Innovations in Pediatric Dentistry: Meet Dr. Angela Austin

There’s something special about being a mother and practicing pediatric dentistry. I personally treat every single child who comes through my offi ce as if they were my own. A person’s impression of the dentist is developed at a very young age and I take this very seriously. So, if there are innovative ways to treat my patients they feel more comfortable with, it’s my pleasure to do so.

Living in Northern Virginia, we are so fortunate to be in the midst of some of the top medical professionals in the country. I absolutely love practicing pediatric dentistry here because there are so many professionals I can consult with, refer to, or trust with my patients should I need to send them somewhere for more advanced specifi c care.

I once practiced dentistry in an underserved area, and I was the main source for everyone’s dental needs. Although this was a very rewarding experience I wouldn’t trade for the world, it was also diffi cult since there was nobody for me to refer patients to, should I need to, and I wasn’t able to incorporate new dental technology into my everyday practice due to limited resources.

Flash forward to 2020, and I am so excited to be practicing dentistry in a time like this. From laser dentistry to needle-free anesthesia, we are now able to ensure our patients have the best experience possible when coming to a once-feared place.

As a mother of three under 6 years old, I am constantly practicing dentistry from a place of, “if this was my baby, how would I treat this situation?” It feels great to be able to offer multiple ways to fi ll a cavity. In dentistry, there is never a “one size fits all” situation. A cavity is a cavity, but the way we treat the cavity is completely different for each patient. Some children walk into our office excited, ready for anything! Others walk into our office shy and need tender, loving care. Some want absolutely nothing to do with a dental office experience and we have ways to overcome this situation as well.

Let’s dive into some fun, innovative trends in dentistry.

The miracle we’ve all been waiting for: laser dentistry. Many pediatric dentists, including myself, are using a powerful dental laser that replaces the dental “drill” in the majority of procedures in our practice. It causes virtually no pain, vibration, or noise. In fact, nearly every patient skips anesthesia because they just don’t need it. A dental laser is our way of keeping you happy. Because more than anything, we love to see you smile.

Most hard and soft tissue procedures in our office can be done with no anesthesia, and soft tissue procedures are done with virtually no bleeding. Blood-free and anesthesia-free procedures are a major leap forward in dentistry, as we can execute multi-quadrant dentistry, fillings on the fl y, and soft tissue procedures in a single appointment. What does that mean for your child? Your child is now able to receive the care they need in a fraction of the time they were accustomed to from traditional drills. The laser is also far less invasive than using a traditional handpiece, which makes healing time following a procedure much shorter.

When patients have anesthesia, they typically leave the offi ce with that numb feeling still prevalent. With the laser, they are able to go right out to lunch or back to school without the numbing sensation following their appointment. The laser is truly changing what it means to go to the dentist.

For infants who suffer from tongue-tie, this laser technology can mean the difference between a colicky infant who isn’t thriving, to one that can start breastfeeding with a natural latch. Infants who receive a laser frenectomy can start breastfeeding almost immediately after the procedure. This is even encouraged to help calm the child.

Unfortunately, tooth decay remains the number one most common disease of childhood, fi ve times more common than asthma. Regularly available snacks, frequent consumption of sugary drinks, bottled water without fl uoride, and infrequent trips to the dentist have all contributed to this epidemic.

So, what happens, when a 2-year-old walks into the dentist for their first dental appointment and is diagnosed with four cavities? When I was in dental school and residency in 2005, we had two options. One: hold them and try our best to do fillings on a screaming baby, or two: sedate them. We typically chose the latter (with parental consent, of course). Flash forward to today and we have an interim treatment option for the pre-cooperative child – Silver Diamine Fluoride (SDF).

SDF is an antimicrobial liquid available to treat cavities in a non-invasive, fast, affordable, and painless manner. FDA cleared in August 2014, SDF became commercially available to dental professionals in April 2015. Compared to a traditional filling, which may require local anesthetic and drilling, SDF is non-invasive and easier for the pre-cooperative patient to tolerate. SDF is a liquid that is simply brushed on to the cavity that can stop current decay and prevent new decay in the future. Sound too good to be true? Well, let me explain the pros and cons of SDF.

Pros: SDF has very low toxicity, it is quick, painless, non-invasive, affordable, and can stop tooth decay and help prevent recurrent decay. The patient can simply lay in the parent’s lap and the dentist brushes the liquid onto the decay and the decay should not progress.

Cons: SDF permanently stains cavities black. SDF does not restore tooth form or function, so large holes that trap food may still eventually require a traditional restoration. SDF will require repeat applications for maximum efficacy. Finally, SDF cannot be used when an infection is present or the decay is into the nerve.

My opinion: I recommend SDF for some patients. One issue with SDF is that esthetically, it is not pleasing. I’ve noticed many parents are not comfortable with the esthetics of SDF despite it stopping the decay from growing, but it can be a good option depending on the circumstances.

In all the years I’ve practiced dentistry, I’ve talked to many adults and (of course) children about their top fears and how dentists can help alleviate these fears. The number one fear I hear is the dreaded “needle.” It’s so dreaded, in fact, that we don’t even use that word in my office. It is banned! The mere thought of children knowing a needle can be used in their mouth is grounds for them running straight out of my offi ce! So, although I’m pretty skilled at providing a painless injection, I understand when parents ask if there is any other way to fill the tooth besides using a needle.

First, I typically offer the dental laser we use. However, there is also another new, innovative way to anesthetize the top teeth without a needle. It’s recommended for patients who are 88 pounds or more, so only some of my patients can use this. Kovanaze is a dental anesthetic that is inhaled as a nasal spray. It is effective at numbing the upper teeth without the feeling of numbing the lips. This is benefi cial because so many times we leave the dentist with our lips so numb it’s very uncomfortable. And for children, many times they are at risk for lip bites, which is no fun once the anesthesia wears off. It is FDA approved and another option for numbing sans needle, which is definitely something to consider when looking at all these new dental trends.

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DR. ANGELA AUSTIN is a Board Certified Pediatric Dentist in Alexandria, VA. She specializes in treating patients aged 1-21. She is also specially trained to treat special needs patients as well as patients with high dental anxiety. She is the owner of Alexandria Children’s Dentistry located at 6303 Little River Turnpike, Suite 345, Alexandria, VA 22312. Phone: 703-942-8404