Fear — Not Dentists Are Brushing Up On New Techniques To Keep Children’s Teeth Healthy

We all remember that first trip to the dentist: squirming in an oddly shaped chair as shiny instruments came toward our mouth, wielded by someone who seemed larger than life. We would sit with our mouths craned open, silently repeating over and over: Please don’t find any cavities. Please don’t find any cavities!Cavities meant another trip to the big chair and more scary tools. It meant Novocain shots. It meant the drill.

Help is on the way for today’s children, though, as dentistry takes a turn for the better, toward more effective prevention methods, less painful treatments and an overall experience that may not be as dreaded by kids as it once was. According to area dentists, dentistry has always been a profession that produces smiles, but many dental offices are striving to prevent frowns among their younger patients, too.

“A lot of what dentists are doing in their offices is in response to fear,” said Rob Matthews, DMD, a pediatric dentist based in Springfield. “Some of the changes being made are designed specifically to allay that fear, like placing equipment behind the chair or in cabinets. Drills are also being made a lot quieter – electric drills are more expensive, but in my opinion, they’re worth it.”

And in addition to quieter drills, new technology is creating a generation of children who will likely never see a drill. Westfield-based dentist Jay Sullivan, DMD, said one of the most exciting developments in pediatric dentistry is that cavities are being both diagnosed and treated using powerful — and nearly painless — lasers.

Sullivan’s office is peppered with the equipment that carries out state-of-the-art laser technology: a DIAGNOdent, for instance, detects hidden decay from the inside out. Meanwhile, a hydrokinetic laser can be used to gently wash away any decay with laser-energized water, and a YAG laser is used for cavities or minor surgery on the gums.

Sullivan uses lasers on both adults and children, but said the effect the new technology has on the younger set is a measurable difference from using painful shots and noisy drills to treat a cavity.

“With lasers, we can remove cavities and perform gum surgery without numbing the patient,” he said. “Overall they allow us to treat patients more effectively and painlessly, and get them in and out of the chair as soon as possible. For children, that’s a big plus.”

Further, lasers that treat cavities eliminate the uncomfortable vibration and heat that drills cause, and allow for more of the healthy tooth structure to stay in place. Fillings also bond to teeth better after laser treatments, so they last longer.

An Ounce of Prevention

Dental technology in general is moving in the direction of increased and improved preventive care, Sullivan said, and lasers such as the DIAGNOdent, which can effectively detect decay in its early stages, are an excellent example of that technology at work.

“It eliminates the guesswork,” Sullivan said. “The equipment gives us a read-out that tells us definitely if there is decay within a tooth or not.”

Not all new developments in dentistry are as flashy as lasers, but they are no less important to safeguarding healthy teeth in children.

Temporary fillings are now being used, primarily in children’s baby teeth, to correct and prevent decay. Those fillings are white, and therefore less noticeable than metal fillings (Sullivan said white fillings are typically used instead of metal fillings today, in both children and adults), and contain fluoride.

The American Dental Assoc. also recommends fluoride supplements for children six months of age to 16 years, especially in Western Mass., where Sullivan said most communities don’t have fluoride in their water systems. Proper nutrition with plenty of calcium is also recommended.

As children age, measures to straighten teeth are also beginning earlier in life, in order to lessen the amount of time some children must wear braces or other corrective devices. Preventive orthodontics can begin as early as 5 years of age, and includes a number of ‘appliances’ to shape the jaw, help accommodate new teeth coming in, or other orthodontic procedures.

“Interceptive orthodontics can prevent the need for braces,” Sullivan said. “By molding young jaws to accommodate adult teeth.”

And although conventional braces are still used on some patients, the newer Invisalign tooth aligners are used frequently on preteens, teenagers, and adults. Sullivan said they often straighten teeth in a shorter amount of time than other methods, and in many ways are more convenient; they allow for normal brushing and flossing, gum health may improve during use, and dental cleanings are quicker and easier than with traditional orthodontics.

A Clean Record

Cleanings, Sullivan said, are still one of the most important aspects of good dental health for children, though they have not changed much over the years.
“Cleanings are still pretty basic, there is nothing especially different,” he said, returning to the pervasive idea of lessening anxiety in young patients before any work is done. “The most important thing for parents to know is how to get their children ready for their first visit.”

Matthews said sleep dentistry is an option for some children for which the ‘frightened factor’ is high – he sees about four to five patients each week to complete dental work under anesthesia. But to prepare children for a conventional visit, similar preparation should go into getting children used to the idea of a trip to the dentist as readying them for their first day of school or another major event.

“First, they need to get used to office visits,” Sullivan said, “then cleanings can start around age 3. They should be told not to be scared, but not that it there will be no discomfort, either… just reassured and comforted about the whole process, to make it go by quickly.”

Matthews added that a more child-friendly environment, coupled with digital file storage systems that are emerging in many of today’s modern offices, can also alleviate some of the fear associated with a visit to the dentist, and that idea is being incorporated into many new office designs.

“If an office is less sterile, it is ultimately less intimidating,” he said. “And digital files make visits easier and more efficient for us and for the patient.”

Matthew said he plans to relocate to West Springfield this year, and in designing his new office, he said the space was customized to appeal to children, with movies playing in each room and décor borrowed from Maurice Sendak’s classic Where The Wild Things Are.

When new design trends fail, though, Sullivan concluded that today’s dental technology has a strong ‘wow’ factor to fall back on, and to help educate and interest children in the process.

“There’s always something new,” he said. “And everybody likes lasers.”