About Good Diet and Healthy Teeth, Baby Bottle Tooth Decay and Sedation And Much More

My Child Hates Needles And Getting Shots In His/Her Mouth, Can Anything Be Done?
For regular, non-sedation appointments, a topical anesthetic gel is used on the gum prior to the injection. We use a topical, Tricaine, which is a combination of three different strong numbing gels. The Tricaine gel is applied and usually left on for a few minutes. It totally numbs the area so your child does not feel anything, even a small pinch when the injection is given. As the tooth starts to get very numb, the anesthetic is placed in other areas around it, as needed, as treatment progresses.

Will My Child Be Unconscious Or Will He/She Feel Pain?
No, your child will not totally be unconscious but extremely relaxed. He/she will be able to communicate with us and follow our directions but he/she will have little memory of the appointment, if any at all. This light type of sedation is termed "Conscious Sedation" and all of the protective breathing reflexes are intact. We continually monitored your child with a sophisticated medical device during the entire sedation appointment. In our practice we use a Pulse Oximetry, ECG, and Blood Pressure monitor from Welch Alyn® Atlas™. If during the appointment your child becomes too sleepy, we can use a reversal medication to lighten the sedation level. Your child will not feel any pain during your sedation appointment as he/she will not perceive any pain or discomfort.

What Kinds Of Sedation Dentistry Are Available?
The most popular are oral, I.V., I.M., and Nitrous Oxide or a combination of these options. Nitrous Oxide (relaxing air) helps our patients achieve a relaxed state where they are less apprehensive, stress - free, and are able to complete the needed care. Many patients who are apprehensive or fearful can complete their dental care comfortably with the help of nitrous oxide.

For our patients who are phobic or fearful and who want to be totally relaxed and have little memory of their appointment, I.V. (intravenous) or I.M. (intramuscular) sedation is recommended. By the time the I.V. is started they are already extremely comfortable and relaxed because they have already taken an oral prior to your appointment. In addition, they have been on Nitrous Oxide air, so starting the I.V. will not bother them at all. The I.V. provides your fluids during your sedation appointment. Through the I.V., we use .9% Sodium Chloride (normal saline) to keep our patients hydrated and provide the necessary medications to keep them very relaxed during the appointment.

Certain sedation medications can be given I.M. (intra-muscular) in an arm or leg muscle or even by drops in the nose (intra-nasal sedation). With any sedation method, doctors typically use only enough sedation medication to keep you safely comfortable throughout your appointment.

What Kind Of Sedation Medicines Does Your Office Use?
Answer: A popular oral medication - sedation that is used is called Versed. It is a Benzodiazepine that relaxes our patients, reduces anxiety, and can causes drowsiness. This sedative can be given in drink form, applied like nose spray intra-nasally, or IM. When given intra-nasally or IM it is taken up immediately by the bloodstream. Its action starts much sooner and more effectively versus swallowing it. If swallowed, it must pass through the stomach where it is diluted and taken up much more slowly. This is also the reason that I.V. sedation appointments can have a great advantage over oral sedation alone. Sedation medications that can be introduced by intravenous route (I.V.) go directly into the blood stream. The effects take place within minutes. We can titrate, or deliver, the sedation medications slowly and judiciously over lengthy sedation appointments lasting 4, 6, or 8 hours long safely and comfortably. The I.V. medication most commonly used in our office that has the best results and safety record is a combination of propofol, fentanyl, and ketamine.  I.V. sedation in our office is performed by certified Dental Anesthesiologist.

Why Are Primary Teeth Important?
Primary teeth are important for several reasons. Foremost, good teeth allow a child to eat and maintain good nutrition. Healthy teeth allow for clear pronunciation and speech habits. Primary teeth also guide eruption of the permanent teeth.  During adolescence the self-image that healthy teeth give is immeasurable.  For this reason it is vital that we help your child develop and maintain habits that will promote good oral health at a very young age.

Is There A Connection Between Good Diet and Healthy Teeth?
The teeth, bones and soft tissue of the mouth require a healthy, well-balanced diet. A variety of foods from the five food groups helps minimize (and avoid) cavities and other dental problems. Most snacks that children eat cause cavities, so children should only receive healthy foods like vegetables, low-fat yogurt and cheeses, which promote strong teeth. 

When Do My Childs Teeth Start Forming?
A child’s teeth actually start forming before birth. As early as 4 months of age, the primary or “baby” teeth push through the gums—the lower central incisors are first, then the upper central incisors. The remainder of the 20 primary teeth typically erupt by age 3, but the place and order varies.

Permanent teeth begin eruption around age 6, starting with the first molars and lower central incisors. This process continues until around age 21. Adults have 28 secondary (permanent) teeth—32 including the third molars (wisdom teeth).

How Can I Prevent Prevent Baby Bottle Tooth Decay?
Baby bottle tooth decay in infants, also known as early childhood caries, can be minimized or totally prevented by not allowing sleeping infants to breast, bottle-feed, or use sippy cups. Infants that need a bottle to comfortably fall asleep should be given a water-filled bottle or a pacifier. Another major cause of early childhood caries is the over use of sippy cups with sugar containing drinks such as fruit juices, sugar containing flavored water drinks, and sports drinks.  Many times we find parents have not been given proper dietary counseling prior to their first dental appointment.  We encourage parents to limit the use of bottles or sippy cups containing drinks with sugars.  We recommend that your child receive a healthy balanced diet of fruits and vegetables.  However, we strongly encourage the limitation of fruit or other sugar containing juices.  These are usually marketed very effectively as “healthy” while research is showing they are major contributors to early childhood decay and even childhood obesity.  In accordance with the American Academy of Pediatrics, for children under 6 years of age we recommend no more than four ounces of juice per day.  If you choose to give your children juices or drinks with sugars we encourage you to dilute them by adding a half cup of water to a half cup of the sugary drink and only allow your child to drink this during meal time.  At meal time there is extra saliva produced that is stimulated by eating which helps to dilute and minimize the deleterious effects of these drinks.  We also encourage you not to give your toddlers a sippy cup with anything other than water to drink during the day.  Placing sugar containing drinks in a sippy cup allows your child to have a constant supply of sugar through the day.  While this may make your child happy, it also makes the harmful bacteria in your child’s mouth thrive by a constant coating of sugar being applied throughout the day to your child’s teeth. Our office is dedicated to fighting baby bottle tooth decay. Let us know if you notice any signs of decay or anything unusual in your child’s mouth.