Restorative Dentistry

Silver Diamine Fluoride (SDF)

SDF is a medication that we paint on teeth as a minimally invasive option for cavities. The medicine works on small cavities by killing the bacteria that are causing the cavity to grow while releasing fluoride directly onto the tooth to help strengthen it. It has an added benefit of decreasing sensitivity to teeth to help prevent pain. However, SDF has the side effect of discoloring any area that has a cavitiy to a dark brown or black. SDF is not an esthetic option. This discoloration is permanent on the tooth but can be removed with a dental drill to place a filling when the child is older. SDF is typically recommended when a child is too young for traditional dentistry or there is a concern that a child of any age will not be able to tolerate the drill or numbing. With proper diet and good oral hygiene, SDF can stop cavities from getting bigger until either the child trusts us enough for dental work or the tooth is ready to fall out on it’s own.

SDF usually involves cleaning the tooth well and using cotton to keep it dry. Then we carefully place the SDF on the tooth using a small brush or a thick piece of floss. We then remove the cotton and typically place fluoride varnish over it.

We exclusively offer white fillings at our office. The two types of fillings offered are resin fillings and glass ionomer fillings. Both are white but we use the material best suited for your child’s needs. Resin fillings are slightly stronger but need cooperation to be placed well. Glass ionomer fillings are more forgiving for our more wiggly patients and have the added bonus of releasing fluoride directly into the site of the previous cavity to help to prevent bacteria from getting between the filling and the tooth.

Fillings

Full Coverage (Crown) Options

Stainless Steel Crowns (SSCs)

SSCs are ideal for baby teeth and some adult teeth as they are durable, long lasting, and allow for placement in one appointment.  In certain cases, these crowns can be placed in the Hall Technique without shots or drilling! Hall Technique is a method of placing silver crowns on teeth without using a dental drill or the need for shots.  The cement used to glue the crown over the tooth traps any bacteria and seals the tooth to prevent further damage to the tooth. The baby tooth naturally adjusts to the new crown in just a few days.  It has been scientifically proven in multiple studies to be as effective as our traditional method of drilling into the tooth to remove the cavity and placing the crown on top.

Pulpotomies are recommended when a cavity on a baby tooth is into the nerve. This procedure involves removing the top portion of the infected nerve from inside the tooth and placing a medicine in the area to allow for healing of the remaining nerve. Unlike a traditional root canal on adult teeth, a pulpotomy and a crown can be completed quickly at the same appointment.

Pulpotomy

When a child loses a baby tooth early due to infection or cavities, we may recommend a space maintainer to hold the area where the tooth was lost until the adult tooth is ready to come into the mouth. This will help to prevent space loss and crowding of the teeth later on.

Space Maintainers

Sometimes we need to take teeth out due to large cavities and infection, and other times to make space for adult teeth for braces. We work very hard to providethe most gentle extractions possible.

Extractions