When a child’s tooth is damaged due to decay or fracture, a “filling” replaces the damaged area and fixes the tooth’s structure. Great Whites uses state-of-the-art, tooth–colored resin to give smiles a natural look and feel.

If a baby tooth has a cavity that involves the nerve inside the tooth, it may require a procedure called a pulpotomy. (Sort of like a baby root canal.) In this procedure the cavity is removed along with the infected portion of the nerve tissue. A sedative filling is placed and the tooth is restored with a crown in the same visit, to keep it in place until the permanent tooth is ready to come in.

Removal of a tooth may become necessary if a baby tooth is preventing the normal development of a permanent tooth, if the tooth has excessive decay or trauma, if the patient has gum disease, or if the tooth (usually a wisdom tooth) is impacted. Impacted wisdom teeth are third molars that often appear in the late teens or early twenties. When wisdom teeth don’t have the proper room to grow in, severe problems can result over time. To avoid this we may advise that one, or more wisdom teeth be removed. If a baby tooth is extracted before it would normally fall out, a space maintainer may be necessary to keep the other teeth from shifting.

A space maintainer is a preventive appliance that keeps teeth in their proper position until a new permanent tooth is ready to erupt. Often it is cemented in place to prevent shifting of surrounding teeth, but some older children may benefit from a removable appliance (like a retainer) to hold the space for permanent teeth. A space maintainer can prevent the need for more complex orthodontic treatment in the future.

Crowns are permanent coverings that fit over your child’s tooth if it has decayed, been damaged, or cracked. Once decay has been removed, the tooth is fitted with the appropriate sized crown in the same visit. For back baby teeth, most crowns are made of stainless steel (the most durable option), which protects the tooth until it is ready to fall out. In some instances, it may be possible to place a tooth-colored zirconia crown on primary teeth. This option is better looking than stainless steel but is not appropriate for all primary teeth. Our doctors will discuss which treatment is best suited for your child’s situation. Crowns for front baby teeth are made in a single visit using a durable tooth-colored resin.

Eighty-eight percent of total cavities in American kids are caused by bacteria reacting with food in the grooves and depressions of chewing surfaces. These are the hardest areas to clean. Tooth sealants protect these areas by sealing the groves and depressions, giving food and bacteria nowhere to hide. Sealants are made from a resin applied to areas prone to cavities. They last for several years but should be checked during regular appointments.

Bonding improves the way teeth look and enhances a smile by repairing chipped or cracked teeth, reducing gaps or spaces between teeth and hiding discolorations on a tooth’s surface. A resin is bonded to an existing tooth. This has many advantages: it usually takes less than an hour, requires minimal reduction to the tooth’s original structure and is fairly inexpensive. The materials used come in many shades to match your child’s natural tooth color. Large fractures of permanent teeth can be repaired with bonding, but often require a more permanent porcelain crown when your child reaches adulthood and the jaws have completed growth. Porcelain crowns are not appropriate for a young, growing child. Bondings can be stained by coffee, tea, soda, foods and candy. But, that’s what proper brushing is for.

Many things can discolor your kid’s teeth: food, beverages and improper care top the list. We do not recommended whitening for primary teeth; a thorough dental cleaning with our hygienist almost always returns baby teeth to their natural pearly white state. Over-the-counter or professional whitening products should not be used until all permanent teeth are in, and usually not before age 14, to ensure that the roots of the teeth are completely formed. When appropriate we can discuss the best and safest professional whitening methods to keep your child’s smile sparkling.

We use several techniques to help keep your child comfortable before and during treatment. Before we do a thing we always explain each step of a procedure to your child using age appropriate and “friendly” words so that there are no surprises. When it makes sense, we demonstrate procedures on a hand or finger or encourage your child to watch in a mirror, so that they understand what to expect and can relax. For fillings or extractions many children benefit from the use of nitrous oxide (“sweet air” or “laughing gas”) to help ease anxiety or curb a strong gag reflex. Nitrous oxide allows the child to remain conscious and talk to the doctor during a treatment. After a procedure, oxygen is administered for five to ten minutes to flush out any remaining gas. The effects wear off almost immediately (side effects of nausea and constipation are rare). Children can return to their normal daily activities (including school) following a treatment using nitrous oxide.

Sometimes young, or special needs patients, who require extensive treatment can benefit from IV or general anesthesia. We offer IV anesthesia in the comfort of our office with a certified anesthesiologist. For some medically compromised patients, we also offer general anesthesia in an operating room setting, at Cohen’s Children’s Medical Center, where Dr. Dawn is on staff. With either of these options your child may be asleep while comprehensive dental treatment is completed in a single visit.

Using a soft-bristled toothbrush and small strip of fluoride toothpaste, move the brush in small, slow, gentle circles to reach food at the gum line. Hold the brush at an angle and brush up on lower teeth, down on the upper teeth, covering the entire surface. Avoid swallowing toothpaste and brush your tongue before rinsing thoroughly with water. (Even if it tickles.)

Teeth should be brushed at least two times a day: after breakfast, before bed. When toothbrush bristles start to wear down, it’s time for a new one.

Dental floss gets the food and plaque from areas toothbrushes can’t. Simply pull a length of floss from the dispenser and wrap around your middle fingers. Guide the floss between all your teeth to the gum line, unwrapping clean floss from your fingers as you go. Floss once a day before bed. Just know, when you first start flossing your gums may bleed a bit. If the bleeding doesn’t go away after the first few flossings, let a staff member know at your next appointment.

Fluoride makes teeth stronger and resistant to decay and luckily can often be found in regular local drinking water. Unlike the majority of counties in the U.S., there is no fluoride in the drinking water in Nassau and Suffolk counties. Our dentists can discuss whether a fluoride supplement may benefit your child’s developing teeth.

Eighty-eight percent of total cavities in American kids are caused by bacteria reacting with food in the grooves and depressions of chewing surfaces. These are the hardest areas to clean. Tooth sealants protect these areas by sealing the groves and depressions, giving food and bacteria nowhere to hide. Sealants are made from a resin applied to areas prone to cavities. They last for several years but should be checked during regular appointments.

Newborns’ gums should be cleaned after feedings with a water-soaked infant cloth to stimulate gums and remove food.

Babies’ first teeth should be gently brushed with a small, soft-bristled toothbrush and a pea-sized amount of non fluoride toothpaste.

Toddlers aged 2 or 3 should be helped by parents and taught the proper way to brush, using a pea sized amount of toothpaste.