At Little Teeth Pediatric Dentistry your kids oral health is our top priority.

We offer exams from age 0 thro 15. Exams are basically examining the mouth, the teeth, the tissues around the teeth. An exam can be comprehensive or limited based on the need. An emergency exam is a limited exam, just to determine the problem. An exam during a cleaning is considered a comprehensive exam. 

During your child’s exam, we will thoroughly examine your child’s teeth and gums for signs of tooth decay, gum disease, and other health problems. Dr. Iyer may also want to take X-rays to see what is happening beneath the surface of the teeth and gums. Whether the X-rays are traditional or digital, the images provided will help us discover dental issues not visible to the naked eye.

Radiographs are valuable aids in the oral health care of infants, children, adolescents, and individuals with special health care needs. They are used to diagnose and monitor cavities, evaluate dentoalveolar trauma, as well as monitor dentofacial development and the progress of treatment.

Radiographs should be taken only when there is an expectation that the diagnostic yield will affect patient care. We attempt to x-rays on a patient typically around age 4 when they tend to be more co-operative for x-rays. 

The purpose of doing x-rays is it should yield a diagnostic result and not take x-rays for the sake of doing x-rays.

Using the most advanced dental technology is just as important as staying up to date on the latest treatment techniques. Because our practice is dedicated to providing your child with the safest and most convenient treatment options available, we utilize advanced digital X-ray technology in our office.

Is a digital X-ray really safer?

Because we care about your child’s bodily health and well-being, we believe that reducing the amount of radiation exposure is extremely important. Although the amount of radiation used in dental X-rays is very small, the effect is cumulative, so all radiation counts. Digital X-rays can reduce your son or daughter’s exposure to radiation by up to 80 percent!

What are the advantages of digital X-rays?

• We want your little one to be as comfortable as possible during the appointment, and digital X-rays eliminate the need to bite down on a sharp piece of film encased in plastic.
• There is no need to wait for the X-ray film to be developed before it can be viewed, so the entire checkup can be a lot shorter.
• The digital images can be enlarged and manipulated, which gives us a clear, more detailed look at your child’s teeth.
• Because your youngster can see the image enlarged on a screen, he or she can better understand why taking care of the teeth is important.
• It’s better for the earth! There is no need to use harmful chemicals to process film.

Our practice is focused on making your child’s dental experience as comfortable as possible. At your next appointment, we’ll be happy to answer any questions you may have.

First visit to the dentist is at age 1 or when the first teeth come in.  Cleaning for kids under 3 are usually done with a regular tooth brush (aka toothbrush prophylaxis) and fluoride is applied.

When kids are 4 and older when they are much more co-operative then we do x-rays and a rubber cup cleaning which spins like a spin brush and we use the coarse toothpaste to clean all teeth. Then a fluoride application is done. 

A dental hygienist will begin your child’s cleaning by exploring the surface of the teeth to determine if there are any cavities, and to examine the quality of existing fillings. The hygienist will also perform a periodontal exam to make sure your son or daughter’s gums adhere tightly to the teeth, and no periodontal disease or bone loss is present.

Next, the hygienist will carefully clean your child’s teeth with a variety of tools to remove any hard mineral buildup (tartar) from the teeth. Then the hygienist will floss your child’s teeth, use a polishing compound, and apply fluoride.

Cleanings usually aren’t painful, but if your little one has any anxiety about the dental exam, be sure to let us know. 

If the dentist or hygienist finds tooth decay or gum disease, we will talk to you about changing your child’s brushing or flossing habits. In severe cases, we may recommend antibiotics or other dental treatments. If the child’s teeth and gums appear to be healthy, Dr. Iyer will probably recommend that the patient continue his or her brushing and flossing routine as usual.

Fluoride is a naturally occuring element in nature. Fluoride is naturally present at low concentration in most fresh and saltwater sources and may also be present in rainwater. Drinking water fluoridation at a level between 0.7-1.2 mg/L is widely practiced in the United States to prevent cavities on teeth.

Fluoride prevents cavities on teeth when consumed in drinking water at 1PPM or topical application at the dentist’s office or by using toothpaste and mouth rinses. Fluoride is also added to other consumed food. 

We offer Fluoride treatment in the office with cleanings and a routine 6 month appointment.

The American Academy of Pediatric Dentistry (AAPD) recognizes nitrous oxide/oxygen inhalation as a safe and effective technique to reduce anxiety. 

Nitrous oxide is a colorless and virtually odorless gas with a faint, sweet smell. Nitrous oxide generally is acceptable to children and can be titrated easily. Most children are enthusiastic about the administration of nitrous oxide/oxygen; many children report feeling a tingling or warm sensation.

We offer laughing gas options to get dental fillings extractions and other dental work in safe effective way.

