Tooth-Colored Bonded Fillings
The doctors at Wild Smiles use state-of-the-art technologies and techniques when restoring tooth decay. Research shows that bonded (composite resin) restorations, particularly in baby teeth, are much stronger and last more predictably than the old silver amalgam (mercury) fillings with which most people are familiar.
The research has shown that more than 30% of silver/mercury amalgam fillings on baby teeth fail within 18-20 months. Treating the same tooth twice is both expensive and unpleasant for the patient.
Composite resin (white filling material) actually bonds to enamel and dentin and strengthens the tooth while restoring it to its original shape. A more conservative tooth preparation is used during decay removal so that less healthy tooth structure is lost as compared to silver/mercury amalgam fillings. This also allows us to restore small cavities earlier, before large restorations are needed.
Bonded restorations are also more comfortable postoperatively and less sensitive to temperature changes.
Baby Tooth Pulp Treatment
The pulp of a tooth is the inner, central core of the tooth. The pulp contains nerves, blood vessels, connective tissue and reparative cells. Large deep dental decay (cavities) are the main reason a tooth would require pulp therapy. Decay progresses much more quickly in baby teeth and can enter the pulp before your child complains of a toothache.
When this happens a "nerve treatment," "baby root
canal," "pulpectomy" or "pulpotomy" is required in
order to save the tooth. The purpose is to treat the
tooth so that it will be comfortably maintained
until normal exfoliation time, typically age 11 to
A pulpotomy removes the diseased pulp tissue within the crown portion of the tooth. Next, an agent is placed to prevent bacterial growth and to calm the remaining nerve tissue. This is followed by a final restoration (usually a stainless steel crown). A pulpectomy is required when the entire pulp is involved (into the root canal of the tooth). During this treatment, the diseased pulp tissue is completely removed from both the crown and root. The canals are cleansed, disinfected and, in the case of primary teeth, filled with a resorbable material so that the roots resorb and the baby tooth falls out at its natural time. Then, a final restoration is placed.
Stainless Steel Crowns
Baby teeth are not just small permanent teeth. They have thinner enamel, relatively larger pulp chambers and decay at a much faster rate than permanent teeth. In addition, baby teeth do not hold large fillings very well.
More than 30% of large fillings placed on baby teeth fail, regardless of the type of filling material, within 18-20 months after placement. That is why stainless steel crowns are often recommended for baby teeth with significant decay. This is particularly important for younger children whose molar teeth are needed for a number of years. This one-appointment technique offers a predictably strong restoration that will protect the tooth until its normal exfoliation. (It will protect molars until 10-12 years old).
A stainless steel crown should be considered based on the extent of the decay and length of time the tooth is scheduled to stay in the mouth. Generally, in the long run, this is the most economical and compassionate approach for your child. No one wants to treat the same tooth twice, because not only does the parent have to pay for things twice, the child has to go through the procedure a second time!
Esthetic Veneered Crowns
Esthetic stainless steel crowns are available for upper front baby teeth. This technology has been successfully used for a number of years for the front teeth of infants and toddlers. If your child has large cavities in the front teeth, it is necessary to restore them to achieve good oral health and speech development. We also want to maintain esthetics for proper psychological and emotional development. For this reason, we are happy to offer esthetic veneered stainless steel crowns to achieve the needed strength of a full coverage crown restoration, while maintaining excellent esthetics.
Yes, your child can receive too much fluoride, and it may start
during infancy. Research indicates that many children, especially
those younger than two, swallow too much toothpaste.
An October 2009 American Dental Association report indicated that infants whose parents use tap water to reconstitute infant formula are at risk of too much fluoride. As a result, almost 15% of elementary school-aged children show evidence of fluorosis, a defect in permanent tooth enamel that ranges from minor white blemishes to objectionable discoloration and weakness of the enamel.
Like dental cavities, this can be prevented. We advise that parents reconstitute infant formulas using non-fluoridated nursery water to avoid over-fluoridation. Also, fluoride toothpaste should be avoided until your child can spit after brushing without swallowing the toothpaste.
When brushing a young child's teeth, make sure to use just a “smidge” of fluoridated toothpaste until you are sure your child can effectively spit the remaining foam from their mouth. When you are sure they can spit, a half of a pea-sized amount of toothpaste on the tooth brush is plenty of fluoride protection and, with supervision, is not associated with an increased risk of fluorosis. Because of such concerns, parental supervision is recommended.
Water fluoridation is by far the best and safest way to prevent cavities. Over the last 65 years, water fluoridation has been shown to reduce tooth decay by 30 to 35%. Water fluoridation in combination with the regular use of a fluoride toothpaste can further reduce tooth decay in children by up to 45 to 50%.
