Your Cary Dentist for Kids

It’s important to start your child off on the right path to lifelong dental health from day one — and Southern Smiles Pediatric Dentistry is here to help.

Visit the office of Dr. Narineh Panoosian for pediatric dental services in Cary. We’re committed to providing a warm and welcoming environment for children of all ages, from the newest-born infants to 18 years of age.

Sealants

Sealants are a protective coating bonded to the biting surface of molars and premolars that serve to keep out bacteria, plaque, and food debris.

The biting surfaces of these teeth, when viewed under a microscope, are full of deep groves, pits, and fissures. The bristles of your toothbrush cannot reach into these areas to clear away the things that make it into these grooves.

Sealants are easy to apply and are one of the best proven low-cost measures to help keep children cavity-free.

Sealants on the permanent molars are generally universally recommended and can be applied as soon as the first set of molars fully emerge, usually around age six.

Before Dental Sealant

Pediatric Treatments

After Dental Sealant

Pediatric Treatments

Tooth-Colored Fillings & Restorations

When tooth decay is detected, and the decay can be easily removed, the shape and the structure of the decayed tooth can be restored with tooth-colored composite material. The composite material is bonded to the tooth.

At Southern Smiles Pediatric Dentistry, we do not use the old-style silver amalgam filling material. Tooth-colored composite fillings/restorations are typically appropriate for small to medium-sized cavities and areas of decay.

Tooth-Colored & Silver Crowns

​Primary / baby teeth that have large areas of tooth decay are often best fixed by placing what is known as a “crown.” The doctor will advise you when a simple filling just won’t do and a crown is necessary.

Most of the time, we will use a stainless steel silver-colored crown. These are safe, effective, and easy to place at a lower cost. They are also a more conservative way of protecting the tooth.

We also offer tooth-colored crowns. However, these are typically more expensive and are not as conservative, as they require additional removal of tooth structure in order to properly make the crown.

Extracting Baby & Permanent Teeth

Sometimes removal of teeth may be recommended. Common reasons for removal are:

  • Tooth decay that is so invasive it will be difficult or impractical to fix with a filling or a crown.
  • An abscess has formed, and there is a difficult-to-resolve infection.
  • Removal of baby teeth to relieve crowding and problems associated with the underlying permanent teeth.
  • A problem has been identified by an orthodontist, and the removal of baby teeth will help resolve it.
  • Severe crowding has been identified by an orthodontist, and the removal of permanent teeth is required in order to align the teeth and improve the bite.
Pediatric Treatments

Nerve & Pulp Treatments

Decay and infection that penetrates into the center of a tooth where the nerve and blood vessels are housed within the tooth can cause significant problems.

The nerve tissue and blood vessels are collectively known as the ‘pulp’. There are various types of treatments that we offer to help remedy these issues. See examples to the right.

 

Direct Pulp Cap & Indirect Pulp Cap

These procedures are even less invasive than a pulpotomy and may be appropriate to effectively treat the nerve issue with the primary tooth. Our pediatric dentist will advise parents as to which procedure is best on a case-by-case basis.

Pulpotomy

A pulpotomy is a procedure where the infected and damaged pulp tissue is removed from the upper part of the inside of the tooth.

Then, any remaining tooth pulp will be treated with a special medication that helps protect the remaining pulp from infection. After this, your child's tooth will be protected with a filling or a crown, and the procedure is complete.

This procedure is not always successful in every case, and some teeth eventually lose the entire blood supply and nerve tissue. Some people refer to this procedure as a ‘baby root canal,’ and this is only partially true.

A true root canal procedure is significantly more invasive and requires a different technique.

Pediatric Treatments

Traditional Fluoride Treatment

Fluoride treatments administered at regular dental checkups are one of the safest and most effective proven measures to greatly reduce the risk of dental decay.

We regularly offer this service and promote safe dosage measures to protect children.

Our general fluoride applications help to strengthen all teeth.

We also have special fluoride treatments that can be targeted to specific areas of teeth where weakened enamel is just starting to decay to stop the decay process from progressing.

Silver Diamine Flouride (SDF)

Silver Diamine Fluoride (SDF) treatments were first introduced in the US in 2015. SDF is an antimicrobial liquid that is able to treat some types of cavities in a non-invasive, fast, affordable, and painless manner.

SDF is a topical treatment applied by the dentist directly into the area of tooth decay. Repeated application over time is required to in order to be fully effective. There are pros and cons to SDF treatment:

Pros

  • Appropriate for use to stop the process of decay in teeth with small to moderate sized cavities.
  • 80% of these cavities stop forming when applied twice yearly to the forming cavity.
  • Relieves sensitivity pain related to decay.
  • Helps delay fillings being placed in teeth that are not fully.
  • Cost-effective.
  • Non-invasive

Cons

  • Permanently stains the cavity black.
  • 20% of cavities treated with SDF will continue to progress and grow larger.
  • If a hole has formed in a tooth, it will eventually require a filling.

Not an option for deep large areas of dental decay

*Note: In some cases, the black staining can be masked by adding a white coating of what is known as Glass Ionomer Cement (GIC coating).