Services

Pediatric dentistry for Elmhurst, Jackson Heights, Corona, Middle Village, Rego Park, and Queens, NY

Digital X-Rays

Because we care about your child’s bodily health and well-being, we believe that reducing the amount of radiation exposure is extremely important. Although the amount of radiation used in dental X-rays is very small, the effect is cumulative, so all radiation counts. Digital X-rays can reduce your child’s exposure to radiation by up to 80 percent! We want your little one to be as comfortable as possible during their appointment, and digital X-rays eliminate the need to bite down on a sharp piece of film encased in plastic. There is no need to wait for the X-ray film to be developed before it can be viewed, so the entire checkup can be a lot shorter. The digital images can be enlarged and manipulated, giving the doctor a clear, more detailed look at your child’s teeth. Because your child can see the image enlarged on a screen, she can better understand why taking care of her teeth is important.

Sealants

Sealants are a thin coating applied to the pits, fissures, and grooves of the chewing surfaces of molars. Tooth structure is NOT removed; rather sealants are added to the teeth. They can be very effective in preventing cavities since chewing surfaces are the areas where food and bacteria can most easily become trapped. Generally, sealants are highly recommended for permanent molars since they are more difficult to keep clean for younger children and because they will be needed in a healthy condition for decades. However, we sometimes recommend sealing baby teeth in high-risk children as well. Having sealants placed is elective but can save the patient time, money, and the discomfort associated with having a filling placed in the future due to dental caries. While sealants can greatly reduce the risk of getting cavities, the patient may still form cavities due to poor oral hygiene or diet and sealants do not protect against cavities in between teeth or on smooth surfaces.

Fluoride Treatments

Topical fluoride application (fluoride varnish) is a service that may be provided at recare visits, when indicated. When used appropriately, fluoride is both safe and effective at preventing dental decay (cavities). The decision to apply fluoride, and how frequently, should be based on an individual assessment of your child’s risk of developing cavities.

Silver Diamine Fluoride

Silver Diamine Fluoride (SDF) is an antimicrobial liquid that we paint on cavities to help stop or slow the progression of caries. There are not shots or drilling involved. We also use SDF to treat sensitivity for teeth with weak enamel. SDF application every 6-12 months is necessary to maintain its efficacy if a definitive restoration is not placed. We recommend use of SDF when finances are an issue, patient is too young to tolerate dental treatment or cavities are too small to be treated traditionally but too large to ignore. It is a great tool in our toolbox but comes with some disadvantages. It will stain the cavity black permanently until the tooth is treated with a filling or crown. It is not guaranteed to complete stop the progression of the cavity, especially if oral hygiene and diet is not improved. It cannot be used on very large cavities close to the nerve.

Nitrous Oxide

Nitrous oxide, or laughing gas, is a colorless gas with a slightly sweet odor. It is a highly safe and effective method to relieve fear and anxiety and help your child feel comfortable while they receive their treatment. When your child receives nitrous oxide, our dentist and team will simply fit a small mask over their nose. The sedative gas is mixed with oxygen and inhaled, and in just a few minutes, your child can begin to feel more at ease. Your child may tell you that they are experiencing a “floating” sensation. When their treatment is completed, we will gradually decrease the flow of the gas until your child has completely recovered. Our team will monitor your child closely throughout their entire appointment to make sure that they are safe and comfortable.

Composite Resin Restoration

These are white-colored filling materials. They are used to restore cavities that are small to medium in size on primary teeth and in children who are considered low to moderate risk for cavities. They are a conservative, esthetic treatment option. While most resins hold up over the life span of the baby tooth, it is possible for resins to fail by fracturing or to form more cavities around the margins of the filling. It is recommended for children who are at a higher risk for cavities or who have large cavities that a stainless steel crown is placed so that extra time and money is not spent on retreatment in the future.

Stainless Steel Crowns

SSCs are the gold standard in treating cavities that are large (wide, deep, or involve multiple surfaces), involve the nerve of the tooth, or in children that are at high risk for having more cavities in the future. They are highly successful in that they are impenetrable by food and bacteria, provide integrity and strength to the compromised tooth, biocompatible with oral tissues, and cemented on using a fluoride-based cement. Although some parents may not like the esthetics of SSCs, they are the best option for reducing the risk of retreatment, and they will eventually fall out when the baby tooth falls out. While very rare, SSCs can be pulled off due to trauma or sticky foods. In most cases, a new SSC can be replaced easily. Generally, when a tooth with a SSC fails, it is most likely due to further degeneration of a compromised nerve (see pulpotomy) and not due to SSC itself.

Pulpotomy

A pulpotomy is the partial removal of nerve tissue on a baby tooth. I only perform a pulpotomy after much thought and consideration. I only recommend a pulpotomy when I am certain that the bacteria in the cavity has reached the nerve. The pulpotomy will hopefully contribute to the longevity of the tooth. The procedure involves removing the top half of the compromised nerve while preserving the healthy, vital bottom half of the nerve in the root. A medicament is placed on the nerve to hopefully reduce the risk of further infection, and an SSC is placed over the tooth to protect and seal it. With proper case selection and correct technique, a pulpotomy is an excellent way to prolong the life span of a tooth, providing the child with increased chewing function and natural space maintenance. Pulpotomies can fail if the disease process progresses to the lower half of the nerve but can be a healthier and cheaper alternative to premature extraction of a vital baby molar.

Extractions

Keeping with my conservative values, extraction of a tooth is only recommended in situations with no other sensible alternatives. These situations may include infection of the tooth; pain on a tooth that is loose but cannot be wiggled out by the patient; a baby tooth that is blocking the eruption of a permanent tooth; severe crowding of teeth where extraction of specific baby teeth may alleviate crowding; and a baby tooth with a cavity that is too severe to ignore but not worth restoring due to advanced age of the patient. I always encourage children to wiggle out their teeth on their own at home when possible.