Austin, TX Pediatric Dentistry Treatments - Thiel Pediatric Dentistry


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General Anesthesia

General anesthesia is a controlled state of unconsciousness that eliminates awareness, movement, and discomfort during dental treatment. A physician or dentist with specialized training can use various medications to provide general anesthesia for patients receiving dental care.

This procedure is recommended for very young children or patients that have difficulty cooperating with treatment in the office; an inhalation anesthetic is administered by a medical anesthesiologist in a surgery center or operating room environment and during this procedure all dental treatment, x-rays, and cleanings are provided.

Is general anesthesia safe for my child?

Although there is some risk associated with general anesthesia, it can be used safely and effectively when administered by an appropriately-trained individual in an appropriately-equipped facility. Precautions are taken to protect your child during general anesthesia; personnel who are trained to manage complications will monitor your child closely. Your pediatric dentist will discuss the benefits and risks of general anesthesia and why it is recommended for your child.

Will my child receive general anesthesia for dental treatment?

General anesthesia may be indicated for children with extensive dental needs who are extremely uncooperative, fearful, anxious, or for the very young who do not understand how to cope in a cooperative fashion. General anesthesia also can be helpful for children requiring significant surgical procedures or patients having special health care needs.

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Check Ups and Exams

Dr. Thiel will review your child’s medical and dental history. He will then gently examine your child’s teeth, oral tissues, and jaws. The teeth will be cleaned and polished, followed by the application of a fluoride solution. At Thiel Pediatric Dentistry, we won’t talk just to you about dental health, we will also talk to your child with easily understandable words, pictures, and ideas. Your child will be motivated to take responsibility for healthy smile.

Why visit twice a year when my child has never had a cavity?

Regular dental visits help your child stay cavity-free. Teeth cleanings remove debris that build up on the teeth, irritate the gums, and cause decay. Fluoride treatments renew the fluoride content in the enamel, strengthening teeth and preventing cavities. Hygiene instructions improve your child’s brushing and flossing, leading to cleaner teeth and healthier gums.

Tooth decay isn’t the only reason for a dental visit. Dr. Thiel will provide an ongoing assessment of changes in your child’s oral health. For example, your child may need additional fluoride, dietary changes, or sealants for ideal dental health. We may also identify orthodontic problems and suggest treatment to guide the teeth as they emerge in the mouth.

How often should my child visit the dentist?

The American Academy of Pediatric Dentistry recommends a dental check-up at least twice a year for most children. Some children need more frequent dental visits because of increased risk of tooth decay, unusual growth patterns, or poor oral hygiene. Dr. Thiel will let you know the best appointment schedule for your child.

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Sedation

Sedation is a technique to guide a child’s behavior during dental treatment. Medications are used to help increase cooperation and to reduce anxiety or discomfort associated with dental procedures. Sedative medications cause most children to become relaxed and drowsy. Unlike general anesthesia, sedation is not intended to make a patient unconscious or unresponsive.

Are there any instructions to follow after the sedation appointment?

Dr. Thiel will evaluate your child’s health status and discharge your child when he or she is responsive, stable, and ready to go. Children recover from the effects of sedatives at different rates so be prepared to remain at the office until the after-effects are minimal. Once home, your child must remain under adult supervision until fully recovered from the effects of the sedation. We will discuss specific post-sedation instructions with you, including appropriate diet and physical activity.

Are there any instructions to follow before a sedation appointment?

Children often perceive a parent’s anxiety which makes them more fearful. They tolerate procedures best when their parents understand what to expect and prepare them for the experience. If you have any questions about the sedation process, please ask. As you become more confident, so will your child.

Should your child become ill, contact us to see if it is necessary to postpone the appointment. Be sure to inform us about any prescribed, over-the-counter, or herbal medications your child is taking. Check with your Dr. Thiel to see if routine medications should be taken the day of the sedation.

We will provide you with additional detailed instructions before your sedation visit. It is very important to follow the directions regarding fasting from fluids and foods prior to the sedation appointment.

Should my child be sedated for dental treatment?

Not necessarily. Sedation may be indicated for children who have a level of anxiety that prevents good coping skills, those who are very young and do not understand how to cope in a cooperative fashion, or those requiring extensive dental treatment. Sedation can also be helpful for some patients who have special needs.

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X-Rays

The process of taking images (with low radiation and a special lead apron to reduce exposure) of your child’s teeth’s subsurface to help identify problems that are not externally visible; allowing treatment to occur for problems before problems become serious.

