Early and Continual Care
We recommend regular dental examinations before serious problems develop. At about the age of 12 months, children should have their first dental examination. There could be instances such as injuries, decay, or congenital problems which would require even earlier visits. This initial visit is also very important so that your child has an established dental home in case future trauma or concerns arise. We also utilize this visit to talk to you as the parent and make sure good home oral and dietary habits are being established.
We recommend a child be seen every six months for a routine examination, dental cleaning, and fluoride application. We monitor each child not only for cavities, but also assess their dental growth and development, check for any current or future orthodontic needs, and observe for any signs of disease in the hard and soft tissues of the mouth.
Dental X-rays are taken when additional information that cannot be obtained just by looking in the mouth is needed, such as when the back molars are in contact and the whole tooth is not visible. This typically occurs about age 3-4 but in some children is even earlier. We often recommend a full mouth “Panoramic” radiograph be taken at about age 8-10 to evaluate full growth and development, check for any pathology, and evaluate presence of third molar “wisdom teeth.”
Care should be continued until such time as our patient wants to "graduate" from our office. We typically will see your child through high school and sometimes college, though they may need to be referred if extensive dental treatment is required.
The application of dental sealants is often recommended for the permanent molars. They are a tooth-colored plastic resin bonded to the grooves of the chewing surfaces of back teeth to help prevent cavities. They are easy to apply and do not require any local anesthetic (no shots!). Avoiding chewing gum and ice will help prolong the life of sealants.
Silver Diamine Fluoride
Silver Diamine Fluoride is an antimicrobial liquid that works to stop a cavity from growing and is fast and painless to apply. It is most beneficial for children who would otherwise have great difficulty receiving local anesthesia (shots) or sitting for traditional dental treatment. It does permanently stain the area of the cavity black. A future filling may be done when the child is more cooperative.
Composite (white) and on occasion amalgam (silver) fillings are recommended when the cavity is relatively small, typically involving less than 1/3 of the tooth. If the cavity is larger, we may recommend a crown. For front teeth, we offer white Zirconia or Composite crowns. For back teeth, we offer white Zirconia or silver Stainless Steel crowns.
If a baby tooth has a deep cavity that extends near or into the nerve of the tooth, it will require some type of nerve treatment or “baby root canal.” This is usually a procedure called a pulpotomy, where the top portion of the nerve is cleaned and a medicine is placed to protect the rest of the nerve. If a baby tooth presents with signs of infection, it will likely need to be extracted. Depending on the child’s stage of dental development and presence of dental crowding or spacing, we may recommend placement of a temporary space maintainer. If a permanent tooth presents with any signs of involvement or infection of the tooth nerve, your child may need to be referred to an Endodontist (Root Canal Specialist).
Nitrous oxide (“laughing gas”) is utilized to help make your child feel less anxious and also feel less pain during dental procedures. It is breathed through the nose with a combination of regular oxygen and within a few minutes of discontinuation is out of the child’s system. It produces a mild sedative effect. For many children it is very effective in making them feel calmer during dental treatment. It is only effective if the child is able to continuously and consistently breathe through their nose. It is common in children age four or younger not to allow its application as they are often scared of putting on the rubber nose and/or will not consistently breathe through their nose.
Oral Conscious Sedation
Oral conscious sedation in our office involves the combination of nitrous oxide / oxygen with a liquid sedative. The goal is to achieve a sedated state that will relax your child and relieve their anxiety to allow their needed dental treatment to be completed in the office safely and effectively.
Intravenous (IV) Sedation
Intravenous sedation in our office involves a deeper level of sedation than oral conscious sedation and is administered and monitored by Kalamazoo Anesthesiology. The goal is for the child to be asleep while still maintaining their own reflexes. It is ideal for a child with limited dental treatment needs for whom oral conscious sedation is not likely to be effective and general anesthesia is not warranted. The child must meet certain criteria to qualify for in office IV sedation.
When dental treatment cannot be safely and effectively completed in the office, we recommend treatment under general anesthesia. This is typically due your child’s age, degree of dental treatment needs, and/or behavior. All cases are completed with a medical Anesthesiologist and Certified Registered Nurse Anesthetist (Kalamazoo Anesthesiology group).
Dr. Jody completes her general anesthesia cases through Bronson in Kalamazoo or Paw Paw. The majority of cases are completed at Bronson Outpatient Surgery Center at 125 W Walnut St in Kalamazoo, two blocks West of Bronson's main hospital.
Dental Trauma and Toothaches
If your child has a dental injury, for example, a chipped, fractured, loosened, or knocked-out tooth; or a toothache, please contact the office during regular office hours, 8 a.m. to 5 p.m., Monday through Thursday, when possible. If outside our office hours, call our office to find out how to best reach Dr. Jody, who will return your call as soon as possible. Some injuries may require immediate care while others may be seen on the next regular office day.
A Knocked Out Permanent Tooth: If your child knocks out a permanent tooth, time is especially important. Hold the tooth by the crown part (do not touch the root) and rinse the tooth gently in water, do not wipe. Place the tooth in Tooth Saver Solution if you have it readily available. Otherwise, place the tooth back in the tooth socket as best you can. If you are unable to do that and your child is able to, have child hold the tooth in mouth. As a last resort, place tooth in milk. Phone Dr. Jody and meet her at the office as soon as possible. The tooth may be able to be replanted. After the tooth is put back in the mouth in proper position, a temporary splint is often applied for 7-10 days, and the tooth may require a root canal within 7-14 days. If too much time has passed since the tooth was knocked out of the mouth and stored properly, replantation may not be recommended. (NOTE: NEVER REPLACE A KNOCKED OUT BABY TOOTH)
The dental care of children with special needs are probably best served by a pediatric dentist. Special planning may be required. Variations from conventional treatment may include pre-treatment sedation or preventative antibiotic medication. If your child has sensory concerns, please click on our Sensory Brochure below. It provides a Social Story and Dental Check List that may help your child prepare for his or her appointment. You can print this out or request a mailed copy. We also have printed copies in our office.
If your child has sensory concerns, please check out these additional tools that may help prepare them for their dental appointment.