![]() Another question I had for you - is it common for pediatric dentists to not let parents go back? What is the reasoning behind this? Thank you. I don't think our dentist thinks our son will sit for it. Any advice, insight? Have you done capping under general anesthesia before? Is it a realtively safe procedure? I know two other parents whose children needed caps for enamal problems, but they were able to do their caps "in the chair". Does this sound like a common solution? Will he also have problems with his permanent molars? I'm a little nervous putting my son "under" for this procedure, but it sounds necessary. He wants to cap all 4 back molars under general anesthesia at an outpatient center. I think our pediatric dentist said this is what my son has - although I can't recall the exact words (enamel hypoplasia) he said the enamel didn't form properly and the teeth are becoming brittle. ![]() To return to the home page for more info click here: Pediatric Dentistry If they need any porcelain work, I usually refer to a cosmetic general dentist when they are finished with braces or around that age. With children and teens, I will try the less invasive techniques first. More severe cases need a white filling or more extensive cosmetic dentistry like a porcelain veneer. A technique called Microabrasion, perhaps followed by a little bleaching, can be very useful to treat these cases and make it look at least a little better and it's very easy to do. It all depends on how severe or how deep the lesion is. Now, for those areas that are on the front teeth with no decay, they just look funny, then there are a few options there too. If it is just a small spot that is decayed then a small white filling is all that may be needed. If there is a good bit of breakdown on a back molar, a crown may be needed. If the area is more severely affected it might get a cavity or begin to crumble, as the enamel is weaker in those areas. The areas will not usually decay and, if it isn't a cosmetic problem, we will just observe the area. Treatment: Well, most of the time you don't have to do anything. *If the spots were not there when the tooth erupted and have formed recently, they might be the beginning stages of decay. In fact, sometimes it is in horizontal lines much like layers of brick are on a building. ![]() Usually I cannot pinpoint what causes the hypoplasia, but I can sometimes tell when the disturbance occurred based on the position and appearance of the defect. Less often, spots are due to Fluorosis, or too much fluoride during development. Hypoplasia can be either a distinct spot on one tooth (sometimes called Turner's tooth, which might have been caused by a trauma or other unknown disturbance to the area during the mineralization of that tooth), or diffuse streaks or cloudy opacities on all the teeth which was some kind of systemic disturbance over a long period of time. You would be surprised how many children have some kind of discoloration. Also, the front teeth can be involved leading to cosmetic concerns. In permanant teeth the first permanent molars are quite commonly affected. In baby teeth, I tend to see it on the very back molars or the cuspids (the corner teeth). These white or yellow spots are very common. Sometimes the Enamel, or outer layer of the tooth is even deformed or thin in places. The defects in the teeth can be milky white, yellow or brown in color. These spots formed during development are called Enamel Hypoplasia or Hypocalcification. When new teeth erupt there may be small (or large) white spots on the teeth.
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