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Prophylaxis (Cleaning)

The process of removing harmful plaque and tarter above and below the gum-line. This includes polishing to remove surface staining on teeth.

What should I use to clean my baby’s teeth?

A toothbrush will remove plaque bacteria that can lead to decay. Any soft-bristled toothbrush with a small head, preferably one designed specifically for infants, should be used at least once a day at bedtime.

When should I start cleaning my baby’s teeth?

The sooner the better! Starting at birth, clean your child’s gums with a soft infant toothbrush or cloth and water. As soon as the teeth begin to appear, start brushing twice daily using fluoridated toothpaste and a soft, age-appropriate sized toothbrush. Use a “smear” of toothpaste to brush the teeth of a child less than 2 years of age. For the 2–5 year old, dispense a “pea-size” amount of toothpaste and perform or assist your child’s toothbrushing. Remember that young children do not have the ability to brush their teeth effectively.

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Fluoride-Treatments

Topical application applied directly to the teeth to provide protection to the tooth from dental decay; this treatment is recommended twice a year directly after the dental cleaning/prophylaxis.

Is it safe for my child?

Dr. Thiel considers many factors before recommending a fluoride supplement. Your child’s age, risk of developing dental decay, and dietary sources of fluoride are important considerations. Infant formulas contain different amounts of fluoride. Bottled, filtered, and well waters also vary in the amount of fluoride they contain. Dr. Thiel can help determine if your child is receiving — and not exceeding — the recommended amount.

Using fluoride for the prevention and control of decay is proven to be both safe and effective. Nevertheless, products containing fluoride should be stored out of the reach of young children. Too much fluoride could cause fluorosis of developing permanent teeth. Fluorosis usually is mild, with tiny white specks or streaks that often are unnoticeable. In severe cases of fluorosis, the enamel may be pitted with brown discoloration. Development of fluorosis depends on the amount, duration, and timing of excessive fluoride intake. The appearance of teeth affected by fluorosis can be greatly improved by a variety of treatments in esthetic dentistry.

What are the benefits?

The use of fluoride, both in systemic dosages and topical applications, is recommended by the American Dental Association, the American Medical Association, the American Academy of Pediatric Dentistry, the American Academy of Pediatric Medicine, the National Institutes of Health and every dental school in the United States. Fluoride combats tooth decay in two ways.

It is incorporated into the structure of developing teeth when it is ingested and also works when it comes in contact with the surface of the teeth. Fluoride prevents the acid produced by the bacteria in plaque from dissolving or demineralizing tooth enamel, the hard and shiny substance that protects the teeth. Fluoride also allows teeth damaged by acid to repair or remineralize themselves. Fluoride cannot repair cavities, but it can reverse low levels of tooth decay and thus prevent new cavities from forming. If your child is not getting enough fluoride internally through water (especially if the fluoride level is deficient or if your child drinks bottled water without fluoride), then fluoride supplements might need to be prescribed.

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Sealants

Sealants protect the grooved and pitted surfaces of the teeth, especially the chewing surfaces of back teeth where most cavities in children are found. Made of clear or shaded plastic, sealants are applied to the teeth to help keep them cavity-free.

How long do sealants last?

Research shows that sealants can last for many years if properly cared for. Therefore, your child will be protected throughout the most cavity-prone years. If your child has good oral hygiene and avoids biting hard objects, sealants will last longer. Dr. Thiel will check the sealants during routine dental visits and recommend re-application or repair when necessary.

Will my child need sealants?

Even if your child brushes and flosses carefully, it is difficult—sometimes impossible—to clean the tiny grooves and pits on certain teeth. Food and bacteria build up in these crevices, placing your child in danger of tooth decay. Sealants “seal out” food and plaque, thus reducing the risk of decay.

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Bleaching/Whitening

This treatment uses a peroxide based material to whiten naturally discolored teeth; agents include whitening strips or custom plastic trays and a gel based peroxide that is used while sleeping.

How are discolored spots on my child’s teeth treated?

A technique called microabrasion can improve the appearance of teeth with discolored areas. In this treatment, Dr. Thiel removes microscopic bits of discolored tooth enamel with an abrasive and a mild acid. Microabrasion is a conservative treatment, usually comfortable for your child. It works best on surface discoloration.

What causes my child’s teeth to become discolored?

