According to the American Academy of Pediatrics, every child should see a dentist by the time they get their first tooth. The first dental visit should take place no later than the child’s first birthday. Helping your child get into the habit of regular dental visits early in life will set positive dental habits that will extend into adulthood. Routine dental cleanings and exams are necessary to help ensure that your child maintains a healthy mouth and good oral hygiene. Although care at home is also important, professional dental cleanings will help remove plaque build-up that can occur despite the best brushing and flossing methods.

During a routine check-up, the teeth of your child will be polished to remove any plaque build-up or tartar. Your child will be given a fun toothpaste flavor and allowed to watch a kid-friendly movie during the entire cleaning process. Our staff will also spend time going over the dietary needs of your child along with daily brushing and flossing routines. We will also give tips on how to properly brush and floss and what foods are best to eat.

If your child has a toothache, clean the affected area with a toothbrush and toothpaste. Rinse the mouth vigorously with warm water and use dental floss in the surrounding areas. If your child needs a pain reliever, administer Tylenol or Motrin according to the package directions. Do not place aspirin on the tooth itself or on the gums. If the face is swollen, apply cold compresses and contact our office immediately. A swollen face could indicate a serious problem requiring immediate attention.

If your child is experiencing a true dental emergency, Dr. Grinbaum can be reached at 516-365-4543. We are available to handle emergency situations for our patients 24/7. If your child appears to be suffering from injuries that extend beyond the mouth, call 911 or take your child to the emergency room.

White Fillings
Stainless steel or White Zirconia crowns are sometimes recommended for children following a baby root canal or if a back baby tooth suffers from severe trauma or cavities. Because most baby molars do not fall out until the ages of 10-12, these crowns are recommended when traditional fillings are insufficient to protect the tooth from further damage until it falls out on its own. The differences between stainless steel and white crowns are mostly color preference. The pros and cons of each type of crown will be discussed with you to help you make a good decision for your child.

Crowns
Stainless steel or White Zirconia crowns are sometimes recommended for children following a baby root canal or if a back baby tooth suffers from severe trauma or cavities. Because most baby molars do not fall out until the ages of 10-12, these crowns are recommended when traditional fillings are insufficient to protect the tooth from further damage until it falls out on its own. The differences between stainless steel and white crowns are mostly color preference. The pros and cons of each type of crown will be discussed with you to help you make a good decision for your child.

Baby Root Canal Therapy
Pediatric root canal therapy is designed to maintain the integrity of the affected tooth to prevent premature loss. The early loss of posterior (back) teeth can lead to future problems with the placement and eruption of adult teeth. To avoid the difficulties inherent with crooked or impacted adult teeth, proper root canal treatment is needed to avoid the premature loss of primary molars. Dental caries and traumatic injury are the primary reasons for pulp therapy in children. Due to the loss of tooth structure involved in teeth requiring pediatric root canal therapy, full coverage restoration such as a pediatric crown is necessary.

Extractions

Extractions are commonly performed on pediatric patients to address extensively decayed non-restorable teeth or orthodontic problems. To help make the procedure as comfortable as possible for your child, we may recommend the inhalation of nitrous oxide (laughing gas) and a local anesthetic. If your child is anxious, oral or IV sedation can also be offered in the comfort of our office.

over-retained baby teeth
coming soon

orthodontic extractions
coming soon

Nitrous Oxide

Nitrous oxide, aka“laughing gas” or “happy air”, is a safe and effective behavior management tool offered at Dr. Kimmy. It is delivered via a nose-piece and your child will breathe through his/her nose. While a child is breathing nitrous oxide, it gives a sense of well-being and relaxation. It will raise the pain threshold and give the feeling of time flying by. Additionally, it works well for children who have a gag reflex during the dental appointment. The American Academy of Pediatric Dentistry recognizes nitrous oxide sedation as a safe and effective technique to use for helping children tolerate dental care.

Happy air is safe because:

Your child remains awake, responsive, and breathing on his/her own without assistance.
Your child receives more oxygen, compared to normal room air.
It begins to work rapidly, and is quickly eliminated from the body after a short period of breathing oxygen, and it has no lingering effects.
We have different “flavors,” such as strawberry, grapes, and bubble gum to choose from for the nose-piece to make the “happy air” experience fun and enjoyable for your child.

