Preventative Treatment:
The dentist will provide a thorough examination following a routine cleaning appointment. The doctor will strive to bond with your child to achieve a lasting relationship with him or her. The exam will include exploration of the child’s mouth and gums and a discussion regarding at-home dental hygiene. If the child’s teeth exhibit decay or other problems requiring further treatment, the dentist will discuss them with you at this time. If needed, an appointment will be set for a later date.
According to the American Academy of Pediatrics, every child should see a dentist by the time they get their first tooth. The first dental visit should take place no later than the child’s first birthday. Helping your child get into the habit of regular dental visits early in life will set positive dental habits that will extend into adulthood. Routine dental cleanings and exams are necessary to help ensure that your child maintains a healthy mouth and good oral hygiene. Although care at home is also important, professional dental cleanings will help remove plaque build-up that can occur despite the best brushing and flossing methods.
During a routine check-up, the teeth of your child will be polished to remove any plaque build-up or tartar. Your child will be given a fun toothpaste flavor and allowed to watch a kid-friendly movie during the entire cleaning process. Our staff will also spend time going over the dietary needs of your child along with daily brushing and flossing routines. We will also give tips on how to properly brush and floss and what foods are best to eat.
Fluoride treatments at our office consist of a sticky varnish. This varnish adheres to the child’s teeth to prevent unnecessary ingestion. Fluoride treatments are generally applied at the end of each visit. They may be recommended more often if your child is especially prone to cavities. Your child is permitted to eat and drink immediately after a fluoride treatment, but you will need to avoid hard or sticky substances for four to six hours after the treatment. Fluoride is commonly used to keep children’s teeth healthy, strong and cavity-free. The dentist may discuss supplemental fluoride intake with you from sources such as fluoridated water, toothpaste and mouth-rinses.
We are strongly committed to prevention and desires to help all patients grow up cavity-free. We strongly recommend sealing your child’s teeth. The application of a sealant is one of the easiest and most effective methods available today to prevent tooth decay. Dental sealants provide a barrier to protect against cavities and can be applied to baby molars, adult premolars and posterior molars. These sealants should be applied as early as possible to help prevent the formation of cavities. Chewing surfaces are the most likely places to develop cavities because toothbrush bristles are often unable to reach into the grooves of the teeth. Sealants help preserve these vulnerable areas by protecting them from food contact and the formation of plaque. Dental sealants cost less than traditional cavity fillings and usually last for several years before needing a re-application.
When your child begins playing sports such as hockey, football and basketball, you should invest in a high-quality sports mouth guard. Sports mouth guards are responsible for protecting your child’s adult teeth from fractures caused by trauma. While you can purchase over-the-counter sports mouth guards, a custom-made mouth guard will provide superior protection to your child’s mouth. Ask our office about a custom-made mouth guard for your child.
Operative Treatment:
Because the safety of our patients is our #1 concern, we use BPA-free composite fillings. These white fillings are safe for children and aesthetically appealing.
Stainless steel or White Zirconia crowns are sometimes recommended for children following a baby root canal or if a back baby tooth suffers from severe trauma or cavities. Because most baby molars do not fall out until the ages of 10-12, these crowns are recommended when traditional fillings are insufficient to protect the tooth from further damage until it falls out on its own. The differences between stainless steel and white crowns are mostly color preference. The pros and cons of each type of crown will be discussed with you to help you make a good decision for your child.
A cavity involving the nerve, or pulp, of a tooth may cause excruciating pain for your child. Although the pain may be manageable using painkillers such as ibuprofen, it will keep recurring until the underlying problem is resolved. When the nerve of a child’s tooth has been infected, it must be treated to restore health to the child’s mouth.
Pediatric root canal therapy is designed to maintain the integrity of the affected tooth to prevent premature loss. The early loss of posterior (back) teeth can lead to future problems with the placement and eruption of adult teeth. To avoid the difficulties inherent with crooked or impacted adult teeth, proper root canal treatment is needed to avoid the premature loss of primary molars. Dental caries and traumatic injury are the primary reasons for pulp therapy in children. Due to the loss of tooth structure involved in teeth requiring pediatric root canal therapy, full coverage restoration such as a pediatric crown is necessary.
A damaged front tooth sometimes requires a cosmetic filling. Fractured permanent teeth are common injuries in adolescent children and may require a simple bonding procedure similar to a filling. With a bonding procedure, however, there is no decayed matter removed during the process.
Extractions are commonly performed on pediatric patients to address extensively decayed non-restorable teeth or orthodontic problems. To help make the procedure as comfortable as possible for your child, we may recommend the inhalation of nitrous oxide (laughing gas) and a local anesthetic.
Oral Appliances:
If a baby tooth is lost prematurely, the dentist may recommend a space retainer to preserve the gap for the adult tooth. Space retainers help prevent shifting of the teeth and the crowding of adult teeth.
