Pediatric Services

· Dental Exam –General examination of face, head, neck, teeth, bite, gums and overall dental development. Generally performed once every six months.TOP

· Teeth Cleaning – An office cleaning done every 6 months is important in keeping your child’s gums and teeth healthy. For cleaning we use a special type of toothpaste called prophylaxis paste. This procedure removes deposits (calculus or tartar) and stains on teeth caused by food or certain bacteria. This procedure is non invasive, painless and helps introduce the child to the dental environment. TOP

. Fluoride – Proper concentrations of fluoride on the surface enamel of erupted childhood teeth and adult teeth make the tooth surface more resistant to the development of cavities. Fluoride assists in the recalcification or hardening of the tooth enamel. Topical application of a concentrated fluoride product to the tooth surface can help to significantly reduce the risk of cavities and sensitivity. Application of concentrated topical fluoride is highly recommended at the time of your cleaning. Eating and drinking is prohibited for 30 minutes after fluoride application to maximize the effect. TOP

· X-rays – Dental X-ray examination provides valuable information that your dentist could not collect otherwise. Radiographs pictures can show cavities, cancerous or benign masses, hidden dental structures (such as wisdom teeth), and bone loss that cannot be seen during a visual examination. X-rays pose a far smaller risk than many undetected and untreated dental problems. TOP

· Dental Sealants - Dental sealant is a plastic resin that bonds to the deep grooves in the tooth’s chewing surface. When sealing a tooth, the grooves of your child’s teeth are filled and the tooth surface becomes smoother — and less likely to harbor plaque. With sealants, tooth brushing becomes easier and more effective against tooth decay. Since the sealant is only on the biting surface of the tooth, areas on the side and between teeth are still at risk for decay. Good oral hygiene and nutrition continue to be very important in preventing decay. A total prevention program includes regular visits to the dentist, the use of fluoride, daily brushing and flossing, and limiting the number of sugar-rich foods that are eaten. TOP

· Sport Mouth Guard – A mouth guard protects the teeth and jaw of athletes who might sustain an impact to the head or face while playing sports. A properly fitted mouth guard can help prevent broken teeth and injuries to the lips, tongue, face or jaw. TOP

· Habits Appliance Such as Thumb Sucking – Sucking is a natural reflex for an infant, and it serves an important purpose. Thumb sucking often provides a sense of security and contentment for a young one. After permanent teeth come in, thumb sucking may cause problems with the proper growth of the jaws and alignment of the teeth. It can also cause changes in the roof of the mouth. The intensity of the thumb sucking determines whether or not dental problems may result. If you notice changes in your child’s teeth – appearance or shape, an appliance can be made to discourage the thumb sucking habit. TOP

· Space Maintainer – If a baby tooth is lost prematurely through decay or injury, you may need a space maintainer to “save” the space. If the space is not preserved, the other teeth may drift and begin to fill the empty space. When permanent teeth emerge, there’s not enough room for them and this results in crooked or crowded teeth and difficulties with chewing or speaking. A space maintainer is used to hold the spot left by the lost tooth until the permanent tooth emerges. TOP

· White Fillings – White fillings or composite/resin fillings are mercury-free non-metallic fillings. This is the material of choice used for filling teeth in our office. TOP

· Pulp Treatment (Pulpotomy/Pulpectomy) – The dental pulp is the part in the center of a tooth made up of living connective tissue provides nutrients and nerves to the tooth. When a cavity gets really deep, close to the pulp of a tooth or even into the pulp, the pulpal tissue becomes irritated and inflamed. This is usually the “tooth ache” you feel. If the inflammation and infection continues without treatment, the tooth will likely eventually abscess. In place of removing the tooth, the pulp is treated which allows the tooth to remain in the mouth until the end of its natural life. The procedure involves removal of dead tissue and placement of medicated materials in the root canal. Following this, a stainless steel crown is placed over the tooth to protect the tooth. TOP

· Extractions – When teeth are not salvageable by any treatment or removing tooth has more benefit than keeping it an extraction is performed. This may be due to decay, infection or trauma. Teeth are also extracted to make space for orthodontic treatment. Cautious use of nitrous oxide, topical anesthetic and local anesthetic, allows for extraction in children with minimal discomfort. TOP

· Crowns – A crown completely caps or encircles a tooth. It is necessary when there is extensive decay or abnormal shape due to decay or injury. Crowns improve the strength of teeth. For front teeth a stainless steel crown with white facing is fabricated and for back teeth an all stainless steel crown is used. If you request, for back teeth a crown with white facing can be prepared; however, such a crown is not as durable as one without a white facing. TOP

