Treatment Procedures


Composite Fillings (tooth colored)


Composite fillings are tooth colored fillings and are made of composite resins, glass ionomer or compomers. They are used to fill decayed teeth or teeth that have been fractured. This is a very esthetic filling material but it can break or fracture as well so avoid chewing on ice or hard candies.



Amalgam Fillings (silver)


Amalgam is a silver colored filling material. It is super strong but not very esthetic. Most people do not like or want the amalgam because of the negative press that has been out there. Our amalgams have very little mercury in them, you will be exposed to more mercury in a tuna sandwich, and there are studies released by the American Dental Association that show that once the amalgam filling is set they will not leak significant amounts of mercury vapor. Our office usually only places amalgam filling on primary teeth.



Stainless Steel Crowns


Stainless Steel crowns (SSC) are referred to in our office as "princess teeth" or "super hero teeth". They become necessary if the tooth has excessive decay, is broken, the enamel is not formed well or if nerve treatment (pulpotomy) has to be done. The SSC is cemented onto the tooth and sits below the gum line, and it will fall out with the baby tooth when the permanent tooth comes in. Plaque sticks easily to the SSC and because of this the gum tissue may be sore or bleed if they are not brushed well. Your child should avoid chewy, sticky candies to prevent the crown from coming off. If it does become loose and falls off call our office to have it re-cemented. This is not considered an emergency.



Anterior Composite Crowns - Strip Crowns


These crowns are tooth colored and are made up of composite resin. They are placed on the primary front teeth when there is significant decay or if the tooth is fractured. Again it is best to avoid chewing on ice or hard candies because the crown can break or fracture as well.



Esthetic Crowns


These crowns are tooth colored and they are much stronger that the strip crowns. We offer two types of these crowns, NuSmile Signitures are a SSC with a tooth colored coating on the front of the crown. In our office these crowns are for the front teeth only. The second crown we offer is the NuSmile Zirconias, these crowns are completely tooth colored and are very strong. They are made of zirconia, which is a very hard ceramic like material and because they are so strong we place these on both the front and back teeth. These crowns are also cemented so avoiding sticky, chewy candies will prevent re-cement visits. Keep in mind if your child grinds their teeth a zirconia crown can cause wear on the opposing tooth.



Nerve Treatment


Nerve treatment is necessary when a cavity is so large that it invades the nerve (pulp tissue) inside the tooth. A pulpotomy is the removal of the nerve tissue that is only in the crown of the tooth. When we have to remove the entire nerve tissue this procedure is called a pulpectomy. The pulpectomy is necessary if the nerve tissue starts to become infected or dies completely. The nerve that lives in our tooth provides resiliency and when that nerve is removed the tooth can become brittle, therefore a crown is placed to prevent fracture. Unfortunately, about 5% to 10% of these nerve treatments fail because it is not possible to remove all of the bacteria, but a tooth is the best space maintainer so we really want to try to save these baby teeth.



Root Canal


A root canal is performed on a permanent tooth when decay is so large that it invades the nerve, or a tooth has been traumatized. Teeth that have had trauma may turn dark grey or purple in color. The nerve tissue is removed from the entire tooth and the canals are filled with a plastic like material called gutta percha. Because there is no nerve tissue present after a root canal a permanent crown should be placed to prevent fracture.



Extractions (Wiggles)


When a cavity (sugar bug) is so severe that a restoration is impossible it may be necessary to extract the tooth. Severe infection or when indicated by an orthodontist can also be reasons for extraction. When primary teeth (baby teeth) are extracted early your child may need a space maintainer (see preventative treatment). Most children can return to school but they should avoid spitting, sucking through a straw and crunchy foods like potato chips for the remainder of the day. Ibuprofen or Tylenol can be taken for any discomfort.



Local Anesthetic - Sleepy Water


Local anesthetic, or as we call it Sleepy Water, is used to "numb" an area in the mouth that requires treatment. We use it so your child will not feel pain or discomfort during certain restorative appointments. We use "The Wand", or as Dr. Tari calls it her magic wand, to deliver the local anesthetic, which makes it much more comfortable. Not all dental procedures require numbing, many can be completed with our dental laser (Wally) or with Nitrous Oxide/Oxygen alone.


Because your child has received local anesthetic their lip, cheek and or tongue may be asleep for 2 to 4 hours. Your child should avoid eating or chewing, if this is impossible they really need to eat soft foods such as soup, mashed potatoes or pudding. If your child chews or bites their mouth the tissue will look bumpy and be white or yellow in color. This is not an infection and the mouth will need 10-14 days to completely heal. Ibuprofen or Tylenol may help with discomfort.



Frenectomy/Frenulectomy


This procedure is done when the soft tissue of the lower and/or upper lip attachments are thick or are causing stress from pulling on the gum tissue around the teeth. The Frenectomy/Frenulectomy procedure is also performed when your child is tongue tied (ankyloglossia). Your child should avoid eating salty, acidic or citrus foods for about 5-7 days after treatment. We use our dental laser (Wally) for this procedure so there is no post operative bleeding and healing time is quick. Post-operative instructions will be given and gone over with you right after treatment. Your child may take Ibuprofen or Tylenol to help with any discomfort.