There are many possible causes. Trauma to a tooth can cause discoloration. Severe illness during tooth development can discolor areas of teeth because of disruptions in tooth development. Additionally, an entire tooth might discolor if exposed to certain medicines or minerals during development. Lastly, poor oral hygiene, especially during orthodontic therapy, can lead to discolored areas on teeth as well.

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Bonding

A procedure where tooth-colored material (composite resin) is added to fill in space between teeth or to replace a part of a tooth that has fractured. Teeth are sculpted to look natural with the bonding agent.

How is the bonding process done?

First, Dr. Thiel puts a mild chemical on your child’s tooth to make it a little rough. This step helps the composite resin stick better to the enamel of the tooth. Then, the composite resin is mixed and tinted to match the color of your child’s natural teeth. Next, Dr. Thiel puts the composite resin on the appropriate teeth in layers and a very bright light is used to harden (or cure) each layer of resin as it is applied. Lastly, after the final layer of composite resin is hardened (or cured), Dr. Thiel will shape and polishe the resin so the finished teeth look natural and smooth.

Is bonding the best option for my child’s developing teeth?

Bonding is among the easiest and least expensive of cosmetic dental procedures. It is mainly used to rebuild chipped, broken, or irregularly shaped teeth, to close gaps and to improve the look of teeth permanently discolored. Capping can camouflage the same conditions, but bonding can also anchor metal bridges containing replacements for missing teeth or orthodontic braces that use plastic brackets in place of metal bands. Capping is generally avoided in the case of children because the tooth is not fully formed. Bonding has no such problem.

However, the composite resin used in bonding isn’t nearly as strong as a natural tooth. Biting your fingernails or chewing on ice or pens can chip the material. Bonding usually lasts several years before it needs to be repaired. How long it actually lasts depends on how much bonding was done and your oral habits.

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Space Maintainers

Space maintainers are appliances made of metal or plastic that are custom fit to your child’s mouth. They are small and unobtrusive in appearance. Most children easily adjust to them after the first few days.

Do space maintainers require special care?

In general, pediatric dentists have four rules for space maintainer care:

How will a space maintainer help my child?

Space maintainers hold open the empty space left by a lost tooth. They steady the remaining teeth, preventing movement until the permanent tooth takes its natural position in the jaw. It is more affordable — and easier on your child — to keep teeth in normal positions with a space maintainer than to move them back in place with orthodontic treatment.

Why all the fuss? Baby teeth fall out eventually on their own!

Baby teeth are important to your child’s present and future dental health. They encourage normal development of the jaw bones and muscles. They save space for the permanent teeth and guide them into position. Remember: Some baby teeth are not replaced until a child is 12 or 14 years old.

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Tooth Extractions

Generally, unless we are are discussing Wisdom Teeth, we would rather not extract a tooth from your child. However, it can be required when a tooth is not lost naturally or if dental decay or trauma results in an infection surrounding the root surface.

What should I expect after my child has a tooth extracted?

Bleeding is typical after a tooth has been extracted. This may last for only about a day.

A small piece of gauze will be applied to the area of the tooth extraction. This should be kept in place for long enough for the blood to clot. It is important for your child’s mouth to be kept as clean as possible during the healing period. This can be done by rinsing the mouth with salt water several times per day.

If any additional swelling occurs or if your child begins to feel additionally ill or comes down with a fever, then be certain to call Dr. Thiel immediately, in case of infection. This rarely happens though.

Children’s Tylenol or Ibuprofen should be purchased if Dr. Thiel did not already prescribe a painkiller for your child to increase their comfort after the extraction is complete. It is often best if these not be used until the blood clot has formed.

It may be good to apply a bag of ice to the outside of the child’s jaw to keep swelling to a minimum and to aid in numbing the pain.

Does everyone have their Wisdom Teeth removed?

No, not everyone has them removed but it is extremely common.

Wisdom teeth are the third and final set of molars that most people get in their late teens or early twenties. Sometimes these teeth can be a valuable asset to the mouth when healthy and properly aligned, but more often, they are misaligned and require removal.

Wisdom teeth present potential problems when they are misaligned — they can position themselves horizontally, be angled toward or away from the second molars, or be angled inward or outward. Poor alignment of wisdom teeth can crowd or damage adjacent teeth, the jawbone, or nerves. Wisdom teeth that lean toward the second molars make those teeth more vulnerable to decay by entrapping plaque and debris. In addition, wisdom teeth can be entrapped completely within the soft tissue and/or the jawbone or only partially erupt through the gum. Teeth that remain partially or completely entrapped within the soft tissue and /or the jawbone are termed “impacted.” Wisdom teeth that only partially erupt allows for an opening for bacteria to enter around the tooth and cause an infection, which results in pain, swelling, jaw stiffness, and general illness. Partially erupted teeth are also more prone to tooth decay and gum disease because their hard-to-reach location and awkward positioning makes brushing and flossing difficult.

