We strive to make comfort and education our top priorities at CCPD! We take our relationship beyond a six-month exam! How is it all done, you ask? By utilizing state-of the art technologies, coupled with our expert specialty knowledge and experience, add on a fun-filled, child-centered environment and the magic begins!

We take our relationship beyond a six-month exam!

Regular Exam Visits

It is important to remain on a biannual exam schedule. Why every six months, you wonder? Children need to feel familiar with their dental office and dentist to alleviate apprehensions. A regimented schedule of six months allows for us to diagnose any concerns at a conservative stage, thereby alleviating your child from further, progressive treatment. At CCPD, we optimize our biannual exams to engage with your child, so that they are comfortable with their oral health experiences today and long into their lives.

Toddler Screenings

Brushing your tiny one’s teeth may seem like a new and challenging concept to you. We are happy to guide you in your approach and technique for the youngest of kids, making parents feel confident in starting their child’s love of oral health. This exam involves both parent and dentist in that we share our laps to cradle your baby and introduce dental brushing techniques for greatest success. This is the time that we discuss dietary concerns, toothpaste options and toothbrush head selections that better influence a cavity-free baby. We are fully in support of both the American Academy of Pediatrics, AAP and American Academy of Pediatric Dentistry, AAPD in the recommendation of a dental visit by age ONE.

Digital Radiographs

With current advances in radiology, minimization of excess radiation is available: introducing digital radiography. We utilize digital sensors and panoramic imaging for immediate diagnostic capabilities and reduced radiation levels. Our radiographic equipment is tested and certified and our dental assistants attain radiographic certification. There is validity in the concern for exposure and at CCPD we fully understand these concerns. We are conservative in our prescription of radiographic imaging, however we are firm in their importance. Caries and trauma are not always clinically evident and we understand that accuracy in diagnosis is the best approach to quality dental treatment and approaches specific to your child. Learn more: Please familiarize yourself with radiation comparisons, as provided by Dental Planet, DP Health.

Topical Fluoride Application

What exactly is fluoride and why is it used in dentistry? Fluoride is a naturally-occurring mineral. Yes, nature made. The fluoride ion is a derivative of fluorine. It is naturally found in low concentrations (approximately 0.1-0.3 ppm) in water and food sourced from river or rain water. Even sea water is found to contain fluoride, though in slightly greater concentrations. Well-water varies in fluoride concentration based on soil sedimentation. Some foods and beverages contain fluoride as a byproduct of these natural water-based sources. Our community water source is treated, as a public health measure, to provide optimal ranges of fluoridation with the intention to reduce cavities. Not a fan? Water fluoridation can be removed at home utilizing reverse osmosis filtration systems. When discussing fluoride, you must consider systemic versus topical supplementations. Some communities are without water-sourced fluoride and therefore are seen to have increases in cavity activity. These patients may receive systemic fluoride vitamins, based on risk factors. Toothpaste and mouthwash are topical formularies of fluoride, as is our professional application of fluoride foam or varnish, applied following the dental cleaning (prophylaxis). Fluoride reduces cavity risks by becoming incorporated into the enamel directly, re-mineralizing the enamel and providing greater barriers to future acid demineralization attacks. Our office follows the recommendation of the AAPD, in that topical fluoride, applied by a dental professional on a regular schedule, helps to reduce cavity risks. We take into consideration a patient’s age, cavity-risk, sugar consumption and oral hygiene when considering their fluoride needs and frequency. Learn more: Read more about the support and understanding of fluoride as provided by the American Dental Association, ADA.

Sealants

We are big believers in protecting the nooks and crannies of our natural tooth anatomy from invasion of cavity-causing bacteria. This is the role of a sealant. Sealant material is a thin plastic-based material bonded to the pits and fissures of posterior teeth, serving as a protective barrier against cavities. They are applied as a caries-reduction measure and are effective. Did you know that sealants reduce cavities by 80%? We utilize BPA-free dental sealants and encourage you to couple sealants with dietary practices low in sugar and acid, along with regular brushing and flossing to avoid acid breakdown of this protective barrier.

Medically Compromised & Special Needs Patients

We understand that some children have unique individual needs that may require special considerations and accommodations. We are experienced and knowledgeable in the handling of their specific oral health needs and are happy to make dental care more convenient and accessible for our patients and their families. Dr. Benitez received strong emphasis in dentistry for children both medically compromised and of special needs in her General Residency and Pediatric Dental Residency programs at the Rose F. Kennedy Children’s Evaluation and Rehabilitation Center, an interdisciplinary clinical and research clinic of Albert Einstein School of Medicine. She continues to provide dental care for patients of compromised medical status and special needs with gusto in private practice.

