Oral conscious sedation

Children who are more anxious may need an oral medication that is stronger than nitrous oxide. Several medications have a significant calming effect. When choosing a medication, the dentist will consider your child’s anxiety level, his or her ability to cooperate and the treatment required.

With oral sedation, your child may be sleepy but can be aroused if necessary and can respond to simple commands. Minor side effects such as nausea or vomiting can occur with some medications.

Before a visit in which your child is to receive oral sedation, you should receive instructions about eating and drinking, what to expect and what to watch for after treatment. You may need to carry your child home after sedation. You may need to stay for a short time after dental treatment has been completed so your child can be observed for full recovery and possible complications.

Nitrous oxide

Nitrous oxide, also known as laughing gas, is most often used for children who are mildly or moderately anxious or nervous. It eases their fears so that they can relax and receive treatment comfortably and safely. Nitrous oxide is administered by placing a small mask over your child’s nose. Your child will be asked to breathe through his or her nose and not through their mouth. As the gas begins to work, the child becomes calm, although he or she is still awake and can talk with the dentist. When the gas is turned off, the effects of sedation wear off almost immediately. As the child gets older and becomes more comfortable with the dentist, nitrous oxide may not be needed.

Hospital / General anesthesia

Sometimes it’s necessary for a child to be unconscious in order to have required dental treatment completed safely. General anesthesia puts a child into a deep sleep. He or she is unable to feel pain or to move around. This is the same kind of sleep a child would have if he or she were to have ear tubes placed or tonsils removed. Your dentist may recommend general anesthesia if your child:

  • Can’t relax or calm down enough for treatment to be performed safely, even with conscious sedation and other behavior management techniques.
  • Needs oral surgery or other dental treatment that would be difficult for the child to tolerate while awake.
  • Needs a lot of dental work that can best be done in one long appointment rather than many shorter appointments.
  • Has a medical, physical or emotional disability that limits his or her ability to understand directions and be treated safely in an outpatient setting.

General anesthesia for dental procedures can be provided by an anesthesiologist or dental anesthesiologist. These professionals are trained to deliver the medications and monitor the child during the procedure and handle any complications that may occur.

A physical examination before receiving general anesthesia is required to ensure your child doesn’t have any conditions that could interfere with or be affected by the anesthesia. If your child is sick on the day of the scheduled procedure, call to see if the appointment should be rescheduled.

On the day of the appointment

  • Follow the guidelines the doctor providing the anesthesia gives you regarding food and fluid intake before and after the procedure.
  • Briefly discuss the procedure with your child; use simple terms that he or she can understand.
  • Let your child rest quietly at home after the procedure. He or she will probably be ready to resume their normal schedule the next day.

Tooth colored fillings

A composite (tooth colored) filling is used to repair a tooth that is affected by decay, cracks, fractures or wear. The decayed or affected portion of the tooth will be removed and then filled with a composite filling.

Because composite fillings are tooth colored, they can be closely matched to the color of existing teeth, and are more aesthetically suited for use in front teeth or the more visible areas of the teeth. As with most dental restorations, composite fillings are not permanent and may someday have to be replaced. They are very durable, and will last many years, giving you a long lasting, beautiful smile.

Composite fillings are usually placed in one appointment. While your child’s tooth is numb, your dentist will remove decay as necessary. The space will then be thoroughly cleaned and carefully prepared before the new filling is placed. If the decay was near the nerve of the tooth, a special medication will be applied for added protection. The composite filling will then be precisely placed, shaped, and polished, restoring your tooth to its original shape and function.

It is normal to sometimes experience sensitivity to hot and cold when some composite fillings are first placed, however this will subside shortly after your tooth acclimates to the new filling.

Good oral hygiene practices, eating habits, and regular dental visits will aid in the life of your new fillings.


Sometimes brushing is not enough. Everyone has hard-to-reach spots in their mouth and brushing doesn’t always fully clean those difficult places. When that happens, you are at risk of tooth decay. Using sealants on your teeth gives you an extra line of defense against tooth decay.