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Fillings (Cavities)

The process where materials such as composite resin are used to replace a decayed surface of the tooth after the decay is removed.

How can I prevent cavities with my child?

The number of cavities can be reduced by proper nutrition, good oral hygiene, fewer snacks in between meals, the use of oral or topical fluorides, and topical sealants.

Nutritional counseling — consuming less simple sugar (sucrose or table sugar) will reduce the number of acid-producing bacteria in the mouth. Adequate dietary calcium, phosphorous, vitamins A, D, and C promote healthy and strong enamel formation.

Home oral hygiene — brushing your child’s teeth frequently helps reduce acid plaque damage to enamel, while frequent flossing removes the acid plaque from the smooth surfaces between teeth. If your child cannot brush and floss immediately after a meal, he/she should try chewing self-cleaning foods at the end of the meal. These include apples and celery that are crunchy and help sweep away food debris and plaque. Chewing sugarless gum for a few minutes at the end of a meal can also help.

Eating fewer snacks in between meals — every snack is followed by an “acid attack” on the teeth. Therefore, snacking all day causes the teeth to be bathed in acid continuously. Fewer snacks and eating desserts only with meals help to reduce the number of “acid attacks” on your child’s teeth.

Fluorides — oral fluorides (fluoride tablets or fluoridated water) strengthen the developing enamel and dentin layers of children’s teeth before they erupt. Topical fluorides fill in the pores of immature enamel or small early cavities and reduce cavities in already erupted teeth. Topical fluorides are usually painted on by Dr. Thiel, and later supplemented at home with topical fluoride gels.

Sealants — sealants are plastic coatings painted on the pits and fissures of chewing surfaces of back teeth (molars and bicuspids), and are highly effective in preventing cavities. Sealants are recommended for all permanent molars in children. They are also used to reduce cavities in baby teeth and in adult teeth that are cavity prone. The procedure is simple and painless, and no anesthesia is required.

How do I know if my child has a cavity?

We can discover cavities during your regular dental check-up. The tooth surface feels soft when probed by Dr. Thiel with a dental instrument. X-rays can also show cavities before they become visible to the eye. In advanced stages of tooth decay, your child might experience a toothache, especially after consuming sweet, hot, or cold foods or drinks. Other signs of tooth decay are visible pits or holes in the teeth.

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Pulpotomy

This procedure removes part of an infected or irritated portion of the nerve and blood vessels within your child’s tooth. A sedative material is placed to help allow the remaining nerve and blood vessel tissue to heal while a restorative material such as a crown is placed over the tooth for strength.

Should I have any post-surgery concerns?

Typically, a vital pulpotomy will save the tooth in question almost 95% of the time. As long as the the nerve is not infected, the tooth and surrounding tissue will recover with a minimal amount of difficulty. Unfortunately, if the root is just starting to become infected, it may not be possible to find out at the time of the procedure. In these cases, a root canal may be required later on.

While most children do not have issues with vital pulpotomy procedures, the medications used can irritate their gums and other tissues. This may create a burning sensation that should subside in a short period of time. In most cases, over the counter pain relievers will be adequate for pain management.

For the most part, this treatment is well tolerated. That said, your child may experience some soreness and pain in the area where the vital pulpotomy was performed. As with any surgical procedure, there is always a risk of infection or other complications. Therefore, if pain gets worse after the procedure, or you notice swelling, it is best to call our office, and make sure the issue gets resolved as quickly as possible.

When would my child need a pulpotomy?

Even though a vital pulpotomy can be done for adults, it is usually used for children. In particular, this procedure is used on primary (baby) teeth, as well as young adult teeth that have not finished maturing. As long as the tooth is not loose, and there are no signs of gum infection, your Dr. Thiel should be able to perform this procedure.

As you may be aware, early loss of primary teeth can affect the way permanent teeth develop and grow in. Therefore, if your child has cavities that extend into the primary tooth pulp, Dr. Thiel may use a vital pulpotomy to prevent nerve and root death. In addition, if young adult teeth break, or the pulp is exposed, a vital pulpotomy may be necessary to prevent infection that could extend to your child’s gums and surrounding teeth.