Restorative Dentistry

Cavities can develop in even the most diligent of brushers. We strongly encourage BRUSHING, FLOSSING and lower refined carbohydrate and sugar diets, including consideration of drinks. Radiographs often enlighten us to cavities between the teeth, not always clinically detectable. There are 4 components to the making of a cavity:
  1. A carbohydrate substrate
  2. Naturally-occurring micro-organisms in plaque
  3. Susceptible tooth surface
  4. Time
Having a cavity is common in primary teeth. Baby teeth have differing anatomy from a permanent tooth. Even the dietary needs of frequent feedings or snacking seen in young children adds to cavity risks.

There are ways to treat these teeth, in a safe, fearless approach and options of materials based on size:

White Fillings
The material used for these cosmetic fillings is a white plastic derivative. This material is used for conservative filling sizes. Yes, sometimes a cavity is too big to receive a white filling due to fracture and failure risks. We at CCPD believe in treatment options that lend to longevity and greatest success rates. 
Stainless Steel Crowns

Once the size of cavity has surpassed a certain width, the greatest success rate against filling fractures and failures, becomes a full coverage, durable alloy material that covers further below the gum line. We do take into consideration the cosmetic appeal of an all-white filling, but recommend a stainless steel crown in cases where nerve therapy was needed or the cavity is too large. These crowns are cemented to the remaining tooth structure and fall out with the tooth when the time comes. These crowns are used for teeth in the back of the mouth, the molars. Take a look around and you will often see many children having these crowns. More esthetic variations are available, but may not be a good option for your child or the tooth in consideration.

Common Dental Emergencies and How to Manage Them

Dental emergencies do occur. Here's how you should handle these common situations:
Baby Tooth Injury
Toddlers are an active age. Often they are learning to be mobile and keep up with older kids. This makes for falls or bumps to occur. First thing, is to remain calm. Clear away any debris from your child’s face and mouth and evaluate for any bleeding. A baby tooth could be missing or partially displaced. If the tooth is knocked out/missing, locate it, but DO NOT REPOSITION INTO THE MOUTH! Baby teeth are NOT re-implanted. Keep it for the tooth fairy! Call your pediatric dental office for specific management. In some circumstances of partial displacement, a dental visit may be necessary.
Permanent Tooth Knocked Out
Children are often engaged in sports or casual play. Unintended injury is something that can be experienced. Again, remain calm. If you see that your child’s PERMANENT tooth is missing, locate it and pick it up by the CROWN, NOT THE ROOT. Reposition it in its place and bite gently on clean gauze or tissue. Call your pediatric dentist for a prompt visit to the dental office to stabilize the tooth. You should expect radiographic imaging to verify positioning prior to splinting. Various follow-up appointments, or even a referral to another specialist(s), may be necessary.
Broken/Fractured Tooth
Upon noting that a portion of a baby or permanent tooth is missing, clear away any debris and look at the core of the tooth. You are looking for a central, localized pinkish-red, fleshy material. This determines the urgency of the incident. If you are able to locate the missing portion of the tooth, store it in MILK . Depending on whether it is a baby or permanent tooth, and size, some treatment may be necessary. Call your pediatric dentist to determine any prompt need to visit the office. These injuries vary and will be further monitored at future visits. Remember to remain calm.
Pain From a Tooth

Tooth decay can cause pain. In circumstances of smaller, conservative cavities, often a “zing” is felt to sweets or food stuck between the teeth. As the decay grows in size, more temperature pain may be noted: pain to cold foods and drinks. Often, Tylenol or Motrin can manage the discomfort until a timely dental appointment for treatment is made.

If a child is noted to have a SWELLING, promptly call your pediatric dentist for further details and management or make a visit to an emergency room/urgent care!

Prevention of Oral Injury

If your child is engaged in high-impact sports, ALWAYS wear a protective mouth guard. These can be over-the-counter boil and bite or custom-made removable appliances.

Try to practice age-related safe measures: car seats, seat belts, tied shoe laces, no rough play, knee and elbow pads, safety helmet, reflective gear, in-home safety measures against falls or electrical injury.

Space Maintainers & Orthodontics

As a Pediatric Dentist, we follow your child’s growth and development pattern. This is a consideration of a child’s future orthodontic needs, if any, to harmoniously align the upper and lower jaws, and tooth orientation within. This allows for optimal airway, symmetry, posture and balance, speech, facial profile and cavity prevention. Occasionally a tooth requires removal based on cavity size, infectious process, redirecting the orientation of the underlying permanent tooth, crowding or trauma. There may be a circumstance of a missing permanent tooth. Each primary tooth is special in that its function is to allow timely eruption of its permanent tooth successor into the developing arch. In situations of the removal of a tooth, it is important to consider space maintenance.

