Orange County Children’s Dentistry believes in establishing an early relationship with your family in order to build a strong foundation to help prevent cavities. We encourage healthy eating, routine dental exams, and daily brushing and flossing. However, we understand that this may not be enough for some children who are at a high risk for developing cavities. Additionally, we understand that accidents can happen. When dental cavities develop or accidents occur, we are prepared to handle them with the following techniques:
For smaller cavities that can be treated with fillings, there are two types of fillings: composite (white or tooth colored) and amalgam (silver). Composite fillings are a mixture of powdered glass and plastic resin. Dr. Ruiz has been highly trained to place composite fillings and attempts to apply them the majority of the time. The advantages of placing composite fillings include: strength, durability, esthetics, preserves tooth structure and a low frequency of requiring replacement. Additionally, composite fillings are compatible with dental sealants. When Dr. Ruiz places composites, she will take the additional step of placing a dental sealant over the composite and surrounding tooth structure for added protection against dental cavities.
There are some rare instances where composite restorations are not possible or recommended to be placed. For these instances, dental amalgam is recommended. Dental amalgam is often referred to as a silver filling because of its color. It’s a self-hardening mixture of silver-tin-copper alloy powder and liquid mercury. When the mercury interacts with the other materials in dental amalgam, its chemical nature is changed and has been found to be safe and durable to use. The advantages of amalgam include: durability, inexpensive, self-sealing, and resistance to recurrent caries.
Dr. Ruiz understands that dental appointments can be difficult for everyone, especially children. For this reason, we want to decrease the chances of having to repair or replace fillings by using proper techniques. Dr. Ruiz’s goal is to minimize the chances of failure of the dental work performed and will make the appropriate recommendations based on your child’s specific need.
Other factors that influence the longevity of the restoration include: cooperation of the child, dental hygiene, home care, diet, and chewing habits.
Compared to adult teeth, baby teeth are smaller and have larger nerve chambers. This means that decay that goes undiagnosed or untreated can affect the nerve more quickly in baby teeth. For this reason, it is important to visit your dentist twice a year. When decay has reached the nerve but has not yet caused a dental infection or abscess, it is possible to save the tooth by performing nerve treatment. Depending on the extent of the cavity and how much of the nerve has been affected, Dr. Ruiz can perform a pulpotomy or pulpectomy to save the tooth. A pulpotomy involves the removal of the pulp tissue from the crown of the tooth (above the gumline). A pulpectomy involves the removal of the pulp tissue from the crown and the roots of the tooth (below the gumline). After nerve treatment is performed, the tooth is weaker and more prone to fracture. For protection from fracture, a crown is placed over the tooth that has received treatment. A stainless steel crown is the restoration of choice to protect the posterior or back teeth that have to withstand strong chewing forces. In the anterior area where more esthetic goals are desired, Dr. Ruiz will place white crowns.
In cases where decay has penetrated deep in the tooth and caused a dental abscess or infection, Dr. Ruiz will recommend removing the tooth. Once the tooth is removed, Dr. Ruiz will assess whether your child needs space maintainers to maintain the space for the adult teeth that will be erupting in the future.
Your child’s baby teeth play a very important role in chewing, smiling and speaking. A beautiful healthy smile gives your child the confidence they need. For this reason, Dr. Ruiz strives to protect your child’s teeth until they are expected to exfoliate naturally on their own. If a baby tooth has extensive decay that involves 3 or more sides of the tooth or has had nerve treatment, it is more prone to fracture or break. In these cases, a filling is not enough to protect your child’s tooth. When it is necessary to safeguard and protect your child’s tooth, a crown will be recommended. There are two types of crown that Dr. Ruiz will recommend. A stainless steel crown is the restoration of choice to protect the posterior or back teeth that have to withstand strong chewing forces. In the anterior area, where more esthetic goals are desired, Dr. Ruiz will place composite (white) crowns.
Stainless steel crowns are the favored choice by most pediatric dentists to protect the posterior teeth for many reasons. They are extremely durable and can withstand the pressure placed on the molars during chewing and grinding. Additionally, they are thin, so it requires less removal of the natural tooth structure, saving more of your child’s natural tooth than other modalities.
Composite crowns are made of “white” filling material and are more esthetic, making them suitable to restore the front teeth. The result is more natural, but placing them requires more time and skill. It is well worth the effort to maintain a natural looking smile. However, over time the material can stain or discolor. Additionally, they are weaker than stainless steel crowns, so they require gentle use. Dr. Ruiz, recommends avoiding using composite crowns to bite into hard foods such as ice, apples, carrots, and other hard foods, so that they don’t fracture.
Our goal is to try to protect your child’s teeth until they will naturally exfoliate. However, in some cases when a tooth has extensive decay or an infection, Dr. Ruiz may recommend removing the tooth. Dr. Ruiz may also recommend removing a tooth if it’s over-retained or the patient is unable to remove it on their own. Sometimes, your child’s orthodontist may recommend removing a tooth (or teeth) if your child’s mouth is very crowded. Dr. Ruiz will need to evaluate your orthodontist’s recommendation and usually feels comfortable performing those extractions.
In cases when a tooth has extensive decay or an infection, Dr. Ruiz will recommend removing the tooth. When a tooth needs to be removed, Dr. Ruiz will assess whether your child needs space maintainers to maintain the space for the adult teeth that will be erupting in the future. Space maintainers are needed to maintain the space of a baby tooth when it has been lost or needs to be removed prematurely. They will help prevent the teeth from drifting and causing orthodontic issues, such as crowding.
We want to treat your children at every stage of life, from the anxious anticipation of the appearance of their first tooth to learning proper brushing and flossing techniques to the providing quality restorative care, if needed.