Procedures

The following is a list of the more common procedures our pediatric dentists perform.  It is not a complete list of work that is possible at our office.  We provide this information for your education.  If you have any additional questions, don’t hesitate to call.

Oral Hygiene Instruction and Education
Routine Cleanings
Exams
Fluoride Application
Diet/Sugar Analysis
Digital X-Rays (radiographs)
Sealants
Tooth-Colored Fillings

Stainless Steel Crowns
Extractions
Pulp Therapy
Space Maintainers/Early Orthodontic Assessments
Common Appliances
Nitrous Oxide (a.k.a. Laughing Gas)
Conscious Sedation
General Anesthesia Dentistry

ProceduresOral Hygiene Instruction and Education

A large part of our practice is educating and demonstrating the techniques for keeping not only teeth, but the entire mouth clean and healthy. We discuss ways for children to improve oral health at home and how to correctly care for their teeth. We present brushing and flossing instructions and discuss risk factors for tooth decay and gum infections in the mouth.

Routine Cleanings

Research has shown that regular cleanings by dental professionals aid in the prevention of oral diseases. A lot of parents may think that gingivitis and periodontal (gum) disease is only an adult problem. However, gingivitis (the first stage of periodontal disease) is a common problem in children and adolescents. The bacteria in plaque can release toxins around the gum and cause inflammation and infection. This makes the gum tissue swell up, turn red, and bleed easily. Routine cleanings help to identify and prevent this issue, and we recommend these cleanings at least twice a year.

Exams

Exams are a very important part of preventative care.  They provide an opportunity for the dentist to observe your child's development, teeth, surrounding soft tissues, and jaw. They also allow us to catch any problems that may be present and discuss treatment options.

Fluoride Application

Fluoride encourages remineralization (a strengthening of weak areas in the tooth). Fluoride is sometimes added in water and in dental products such as toothpaste, mouthwashes and other products.  You only need to use small amounts of fluoride to get the maximum benefit.  Because the water in western Montana does not contain fluoride, we may prescribe fluoride supplements in the form of drops, a pill or paste.  At each dental follow up appointment, we apply a fluoride varnish to your child's teeth.  Fluoride is documented to be safe and highly effective if used in the recommended quantities.

Diet/Sugar Analysis

We make an effort to discuss your child's diet, and make suggestions that will help to improve not only the health of their teeth, but the overall health of their body. Healthy eating habits lead to healthy teeth. Like the rest of the body, the teeth, bones and the soft tissues of the mouth need a well-balanced diet.

Digital X-Rays (radiographs)

Digital radiographs offer a reduced amount of radiation, high-speed technology and a more comfortable experience. Radiographs are a vital and necessary part of your child's dental diagnostic process. Radiographs spot much more than cavities and without them, certain dental conditions can be missed.

For example, radiographs may be needed to survey erupting teeth, diagnose bone diseases, evaluate the results of an injury or plan orthodontic treatment.  If such dental problems are found and treated early, dental care is more comfortable for your child and more affordable for you.

The American Academy of Pediatric Dentistry recommends radiographs and examinations every six months for children with a high risk of tooth decay.  Digital radiographs and proper shielding assure that your child receives a minimal amount of radiation exposure.  Radiation exposure is sometimes a concern when consenting to dental x-rays for you or your children.  Our machines have quoted very low radiation: 70–90% less than the traditional film x-rays.  In fact, it is so low that there is more radiation received by spending a few hours in the sun.

Sealants

The American Dental Association recognizes that sealants can play an important role in the prevention of tooth decay. When properly applied and maintained, they can successfully protect the chewing surfaces of your child's teeth. By forming a thin covering over the pits and fissures, sealants keep out plaque and food, thus decreasing the risk of decay.  Since the covering is only over the biting surface of the tooth, areas on the side and between teeth cannot be protected with the sealant.

