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Patient Management
Conventional Treatment
We offer a fun facility and the expertise and training of our staff and doctors to care for our patients. Our staff obtains the cooperation of our child or adolescent patients by using warmth, friendliness, persuasion, humor, charm, gentleness, kindness, and understanding. Our doctors and staff use several behavior management techniques during a visit with each patient. These techniques include:
- Tell-Show-Do
- Modeling from other patients
- Positive reinforcement
- Distraction – music, movies
- Helpful tools – mouth pillows, rubber raincoats
- Guessing Games
During our new patient visit, we will explore options that are best for your child.
Nitrous Oxide
Nitrous oxide, commonly known as “laughing gas”, is widely used in pediatric dental offices with children receiving dental care. It is a blend of two gases – nitrous oxide and oxygen. It is delivered via a nasal mask and enters the system through the lungs. The American Academy of Pediatric Dentistry recognizes this as a very safe, effective technique to use for helping children tolerate dental care. It is ideal for use in our office because it is very safe, begins to work rapidly, and is quickly eliminated from the body after a short period of breathing oxygen. Children are not put to sleep when breathing nitrous oxide, they are fully conscious and keep all natural reflexes.
Please note that nitrous oxide is intended to decrease anxiety. As such, it is not always effective in extremely anxious/fearful children. Dr. Galliani will discuss all options with you to help you decide which is most appropriate for your child.
Prior to the use of nitrous oxide:
- Please inform us of any change to your child’s health and/or medical condition.
- Tell us about any respiratory condition that makes breathing through the nose difficult for your child. It may limit the effectiveness of the nitrous oxide/oxygen.
- Let us know if you child has had a recent ear infection
- Let us know if your child is taking any medication on the day of the appointment.
Outpatient General Anesthesia
Outpatient General Anesthesia may be indicated for children with extensive dental needs who are extremely uncooperative, fearful or anxious, for the very young who do not understand how to cope in a cooperative fashion or for some patients with special needs.
General anesthesia renders your child completely asleep. This would be the same as if he/she was having their tonsils removed, ear tubes placed, or hernia repaired. This is performed in surgical center or a hospital only. Our staff is happy to answer any questions you may have about treatment under general anesthesia.
Preventative
Dental Exam
The American Academy of Pediatric Dentistry recommends a dental check-up at least twice a year for most children. Some children need more frequent dental visits because of increased risk of tooth decay, unusual growth patterns, or poor oral hygiene. At this visit we will provide a general review of your child’s medical and dental history, general examination of face, head and neck. Your child will receive an examination of teeth, bite, gums, overall dental development and a caries risk assessment.
Teeth Cleaning
An in-office teeth cleaning appointment removes plaque that can irritate the gums and can cause tooth decay. It is generally recommended every 6 months. This procedure removes extrinsic stains on teeth caused by food or certain bacteria and deposits. During this appointment we will review oral hygiene instructions to improve your child’s brushing and flossing habits, leading to cleaner teeth and healthier gums.
Digital Radiographs
Dental radiographic examination provides valuable information that your dentist could not collect during the clinical examination. Radiographs pose a far smaller risk than many undetected and untreated dental problems. The frequency of radiographs is determined by your child’s caries risk.
Sealants
A sealant is a protective coating that is generally applied to the chewing surfaces (grooves) of the back teeth (premolars and molars), where four out of five cavities in children are found. This sealant acts as a barrier to food, plaque and acid, thus protecting the decay-prone areas of the teeth. A sealant will decrease the chances of getting a cavity.
Sport Mouth guard
When a child begins to participate in recreational activities and organized sports, injuries can occur. Mouth guards help prevent broken teeth, and injuries to the lips, tongue, face or jaw. A properly fitted mouth guard will stay in place while your child is wearing it, making it easy for them to talk and breathe.
Space Maintainer
Baby teeth hold space for permanent teeth and also act as an eruption guide for permanent teeth. Early loss of primary teeth could cause permanent teeth to drift or erupt into the wrong position. A space maintainer is used to hold the spot left by the lost tooth until the permanent tooth emerges
Restorative/ Treatment of cavities
Treatment of cavities with white fillings
Tooth colored fillings or composite/resin fillings are mercury-free non-metallic fillings. This is the only material used for filling teeth in our office.
Crowns
A crown is necessary when there is extensive decay, abnormal shape due to decay or injury or there has been a pulp (nerve) treatment. For front teeth we use composite crowns or zirconia (white ceramic) and for back teeth we use all stainless steel crowns or zirconia crowns (white ceramic). The crown on the back molar teeth is used to re-establish normal chewing function and speech development and continues to hold the space until the permanent tooth can take its place. The crown will stay until the tooth naturally falls out. Your child will clean around the base of their crown like they do their natural teeth.
Pulp therapy
Inside each tooth is the pulp which provides nutrients and nerves to the tooth, which runs like a thread down through the root.
Dental caries (cavities) and traumatic injury are the main reasons for a tooth to require pulp therapy. Pulp therapy is often referred to as a “nerve treatment”, “children’s root canal”, “pulpectomy” or “pulpotomy”. The two common forms of pulp therapy in children’s teeth are the pulpotomy and pulpectomy.
A pulpotomy removes the diseased pulp tissue within the crown portion of the tooth. Next, an agent is placed to prevent bacterial growth and to calm the remaining nerve tissue. This is followed by a final restoration (usually a stainless steel crown).
A pulpectomy is required when the entire pulp is involved (into the root canal(s) of the tooth). During this treatment, the diseased pulp tissue is completely removed from both the crown and root. The canals are cleansed, disinfected and, in the case of primary teeth, filled with a resorbable material. Then, a final restoration is placed. A permanent tooth would be filled with a non-resorbing material.
Extractions
Teeth are extracted or removed when they are unsalvageable by any treatment. This may be due to decay, infection or trauma. Teeth are also extracted for orthodontic reasons when there is inadequate space in the jaws to accommodate all teeth.
Treatment Instructions
Pre-Treatment Instructions
- Please schedule your child at their happiest time to increase the chance of successful treatment(Most young children do best in the morning).
- Please give your child a light meal prior to their visit.
- Please give your child their normal medications at their normal time.
- If your child has had an ear infection within the last 2 weeks, please call our office.
- We welcome one parent at your child’s treatment visit. Please do not bring siblings to treatment visits.
Post-Treatment Instructions
- Local Anesthetic: If local anesthetic was used, please do not allow your child to eat anything hard or crunchy that requires chewing because they can bite themselves without noticing. We recommend foods such as yogurt, smoothies and apple sauce. Please stop your child immediately if you see them playing with, biting or touching the numbed area to prevent injury.
- Discomfort: If needed, you can give your child Motrin or Tylenol after the dental procedure unless their physician has told you your child should not take these medications due to their medical history. Some discomfort or abrasions around the area where treatment was done are normal. Facial swelling or pain that wakes your child at night is not expected and you should contact us immediately or seek emergent care if this occurs.
- Nitrous Oxide: Your child received 100% oxygen for a minimum of 5 minutes after the procedure and there should be no lingering effects of nitrous oxide after the appointment.
- Dental Emergency Contact: If you need to reach one of our dentists after hours, please call (703)-241-5437 If you are unable to contact us, please take your child to the nearest emergency room.
