Both the Canadian and American Academies of Pediatric Dentistry recommend that children visit the dentist by their first birthday or within 6 months of their first tooth coming in. This is when preventive care can begin. The earlier the first dental visit, the greater the chance that your child can have a cavity-free childhood with optimal oral development.

Ensure proper habits are established early

Review and educate parents on oral hygiene technique and diet recommendations to best maintain proper oral health

Routine preventive care
  • We suggest kids are brought to the dentist every 6 months for their dental check-up and cleaning
  • These appointments include:
    • Clinical examination by a pediatric dentist
    • Cleaning – Plaque and tartar removal (scaling and polishing)
    • Application of fluoride to strengthen enamel and manage cavity risk
    • Dental x-rays as needed
    • Guidance on oral health management and dental development
  • A frenectomy, or release of a tongue tie or lip tie, is most commonly recommended to assist with breastfeeding challenges such as trouble latching or suckling.
  • As the child gets older, a frenectomy may be advised to help improve speech difficulties, early orthodontic concerns, and ability to clean the teeth to decrease cavity risk.
  • At Bolton Kids Dental, frenectomy is typically done using a laser which limits bleeding and can be less painful than alternative methods.
  • It is recommended that your child has a multidisciplinary team to manage their needs, ensure proper function/healing and aftercare. This may include care from a lactation consultant (LC), speech therapist (SLP), osteopath, or myofunctional therapist (OMT).

We are proud to offer “alternative” treatment options when convention dental treatment is not possible or not preferred. Minimally invasive dentistry aims to treat patient in exactly that way, “minimally invasive”. These treatment options limit the use of dental freezing or drilling so that patient can remain comfortable and treatment can be completed safely. Minimally invasive options are not always appropriate and have limitations.

Options include: Silver diamine fluoride (SDF), atraumatic restorative technique and HALL technique crowns.

Ask us about minimally invasive options for more details.

Silver Diamine Fluoride (SDF)

SDF is a minimally invasive option to help manage cavities. It is used to slow/stop decay from progressing. SDF can also be used to treat dental sensitivity. SDF is a liquid that is applied to a cavity using a small brush or flossed between teeth, and can be completed in minutes with fair cooperation. The downside is that SDF will stain the cavity black, which may be a cosmetic concern particularly for front teeth. Our team can review further details of SDF with you and determine if it is an appropriate option.

Atraumatic Restorative Technique (ART)

This “alternative” minimally invasive restorative approach allows cavities to be treated with no dental freezing and limited drilling. ART fillings are used to restore the tooth and limit cavity progression. ART fillings require regular follow up and may require additional treatment in the future.

HALL Technique Crowns

In some cases, we may be able to treat a tooth with a crown in a way that does not require any freezing and no/limited drilling. This may be a great alternative for patients with dental fear or limited cooperation. Ask us about HALL crowns for more information.

A minimally invasive preventive procedure that involves the application of a bonded protective white/clear coating over the pits and grooves of the teeth to prevent plaque and food accumulation, thereby aiming to prevent cavities in high-risk areas.

  • Once cavities progress beyond the earliest stages of demineralization, restorative treatment with a filling or crown is required.
  • Fillings (tooth coloured fillings)
    • When cavities are small and localized, the cavity (decay) can be removed and restored using a bonded tooth coloured (white) filling.
  • Pediatric Crowns (Caps)
    • When a cavity is larger, deeper, or is on multiple surfaces of the same tooth, a full coverage crown may be the best option to treat and maintain the tooth. We offer two types of crowns (see below) at Bolton Kids Dental and, in either case, the baby tooth (with the crown overtop) falls out as usual at the appropriate age.
    • Stainless steel crowns (metal caps)
      • These silver crowns provide excellent protection and a high success rate for teeth with large cavities.
    • Zirconia/Porcelain crowns (white caps)
      • Zirconia crowns are a more esthetic option that may be preferred for certain teeth. Ask us about the differences to see if tooth coloured crowns are of interest to you.
    • Pediatric crowns are much more commonly needed than adult tooth crowns which many parents do not realize. Baby teeth have much thinner enamel which contributes to cavities progressing more quickly. Fillings also rely on adequate enamel for optimal bonding. Therefore, in cases with larger, deeper or multi-surface cavities, fillings have much poorer outcomes (new cavities, recurrent cavities, broken filling, abscess) leading to more repeated treatment. For these reasons, a full coverage crown in these cases is advised, has significantly better outcomes and is the standard of care.