Nitrous oxide, or laughing gas, is the most frequently used method for easing mild-to-moderate anxiety in children. Administered through a small mask that fits over your child’s nose, it is an effective way to calm anxiety.

Your little one will be asked to breathe through his or her nose and not through the mouth. As the gas begins to work, your youngster will become calm, although he or she will still be awake and able to talk with the dentist.

At the end of your child’s appointment, he or she will resume breathing regular oxygen, and all the effects of nitrous oxide will disappear. As your son or daughter gets older and becomes more comfortable during dental visits, nitrous oxide may not be necessary.

Composite resins, or tooth-colored fillings, provide good durability and resistance to fracture in small- to mid-size fillings that need to withstand moderate pressure from the constant stress of chewing. They can be used on either front or back teeth. They are a good choice for people who prefer that their fillings look more natural.

Composites cost more than amalgam and occasionally are not covered by some insurance plans. Also, no dental filling lasts forever. Some studies show that composite fillings can be less durable and need to be replaced more often than amalgam fillings.

It generally takes longer to place a composite filling than it does for a metal filling. That’s because composite fillings require the tooth be kept clean and dry while the cavity is being filled. Tooth-colored fillings are now used more often than amalgam or gold fillings, probably due to cosmetics. In a society focused on a white, bright smile, people tend to want fillings that blend with the natural color of their teeth.

Ultimately, the best dental filling is no dental filling. Prevention is the best medicine. You can dramatically decrease your risk of cavities and other dental diseases simply by:

brushing your teeth twice a day with fluoride toothpaste
flossing daily
eating a balanced diet
visiting the dentist regularly.

When a baby tooth is extensively decayed and using other filling materials isn’t likely to be successful, the American Academy of Pediatric Dentistry (AAPD) recommends restoring the tooth with a stainless steel crown especially if the tooth has received pulpal therapy. After removing the decay, your dentist will fit and cement a prefabricated crown made of stainless steel over the tooth. Here are some advantages of stainless steel crowns:

Durable but inexpensive
Full coverage protection for the tooth
Very little sensitivity
Less likely to need retreatment
More successful than metal fillings in children under four years old
Good choice for children who need general anesthesia
Often used as an attachment for a space maintainer
If the pulp of the tooth is involved, the dentist may also need to perform pulpal therapy before placing the crown. But rest assured it is quite common, even for young permanent teeth.

Inside every tooth, in every person, is a material known as pulp. While the enamel and dentin on the outer layers of the teeth are tough and lifeless, the pulp inside is soft, living and very sensitive. When the outer layers of the tooth are damaged, it is possible for the pulp inside to become infected. In some cases, the best option for saving the tooth is a procedure known as a pulpectomy or pulpotomy.

What Happens During Treatment?
The simplest explanation of the procedure is that it removes infected or diseased pulp from the tooth. The goal of the treatment is save the tooth so that it doesn’t have to be pulled. A pulpectomy is similar to a root canal, and is actually typically a part of the root canal process. After a dentist or endodontist removes the damaged pulp from the tooth, the area inside the tooth is disinfected and then filled with an inert material.

Who Is the Treatment for?
Often, a pulpectomy is performed on children who still have their baby or deciduous teeth. The roots of baby teeth are somewhat different from the roots of permanent teeth. Usually, baby teeth have shorter roots that are meant to be eventually reabsorbed by the body. The reabsorption of the roots allows the teeth to fall out and be replaced by the permanent ones. Since the roots of baby teeth should be reabsorbed, a pulpectomy procedure typically uses a material that can be absorbed to fill in the empty canal area, according to the American Academy of Pediatric Dentistry.

Why Not Just Remove the Teeth?
A common assumption about the baby teeth is that since they are going to fall out eventually, there’s no reason to save them. It can be difficult for people to understand why a procedure should be performed on a tooth that’s just going to fall out.

The primary teeth play a role that goes beyond simply waiting for the permanent teeth to erupt. Along with helping your child eat and speak, the primary teeth also preserve space in the mouth for the permanent teeth. If one or more primary teeth are removed before the permanent teeth are ready to grow in, a child may develop problems with the alignment of his or her teeth.

That’s not to say that removing and restoring the pulp is always the right treatment. In some cases, extracting the tooth is the appropriate option. It all depends on whether the permanent tooth is ready to come in and replace the damaged baby tooth, how damaged the baby tooth is and how deep the infection is.

Can You Avoid a Pulpectomy?
If the idea of having your child undergo an intense dental procedure doesn’t sit well with you, there are ways to reduce the risk for damage or infection in the pulp. Encouraging good dental care habits in your kids, starting at a very young age, will help protect their teeth and reduce the risk for decay or infection. The American Dental Association notes that starting good oral care habits early will help keep kids’ teeth and mouths healthy for many years to come.

