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A first dental visit for your child may cause you anxiety, but your child does not know what to expect, and will generally follow your lead. Starting a child off with enjoyable,

Pediatric Dentistry Marielaina Perrone DDS

Pediatric Dentistry Can Be Fun!

comfortable dental visits can make it easier for both of you, and lead to a lifetime of worry free, healthy dental care. So what can be done to make the dental visits and treatment go as smooth as possible?

Tips For A Fun Dental Visit

-Start With Good Oral Hygiene, and a Healthy Diet at Home. Good nutrition, and proper brushing should help keep your child cavity free. Dental visits are much easier to cope with, and feel at ease with, when there is little work to be done. Stay away from , soda, sticky sweets, and fruit gummies. Drink lots of milk and water, keep juice to a bare minimum. Teach and help with brushing and flossing everyday. Your child’s first dental visit should hopefully not be due to dental decay causing a toothache.

-Choose The Right Dentist – Not all dentists are comfortable treating children. In my opinion, a family dentist is the perfect choice for the ease of scheduling and the fact that the dentist you choose can treat your child into adulthood. Plus, children feel like grown ups to go to the same dentist as their parents and older siblings.

-Have Older Siblings Act as Role Models. A younger child usually will try harder to do something that they see big brother or sister do. If there are no siblings, have your child sit in the office with you, and at the end, have them sit in your lap for a quick peek, and a ride in the chair.

-Start Young – The earlier a child visits the dentist, the better. This will make a child very familiar with the surroundings of the dental office. It is best that the first visit starts at age 1 or when the first tooth is visible. The initial visit generally is an introduction visit with oral hygiene education for parents.

 -Be Honest – Never try to fool or trick a child into doing something. Kids generally have a good sense of their surroundings and will react badly if they are tricked. Kids are quite strong and should be told what is going on so they can prepare themselves for it.

-Stay Positive – Most children’s dental fears arise from hearing their parents talk about their bad experiences of the dentist. Keep positive communication regarding dental care and dental treatment and visits with your children will go much smoother for all involved.

Pediatric Dentistry Marielaina Perrone DDS-Watch Your Words – Never use the words “shot” or “pain” words with children. Always use positive phrases to keep them happy. Negative words will transfer worry to the child.

-Communicate – Constant communication is needed to make this a great experience. If you encourage your child, and explain that they are going to have pictures taken of their teeth, their teeth polished and shined, etc. They will look forward to their appointment, and want to ask questions. A good dentist will also reinforce what you said and place your child at ease, answering questions, and explaining all that they do throughout the dental visit.

-Reward Good Behavior – Promise a reward for good behavior following dental treatment. Kids will associate the dentist with the prize and look past the actual visit toward what they may receive afterward, even if it is just a shiny, new toothbrush from the dentist. A second reward by you after the visit such as going to the park or a favorite place for lunch.

-Schedule Appointment Early In The Day – Arrange a dental visit as early as possible in the morning. This allows the visit to be done early in the day while the child is not tired and before the kids get wound up from the day. Kids deal with new things better when they are not exhausted.

Pediatric Dentistry Conclusion

Dental visits can be fun experiences. Most children who start young and problem free, can build a trust and confidence in themselves and their dentist. Children who learn good oral hygiene at a young age will thank their parents later in life when they experience less tooth related issues and stay healthier longer.



There are many dental myths floating around the internet that have little to no basis in truth.

MYTH: I should not brush my teeth when my gums bleed.

TRUTH: Normally, when the body has a wound we need to give it time to heal. Usually that means placing a band aid over it so we do not disturb the healing process. The opposite is true of bleeding gums.  Bleeding gums could be a sign of more than just periodontal disease and should be examined by a dentist. Gingival tissue bleeds because of a buildup of plaque and bacteria. The plaque, food particles and bacteria are producing toxins that will eventually destroy the supporting tissues surrounding your teeth. The earliest form of this is called gingivitis and it is reversible. But periodontal disease is a progressive one and it will get worse without proper care. Seeing your dentist regularly will allow you to manage and stop this disease before it can progress further.

MYTH: Placing an aspirin in my mouth next to a toothache can relieve pain.

TRUTH: This is an old at home remedy that has somehow continued to linger. Even ingested orally aspirin will do little for a toothache. It is not powerful enough of an analgesic. But placing it in the mouth against the oral tissues is a recipe for disaster.

The only safe and effective way to take an aspirin tabs to swallow it. The aspirin then gets absorbed into your body through your digestion. It then enters your bloodstream and travels throughout your body. Aspirin works by stopping the production of prostaglandins.Prostaglandins transmit pain messages from the injured part of your body to your brain. This reduces pain felt in the body. Also placing the aspirin directly on the gums or lips can cause an acidic burn to the oral tissues.