Patient Management

Nitrous Oxide

Some children are given nitrous oxide/oxygen, or what you may know as laughing gas, to relax them for their dental treatment. Nitrous oxide/oxygen is a blend of two gases, oxygen and nitrous oxide. Nitrous oxide/oxygen is given through a small breathing mask which is placed over the child’s nose, allowing them to relax, but without putting them to sleep. The American Academy of Pediatric Dentistry, recognizes this technique as a very safe, effective technique to use for treating children’s dental needs. The gas is mild, easily taken, then with normal breathing, it is quickly eliminated from the body. It is well tolerated, not addictive, has quick onset, is reversible, can be adjusted in various concentrations, and is non-allergic. While inhaling nitrous oxide/oxygen, your child remains fully conscious and keeps all natural reflexes.

Prior to your appointment:

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 your child is taking any medication on the day of the appointment.

· Papoose Board (Used to Stabilize and Immobilize) – To help keep a child still, we may use the papoose board, which is like a “safety blanket” or “car seat”. It is used for the patient’s own safety. In general, it might be used on young uncooperative immature children and/or special needs patients in order to immobilized and secure them during dental treatment. An assistant may hold your child’s head to prevent movement so Dr. Mina can perform treatment safely and as efficiently as possible. To help keep the mouth open, a “mouth pillow” may be used. In general, these methods are an alternative to using any type of sedation. Prior to using the papoose board, the parent is always informed and consent obtained. It is never used without parent permission. TOP

Conscious Sedation

Conscious Sedation is recommended for apprehensive or pre-cooperative children. It is used to calm your child and to reduce the anxiety or discomfort associated with dental treatments. Your child may be quite drowsy, and may even fall asleep, but they will not become unconscious.

There are a variety of different medications, which can be used for conscious sedation. The doctor will prescribe the medication best suited for your child’s overall health and dental treatment recommendations. We will be happy to answer any questions you might have concerning the specific drugs we plan to give to your child.

Prior to your appointment:

Please notify us of any change in your child’s health and/or medical condition. 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 solid food for at least 6 hours prior to their sedation appointment and only clear liquids for up to 4 hours before the appointment.
The child’s parent or legal guardian must remain at the office during the complete procedure.
Please watch your child closely while the medication is taking effect. Hold them in your lap or keep close to you. Do not let them “run around.”
Your child will act drowsy and may become slightly excited at first.

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.
Because we use local anesthetic to numb your child’s mouth during the procedure, your child may have the tendency to bite or chew their lips, cheeks, and/or tongue and/or rub and scratch their face after treatment. Please observe your child carefully to prevent any injury to these areas.
Please call our office for any questions or concerns that you might have.

In Office General Anesthesia

If your child is unable to tolerate conscious sedation, or has extensive dental treatment needs, Dr. Mina may recommend In Office General Anesthesia. A Pediatric Anesthesiologist is present to administer general anesthesia and monitor your child in our office. These highly trained physicians provide anesthesia to infants and children everyday at Children’s Hospital in Fairfax and the offices of many pediatric dentists. All have subspecialty (fellowship) training in pediatric anesthesia and are board-certified by the American Board of Anesthesiology TOP

Prior to your appointment:

Please notify us of any change in your child’s health and/or medical condition or any illness.
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 general anesthesia 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.

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Outpatient General Anesthesia

Outpatient General Anesthesia is recommended for apprehensive children, very young children, and children with special needs that would not work well under conscious sedation or I.V. sedation. General anesthesia renders your child completely asleep. This would be the same as if he/she was having their tonsils removed, ear tubes, or hernia repaired. This is performed in a hospital or outpatient setting only. While the assumed risks are greater than that of other treatment options, if this is suggested for your child, the benefits of treatment this way have been deemed to outweigh the risks. Most pediatric medical literature places the risk of a serious reaction in the range of 1 in 25,000 to 1 in 200,000, far better than the assumed risk of even driving a car daily. The inherent risks if this is not chosen are multiple appointments, potential for physical restraint to complete treatment and possible emotional and/or physical injury to your child in order to complete their dental treatment. The risks of NO treatment include tooth pain, infection, swelling, the spread of new decay, damage to their developing adult teeth and possible life threatening hospitalization from a dental infection. TOP

Prior to your appointment:

Please notify us of any change in your child’s health and/or medical condition or any illness.
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.
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 hospital or surgical site waiting room during the complete procedure.

After the 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.
Prior to leaving the hospital/outpatient center, you will be given a detailed list of “Post-Op Instructions” and an emergency contact number if needed.

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