Dental sealant is a plastic resin that bonds to the deep grooves in your tooth’s chewing surface. When sealing a tooth, the grooves of your teeth are filled and the tooth surface becomes smoother — and less likely to harbor plaque. With sealants, tooth brushing becomes easier and more effective against tooth decay. Sealants are usually applied to children’s teeth as a preventative measure during the years of most likely tooth decay. However, adult’s teeth can also be sealed. It is more common to seal “permanent” teeth rather than “baby” teeth, but every person has unique needs. Your dentist will recommend sealants on a case-by-case basis. Sealants generally last from 3 to 5 years. However, it is fairly common to see adults with sealants still intact from their childhood. A dental sealant only provides protection when it is fully intact so if your sealant comes off you must let your dentist know.


Stainless steel crowns

Crowns on primary (“baby”) teeth are typically made of stainless steel (for strength) and are silver in color. On most front teeth white crowns can be used. Dr. Higham will discuss with you the options and his recommendation. Stainless Steel Crowns are placed on primary teeth to protect, seal and strengthen a tooth:

  • After large decay has been removed
  • After a pulpotomy has been performed
  • To correct a malformed tooth
  • To preserve a tooth with severe attrition.

Stainless steel crowns are considered a good temporary restoration to save the primary tooth until the permanent tooth can erupt and take its space. Keeping the primary tooth if at all possible is very important. A primary tooth can be restored with a stainless steel crown during one appointment. The decay is removed, the tooth is shaped for a crown then the crown is cemented. A crowned tooth must be brushed and flossed just like other teeth.


A pulpotomy is a procedure that requires the removal of part of the nerve tissue that has been infected. The remaining vital tissue is then treated to preserve the function of the tooth.


The best space maintenance therapy is the preservation of the primary molars until they are lost naturally. Sometimes, when the teeth are unrestorable, the need for extraction is unavoidable. The purpose of the space maintainers or “spacers” is to preserve the space for the developing permanent teeth.

Some Common Space Maintainers:

Lower Lingual Holding Arch (used in the lower jaw with more than one missing tooth.)

Band and Loop (single missing tooth.)

Nance Appliance (used in the upper jaw with more than one missing tooth.)

Preventative Orthodontics

The American Association of Orthodontists recommends that all children receive an orthodontic evaluation no later than 7 years of age. Sometimes, problems need to be identified even earlier than this. It is very important that your child receive an evaluation by an orthodontist or a pediatric dentist or general dentist trained in the correction of orthodontic abnormalities.

Early identification and treatment of orthodontic problems can prevent more serious problems later in life. In addition, there are some conditions that are much easier to correct as the child’s mouth and jaws are actively growing. Early treatment can sometimes achieve results that are not possible after the jaws have grown.

Athletic Mouth Guards

Injuries to the teeth and jaws can be dramatically reduced through the use of an athletic mouth guard. When a child begins to participate in recreational activities and organized sports, injuries can occur. A properly fitted mouth guard, or mouth protector, is an important piece of athletic gear that can help protect your child’s smile, and should be used during any activity that could result in a blow to the face or mouth. At our office, we fabricate custom made mouth guards which have better fit and comfort, are less likely to affect a child’s speech, and are less likely to come loose as opposed to commercially offered mouth guards.

School Programs

We offer two school programs for pre-school and grade school aged children. The programs are designed to educate children about the importance oral health. We try to make the programs fun and interactive for the children while at the same time teaching them about oral hygiene and nutrition. We will talk about teeth, “sugar bugs”, brushing and flossing, healthy snacking, and what to expect when visiting the dentist. At the end of the presentation, each child will be given a goody bag with a toothbrush and other dental supplies to take home.

Program 1: We will arrange for you to bring your school/class in to our office to meet Dr. Higham and take a tour of the office. We will talk to the children about the importance of taking care of their teeth. The office visit can be very beneficial for young children as it familiarizes them with the dental office setting and many times gets them excited to come back for their own visit to the dentist.

Program 2: We will arrange for someone from our staff to visit your school/class and give a short interactive presentation to the children about their teeth and oral health.