Taking dental x-rays or radiographs is essential for diagnosing dental disease and concerns. These radiographs show teeth, bones and soft tissue to help dentists determine if there are caries or hidden dental problems such as bone loss that cannot be seen when looking into a mouth. Taking dental x-rays can also help catch dental disease early to prevent pain and expensive dental treatment.

Dental x-rays use very small amounts of radiation and exposure to this small amount of radiation is safe. When a patient receives a full mouth series of x-rays, this is equivalent to radiation exposure in everyday life.

Nitrous Oxide aka ‘Laughing Gas’ (Mild sedation)
This type of sedation is given as an inhalational agent, where the child wears a mask on their nose, which delivers the nitrous oxide. The patient inhales the agent and exhales the agent without processing the agent. This means they breathe it out the same way they breathe it in. This type of sedation is good to use with children who may have slight anxiety, or have limited work that needs to be done.

Nitrous oxide acts to change the nitrogen levels in the body, and creates a slight “happy” feeling in children. It does not put your child to sleep. Once your child is on 100% oxygen, they will have no residual effects. Nitrous oxide is the safest drug that we have in anesthesia and dentistry.

This type of sedation is good to use with children who may have slight anxiety, or have limited work that needs to be done.

We offer the option of IV sedation with a highly trained dental anesthesiologist. This is sometimes necessary when the dentistry could not be completed otherwise.

Coming Soon

SMART (Silver Modifies Atraumatic Restorative Technique)
What Is Silver Diamine Fluoride (SDF)?
Made only of fluoride, silver, ammonia, and wate; SDF is a painless liquid treatment for individual teeth. Placed directly onto a cavity, it will act quickly to help halt the spread of decay and prevent further damage to the tooth. It can also be used as a preventive measure against future cavities and it works well on reducing sensitivity on teeth

It’s important to keep in mind that SDF will blacken and discolor parts of the tooth (where the decay is). SDF treatment can be an easy and non-invasive way to delay tooth decay while your young child is still growing and devleoping

Ideal for Young and Special Needs Children
Because SDF is so easy to apply, it’s often recommended for very young children and/or for children with developmental disabilities. Unlike a standard cavity filling, SDF requires no anesthetic or drilling, making it perfect for children who have a hard time sitting still.

Here are a few of the main advantages to using silver diamine fluoride:

Kills the bacteria causing decay
Prevents cavities
Halts the spread of tooth decay
Easy and pain-free procedure

ITR (interim therapeutic restorations)
Coming Soon

Hall technique
Coming Soon

Good dental hygiene starts with routine cleanings for your child with a dentist. During appointments, we’ll show your child how to brush, floss and develop a great health care routine he or she can carry into adulthood. We also make regularly scheduled cleanings a time of discovery and learning as our team identifies and talks about each instrument they use.

Our playful and professional dentist or dental hygienists will perform your child’s cleanings. They use special toothbrushes to loosen and remove deposits such as stains and plaque from teeth. Routine cleanings give our dentists a chance to locate problem areas that need special attention. We may also recommend special treatments such as fluoride and sealants.

We engage our young patients with an activity called “Tell, Show, Do.” We tell them about our special toothbrush that will tickle each of their teeth, show them on their finger, and then brush their teeth.

Dental cleanings are essential for preventive care. We recommend cleanings twice a year for all pediatric patients under our care.

The American Academy of Pediatric Dentistry (AAPD) recommends children start going to the dentist by age 1 or within 6 months of their first tooth. We recommend oral health exams twice a year, preferably during your child’s bi-annual teeth cleaning.

Education is a priority. We want to make sure you and your child learns the importance of practicing daily oral hygiene. Our trained staff will show your child how to brush and floss properly and discuss proper nutrition.

Our professional dental hygienists or your dentist will perform your child’s cleanings. They use a special toothbrush to loosen and remove deposits such as stains and plaque from teeth. We also make regularly scheduled cleanings a time of discovery as our team demonstrates tell, show, and do with your child. We recommend special preventative treatments, such as fluoride and sealants that will benefit your child’s oral health.

During the exam, our pediatric dentist will check your child’s teeth, lips, tongue, hard and soft tissues, and bite. As well as look for any abnormalities that may generate problems as your child grows. That includes examining primary or “baby teeth” and any adult teeth that may be coming in. Our pediatric dentists and trained staff will explain all of the findings and let you know if your child needs follow-up treatment.