Helping your child brush his or her teeth twice a day with a fluoride toothpaste will reduce the chance of the primary teeth developing cavities and decay, and lower the risk for infection in the pulp. If you’re having trouble getting your kids excited about brushing, encourage them to choose their own toothbrushes, such as ones with SpongeBob SquarePants or another fun character on them. This product is specifically designed for kids, with developing teeth.

Regular dental visits are also a must. The more frequently your child sees a dentist, the sooner the dentist is able to spot early signs of decay and prescribe treatment before it evolves into a serious condition. 

When baby teeth are lost prematurely or permanent teeth are late in erupting, dentists may recommend space maintainers to support the child’s mouth until the gaps are filled with permanent teeth.

Why Maintainers Are Needed
Children lose baby teeth earlier than expected for several reasons. Some experience trauma to the mouth, such as from accidents like tripping or getting whacked in the mouth by a ball. Others develop early childhood cavities, known as “baby bottle tooth decay.” This often happens when babies fall asleep at either breast or bottle, or walk around with a bottle for extended periods of time. The sugar content in the milk causes enamel to decay, which may result in tooth loss. Occasionally, some primary teeth may be absent because of a genetic condition. It’s unusual for children to suffer from oral infections severe enough to cause tooth loss, although it’s not impossible.

When to Consider Space Maintainers
Regardless of why a child has missing primary teeth, it’s important to consider space maintainers to ensure he or she develops permanent teeth in correct locations. If one primary tooth is missing for more than a short period, the child risks other teeth becoming loose because they aren’t properly supported. When this happens, the loose teeth can move into the spaces intended for other teeth. This affects permanent teeth when they erupt by guiding them into incorrect positions. If your child loses primary teeth to make way shortly for permanent ones, it might not be necessary to fit maintainers. If permanent teeth are some time away, however, consult with your dentist to determine whether maintainers are a suitable option.

Types of Appliances
Space maintainers come in two types: removable and fixed. Removable devices are made of acrylic and use artificial teeth or blocks of dental material to hold open the spaces. This device works better in an older child, who can remove the appliance to clean and care for it. Partial dentures are suitable removable maintainers for children with several missing teeth.

Fixed maintainers are attached with dental cement to teeth beside the gap. These are more suitable for young children or those who have lost a back tooth. Unilateral maintainers are fixed on one side, while bilateral appliances are fixed on both sides. They can be fitted on the upper or lower jaw to maintain space for front or back teeth. The device your dentist recommends depends on the number and location of missing teeth.

Band-and-loop device. Composed of stainless steel wire, it is held in place by orthodontic bands that allow the permanent tooth to erupt without blocking it. It is used when one or more baby molars are lost in one dental arch.
Lingual holding arch. This is used to maintain space for lower back teeth on both sides.
Transpalatal arch. A transpalatal arch is fitted on the upper jaw to preserve space on both sides of the dental arch and held in place by wire fastened around the adjoining teeth.

These appliances are custom-made to fit each child. In most instances, the dentist takes impressions of the patient’s mouth, which are sent to a dental laboratory to manufacture the device. Space maintainers are typically made from acrylic, with loops or bands made from stainless steel wires to hold them in position.

Oral Care for Appliances
It takes time for a child to adapt to wearing a device. During this time the dentist keeps an eye on oral hygiene, jaw growth and progression of the permanent teeth. The maintainer needs adjustment periodically and requires immediate attention if it gets damaged.

The child will have to brush daily with a fluoride-based product like Colgate Kids Cavity Protection toothpaste, which is extra gentle on tooth enamel and comes in a fun bubble fruit flavor that kids will love. He or she will need to avoid chewing gum, biting hard candy and fruits, and pushing or pulling the device with fingers or other objects.

Mouth Guards for Sports
Whether you are a weekend warrior soccer fanatic or your kids just joined the hockey team, protecting your family’s teeth from injury is critical. Most mouth-related sports injuries involve broken or chipped teeth (most often the central incisors), fractured tooth roots and cuts to the lips and tissue inside of the mouth. But the risk of a sports injury is greatly reduced when wearing a well-fitting mouth guard. The soft absorbing material that they are made from helps cushion any hits to the face or teeth. According to the Academy of General Dentistry, a custom-made mouth guard may even protect against a concussion.

If you or your child has braces, you are especially vulnerable to soft tissue injuries from the impact on a mouth full of metal. A mouth injury can also cause damage to your orthodontics if you aren’t wearing a mouth guard made to fit over braces. This type of guard is designed to be a bit wider to provide protection for your braces as well as your teeth and gums.