If your child has a habit of sucking the thumb, fingers, pacifiers, lips or tongue, he or she may be causing unconscious damage to the oral structure of the mouth. Abnormalities include an improperly shaped mouth, protruding teeth and bite shifting. Traditional counseling methods and positive reinforcement strategies are commonly used to combat these problems, but they are not always successful. Our dental office offers many types of custom-designed oral appliances that can help your child stop these harmful habits when traditional methods fail to work. We will never make your child feel bad or embarrassed by his or her habit. Instead, we will offer positive encouragement to help your child feel empowered and in control. These motivations will help your child want to stop the harmful habit.
It’s never too early to keep an eye on your child’s oral development. The dentists can identify malocclusion (crowded or crooked teeth) or bite problems and actively intervene to guide the teeth as they emerge in the mouth. Interceptive orthodontic treatment can prevent more extensive treatment later. The dentist checks the progress of your child’s bite and jaw development with routine dental examinations. This early assessment of your child’s teeth may prevent extensive orthodontic work in his/her future.
Emergency Treatment:
If your child is experiencing a true dental emergency, We can be reached at 305-834-7575. We are available to handle emergency situations for our patients 24/7. If your child appears to be suffering from injuries that extend beyond the mouth, call 911 or take your child to the emergency room.
If your child has a toothache, clean the affected area with a toothbrush and toothpaste. Rinse the mouth vigorously with warm water and use dental floss in the surrounding areas. If your child needs a pain reliever, administer Tylenol or Motrin according to the package directions. Do not place aspirin on the tooth itself or on the gums. If the face is swollen, apply cold compresses and contact our office immediately. A swollen face could indicate a serious problem requiring immediate attention.
Baby teeth are not reinserted into the gums as this can cause harm to the permanent teeth
Many children sustain facial and dental trauma from sports-related injuries and other accidents such as riding into a stationary object on a bicycle. If your child has sustained an injury, remain calm. If your child has knocked out a permanent tooth, prompt attention is necessary to maintain the life of the tooth. We may be able to treat the injury at our office, although less severe cases may be able to be treated at home until you can find time to come in. If your child is suffering from an injury that goes beyond the extent of the mouth or other oral structures, call 911 or take your child to the emergency room.
If your child’s permanent tooth has been avulsed (knocked out), follow the steps below to attempt to reinsert it.
- Hold the tooth by the crown. Avoid touching the root.
- Rinse the tooth with salt water or milk. NOTE: Do not use water to rinse the tooth.
- If the root is intact, try to reinsert the tooth into the socket. If unable to do so, place the tooth in a glass of milk and take it and your child to the dentist immediately.
If your child has knocked out a baby tooth, take him or her to the dentist as soon as possible.
Behavior and Pain Management:
The dentists are committed to providing dental care to your child in the most compassionate and comfortable way possible. Many children are nervous about going to the dentist for the first time and may have unique dental problems that exacerbate their worries. These fears can be easily relieved by using routine strategies, but more advanced techniques are sometimes needed to help the child relax and trust the dentist. Part of pediatric dental training includes early childhood development and childhood psychology. Our staff is well-versed in effective behavioral management techniques. Please feel free to discuss any concerns or behavioral problems with our staff. We encourage open communication between the doctor, the patient and the parent.
This type of sedation is given as an inhalational agent, where the child wears a mask on their nose, which delivers the nitrous oxide. The patient inhales the agent and exhales the agent without processing the agent. This means they breathe it out the same way they breathe it in. This type of sedation is good to use with children who may have slight anxiety, or have limited work that needs to be done.
Nitrous oxide acts to change the nitrogen levels in the body, and creates a slight “happy” feeling in children. It does not put your child to sleep. Once your child is on 100% oxygen, they will have no residual effects. Nitrous oxide is the safest drug that we have in anesthesia and dentistry.
This type of sedation is good to use with children who may have slight anxiety, or have limited work that needs to be done.
General anesthesia is sometimes necessary for children that are unable, by either age or maturity level, to cooperate during dental treatment. These services are provided with a team of our highly skilled doctors as well as a board certified anesthesiologist.
General Anesthesia is most helpful for:
- Children who require major treatment.
- An extremely anxious child, or
- Children who are medically compromised or have special needs.
Our team will discuss all treatment options with you and make recommendations as to what is the best modality to treat your child while keeping them safe and comfortable.
Dr. Landa has hospital privileges at Nicklaus (Miami) Children’s Hospital, Baptist Hospital, and Joe DiMaggio Children’s Hospital.
I.V. Sedation is recommended for apprehensive children, very young children, and children with special needs that would not work well under nitrous oxide. Dr. Landa performs the dental treatment in our office with the child under I.V. sedation, which is administered and monitored by our board certified Pediatric anesthesiologist, Dr. Kimmel. We carefully plan our sedation time to maximize the safety of your child’s treatment. Therefore, sedation takes place once a month when our office is dedicated solely to sedation.
Prior to your appointment:
- Please notify us of any change in your child’s health and/or medical condition. Do not bring your child for treatment with a fever, ear infection or cold. Should your child become ill, contact us to see if it is necessary to postpone the appointment.
