General dentists are able and organize to integrate children in to their practices. The office is geared to children and the child feels secure and comfortable throughout their unfolding experience. Children need to be heard, encouraged, see other children having a positive experience, and children need to be continually re-inforced about their level of accomplishment. When we can understand a child's level of self esteem, we can encourage them, gain their trust and acknowledge their participation making them (your child) feel secure and safe in the environment.
In our office both staff and dentist have the experience, training and professional skills to enable a child to have a positive, non threatening and no traumatic introduction into dentistry. We work in an open, show, tell and do environment, listening to children, speaking to children at their level of understanding, working with parents in the room showing a win-win relationship can be achieved.
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Your child deserves the best dental care available. Your personal comfort level with your own dentist and your knowledge of the office and your own child should help you decide where your child's needs are best served. You need not be referred to our office.
Many families prefer that their children be attended to by our practice and stay with us, not only through the early years where confidence is developed and maintained, but also through their teen years.
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Our practice is geared for children and teenagers. We focus on total care with emphasis on preventive dental care. We provide all phases of dental treatment for children. Our only restriction is age. Our practice procedures allow for treatment to be completed more efficiently and effectively in comparison to general practices because of experience, expertise and effective team work. We save baby (deciduous teeth) utilizing nerve treatments where necessary; we prevent space loss and drifting of teeth and provide interceptive and full orthodontic treatment procedures.
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Parents in our area of the country are usually well informed about health care and can readily inspect their growing child's mouth and teeth. However any suspicious dark colour changes of enamel (teeth) should be checked out. Remember the white edges of enamel seen during the erupting of your child's front teeth? If those edges have changes or the behind surfaces of those upper baby teeth appear yellow or brown and if your child is still taking a bottle or even sleeps on the breast, chances are nursing bottle caries may be developing.
By waiting too long until the child is three years old, these areas will be too extensively broken down and more extensive nerve treatment of baby incisors as well as bonded white filling may be required. A paediatric specialist can also give you advice with regard to a developing overbite due to a retained soother sucking habit or bottle of thumb sucking habit resulting in either a narrowing of the upper jaw, protruding baby teeth with poor swallowing and speech development.
Most children have the confidence and self esteem to have a positive introduction to a dental assessment and evaluation by three years of age. We often examine children under three years old comfortably while the children sit on their mom or dad's lap
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We are very conservative about our care and only do what radiographs are necessary, attempting them only when we are sure a child can achieve any task successfully. We don't waste x-rays. We take them to enable us to diagnose properly. Dental radiographs reveal and confirm normal or unhealthy conditions, showing us normal developing adult teeth underneath baby teeth thus helping us understand how to repair the baby teeth. The radiograph also assist us in the decision making as to the type of filling material we should use in each individual situation. Approximately 3% of the population have an extra or missing tooth. Dental x-rays confirm the presence, position, size and shape of the teeth underneath the baby teeth. It is always best to do only what is best for your child. Dental x-rays enable us to do that for you.
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Children learn through the modeling and shared values of their parents. Parents should brush the teeth of the pre-schoolers and infants using wash cloths during bathtime. A child's toothbrush can also be used. Let them see and hear. Brush your teeth and floss your teeth together. Children can learn from Mom and Dad.
As your children get older, let them brush on their own. Start with your hand over their hand on the toothbrush, showing how and where to place the brush in the rolling stroke way,. (hand over hand). Primary school children need coaching and encouragement. They do not have the interest, dexterity or know the difference between clean and unclean. They need the information from dental hygienists and dental assistants to learn better techniques.
As children mature and peers come into play, they are ready and can achieve excellent dental hygiene. With gentle persuasion, and positive re-inforcement without shame or embarrassment, we can eventually instill good brushing habits. In our office we teach and encourage children of all ages that good dental hygiene is very attainable. With regular routine continuing care visits to our office and the help and encouragement of an empathetic team can we reach goals of excellent oral hygiene.
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In our office we want children to develop regular, timely tooth brushing skills first. Brushing, at least, morning and nighttime every day is our goal. Control your child's snacking habits, (acid attacks, we call them). With the principle of "a clean tooth won't decay" attitude, most children including those with repaired cavity lesions and pit and fissure sealants placed on their permanent six year molar need not floss until they are able.
The dexterity and interest usually kick in around 12-13 years old. If you are a flossing family and your child is ready earlier, go ahead and floss. Kids' floss, mint floss, floss tape etc. enable us to show and encourage your child to take care of their teeth to the best of their ability.
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Children are very active and will fall and bump heads and mouths very readily. A cut lip and bleeding around the gum line can occur and be forgotten. However, a darkened or a displaced tooth should be checked out by a dentist. A displaced tooth can interfere with the closure of the lower jaw and would require repositioning by the dentist. A darkened tooth indicates bleeding into the pulp chamber and probably degeneration of the nerve tissue inside the tooth which can lead to a dental abscess. A dental abscess can result in pain and discomfort, the developing of tenderness, redness or pus accumulation above the darkened tooth in the gum tissue.
Paediatric dentists routinely treatment the nerve tissue of darkened baby teeth preventing the re-occurring of the abscess formation. Some darkened teeth, if left alone and do not develop abscess formation, can deflect the eruption pattern of the permanent incisor at 7-8 years of age and such would be examined at that time by a dentist.
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Dentists and their dental hygienists have been placing fissure sealants for almost twenty years. Fissure sealants are space age bonding or adhesive nail polish like substances that can fill grooves of posterior molars. By following the grooves of susceptible and difficult to clean biting surfaces, the acids produced in our every day diet cannot weaken the enamel surfaces.
