Common Treatments

Baby Bottle Tooth Decay

Also known as early childhood caries, baby bottle tooth decay refers to tooth decay in infants and toddlers. Your child needs strong, healthy primary teeth to properly chew food and learn to speak, so preventing baby bottle tooth decay is very important.

The Causes of Tooth Decay in Children

There are many risk factors when it comes to children’s tooth decay. A common cause is frequent and prolonged exposure of your child’s teeth to sugary drinks, including milk, formula, and fruit juice. Giving your child a sugary drink at nap or nighttime can be especially harmful because the flow of saliva decreases during sleep. Bacteria in the mouth thrive on sugar and produce acids that attack the teeth.

Tooth decay can also be caused by bacteria passed from you to your baby through saliva by sharing spoons, testing foods before feeding them to your baby, and cleaning off a pacifier in your mouth instead of with water. These germs can start the process that causes cavities even before your baby’s primary teeth emerge, so it’s important to avoid sharing saliva with your baby from the start.

If your infant or toddler does not receive an adequate amount of fluoride internally through water, especially if he or she drinks bottled water, there can also be an increased risk for tooth decay. Your pediatric dentist may prescribe fluoride supplements to help prevent tooth decay.

Silver Diamine Fluoride

Silver Diamine Fluoride (SDF) is an FDA-approved topical solution that treats and prevents dental caries and reduces tooth sensitivity. It is made with two acting ingredients: the silver component is an anti-microbial agent that kills bacteria and prevents the formation of new biofilm, and the fluoride prevents further demineralization (softening) of the tooth structure.

Treatment with SDF does not eliminate the need for restorative dentistry (fillings, crowns, etc.) to repair function or aesthetics, but is effective at preventing further decay.

Why use SDF?

We recommend using SDF in several situations, including:

• Children who have extreme decay (severe early childhood caries)
• Young children who have difficulty sitting still for treatment
• Special needs patients
• Children with carious lesions (cavities) that need to be treated over several visits

The Advantages of SDF:

• Provides immediate relief from tooth hypersensitivity
• Kills the organisms that cause cavities
• Hardens softened dentin making it more acid- and abrasion-resistant
• Does not stain healthy dentin or enamel

Pulpotomy

If the decay or trauma is confined to the crown of the tooth, a pulpotomy may be recommended. When a cavity gets really deep, close to the pulp of a tooth, or even into the pulp, the pulpal tissue becomes irritated and inflamed. A pulpotomy is when the inflamed pulp chamber, usually on a baby molar, is removed. The dentist will remove all the infected material in the pulp of the crown only, leaving the living tooth root intact. After a pulpotomy on a baby molar, the empty space will be filled with dental cement and a stainless steel crown will be placed to restore the tooth.

Pulpectomy

If the infection involves tissue in both the tooth crown and the tooth root, a pulpectomy may be the best option. In a pulpectomy, the entire pulp material is removed from both the crown and the roots. After numbing your child’s tooth, the dentist will remove the pulp and nerve tissue from the crown and from the canals of the roots. Then, the pulp chamber and root canals will be thoroughly cleaned and disinfected. Next, the dentist will fill the tooth and tooth roots with a dental cement, and finish with a stainless steel crown.

Crowns

Crowns are “cemented” onto an existing tooth and fully cover the portion of the tooth above the gum line. In effect, the crown becomes the tooth’s new outer surface.

Stainless steel dental crowns are considered a good temporary restoration to save a primary tooth until the permanent tooth can erupt and take its place. Keeping the primary tooth if at all possible is very important. A primary tooth can be restored with a stainless steel crown during one appointment. A crowned tooth must be brushed and flossed just like other teeth.

Dental Abscess

An abscessed tooth is a dental condition in which the nerve, also called dental pulp, has become infected. The infection usually occurs when a dental cavity goes untreated and bacteria spread deep within the tooth. Left untreated, an abscess can progress to a serious, life-threatening bacterial infection throughout the entire body. This is especially harmful to children, because their immune systems are not fully developed.

Signs Your Child May Have an Abscess

• Continuous sharp or throbbing pain
• Pain when chewing
• Red, swollen gums
• Swollen neck or jaw
• Fever
• Bitter taste in the mouth or bad breath

Treatment of an Abscess

If an abscess occurs in one of your child’s primary or baby teeth, it will most likely need to be extracted. Depending on the location of the extraction, a space maintainer may be necessary until the permanent tooth emerges to prevent the surrounding teeth from drifting into the open space.

If your child’s permanent tooth has an abscess, the treatment options consist of root canal therapy to clean and remove the infection, or tooth extraction. Your pediatric dentist may also choose to add an antibiotic to your child’s treatment plan. This will prevent the infection from spreading further into the jaw and bone tissue.

Sealants

Sometimes brushing is not enough, especially when it comes to those hard-to-reach spots in your child’s mouth. It is difficult for a toothbrush to reach between the small cracks and grooves on teeth. If left alone, those tiny areas can develop tooth decay. Sealants give your child’s teeth extra protection against decay and help prevent cavities.

Dental sealants are plastic resins that bond and harden in the deep grooves on the tooth’s surface. When a tooth is sealed, the tiny grooves become smooth and are less likely to harbor plaque. With sealants, brushing becomes easier and more effective against tooth decay.

Sealants are typically applied to children’s teeth after their permanent teeth have erupted as a preventive measure against tooth decay. It is more common to seal “permanent” teeth rather than “baby” teeth, but every patient has unique needs, and the dentist will recommend sealants on a case-by-case basis.

Sealants last from three to five years, although it is fairly common to see adults with sealants still intact from childhood. A dental sealant only provides protection when it is fully intact so if your child’s sealants come off, let the dentist know, and schedule an appointment for your child’s teeth to be re-sealed.