- You must tell the doctor of any drugs that your child is currently taking and any drug reactions and/or change in medical history.
- Please dress your child in loose fitting, comfortable clothing.
- Please make sure that your child goes to the bathroom immediately prior to arriving at the office.
- Your child should not have milk or solid food after midnight prior to the scheduled procedure and clear liquids ONLY (water, apple juice, Gatorade) for up to 6 hours prior to the appointment.
- The child’s parent or legal guardian must remain at the office during the complete procedure.
After the sedation appointment:
- Your child will be drowsy and will need to be monitored very closely. Keep your child away from areas of potential harm.
- If your child wants to sleep, place them on their side with their chin up. Wake your child every hour and encourage them to have something to drink in order to prevent dehydration. At first it is best to give your child sips of clear liquids to prevent nausea. The first meal should be light and easily digestible.
- If your child vomits, help them bend over and turn their head to the side to insure that they do not inhale the vomit.
- Please call our office for any questions or concerns that you might have.
Orthodontics
Having orthodontic treatment in childhood is ideal in order to take advantage of a youngster’s natural growth processes to help move the teeth into proper alignment. Like the rest of the body, the teeth and jaws are now changing rapidly. So at this time it’s possible (for example) to create more room for teeth in a crowded mouth by using a “palatal expander” to rapidly widen the upper jaw. This phase of growth modification can shorten overall treatment time and ensure the best result if additional orthodontic appliances are needed.
Adult Orthodontics
But remember, healthy teeth can be moved at any age, so you’ve never “missed the boat” for orthodontic treatment. In fact, about one in five of today’s orthodontic patients is an adult. Several new technological developments — including tooth-colored ceramic braces, clear aligners and invisible lingual braces — have made orthodontic appliances less evident, and enhanced the treatment experience for grown-ups. Before treatment, adults are carefully examined for signs of periodontal (gum) disease, which will be brought under control before treatment begins.
When you imagine someone wearing braces, you probably picture small metal brackets bonded to the front of the teeth, with a thin wire running through them. This time-tested style remains very popular — but it’s no longer the only option. Clear braces use brackets made of ceramic or plastic which, except for the slim archwire, are hardly visible. Lingual braces are just like traditional metal braces — except they’re bonded to the back of your teeth (the tongue side) so that no one can see them.
Removable clear aligners are an alternative to fixed orthodontic appliances. They consist of a series of clear plastic “trays” that fit over your teeth exactly; each one moves your teeth a little bit, until they are in the proper position. Whether fixed or removable, each type of appliance may have advantages or disadvantages in particular situations. After a complete examination, the best treatment options for you will be discussed.
Once your orthodontic treatment is completed, it’s extremely important to wear a retainer as directed. That’s because teeth naturally tend to drift back to their original locations — which is the last thing you want after you’ve gone to the trouble of straightening them! Wearing a retainer holds your teeth in their new position long enough for new bone and ligament to re-form around them, and helps keep your gorgeous new smile looking good for a lifetime.
Orthodontic treatment can resolve a number of bite problems, which often become evident by around age 7. These include underbite, crossbite or excessive overbite, where upper and lower teeth don’t close in the proper position; open bite, where a space remains between top and bottom teeth when the jaws are closed; and crowding or excessive spacing, where teeth are spaced too close together or too far apart.
To correct bite problems, teeth need to be moved — but doing that isn’t as hard as you might think! Teeth aren’t fixed rigidly in their supporting bone; instead, they’re held in place by a hammock-like structure called the periodontal ligament, which is very responsive to forces placed on the teeth. Orthodontic appliances move teeth by careful application of light, constant pressure. This force can be applied via metal wires that run through small brackets attached to the teeth (braces), or via the semi-rigid plastic of clear aligners.
Laser
A dental laser generates a beam of concentrated light. The beam of light brings energy into your child’s mouth to help us remove areas tissue growth or infection with precision and accuracy. The laser beam sterilizes the affected area and seals off blood vessels, which minimizes the chance of infection and bleeding. Laser dental patients are much more comfortable both during and after treatment, because in most instances, the need for anesthetic injections is reduced, as well as the associated side effects. Some cases benefit from nitrous oxide or sedation, but most procedures are simplified with the introduction of the soft tissue laser into the treatment.
Our Dental Laser can:
- Desensitize sensitive teeth
- Remove salivary gland injuries
- Reshape “gummy smiles”
- Frenectomy (frenulum). Lip/Tongue Tie elimination or revision.
- Soft tissue biopsies
- Benign gum overgrowth
- Full crown exposure
- Treat oral ulcers
Soft-Tissue Laster Dentistry Patient Benefits
- Reduces pain and discomfort
- Eliminates or reduces injections of local anesthesia
- Reduces bleeding
- Eliminates need for sutures in most cases
- Reduced in ammation and faster initiation of healing response Reduces post-operative discomfort
- Reduces need for antibiotics post-operatively