Your toothbrush should be replaced every three months (once bristles curve) to enable your child to clean properly. Fissure sealants are non-toxic, safe but can be worn down. Fissure sealants should be inspected at recall re-assessment visits and can be re-applied. Children born in the 80's and 90's now can arrive as adults mostly cavity free,. (a cavity free generation) with the use of bonded sealants.
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In our office we work with the concept of no discomfort and a positive non traumatic experience. Therefore, we want your child to be comfortable throughout his short visit. We explain all procedures and in most instances require a local anaesthetic (needle). We use topical (surface skin) freezing where necessary. In most cases by using a very small injection and depositing freezing slowly your child is not aware of the procedure being done.
We have also been using for three years a no-freezing air abrasion system. Utilizing kenetic energy and pulsating salt molecules, we can remove early and shallow cavities utilizing a no drill, no heat producing instrument that only feels cold during activation. Many permanent molar fillings can be completed utilizing this no anaesthetic machine. The best thing about this instrument is your child or teenager leaves the office with no numbness or lasting effect of his appointment. Everyone raves about air abrasion.
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All children are born with an innate sucking habit and hence pacifiers are important. Most children will take to a pacifier if the parent persists. A proper orthodontic soother (NUK) aids an infant in swallowing and minimizing a tongue thrust habit.
As a child becomes a toddler the pacifier can be eliminated as the child's busyness induces good sleep patterns. The best time to do this is when your child is beginning to walk. It is much more difficult to discard a pacifier habit at 2-3-4 years of age as the child become very attached to the habit.
Finger and thumb sucking is usually prevented if a child gains the use of a pacifier as an infant. Most oral habits (pacifiers, thumb and finger sucking) will distort the upper jaw and upper tooth positioning and may result in crossbite and openbite relationships affecting speech and swallowing. If oral habits are retained after 5-7 years of age it is likely that some permanent tooth and jaw relationships will require orthodontic appliance treatment by the dentist.
A paediatric dentist, attending to a 4 year old's care, can encourage, build self-esteem and big person expectatiions that a 4 year old can meet. Often we can initiate in the "ready" child the impetus for the child to break the oral habit condition. Ask us for our help.
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We often seen children after they have misbehaved or felt insecure and panicked in the general dentist office. The general dentist refers the child to us for specific treatment. When your child has been told that we are to see them as a "last resort" and you, the parent emphasize the same, more often than not your child behaves better and gives us a better chance to do treatment than the previous dentist had. Our office does not believe in dragging or coercing children into the office.
The pre-schooler who just won't try or listen to a parent or the dentist may be required to be picked up by the parent and placed in the dental chair, allowing us to have a "look see". We won't fight with children who can understand and follow basic instructions. We work with parents in the room and if the child is a normal healthy 3-5 year old we can reason with them, calm them down as no one can hear when there is fussing and tears. By being truthful, honest and sincere we are usually able, in a step by step fashion, gain the confidence of the child and complete a clinical assessment. We can then share the information and treatment needs with mom or dad.
We prefer not to do treatment at the first visit as everyone should understand the treatment required and the options available. Hence the fearful 8 year old and older child's fear can be eliminated utilizing these principles. We complete 99% of our dental treatment in the dental chair utilizing local anaesthetic where necessary. We will use an oral sedation if advantageous, and we will use nitrous oxide (anxiety treatment) if warranted.
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As a paediatric specialty practice we try to complete procedures that stand up over time. You have the final say in the type of filling material used. We would most certainly repair the permanent tooth cavity with a bonded white tooth coloured filling and feel comfortable about its lasting power. We still prefer to used metal amalgam fillings on posterior baby molars unless the family and medical history states otherwise. Baby molar's enamel is more difficult to bond and if there is already extreme posterior clenching and wear of the baby teeth, the metal filling will stand up better. We prefer to restore a tooth once and know that it will remain intact.
Since the baby molars will be shed by 13 years of age, the metal is only in the mouth for up to five years. The amount of metal involved with the four posterior fillings would be conservative and likely not cause an allergic problems. The Canadian Dental Association still considers amalgam (metal) restorations to be safe. The relationship of sensitivity of amalgam depends upon the amount of metal, type of metal and length of time the metal has been in the mouth. For children it is still considered, in our practice, the filling of choice with baby molars. Parents' advice and input is valued and you have the final say in treatment materials used for your child in our practice.
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Over the last twenty five years dental insurance plans have evolved to aid working families; a fringe benefit of their employment package. We are a fortunate country that has high living standards and high health standards. Your dental insurance presently pays for a decreasing amount of benefits required for your family's dental health.
Over the last five years insurance premiums have increased and employers have been unwilling to cover these increases in dental benefits and have kept costs down by reducing the amount of coverage or the percentage of re-imbursement. Over this period of time I am sure your dental plan has changed and no longer covers a six month check-up but now cover a nine month check-up and probably in the future only one annual dental check-up will be covered.
Your children are now being short changed compared to coverage in the mid '70's and '80's. Your child is getting fewer topical fluoride applications that the child in the '80's had and will be more susceptible to cavities in years ahead compared to the '80's child. Dental insurance is an employee benefit to assist in enabling your family to have ongoing and optimal dental care.
As we move into the new millenium be thankful that a small portion of your dental benefits is paid by your insurance, assisting your family in remaining dentally healthy. Don't let your plan dictate the dental treatment. You will be given choices, informed ones, prior to treatment. Your values system and not your carrier's benefit system should rule your decision with regard to your dental care for your children. As a paediatric specialist our fees could be 20% higher than the general practitioner's fees. However, our fees are set individually and are generally only 10% higher, if at all, (some areas are not,) compared to the general practitioner's fee guide.
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Dr. Hune
