child in the office, sometimes this becomes unsafe and impractical. With the patient completely asleep under general anesthesia, the dentists can safely and effectively provide your child the optimal treatment in a safe and controlled environment. He or she is unable to feel pain or to move around making the treatment much faster and less traumatic for the child. This is the same kind of sleep a child would have if he or she were to have ear tubes placed or tonsils removed.

Dr. Asgari has extensive training and experience treating patients in the operating room

If your child is under the age of 7 or handicapped, California state law requires that the insurance provider allow for the treatment to be done at the hospital.

WE MAY RECOMMEND GENERAL ANESTHESIA IF YOUR CHILD:

1) Is unable to relax enough for treatment to be performed safely in the office and conventional behavior management techniques have been ineffective.
2) Needs oral surgery or other dental treatment that would be difficult for the child to tolerate while awake.
3) Needs extensive dental treatment that can best be done in one long appointment rather than many shorter visits.
4) Has a medical, physical or emotional disability that limits his or her ability to understand directions and be treated safely in an outpatient setting.

General anesthesia for dental procedures is provided in the hospital setting by an anesthesiologist. These professionals along with the nursing staff are trained to monitor the child during the procedure and make certain that the treatment is delivered optimally.

A physical examination before receiving general anesthesia is required to ensure your child doesn’t have any conditions that could interfere with or be affected by the anesthesia. If your child is sick on the day of the scheduled procedure, call to see if the appointment should be rescheduled.