Prevention is always better than cure. Dental decay is a preventable disease. Appropriate recommendations on fluoride use, oral hygiene and diet can ensure children remain cavity free. Topical application of fluoride has been shown to be a very effective way to protect teeth from disease. Fluoride alone will not be enough to prevent decay if dietary and brushing habits are poor.
Fissure sealants are another method of preventing decay. A plastic barrier is placed into the grooves in your child’s teeth to prevent food and bacteria lodging in the cracks. This has been shown to be a very effective method of preventing decay in children at risk of developing dental disease.
If your child has decayed teeth treated and preventive care is not adhered to, decay will cause fillings to fail and any new teeth that erupt may also be affected by the decay.
When primary teeth become decayed, inflammatory changes soon begin to occur in the nerve of the tooth even though the tooth may not be painful. In order for the tooth to be restored fully, the inflamed portion of the nerve must be removed and the remainder is medicated. This procedure is no different from the child’s point of view to having a filling done. The purpose of the technique is to maintain the vitality of the tooth, prevent pain and infection and the need for extraction of the tooth. This procedure is known as a pulpotomy.
When decay is extensive the nerve of the tooth may die and become infected. In this case if there is sufficient tooth left to fix the tooth, the infected part is removed and the nerve space is filled before the tooth is fixed. This is known as a pulpectomy.
Anterior White Crowns
Front teeth are important for speech, eating, general social development and confidence.
Nowhere is this more important than in the anterior ‘aesthetic zone’ which are those front teeth regularly on display.
Anterior white crowns are used to restore the appearance of damaged or discoloured front teeth.
Ceramic crowns for incisors
Silver Caps/Stainless Steel Crowns
Stainless Steel crowns are still the gold standard for fixing children’s teeth where there is deep decay, in molars with pulp therapy or where the enamel of the tooth is weak.
They are used at the back of the mouth where aesthetics are not as much of a concern. They are well accepted by children.
We call them “jewellery teeth” for girls and “pirate’s teeth” for boys. The success rates for these restorations are between 97-100%. They have a long track record of success and safety.
The aim of placing a stainless steel crown is to prevent pain and infection and to keep the primary molar in the mouth for as long as possible or until the adult molar is ready to erupt.
Silver caps for back teeth
Posterior White Crowns
Some parents do not like the idea of silver crowns.
White crowns are available in these situations.
White crowns require excellent plaque control to be successful.
Here is an example of a crown and space maintainer on the right, replacing a first primary molar. On the left is a distal shoe space maintainer which is also shown on the model and the x-ray.
These are used to fix decayed or fractured teeth.
They are principally used where aesthetics are a concern. They may be used to fix back teeth where cavities are minimal.
They are matched to the colour of your child’s natural tooth colour.
Looking after injuries to primary teeth and immature adult teeth requires special attention. We use conservative restorations and age-appropriate endodontic management to achieve optimal growth and development for these children.
This is a procedure which facilitates the proper eruption of the developing dentition into a functional and stable position compatible with a healthy growth pattern.
When teeth erupt into the wrong position in the mouth, interference with the development of other teeth and the jaws may occur.
The treatment may require either a removable appliance to be worn or to have teeth removed to guide the teeth into their correct position.
Tongue and Lip Tie
Tongue-tie (ankyloglossia) is a condition in which the bottom of the tongue is tethered to the floor of the mouth by a membrane (frenulum).
Tongue and lip ties are recognized as a cause of breastfeeding difficulties. Tongue ties tend not to cause a significant impact on bottle feeding however, the growing popularity of breastfeeding has meant that more tongue and lip ties are being picked up early.
Many babies with a tongue-tie also have a lip tie.