Tooth-Colored Fillings

We use a plastic based composite filling for most cavities at Missoula Pediatric Dentistry.  The great thing about this improved filling material is that we can match the color of the surrounding teeth leaving little evidence any flaw ever occurred.  The placement must happen in a dry environment, therefore isolation of the tooth using a rubber dam is critical.  Similar to all filling materials, composite must be kept clean due to the risk of cavities forming around the filling, and to prevent staining.

Stainless Steel Crowns

Stainless Steel Crowns are used to restore teeth that are badly damaged due to large cavities, excessive grinding or wear.  They are utilized when a filling is not possible in a tooth. For front teeth, stainless steel crowns with white facing are used to help with aesthetics.

Extractions

Extractions may be necessary for many reasons, including risk of infection, preparation for orthodontics, crowding or for large cavities. We regularly perform extractions right here in our office.

Pulp Therapy

The pulp of a tooth is the inner core of the tooth. The pulp contains nerves, blood vessels, connective tissue and reparative cells. The purpose of pulp treatment is to maintain the affected tooth so that the tooth is not completely lost. Dental cavities and traumatic injury are the main reasons for a tooth to require pulp treatment. Pulp treatment removes the diseased pulp tissue within the crown portion of the tooth. An agent is then placed to prevent bacterial growth and to calm the remaining nerve tissue. This is followed by a final restoration (usually a stainless steel crown).

Space Maintainers/Early Orthodontic Assessments

Space Maintainers are used to hold adequate space for permanent teeth. When a baby tooth is lost too soon, the teeth beside it may tilt or drift into that empty space. Teeth in the other jaw may move up or down to fill the gap.  As teeth beside the gap shift into the empty space, they create a lack of space in the jaw for the permanent teeth.  When that happens, permanent teeth are crowded and can come in crooked. If left untreated, the condition may require extensive orthodontic treatment.

Space maintainers are used to prevent any drifting of teeth and loss of space in your child's teeth.  They keep the remaining teeth in place until a permanent tooth is in that natural position. Space maintainers are appliances made out of metal and are custom fitted to your child's mouth. Using space maintainers is more affordable and easier on your child than having to move those teeth back in place with orthodontic treatment.

We try to recognize and discuss orthodontic concerns at an early age. If we are aware of problems early on, we have more options and can create a plan for the future.

Common Appliances

Lower Lingual Holding Arch (lower jaw with more than one missing tooth)

Lower Lingual Holding Arch
(lower jaw with more than one
missing tooth)

Band and Loop (single missing tooth)

Band and Loop (single missing
tooth)

Nance Appliance (upper jaw)(upper jaw with more than one missing tooth)

Nance Appliance (upper jaw)(upper jaw with more than one missing tooth)

Nitrous Oxide (a.k.a. Laughing Gas)

Nitrous Oxide is a gas that is breathed in and out through the nose and is used primarily for relaxation purposes.  Patients are fully awake and conscious during the treatment. We recommend using Nitrous Oxide during restorative appointments, and can also use it during cleaning appointments for exceptionally anxious patients. Nitrous Oxide is always mixed with oxygen. 100% oxygen is administered at the end of the appointment, eliminating the Nitrous and its effects from your child's system. Patients can return to school, daycare or any other usual activities immediately after their dental appointment.

Conscious Sedation

Occasionally a child who is exceptionally fearful, anxious or cannot cooperate will be recommended for Conscious Sedation.  Conscious Sedation is a controlled, pharmacologically induced, minimally depressed level of consciousness that retains the patient's ability to independently maintain an airway.  Special informed consent and instructions are necessary for these appointments.

General Anesthesia Dentistry

Pediatric dentists treat patients who have special challenges related to their age, behavior, medical status, and developmental disabilities.  Cavities, gum disease, and other oral conditions, if left untreated, can lead to pain, infection, and loss of function.  In such cases, it is important to treat these conditions utilizing staff that is trained in general anesthesia and sedating children.  This provides a safe and controlled environment to complete comprehensive dental care.  This treatment is provided in a variety of settings and also includes specific informed consent and instructions.