Preventive Treatment
This includes initial as well as periodic oral examinations, cleaning and fluoride treatment and appropriate x-rays based on your child’s age, development and individual needs. Along with removing the plaque and calculus (bacteria) from your child’s teeth that can cause cavities and gum disease, applying topical fluoride to make their teeth more resistant to decay, the doctors will perform a thorough oral exam and assess their orthodontic development.

Sealants
The chewing surfaces of children’s teeth are the most susceptible to cavities and least benefited by fluorides. Sealants are applied to the tops or chewing surfaces of back teeth and are highly effective in preventing tooth decay. Sealant’s commonly last 3-5 years. Dietary habits such as chewing ice or hard candy can shorten the life expectancy of a sealant. No numbing is required to place them. Click here for more information on sealants.

Restorative Treatment (Fillings)
This can range from simple tooth colored fillings to full coverage stainless steel crowns for back teeth where the tooth is too badly decayed to hold a white filling.

Extractions
Extractions are done only as a last resort. If a primary molar is removed prematurely, a space maintainer will be placed. Some extractions are needed for orthodontic reasons to help facilitate tooth alignment.

Space Maintainers
Space maintainers are used when a primary tooth has been prematurely lost to hold space for the permanent tooth. If space is not maintained, teeth on either side of the extraction site can drift into the space and prevent the permanent tooth from erupting.

Nitrous Oxide/Oxygen (“Laughing Gas”)
Nitrous oxide combined with oxygen is breathed by your child during the appointment. It is a very safe and effective way to relax a mildly anxious child and help even a great child have a more pleasant visit, and does not put your child to sleep. It gives them a sensation something is happening but they don’t seem to care and better tolerate the appointment.
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Conscious Sedation
Some children benefit from being sedated before dental treatment. The sedative medicine will make your child drowsy but does not put them to sleep and has an amnesiac property that makes your child unlikely to remember the treatment. It is administered either orally or by nasal route (nose spray). This works best for 2 to 5 year-old children with minor treatment needs that can be completed in one or two visits. Because your child is not asleep, they may still cry, but may be less likely to remember the visit. Restraint (hand holding and/or Papoose Board) may still be required to safely complete treatment. Sometimes the sedation will not be effective and we may recommend that your child be treated with general anesthetic. Oral sedation of healthy children has an excellent safety record: however, there are still risks whenever a child receives sedation medications. Possible risks include, but are not limited to, over sedation skin irritation/bruising from restraints, abnormal breathing, brain function or even death. Children treated with sedation must have a physical examination form completed by a physician prior to their treatment.

Hospital Treatment
Dental treatment can be provided while your child is given a general anesthetic by a physician (anesthesiologist). Treatment is performed in a hospital operating room while they are completely asleep. An anesthetic gas is given to your child through a breathing tube that will keep them asleep during the procedure. All of their dental treatment needs can be completed in one visit. Administrating general anesthesia has risk ranging from and including but not limited to sore throat, puffy lips, abnormal breathing, brain function or even death. The rate of serious reactions is estimated to be between 1 in 25,000 to 1 in 250,000 in children managed with general anesthesia. Like oral sedation, your child will need a physical examination prior to treatment and you may need to meet with the anesthesiologist.

Cost
There is substantial variation in the cost of different methods. Additional costs may/are incurred for each specific option as preparing, scheduling and caring for the special attention your child needs requires significant time, resources and extra staff to safely and effectively treat you child. Costs will vary depending on you child’s needs and will be discussed with you.

Second Opinion
We urge you to seek a second professional opinion if you are uncomfortable with our treatment recommendations for your child.
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Cary, NC Pediatric Dentists - Dr. Robert Moran and Dr. Richard Brooks
Dentistry for infants, children, young adults, and patients with special needs ~ Cary, North Carolina