Pediatric restorative dentistry

Skip ahead to “the after”

Services for kid smile makeovers

Dr. Laura Juntgen (rhymes with “dungeon”) and her team correct and transform the smiles of toddlers, children, teens, and young adults using modern technologies, advanced pediatric restorative dentistry techniques, and proven minimally invasive treatments, including:

• Pediatric cavity fillings
• Pulp therapy
• Crowns
• Atraumatic restorative treatments

Pediatric cavity fillings

The purpose of pediatric cavity fillings is to restore normal function by replacing the decayed portion of the tooth. If Dr. Juntgen identifies a cavity starting to take shape, she will evaluate the tooth and then recommend a filling using the best material for your child’s needs. She is happy to discuss the advantages and disadvantages of each material so you’ll feel informed and confident in your decision-making.

Our pediatric dentist office offers two types of pediatric cavity fillings: 

• Composite
• Glass ionomer

Composite (white) fillings

Dr. Juntgen may suggest a composite filling for a more natural finish. These pediatric cavity fillings match the color of children’s teeth and are mercury-free, making them an excellent choice for baby and adult teeth.

Another advantage of composite material for fillings is its bonding strength, which allows us to restore a tooth by placing a smaller, more conservative filling. 

Glass ionomer fillings

For our younger patients, we may recommend a glass ionomer filling. These fillings chemically bond to the tooth and continuously release fluoride, allowing them to help prevent future decay. They are more easily placed and less sensitive to moisture but aren’t as strong and long-lasting as composite. 

Glass ionomer may also be used on adult teeth as a temporary filling when sensitivity or gum tissue prevents the placement of a composite filling.

Pulp therapy

Sometimes, a tooth infection reaches inside the tooth (pulp), affecting its nerve and blood vessels. If left untreated, this can cause severe pain, inflammation, and even tooth loss. Thanks to advancements in pediatric restorative dentistry, we can use pulp therapy to treat, restore, and save some infected baby teeth. 

As always, we start care conservatively. Dr. Juntgen may begin by removing decay and applying medication directly to the nerve. This helps relieve pain and evaluate the effectiveness of treatment and the tooth’s health. She uses dental X-rays at follow-up visits to see how the tooth is healing and determine if further care is required.

If the decay is extensive, Dr. Juntgen may need to remove diseased or damaged pulp tissue from the part of the tooth above the gums (for a pulpotomy) or its roots (for a pulpectomy). She does this to prepare a child’s baby tooth for a crown that, when placed overtop, will protect it and help return its functionality until the permanent adult tooth erupts.

Crowns

Crowns are placed when cavities are very large, and a significant amount of the tooth must be removed. Dr. Juntgen may recommend a crown for your child after pulp therapy or when an injury results in substantial tooth loss. We offer two types of crowns: composite and stainless steel.

Composite (white or tooth-colored) crowns

Composite crowns—made from the same material as white-colored fillings—are used to treat front teeth. They are very aesthetically pleasing but more prone to staining and fracture. Dr. Juntgen’s composite crown placement technique is complex and requires your child to remain very still.

Stainless steel (silver) crowns

Stainless steel crowns, used to treat back teeth, are very durable and often remain in place until the baby tooth is lost. 

Our silver crowns for kids come in various sizes and can often be placed in a single visit. For high-risk and cavity-prone children, Dr. Juntgen may recommend a stainless steel crown instead of a filling. A crown covers the entire tooth’s surface and offers better long-term protection against future decay.

Atraumatic restorative treatments (ART)

For some kids with cavities, Dr. Juntgen may recommend a painless, minimally invasive procedure called atraumatic restorative treatment. Using this in-office technique, which doesn’t usually require anesthesia, she gently removes decay from the affected portion of a child’s tooth. Then she restores it with a resin-modified glass ionomer filling or stainless steel crown.

A cost-effective and time-saving variation of this technique—called a silver-modified atraumatic restorative treatment (SMART)—works well for children who are very anxious about dental work, have special needs, or find sitting still challenging because it’s more comfortable. Usually done in just a few minutes, it involves Dr. Juntgen applying an antimicrobial liquid, known as silver diamine fluoride (SDF), to the child’s tooth to stop a cavity from growing and re-mineralize it before a glass ionomer filling or stainless steel crown is placed.

Aftercare instructions

Watch your child closely throughout the healing process, paying special attention to them until the anesthetic’s effects wear off.

• Monitoring: For the first one to two hours after the appointment, you may need to remind your child to avoid biting, pinching, scratching, or sucking while their mouth is still numb so they don’t unknowingly hurt their tongue, inner cheeks, or lips. If bleeding resumes, have them bite on a damp towel.
• Medication: If needed, give your child over-the-counter pain medication (such as Tylenol or ibuprofen) during the first one to two days after their procedure. Follow the instructions on the package for appropriate dosing.
• Snacks & meals:  If possible, wait one to two hours before allowing your child to eat. If they’re hungry and can’t wait until the anesthetic goes away, only give them a soft snack that doesn’t require chewing (such as a milkshake, smoothie, yogurt, applesauce, or soup) while their mouth is numb. Once your child’s numbness has subsided, it’s okay for them to resume normal eating.
  • To avoid the loss of a tooth after receiving a crown, your child must avoid eating sticky foods (including fruit snacks, dried fruits, caramels, gummy bears, Starbursts, suckers, and Jolly Ranchers).
• Oral health: After the numbness passes, it’s okay for your child to resume regular brushing and flossing.