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Dentistry/2 small cavities

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QUESTION: Hi!

My daughter who is 4 has two small pits in both of her baby first molars on the bottom (occulusal part of each tooth). Our pediatric dentist said that he is going to watch them. They tried to take x-rays 6 months ago at her last cleaning but my daughter was having a difficult time with that whole process so the dentist said they will try again at her cleaning appointment in 2 weeks. Anyhow, I don't want even a small amount of decay to spread to her other teeth so is it better to have those pits cleaned out and filled now before they get worse? He said that he thinks the pits are only in the enamel. Any suggestions?

ANSWER: I don't subscribe to the concept of "wait and see" when it comes to decay.  In our office we use a technology that requires no numbing to remove the decay on a small, early cavity.  Placing a tooth colored filling is also quite painless.  The only difficulty is that some children at this age will not cooperate and sit still for the process.  In those instances one has to decide between using sedatives or working with the youngster over a series of appointments to gain the trust and confidence of the child so the procedure can be accomplished safely and effectively.  In that case one has to decided between these two very different options.

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QUESTION: I don't like the wait and see concept at all. What technology is that? Thd dentist said they would have to give her gas? I'm considering changing pediatric dentists now. Should I call them and tell them to fix her teeth NOW. There is no financial reason to not plus we have great insurance. I have zero idea why he said wait besides the fact he said that the cavities may not progress.

Answer
The use of nitrous oxide and oxygen (what you call "gas") is universally accepted in pediatric dentistry as an extremely safe and effective way to calm a child and achieve the necessary cooperation to proceed with dental treatment.  The technology we use to avoid the dental drill and the use of local anesthesia is called air abrasion and can be very effective in the treatment of small, early cavities.

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Dr. Randolph Myerson

Expertise

Please limit your inquiry to questions about orthodontics (braces) and children's dentistry. I am both an Orthodontist and a Pediatric Dentist, having been trained in both of these dental specialty fields. Orthodontics is the dental specialty that treats problems of tooth, bite and jaw alignment using braces and removable appliances. Pediatric Dentistry is the dental specialty also known as dentistry for children, which deals specifically with the dental problems of this special age group from infants to adolescents. I am also experienced in Forensic Dentistry, the application of dentistry to law enforcement and identification using dental records.

Experience

I have been in the private practice of orthodontics and pediatric dentistry for over 20 years. Prior to that I served for three years on the Cleft Palate and Cranio-facial Reconstruction team at Children''s Hospital of Philadelphia and was an Assistant Professor of Dentistry at University of Pennsylvania School of Dental Medicine. I also served as a dentist in the U.S.Air Force, stationed at Andrews AFB in Washington, DC.

Organizations
I am a Fellow in the American Academy of Pediatric Dentistry, and a member of the American Association of Orthodontics, as well as a member of the American Dental Association and the Dental Society of the State of New York.

Education/Credentials
I received my BA in Biology from Frankin & Marshall College in 1969, and my dental degree from University of Pennsylvania School of Dental Medicine in 1973. In 1978 I received both my Certificate in Orthodontics from University of Pennsylvania School of Dental Medicine, and my Certificate in Pediatric Dentistry from Children''s Hospital of Philadelphia after completing a three year Teaching Fellowship in Orthodontics and Pediatric Dentistry in 1978.

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