Treatment

Services

Digital Records/Charts
Oral Exams
Consultations
Infant Oral Exams
Comprehensive dental care for special needs children
Lowest radiation digital dental x-rays
Intraoral digital camera images
Thorough cleanings
Brushing & Flossing Instructions
Nutritional Counseling & Guidance
Fluoride Treatment
Sealants
Whitening
Sports Guards

Dental Restorations

Aesthetic tooth colored filling
All white Zirconia crowns
Stainless steel crowns
Replacement of missing teeth Early Orthodontic Treatment
Monitoring of Growth & Development
Tooth Eruption Guidance
Cross-bite correction
Limited tooth movement
Thumb/Finger habit appliances
Orthodontic extractions
Space Maintenance Emergency Dental Care
Treatment of traumatic dental injuries
Extractions
Laser Dentistry
Newborn Frenectomies
Gingivectomies
Tooth Exposure for orthodontics

Sedation Dentistry

In-office oral sedation
Nitrous Oxide
Day Surgery/General Anesthesia

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 non-addictive. 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. This includes prescribed, over-the-counter, or herbal medications.
To avoid an upset stomach, it is best not to feed your child a large meal right before the apt.
Limit strenuous activities for the rest of the day.
Avoid foods that are hot and may burn the mouth (ex. Pizza) until numbing has warn off.
Give Tylenol or Motrin for discomfort.

Oral Sedation

Oral Sedation is recommended for apprehensive children, very young children, and children with special needs. 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. 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 (prescribed, over-the-counter, or herbal medications) and any drug reactions and/or change in medical history.
Please dress your child in loose fitting, comfortable clothing.
Do not bring other children to this appointment. Your child will need your undivided attention.
Please make sure that your child goes to the bathroom immediately prior to receiving treatment.
Your child must not have anything to eat or drink after midnight the evening before their 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.
Give Tylenol or Motrin for discomfort.
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. (936) 559-7200

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Day Surgery/General Anesthesia

General Anesthesia is recommended for apprehensive children, very young children, children with extensive decay, and children with special needs that would not work well under conscious sedation. The dentist performs the dental treatment at the Nacogdoches Memorial Hospital or the Surgery Center with the child anesthetized under general anesthesia, which is administered and monitored by an anesthesiologist.

Prior to your appointment:

Please notify us of any changes 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.
Make arrangements for childcare for your younger children.
You must tell the doctor of any drugs that your child is currently taking (prescribed, over-the-counter, or herbal medications) and any drug reactions and/or change in medical history.
Please dress your child in loose fitting, comfortable clothing.
Your child must not have anything to eat or drink after midnight the evening before their appointment.
The child’s parent or legal guardian must remain in the waiting room until the procedure is complete.
Bring entertainment for your child – surgeries are performed based on age – you may have a 2-3 hour wait.

After the day surgery 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 eaily 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.
Give Tylenol or Motrin for discomfort
Use prescribed mouth rinse for 2 weeks post-surgery.

Post-Operative Care

Care of the Mouth After Local Anesthetic

If the procedure was in the lower jaw the tongue, teeth, lip and surrounding tissue will be numb or asleep.
If the procedure was in the upper jaw the teeth, lip and surrounding tissue will be numb or asleep.
Often, children do not understand the effects of local anesthesia, and may chew, scratch, suck, or play with the numb lip, tongue, or cheek. These actions can cause minor irritations or they can be severe enough to cause swelling and abrasions to the tissue.
Monitor your child closely for approximately two hours following the appointment. It is often wise to keep your child on a liquid or soft diet until the anesthetic has worn off. Please do not hesitate to call the office if there are any questions.

Care of the Mouth After Trauma

Please keep the traumatized area as-clean-as possible. A soft wash cloth often works well during healing to aid the process.
Watch for darkening of traumatized teeth. This could be an indication of a dying nerve (pulp).
If the swelling should re-occur, our office needs to see the patient as-soon-as possible. Ice should be administered during the first 24 hours to keep the swelling to a minimum.
Watch for infection (gum boils) in the area of trauma. If infection is noticed - call the office so the patient can be seen as-soon-as possible.
Maintain a soft diet for two to three days, or until the child feels comfortable eating normally again.
Avoid sweets or foods that are extremely hot or cold.
If antibiotics or pain medicines are prescribed, be sure to follow the prescription as directed.

Please do not hesitate to call the office if there are any questions.

Care of the Mouth After Extractions

Do not scratch , chew, suck, or rub the lips, tongue, or cheek while they feel numb or asleep. The child should be watched closely so he/she does not injure his/her lip, tongue, or cheek before the anesthesia wears off.
Do not rinse the mouth for several hours.
Do not spit excessively.
Do not drink a carbonated beverage (Coke, Sprite, etc.) for the remainder of the day.
Do not drink through a straw.
Keep fingers and tongue away from the extraction area.

Bleeding - Some bleeding is to be expected. If unusual or sustained bleeding occurs, place cotton gauze firmly over the extraction area and bite down or hold in place for fifteen minutes. This can also be accomplished with a tea bag. Repeat if necessary.

Maintain a soft diet for a day or two, or until the child feels comfortable eating normally again.
Avoid strenuous exercise or physical activity for several hours after the extraction.

Pain - For discomfort use Children's Tylenol, Advil, or Motrin as directed for the age of the child. If a medicine was prescribed, then follow the directions on the bottle.

Please do not hesitate to call the office if there are any questions.

Care of Sealants

By forming a thin covering over the pits and fissures, sealants keep out plaque and food, thus decreasing the risk of decay. Since, the covering is only over the biting surface of the tooth, areas on the side and between teeth cannot be coated with the sealant. Good oral hygiene and nutrition are still very important in preventing decay next to these sealants or in areas unable to be covered.

Your child should refrain from eating ice or hard candy, which tend to fracture the sealant. Regular dental appointments are recommended in order for your child's dentist to be certain the sealants remain in place.

The American Dental Association recognizes that sealants can play an important role in the prevention of tooth decay. When properly applied and maintained, they can successfully protect the chewing surfaces of your child's teeth. A total prevention program includes regular visits to the dentist, the use of fluoride, daily brushing and flossing, and limiting the number of times sugar-rich foods are eaten. If these measures are followed and sealants are used on the child's teeth, the risk of decay can be reduced or may even be eliminated!

Oral Discomfort After a Cleaning

A thorough cleaning unavoidably produces some bleeding and swelling and may cause some tenderness or discomfort. This is not due to a "rough cleaning" but, to tender and inflamed gums from insufficient oral hygiene. We recommend the following for 2-3 days after cleaning was performed:

A warm salt water rinse 2-3 times per day. (1 teaspoon of salt in 1 cup of warm water)
For discomfort use Children's Tylenol, Advil or Motrin as directed by the age of the child.

Please do not hesitate to contact the office if the discomfort persists for more than 7 days or if there are any questions.

Post Fluoride Varnish

Your child should refrain from eating ice or hard candy, anything really sticky or chewy. Your child doesn't have to brush their teeth the night of getting fluoride varnish, but can resume normal brushing habits the next morning.

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