MYTH: By eating more sugar, you will get more cavities.

TRUTH: Many of us can remember our parents or grandparents telling us not to eat too much sugar or our teeth will fall out. But truth be told, the amount of sugar is not the deciding factor whether or not you end up with tooth decay. How tooth decay process works is the bacteria that are naturally in your mouth are able to feed on sugars (and carbohydrates in general). In turn these bacteria produce acids that erode our teeth. The longer the sugar is able to stay in your mouth, the longer these bacteria are producing acid which will eventually erode the tooth and cause a cavity.

So, this means eating two candy bars, then immediately brushing and rinsing your teeth is less harmful than eating one candy bar and not brushing afterwards. This is why sugary soft drinks are bad for our teeth. Every sip we are reintroducing sugar into the mouth for the bacteria to feed on.

MYTH: Using tooth picks will widen the gaps between your teeth.

TRUTH: Most commercially available tooth picks are quite harmless and when used properly are a good cleansing tool for the plaque and food build up between teeth. However, it should not replace flossing and brushing as the staple to your oral hygiene program. One word of warning regarding tooth picks…..be careful not to injure your gums.

MYTH: Osteoporosis does not affect teeth and only affects major bones like the spine and hips.

TRUTH: Osteoporosis is a disease that affects the bones. It is the thinning of bone tissue and loss of bone density over time. Osteoporosis can also affect the bones of the jaws so tooth loss is possible. Diet become doubly important in osteoporosis patients to maintain the nutrients needed for proper bone support.

MYTH: Bad Breath means you are not brushing properly.

TRUTH: A person’s bad breath can be caused by poor oral hygiene but it can also be a sign of a systemic disease. The foods we eat like garlic or onions will also change our breath smell but only for a short time. A well known systemic disease that gives a tell tale bad breath sign is diabetes. In diabetics this is called diabetic ketoacidosis. Ketoacidosis is usually seen in type 1 diabetics. This complication occurs when the body is unable to use sugar (glucose) as a fuel source because the patients do not produce enough insulin, and because of that the fat is used instead. Ketones build up in the body and this is the byproducts of fat breakdown. The bad breath smell is from the ketones. The body has only two ways of removing these ketones, thru our urine and thru our breath.

MYTH: Losing baby teeth from tooth decay is not a big deal.

TRUTH: This is a very common myth. Most people believe well the primary teeth are going to fall out anyway so no big deal. The tooth decay in the primary teeth can affect the erupting teeth. If the primary teeth are lost prematurely the permanent teeth may erupt misaligned. The other purpose of primary teeth is to hold “space” for the permanent teeth. if those space holders are gone prematurely then there will be less room for the adult teeth to erupt. This will cause overcrowding. and require orthodontics later on.

MYTH: Poor oral health only affects the teeth and gums.

TRUTH: This has been a big misconception for years but the media has done a good job of late bringing this to the general public’s attention. Periodontal disease has shown stperfect smilerong links to diabetes and heart disease. Untreated periodontal disease will affect your body as a whole. Research has proven this.

MYTH: Teeth whitening is bad for your teeth.

Teeth whitening when done properly is completely safe and harmless to the teeth and gums. Teeth whitening products only affect color of teeth not their strength or health. There are some possible side effects to teeth whitening that are generally very temporary. These include teeth sensitivity or possibly gum irritation if not applied properly.

MYTH: Avoid the dentist when pregnant.

When a woman is even thinking about becoming pregnant she should schedule a dentist appointment to ensure her teeth and gums are healthy for the possible baby on the way. Necessary dental treatment is safe and effective for most pregnant women throughout their pregnancy. Obviously you prefer to not have treatment in the third trimester when sitting in a dental chair may be uncomfortable for the mother.

 



Root Canal Therapy (also called root canal treatment or endodontic treatment)  is a dental procedure in which the diseased or damaged nerve (pulp) of a tooth is removed and the inside areas (the nerve or pulp chamber and root canals) are cleaned, filled and sealed permanently to avoid dental infection. Without treatment, the surrounding tissues of the tooth (including the gums and bone) will become infected and a dental abscess can form.

A tooth’s nerve and blood vessel provide nutrients and hydration to a tooth as well as the ability to sense temperature. It provides the sensation of hot or cold. The presence or absence of a nerve will affect the routine functioning of a tooth. Over time, the tooth with the root canal dehydrates which makes the tooth brittle and more susceptible to fracture. Most often, a crown is placed following root canal treatment is completed to protect the tooth and restore full function to the patient.

Root canal therapy is considered by many to be the most feared dental procedure. Does that surprise you?  Surveys completed by the American Association of Endodontists reveals that most people with a fear of the dentist are based on others’ experience and not on their own.

