dr. joshua a. brink
dr. jason e. white
dr. emily m. sheppard
dr. mary austin smith
American Academy of Pediatric Dentistry
American Board of Pediatric Dentistry
Pediatric Dental Treatments
Cavity prevention ties into the dietary counseling discussion, since a healthy diet plays a vital role in cavity prevention. Our patients can look forward to picking out a new toothbrush at every routine cleaning visit. The most important time to brush is night time right before bed, since cavities are more likely to form when the mouth is still and germs have more opportunity to flourish.
During each patient's routine cleaning appointment, the hygienist or one of the clinical assistants will discuss proper dietary protocol. Topics include a brief lesson on what types of drinks to consume when (for example, when watching TV try to drink water, because drinking a sugary beverage slowly over a longer period of time is more damaging to the teeth than drinking the same sugary beverage quickly in the kitchen) and what kinds of candy tend to be most cavity-inducing. The hygienist or assistant will also ascertain any potential dietary pitfalls that could lead to future problems.
The cosmetic restorations we offer range from composite (white) fillings to NuSmile crowns, which are stainless steel crowns with a white facing. These crowns are used on the more visible upper anterior teeth, because from the front they look like the patient's natural, pearly whites. Essentially, NuSmile crowns offer the best of both worlds; they have the durability of stainless steel and the cosmetic appeal of porcelain crowns.
Our office's policy is to perform composite fillings whenever possible – particularly on permanent teeth. However, in order for a composite filling to work, we must be able to keep the area around the tooth completely dry. If the child is too wiggly or the tooth is so far back in the mouth it is difficult to isolate, we may have to put in an amalgam (silver) filling instead. We always strive to do what is best for the patient!
Tooth whitening services are growing in popularity; after all, little improves the appearance more than a bright, white smile! We offer a variety of whitening options including Zoom (a procedure using a special light we shine on the patient's teeth), custom made bleach trays (typically worn at night), and Xantia (bleaching material painted directly on the teeth in the comfort of your own home).
Our apprehensive patients may benefit from conscious sedation, and our doctors are specially trained to offer this treatment option. For this type of appointment, your child should arrive on an empty stomach (i.e. nothing to eat or drink) for an early morning appointment. If your child takes medications routinely in the morning, please ask our staff about dosing for the day of the sedation appointment. Please remember that it is vital to inform the dentist of all medications your child may be taking before your child is scheduled for a sedation appointment. Your child will most likely need to stay home from school directly following a sedation appointment. After being weighed, Dr. Josh or Dr. Emily will give your child some “koolaid” to drink. This “koolaid” contains the sedative medication. Then your child returns to the waiting room while the medication takes effect. This typically takes around ten to fifteen minutes, depending on the type of medication administered. Please refer to the medication options below for more detailed information on the types of sedation medication. It is important to remember that conscious sedation is not intended to put the patient to sleep, but children sometimes fall asleep during the treatment because they are so relaxed. In general, if children relax, we can complete the necessary treatment. Often the patient will not even remember having been to the dentist!
Vistaril: A mildly sedating drug—like Benadryl—that soothes the child's stomach and counteracts nausea and any allergic tendencies that cause anxiety to be stimulated in a young patient.
Versed: A medication used mainly for children 6-7 and younger. Its effects are rapid in onset—often in as little as 10 minutes—and it wears off quickly as well. Versed causes anxiety relief and often memory lapse, so we often use it when a young patient may have multiple appointments or we expect the patient to have difficulty with the procedures.
Valium: This drug is well known for relief of anxiety. Its effects begin slowly and last relatively longer—including a rebound effect following the child's first meal after dental treatment. Valium is typically only used on older children (7 and up) and it may have associated memory loss of the visit. This drug is mainly used to help an apprehensive patient relax enough to complete the necessary treatment.
Demerol: This drug is a pain medicine that has sedating effects as well. Its onset of effects is longer—up to one hour—and typically will be used on younger children (under 60 pounds). It lasts up to 2 hours after treatment, and it causes drowsiness.
Nitrous Oxide, more commonly known as “laughing gas,” is frequently used to help relieve apprehension during a restorative visit. This gas is administered with a mixture of oxygen and has a calming effect that helps anxious patients to relax. Because it is a very mild analgesic, the patient will still be able to interact with the dentist and assistants during the visit. After the patient appears sufficiently relaxed, the nitrous is turned off
and the patient breathes only oxygen. The analgesic effect of the nitrous wears off within 5 minutes of breathing oxygen only. Sometimes side effects of nausea or dizziness may persist, so we always make sure the patient is feeling normal—not dizzy or flushed—before leaving the office. Our doctors are licensed to administer nitrous oxide, and our clinical staff members are certified to monitor its delivery during the procedure.
OUTPATIENT GENERAL ANESTHESIA
When a patient is too young, too uncooperative, or has extensive work to be performed, we recommend going to LeBonheur's outpatient surgery center to complete the work all at once. Dr. Josh or Dr. Emily will discuss the details of this procedure with you, and our front office staff will assist you with filling out the necessary forms and verifying insurance coverage. The benefits of this treatment option prevent medical concerns that in-office treatment cannot overcome as well as completing extensive treatment in one visit. For example, the dentists can provide excellent treatment without concern of the patient being uncooperative, and the patient will not associate the dentist with treatment.
brushing & flossing