Pediatric Dental Specialist
Randall J. Pagenkopf, DMD, PA
A pediatric dentist has an extra two years of specialized training after dental school and is dedicated to the oral health of children from infancy through the teenage years. The very young, pre-teens, and teenagers all need different approaches in dealing with behavior, guiding their growth and development, and helping them avoid future dental problems. With the additional education, pediatric dentists have the training which allows them to offer the most up-to-date and thorough treatment for a wide variety of pediatric dental problems.
According to the American Academy of Pediatric Dentistry (AAPD), your child should visit the dentist by his/her 1st birthday or at least 6 months after the eruption of the first tooth. Beginning dental care at an early age allows guidance for caring for your child's teeth and opportunities to address preventive issues that are important for healthy teeth and a pleasing smile. Early visits also help establish a positive relationship between the dentist and your child.
With each subsequent visit, your child will mature and confidence and trust will most likely increase. Usually after age 3, we will begin preventive care visits which include examination, cleaning, fluoride treatments, and appropriate radiographs.
It is very important to maintain the health of primary teeth (baby teeth). Neglected cavities can cause pain and infection, and it can also lead to problems which affect the developing permanent teeth. Primary teeth are important for (1) proper chewing and eating, (2) providing space for permanent teeth and guiding them into position, and (3) permitting normal development of the jaw bones and muscles.
Radiographs (x-rays) are a necessary part of your child's dental diagnostic process. Without them, certain cavities will be missed. They also help survey developing teeth, evaluate results an injury, or plan for orthodontic treatment. If dental problems are found and treated early, dental care is more comfortable for your child, and more affordable for you.
On average, our office will request bitewing radiographs approximately once a year and panoramic radiographs every 3-5 years. In children with a high risk of tooth decay, we will recommend radiographs and examinations every six months.
With contemporary safeguards, the amount of radiation received in a dental x-ray examination is extremely small. The risk is negligible. In fact, the dental radiographs represent a far smaller risk than an undetected and untreated dental problem. Lead body aprons and shields will protect your child. Today's equipment restricts the beam to the area of interest. Our office also employs digital radiography which allows us to decrease the amount of radiation exposure.
A sealant is a clear or shaded plastic material that is applied to the chewing surfaces (grooves) for the back teeth (premolars and molars), where most cavities in children can form. This sealant acts as a barrier to food, plaque, and acid, thus protecting the decay-prone areas of the teeth. However, cavities between the teeth are not protected by sealants. As long as there is no cavity in the tooth, sealants will be recommended for all children.
If your child has a cavity, a filling is placed after the cavity is removed. Most of the time, the filling is a tooth colored (white) filling, but there are certain situations in which a silver filling is necessary. In our practice, when a tooth needs a filling, a sealant is placed over the filling and the remaining tooth for added protection.
In a primary tooth, if a cavity is too large to restore with a filling, a crown may be recommend or the tooth may need to come out. If the cavity is too large and has involved the nerve of the tooth, then the nerve will be removed (pulpotomy) along with the cavity, and a crown will be placed. A crown can either be tooth colored or stainless steel. For front teeth, white crowns are routinely used for esthetics. For back teeth, stainless steel crowns are used for their durability and longevity. The purpose of the crown is to help provide structure for the tooth, to help maintain space for permanent teeth to erupt properly, and to help protect the remaining tooth.
General anesthesia may be indicated for children with extensive dental needs who are extremely uncooperative, fearful or 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.
Apply ice to bruised areas. If there is bleeding, apply firm pressure with a clean gauze or cloth. If bleeding does not stop after 15 minutes or it cannot be controlled by simple pressure, take the child to the
Clean the area around the sore tooth thoroughly. RInse the mouth with warm salt water or use dental floss to dislodge impacted food or debris.
DO NOT place aspirin on the gum or on the aching tooth.
If the face is swollen or the pain still persists, contact our office as soon as possible.
Find the tooth. Handle the tooth by the crown, not the root portion. You may rinse the tooth, but DO NOT wipe or handle the tooth unnecessarily. Inspect the tooth for fractures, if there are no fractures, try to reinsert it into the socket. Have the patient hold the tooth in place by biting on a gauze. If you cannot reinsert the tooth, transport the tooth in a cup containing milk. If there is no milk, place the tooth in a cup containing the patient's own saliva. DO NOT place the tooth in water. Call our office immediately or go to your nearest emergency room.
Time is a critical factor in saving the tooth.
Rinse debris from injured area with warm water. Place cold compresses over the face in the area of injury. Locate and save any broken tooth fragments in milk. If your child experiences severe pain, contact our office as soon as possible.
Whenever he or she is in an activity with a risk of falls or of head contact with other players or equipment. This includes football, baseball, basketball, soccer, hockey, skateboarding, even gymnastics. We usually think of football and hockey as the most dangerous to the teeth, but nearly half of sports-related mouth injuries occur in basketball and baseball. Dr. Randy will recommend the best mouth guard for your child.