The inaccurate information they receive about root canal therapy prevents patients from making a properly informed decision regarding their teeth.  Many patients will ask that a tooth be extracted rather than experience a root canal procedure simply fearing the unknown.

Painless DentistryRoot canal treatment is needed when the nerve or pulp tissue becomes inflamed or infected. The inflammation or infection can occur from a number of ways: Decay that extends into the pulp chamber, repeated dental procedures on the tooth, or a fracture or chip in the tooth that allows bacteria to spread into the pulp chamber. Also, a traumatic injury to a tooth may cause pulp damage even if the tooth has no visible chips or cracks. If pulp inflammation or infection is left untreated, it can cause pain or lead to a dental abscess.

Root canal therapy is almost always recommended because a tooth is causing pain from a condition that is irreversible. Pulpitis (inflammation of the pulp), an infected pulp, broken teeth, or a slowly dying nerve are all common reasons for root canal therapy.

Root canal therapy is used to alleviate that dental pain. Most people who have root canal therapy admit they did not experience any pain during the appointment and felt better almost immediately afterward.

Signs that a root canal may be necessary include pain, prolonged sensitivity to temperature (hot or cold), tenPainless Dentistryderness to touch and chewing, darkening or discoloration of the tooth, and swelling, drainage and tenderness in the lymph nodes, bone and surrounding gingival tissues. Sometimes, no symptoms are shown at all

Root Canal Therapy generally requires one or more visits to the dentist and can be performed by either a dentist or a specialist called an endodontist. An endodontist is a dentist who specializes in the causes, diagnosis, prevention, and treatment of diseases and injuries of the human dental pulp or the nerve of the tooth. The choice is generally up to the dentist on who will perform the root canal. The reasons the dentist may send you to the endodontist include: degree of difficulty of the tooth involved and need for a microscope, re treatment of a Painless Dentistryprevious root canal, and the patients preference. You and your dentist will discuss who is best suited to complete this treatment for you and make the best decision for your treatment.

The first step is to take an X-ray (if one has not been already taken during the diagnosis) to see the shape of the root canals and determine if there are any indications of dental infection in the surrounding bone tissues. Your dentist or endodontist will then use a local anesthetic to numb the area surrounding the tooth. Anesthesia is not always necessary but generally preferred by patient to make the procedure more comfortable.

Once numb, the pulpal tissue along with bacteria, the decayed nerve tissue and related debris are cleaned out from the inside of the tooth and roots. Tiny instruments called dental files are used to measure the length of the root canal and to shape and clean the inside of each root. Sterile water, peroxide, or sodium hypochlorite are used periodically to flush away the debris and kill bacteria..

Once the tooth is thoroughly cleaned, each root canal is filled to the end with a rubbery compound called gutta percha and sealed . The process essentially is like a cork to prevent bacteria and fluid from re-entering the tooth, and keep it sterile. Some dentists like to wait a week before sealing the tooth. This will give the Painless Dentistryinflammation a chance to settle down back to normal. Some prefer to seal the tooth the same day it is cleaned out. If the root canal is not completed on the same day, a temporary filling is placed to keep out contaminants like saliva and food until the next appointment.

The final step may involve a more extensive restoration of the tooth. Generally a tooth that needs a root canal often is one that has a large filling or extensive decay. Even when decay was not a factor, the root canaled tooth is weaker than a ”live” tooth. Therefore, a crown, crown and post, or other restoration often needs to be placed on the tooth to protect it, prevent it from breaking, and restore it back to full function again. After restoration, you will not notice any difference in its function or form. You and your dentist will discuss this need further and decide together the best course of action for you.

Root canal therapy is highly successful and has more than a 95% success rate. Many teeth repaired with a root canal can last a lifetime.

Most root canals are performed to relieve the pain of toothaches caused by pulpal inflammation or infection. With modern techniques, materials, and anesthetics, most patients report that they do not feel any pain once the procedure is underway. Root canal procedures have the reputation of being painful. Usually most patients report that the procedure itself is no more painful than having a routine filling placed.

For a few days following treatment, your tooth may feel sensitive, especially if there was pain or infection before the procedure. This discomfort can be relieved with over the counter or prescription pain medications or an antibiotic may be necessary if an infection was present. Follow directions given to you very carefully and feel free to ask questions if an issue arises.

Your tooth may continue to feel slightly different from your other teeth for some time after your root canal treatment is completed. However, if you have severe pain or pressure or pain that lasts more than a few days, call your dentist.

As noted above, the pain from root canals in modern dentistry is from the infection that presents to the dentist and the actual procedure should be pain and worry free. Best defense against developing a toothache is to see your dentist regularly, maintain proper oral hygiene, and call your dentist at the earliest signs if you have any pains or discomfort.

Radiograph of RCT

Xray of completed root canal