Contemporary fluoride protocols avoid ingested fluoride supplements and recommend the safety and efficacy of a topical approach. Research shows that cavitiy-prone children over age five benefit from a low concentration, high frequency fluoride protocol, such as topical fluoride gels (Omni-Gel) or a prescription fluoride toothpaste prescribed by your dentist.
Wild Smiles uses the most appropriate fluoride protocols following your child’s routine teeth cleaning. Research has shown that these techniques are effective at further reducing cavities by up to 15-20%. In total, fluoride protocols are able to reduce the incidence of childhood cavities by up to 65 to 70%. This, in combination with sealants, proper diet and brushing and flossing at home, make becoming a cavity-free adult a very realistic goal for most — if not all of our patients — at Wild Smiles.
Should your child develop a cavity, as do nearly 40 percent of five-year-old children, be aware that newer restorative materials can help with time-released fluorides that can prevent future decay. Regardless, Wild Smiles is committed to implementing the newest advances to minimize the chance of future tooth decay for your child.
Why does Wild Smiles use fluoride varnish?
Wild Smiles uses the newest fluoride protocol that recently was established by the American Dental Association. Research has shown that fluoride varnish is almost 50% more effective at reducing cavities as compared to the traditional fluoride gel approach.
In addition, fluoride varnish results in a significantly lower systemic fluoride uptake the previously available gels. Fluoride varnish places 23,000 parts per million fluoride directly into the teeth over a six-hour time span as opposed to 2,000 parts per million fluoride over four minutes using the traditional fluoride gel in trays. Since our goal is to fluoride the teeth, not the body, this has proven to be an exciting advancement.
Did you know that 38% of children who have fluoride varnish applied every six months have fewer cavities than those who did not? Fluoride varnish, in combination with water fluoridation and fluoride toothpaste, will reduce the incidence of childhood cavities by up to 65 to 70%.
The grooves and depressions that form the chewing surfaces of the back teeth are extremely difficult (if not impossible) to clean of bacteria and food. As the "sugar bugs" metabolize food containing sugar, acids form and break down the tooth enamel, causing cavities. Recent studies indicate that 88 percent of total cavities in American school children are caused this way. The other 12% are most likely caused from very acidic foods and beverages.
Tooth sealants protect these susceptible areas by sealing the grooves, preventing bugs and food particles from packing into these grooves. Sealant material is a resin typically applied to the back teeth, molars and premolars and areas prone to cavities. It lasts for several years but needs to be checked during regular appointments.
Xylitol is natural sugar that is widely distributed throughout nature and is available in fruits, berries, mushrooms, lettuce, hardwoods and corn cobs. For example, one cup of raspberries contains almost one gram of Xylitol.
Xylitol is a five-carbon sugar that the cavity-producing bugs in the mouth readily ingest, but cannot metabolize into enamel-destroying acid.
Over the past ten years, research has shown Xylitol’s effectiveness in dramatically reducing the incidence of caries, particularly in cavity-prone children.
Just two Xylitol mints or gums daily can aid in controlling these menacing bugs! Ask Wild Smiles staff members about information in ordering Xylitol gum and mints.
It’s unfortunate, but the research is clear: Children who have cavities are very likely to have more cavities in the future. As a group, these children continue to be cavity prone, despite good diet, hygiene and traditional caries prevention practices. The research has also shown that cavity-prone children carry a stronger, more virulent cavity forming strain of bacteria (bugs).
Many times, the only way to help reduce the risk of ongoing decay is to help change the strain of bugs these children carry. Most people are aware of how Activia, a probiotic yogurt, helps change the flora of the GI tract (gut) to help regulate digestion. Similar probiotic technology is now available in dentistry and is proving effective in altering the influence of the "pro-cavity" organisms in dental plaque.
Products, such as Biogaia®, are now available and proven effective in changing a child's oral flora from "pro-cavity bugs" to "anti-cavity bugs." The procedure is simple and begins with an anti-microbial varnish (chlorhexidine). This "sterilizes" the current oral flora (bugs) and allows for recolonization by non-cavity producing bugs. Pro-biotic drops, straws, and chewable tablets are then used for two weeks to promote an "anti-cavity" strain of bugs to colonize in the mouth and crowd out any "pro-cavity" bugs that try to adhere to teeth.
Your child’s primary molars (baby molars) will not be lost until age 11 or 12. Until then they serve many important functions, such as promoting normal growth of the face and jaws, preserving space for the eruption of permanent teeth and guiding the permanent teeth into their proper orthodontic positions.
If your child loses a baby molar due to injury or decay, the doctors at Wild Smiles may recommend placement of a space maintainer. New technology allows for easy placement with a customized fit that is comfortable in your child’s mouth, is easy to brush and does not interfere with eating. The spacer is also easy to remove when the new permanent tooth is erupting. These pictures show a small one-sided space maintainer and a two-sided space maintainer that will be in place until age eleven or twelve when the permanent teeth are scheduled to erupt.