Patient management

Conventional Treatment

We offer a fun facility and the expertise and training of our staff and doctor to provide care to our patients. Our staff obtains the cooperation of our child or adolescent patients by using warmth, friendliness, persuasion, humor, charm, gentleness, kindness and understanding. There are several behavior management techniques used by Dr. Galliani and staff during a visit with each patient. These techniques include:

• Tell-Show-Do
• Modeling from other patients
• Positive reinforcement
• Distraction – music, movies
• Helpful tools – mouth pillows, rubber raincoats
• Guessing Games

During our new patient visit, we will explore options that are best for your child.

Nitrous Oxide

Nitrous oxide, commonly known as “laughing gas”, is widely used in pediatric dental offices with children receiving dental care. It is a blend of two gases - nitrous oxide and oxygen. It is delivered via a nasal mask and enters the system through the lungs. The American Academy of Pediatric Dentistry recognizes this as a very safe, effective technique to use for helping children tolerate dental care. It is ideal for use in our office because it is very safe, begins to work rapidly, and is quickly eliminated from the body after a short period of breathing oxygen. Children are not put to sleep when breathing nitrous oxide, they are fully conscious and keep all natural reflexes.

Please note that nitrous oxide is intended to decrease anxiety. As such, it is not always effective in extremely anxious/fearful children. Dr. Galliani will discuss all options with you to help you decide which is most appropriate for your child.

Prior to the use of nitrous oxide:

• 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 you child has had a recent ear infection
• Let us know if your child is taking any medication on the day of the appointment.

Outpatient General Anesthesia

Outpatient General Anesthesia may be indicated for children with extensive dental needs who are extremely uncooperative, fearful or anxious, for the very young who do not understand how to cope in a cooperative fashion or for some special needs patients.

General anesthesia renders your child completely asleep. This would be the same as if he/she was having their tonsils removed, ear tubes placed, or hernia repaired. This is performed in a hospital only. Our staff is happy to answer any questions you may have about treatment under general anesthesia.

Preventative

Dental Exam

The American Academy of Pediatric Dentistry recommends a dental check-up at least twice a year for most children. Some children need more frequent dental visits because of increased risk of tooth decay, unusual growth patterns, or poor oral hygiene. At this visit we will provide a general review of your child’s medical and dental history, general examination of face, head and neck. Your child will receive an examination of teeth, bite, gums, overall dental development and a caries risk assessment.

Teeth Cleaning

An in-office teeth cleaning appointment removes plaque that can irritate the gums and can cause tooth decay. It is generally recommended every 6 months. This procedure removes extrinsic stains on teeth caused by food or certain bacteria and deposits. During this appointment we will review oral hygiene instructions to improve your child's brushing and flossing habits, leading to cleaner teeth and healthier gums.

Digital Radiographs

Dental radiographic examination provides valuable information that your dentist could not collect during the clinical examination. Radiographs pose a far smaller risk than many undetected and untreated dental problems. The frequency of radiographs is determined by your child’s caries risk.

Sealants

A sealant is a protective coating that is generally applied to the chewing surfaces (grooves) of the back teeth (premolars and molars), where four out of five cavities in children are found. This sealant acts as a barrier to food, plaque and acid, thus protecting the decay-prone areas of the teeth. A sealant will decrease the chances of getting a cavity.

Sport Mouth guard

When a child begins to participate in recreational activities and organized sports, injuries can occur. Mouth guards help prevent broken teeth, and injuries to the lips, tongue, face or jaw. A properly fitted mouth guard will stay in place while your child is wearing it, making it easy for them to talk and breathe.

Appliances to discourage habits

The proper growth of the jaws and alignment of the teeth could be affected by the presence of oral habits such as thumb sucking. If other methods have been exhausted an appliance can be made to discourage the habit.

Appliances to correct cross bite

We evaluate your child’s bite and monitor growth and development. Bite problems such as cross bite should be treated early to allow for proper growth of face and jaws. Teeth in incorrect positions undergo abnormal wear and tear compromising appearance and function.

Space Maintainer

Baby teeth hold space for permanent teeth and also act as an eruption guide for permanent teeth. Early loss of primary teeth could cause permanent teeth to drift or erupt into the wrong position. A space maintainer is used to hold the spot left by the lost tooth until the permanent tooth emerges

Restorative/ Treatment of cavities

Treatment of cavities with white fillings

Tooth colored fillings or composite/resin fillings are mercury-free non-metallic fillings. This is the only material used for filling teeth in our office.

Crowns

A crown is necessary when there is extensive decay or abnormal shape due to decay or injury. For front teeth we use composite crowns and for back teeth we use all stainless steel crowns.  A more cosmetic crown can be provided for the back teeth; however, such a crown is not as durable as the stainless steel crown. The stainless steel crown (SSC) on the back molar teeth is used to re-establish normal chewing function and speech development and continues to hold the space until the permanent tooth can take its place. The crown will stay until the tooth naturally falls out. Your child will clean around the base of their crown like they do their natural teeth.

Pulp therapy

Inside each tooth is the pulp which provides nutrients and nerves to the tooth, which runs like a thread down through the root.

Dental caries (cavities) and traumatic injury are the main reasons for a tooth to require pulp therapy. Pulp therapy is often referred to as a "nerve treatment", "children's root canal", "pulpectomy" or "pulpotomy". The two common forms of pulp therapy in children's teeth are the pulpotomy and pulpectomy.

A pulpotomy removes the diseased pulp tissue within the crown portion of the tooth. Next, an agent is placed to prevent bacterial growth and to calm the remaining nerve tissue. This is followed by a final restoration (usually a stainless steel crown).

A pulpectomy is required when the entire pulp is involved (into the root canal(s) of the tooth). During this treatment, the diseased pulp tissue is completely removed from both the crown and root. The canals are cleansed, disinfected and, in the case of primary teeth, filled with a resorbable material. Then, a final restoration is placed. A permanent tooth would be filled with a non-resorbing material.

Extractions

Teeth are extracted or removed when they are unsalvageable by any treatment. This may be due to decay, infection or trauma. Teeth are also extracted for orthodontic reasons when there is inadequate space in the jaws to accommodate all teeth.