Most athletic mouth guards are designed to protect the upper teeth, but some sports require a mouth guard for both the upper and lower arches. Always check with a coach or league referee to determine their requirements before making your dental appointment. You will also find that guards made for sports activities usually need to be replaced after each season since wear and tear can make them less effective over time. Because the mouths and teeth of children and teens are still growing, more frequent replacements may be necessary for your child’s sports guard.

It’s always a good idea to have your dentist take a look at your mouth guard during your six-month checkup to evaluate if the guard is still fitting properly, effective or in need of a replacement. Your mouth guard is just as important as any other piece of athletic equipment.

What Is It?

Tooth extraction is the removal of a tooth from its socket in the bone.

What It’s Used For

If a tooth has been broken or damaged by decay, your dentist will try to fix it with a filling, crown or other treatment. Sometimes, though, there’s too much damage for the tooth to be repaired. In this case, the tooth needs to be extracted. A very loose tooth also will require extraction if it can’t be saved, even with bone replacement surgery (bone graft).

Here are other reasons:

Some people have extra teeth that block other teeth from coming in.

Sometimes baby teeth don’t fall out in time to allow the permanent teeth to come in.

People getting braces may need teeth extracted to create room for the teeth that are being moved into place.

We recognize that some of our young patients may feel anxious or apprehensive about receiving dental care. Dr. Iyer and our staff work hard to make sure your child has a comfortable, positive experience.

That’s why we are pleased to offer IV sedation dentistry to patients who need a little extra comfort before receiving treatment. Feeling anxious about receiving dental care should never prevent obtaining a beautiful, healthy smile.

Our office is proud to offer customized IV sedation dentistry that is safe and effective.
There are different types of sedation dentistry, and working together, you and our team will decide on a personalized treatment plan that will give your son or daughter the necessary care while ensuring comfort every step of the way.

Using sedation dentistry, we are able to complete many different procedures, including complex smile makeovers, during a single office visit.

Common questions about IV sedation dentistry
We understand that before receiving treatment, you may have many questions about IV sedation dentistry. Here are some of the most common questions and answers about it.

Is IV sedation dentistry safe?
IV sedation dentistry is a safe and effective way for many patients to receive dental treatment. Before starting treatment with IV sedation, Dr. Iyer will talk with you to help you decide if IV sedation is right for your child’s treatment.

How long will it take the sedation to wear off?
The time it takes for the sedatives to wear off depends on the dose received, how long the treatment is, and how quick your little one’s body can recover.

Is my child a good candidate for IV sedation dentistry?
Any patients who experience dental anxiety are good candidates for IV sedation dentistry. If your child has any of the following fears or concerns, ask us about IV sedation dentistry as an option for his or her next dental treatment:

Extreme dental anxiety or fear of visiting the dentist
Fear of needles and/or shots
Past traumatic dental experience
Can’t handle the smells or noises of being at a dentist’s office
Has overly sensitive teeth, a strong gag reflex, or trouble getting numb
Requires a more complex dental treatment
Wishes to have a more comfortable dental treatment
If you feel that your son or daughter could benefit from IV sedation dentistry, please contact us and let us know how we can better accommodate your family’s needs.å

PEDIATRIC HOSPITAL DENTISTRY
If your child cannot receive dental care in a traditional dental office, our practice offers gentle and effective dental care to infants, children, teens, adolescents, and those with special needs in the nurturing environment of our local hospital.

One of the only pediatric dentists in the area to offer this unique service, Dr. Iyer has the distinctive ability to understand the specific needs of children who need dental care but cannot cooperate for safe dental treatment. Through hospital dentistry, you can eliminate the struggles and trauma that can lead to a lifetime fear of dental treatment for your child.

Is hospital dentistry right for my child?
Pediatric hospital dentistry services are ideal for:

Physically, emotionally, or developmentally challenged children who are unable to hold still for dental treatment
Children who have a severe gag reflex
Children with complex medical conditions that make it unsafe to receive dental care in an office situation
Children who have allergies to local anesthetics or experience difficulty achieving numbness
For these situations, the use of general anesthesia may be the best option for your family.

General Anesthesia
General anesthesia will put your son or daughter into a deep sleep. He or she will be unable to feel pain or move around. General anesthesia for dental procedures can be provided by an anesthesiologist or dental anesthesiologist. These professionals are trained to deliver medication, monitor the patient during the procedure, and handle any complications that may occur.

A new cavity fighting liquid…

This may be an option for some who are hoping to avoid the dentist’s drill!

Silver Diamine Fluoride is a liquid that can be used to halt the progression of cavities. This is especially helpful in small children who are not mature enough to handle routine restorative care.

This liquid takes less than 1 minute to apply with no noise, no drilling, and at the same time it kills the bacteria that cause decay.

For more information talk to us at your next visit. We are always happy to help!