Mild Oral Conscious Sedation

For some children with greater anxiety or younger, pre-cooperative ages, nitrous oxide is not sufficient to provide safe dental treatment. In these circumstances, a MILD oral sedative would be discussed. The sedative medication selection is based on a child’s medical history, airway assessment, extent of dental needs and their pre-operative disposition. Our office was carefully designed for safety during nitrous oxide and mild conscious sedations. We are a licensed site for the administration of an oral sedative by the Maryland Dental Board. This signifies that our office has been inspected and certified and that I, as a provider, have passed a separate oral exam, and attain a separate permit to administer sedative medications, signifying my competency in oral sedation. These permits are renewable with proof of competency and continuing education. It is a focus in our practice that we continuously attend education lectures specific to conscious sedation, medically compromised patients, immunology and allergenicity and PALS/BLS (Pediatric Advanced Life Support/Basic Life Support). What to consider and expect during a mild sedation in the office:
  1. A consultation is mandatory. Please provide a Comprehensive Medical History including:
    1. Name and contact information for your child’s pediatrician and other specialists
    2. Cardiac, respiratory, organ function and metabolic concerns
    3. Medications
    4. Ongoing medical evaluations
    5. Allergies to food and/or medicine
  2. Extensive coordination between our office administrator, the child’s pediatrician (and any other specialists), as well as your insurance company (DENTAL & MEDICAL).
  3. Compliance with a History & Physical performed by the child’s pediatrician WITHIN 30 DAYS.
  4. Our office must be able to communicate with you 48 hours prior to your appointment. If we are unable to communicate, your appointment may be cancelled.
  5. A LEGAL GUARDIAN must be present the day of the appointment. They are not allowed to leave the office for any reason, until discharge with their child.
  6. Dress your child in a short-sleeve shirt for ease of access and to avoid over-heating. Some medications cause diaphoresis (sweating).
  7. Compliance with dietary restrictions: NO FOOD OR DRINK FOR 8 HOURS PRIOR. Failure to meet this results in cancellation.
  8. Medications are flavored for patient satisfaction. Administration may require a parent’s help with the dentist.
  9. Varying waiting times based on the medication selected.
  10. ONLY 1 LEGAL GUARDIAN ALLOWED IN THE ROOM for safety. (This is subject to change based on the child’s and parent’s behavior). We must be judicious in order to optimize results when a sedative is elected and ingested.
  11. They are monitored in respiratory rate, heart rate, blood pressure and with a precordial stethoscope.
  12. It is coupled with nitrous oxide, the titratable component of a sedation.
  13. They are groggy, but arousable and we will continuously be engaging them in comfort and depth assessment.
  14. Your child is provided with a selection of juice, popsicle or pudding and must meet criteria for discharge prior to being dismissed from the office.
Learn more: http://www.aapd.org/media/policies_guidelines/g_sedation.pdf http://www.aapd.org/assets/1/25/Houpt-26-01.pdf

Hospital Dentistry

Aside from treatment options of nitrous oxide and a mild oral sedative, there exists hospital dentistry. This is a viable option for many children who are experiencing numerous carious teeth at pre-cooperative ages; significant fears and anxiety that a mild sedative cannot address; and/or special needs patients in which an oral sedative is contraindicated. In these situations, a patient is under general anesthesia, provided by a medical anesthesiologist in an operating room of the hospital or surgical center. ALL dental needs are completed during this time if hospital dentistry is needed or the only option for a patient to receive dental care. What to consider and expect for hospital dentistry:
  1. A consult is mandatory. Please provide a Comprehensive Medical History including:
    1. Name and contact information for your child’s pediatrician and other specialists
    2. Cardiac, respiratory, organ function and metabolic concerns
    3. Medications
    4. Ongoing medical evaluations
    5. Allergies to food and/or medicine
  2. Extensive coordination between our office administrator, the hospital or surgical center Operating Room Coordinator, the child’s pediatrician (and any other specialists), as well as your insurance company (DENTAL & MEDICAL).
  3. Compliance with a History & Physical performed by the child’s pediatrician WITHIN 30 DAYS.
  4. Our office must be able to communicate with you 48 hours prior to your appointment. If we are unable to communicate, your appointment may be cancelled.
  5. A LEGAL GUARDIAN must be present the day of the appointment. They are not allowed to leave the office for any reason, until discharge with their child.
  6. Compliance with dietary restrictions: NO FOOD OR DRINK 8 HOURS PRIOR. Failure to meet this results in cancellation.
  7. NO PARENTS ARE ALLOWED DURING THE PROCEDURE.
  8. Anesthesia is administered and monitored by the anesthesiologist and surgical nurse; Dental treatment is secondary to stable anesthesia and is completed by a separate dental team.
  9. Your child is moved into a separate part of the hospital for recovery and assessment for discharge, PACU. A child must meet criteria for discharge prior to being dismissed from the PACU.
  10. A follow-up appointment is required in the dental office 2-3 weeks following Full Mouth Dental Rehabilitation in a hospital or surgical center.
Learn more: http://www.aapd.org/media/Policies_Guidelines/P_HospitalizationInfants.pdf http://www.aapd.org/media/policies_guidelines/g_shcn.pdf