When cavities are deep and extend into the pulp (nerve) of the tooth, nerve treatment (a pulpotomy) may indicated. Teeth treated with a pulpotomy are then restored with a crown. Baby teeth that are infected or too broken to be saved are indicated for extraction

There are a number of reasons a child may require a dental extraction (removal).

  • In cases of extensive tooth decay, the tooth may no longer be able to be saved and an extraction is the only appropriate treatment option.
  • Infected or abscessed baby teeth are often best treated by extraction to prevent further pain, spread of infection, or damage to the developing adult tooth
  • Teeth that have undergone trauma may be indicated for extraction to manage and prevent pain, infection and/or damage to developing teeth
  • For orthodontic purposes: in cases of severe dental crowding, extraction of teeth is occasionally suggested to allow for better alignment
Space Maintainers

If a baby tooth is lost too early (often the result of an extraction), the neighbouring teeth may drift/tip into the space over time. If this occurs, it could lead to insufficient space for the future adult tooth and complicate future orthodontic needs for your child. Space maintainers are used to prevent drifting of the adjacent teeth and to hold the space needed for the adult tooth to come into position.

A mild sedative that is used to decrease anxiety and help patients feel more comfortable during treatment. Laughing gas is inhaled through a “magic nose” and begins working within minutes. Kids may feel ‘floaty’, ‘tingly’, ‘extra comfy’ and sometimes a little ‘silly’ . When the procedure is completed, the laughing gas is turned off and replaced with oxygen, allowing the laughing gas to completely leave the body within minutes, leaving your child feeling back to normal. Laughing gas is a very safe option; your child will remain awake and responsive throughout the procedure and can return to normal activity after most treatments. Adults who are treated with laughing gas are able to drive themselves home afterwards.

Nitrous oxide (laughing gas)

Some children may have greater anxiety or may have more extensive treatment needs that may benefit from stronger sedation options, other than laughing gas alone. Oral sedation involves the child drinking a sedative medication in our office, prior to starting the procedure. It aims to further decrease anxiety, increase drowsiness and relaxation or for its amnesia properties to limit memory of the procedure. The child is still awake and responsive throughout the procedure, but may allow for treatment to be completed in a safer and more effective way. Oral sedation may not be appropriate for all patients or their specific needs. Our team will go through all options with you and determine which may be most appropriate for your child.

For patients that are not able to safely tolerate treatment awake, or for those who require extensive dental treatment, comprehensive dental care while asleep (under general anesthesia) may be the ideal option. Sleep Dentistry allows treatment to be complete without any discomfort or memory of the procedure, and limits the potential for a negative dental experience. We offer in-office sleep dentistry with our team of medical anesthesiologists and nurses to best care for your child. Most children are feeling back to themselves by the end of the day and often return to their regular activities the next day.

Dental Operatory

For Children with special health care needs, we understand the potential challenges and stimulating nature of the dental environment. We welcome all children with special health care needs including those with Autism Spectrum Disorder, ADHD, genetic anomalies and sensory disorders. Dr. Jeremy has additional specialty training in the management of patients with special health care needs. When scheduling your appointment, please let us know of any sensory concerns and strategies that will help ensure the best experience for your child.

We are here for you! As soon as you can, call our team or send us an email with a photo and we will do our best to have you seen quickly. If we are unavailable and you are unable to seek local dental care, please contact the padiatric dental resident on-call at the Hospital for Sick Children through the hospital switchboard at 416-813-7500

These various treatment options will be recommended by our team and reviewed with you to determine what type treatment is most appropriate for your child

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