We will take X-rays only when necessary to help identify cavities or other abnormalities. If your child has any decay, our pediatric dentists will recommend the appropriate treatment options.
At the end of the appointment, your child will be able to pick a prize to take home. Just a way to reward kids and show how proud we are to have them as part of the family.

During your child’s hygiene appointment, our team will talk about healthy habits, such as brushing, flossing, and snacking. They will also learn how many times a day and for how long each they should brush their teeth to keep them healthy! Children also get to pick a surprise from the prize wall. Plus, we treat new patients to an electric spin brush. It’s our way of saying, “Welcome to our family!”

Your child’s visit will be anything but routine. It’s a time for smiles, laughs, high-fives, and learning healthy habits.

Dental X-rays allow us to detect cavities that may form between the teeth and cannot be seen with our eyes. But they also detect much more than just cavities, they allow us to observe the growth and development of your child, aid in the surveying of unerupted teeth, or plan for orthodontic treatment. They also aid in the diagnoses of less common situations such as bone disease and evaluate the results of an injury your child may have experienced. X-rays allow dentists to diagnose and treat conditions that cannot be detected during a clinical examination. Without them, we are unable to guarantee the exact current or future condition of your child’s teeth, as well as, monitor growth and development.

In general, children need X-rays more often than adults. Their mouths grow and change rapidly. Their teeth are more susceptible to tooth decay than adults because the enamel is thinner on primary teeth then permanent. For high caries risk patients, the American Academy of Pediatric Dentistry recommends X-rays every six months to one year. Children with a low risk of tooth decay may require X-rays less frequently such as once every year. We always preform a Caries Risk Assessment during every hygiene appointment and can identify risk factors that may increase your child’s risk for developing cavities.

Sealants protect and seal off the “the nooks and crannies” on the chewing surfaces of the back teeth. The sealant blocks out food particles that could get caught in the grooves of the teeth, causing cavities. Sealants are made of a whitish/clear, BPA free material and are applied to the teeth to help keep them cavity-free. Although they are very effective, they do not guarantee that your child will not get a cavity. Research shows they help prevent and reduce the incidences of dental caries when used in conjunction with healthy snacking, brushing, floss, and regular dental visits.

The application of a sealant is quick and comfortable. The tooth is first cleaned (shampooed!) and dried. The sealant material is then flowed into the pits and fissures (nooks and crannies) of the tooth and hardened by a special light (our blue Elsa light!). Your child will be able to eat right after the appointment.

Your pediatric dentist will check the sealants during routine dental visits and recommend re-application or repair when necessary.

Tooth-colored fillings, or Composites, are made of a durable material made of quartz, ceramic, or silica. They provide good durability, are BPA free, and are resistant to fractures in small to mid-size fillings that need to withstand moderate pressure from the stress of chewing. Composites can be used on either front or back teeth. They are a good choice for patients who have small to medium cavities or have cavities in areas that require high esthetics.

Composite fillings require the tooth be kept clean and dry while the cavity is being filled. Some tooth-colored fillings contain materials that release fluoride, protecting them from further risk to caries. In a society focused on a white, bright smile, patients tend to want fillings that blend with the natural color of their teeth.

Ultimately, the best dental filling is NO dental filling. Prevention is the best medicine. You can dramatically decrease your risk of cavities and other dental diseases simply by:

  • Brushing twice a day with a fluoridated toothpaste
  • Flossing daily
  • Eating a balanced diet and limit snacking
  • Scheduling a dental visit every 6 months

Nitrous oxide or “laughing gas” is a safe and effective treatment, even for children. It’s used to sedate and calm patients who may feel anxious. For your child, it’s a relaxing and comfortable way to get through a dental procedure.

Nitrous Oxide/Oxygen inhalation, also known as “laughing gas,” is a mild, colorless, sweet smelling form of sedative used by many dentists to help facilitate the patient’s dental treatment needs. It is safe and tolerated well by most children. Nitrous Oxide/oxygen inhalation can reduce anxiety and hyperactive gag reflex. It may produce sensations of euphoria, drowsiness, warmth and tingling of the hands and feet resulting in an increase of tolerance for longer appointments.

Dental professionals consider it the safest sedative in dentistry. Both children and adults tolerate it well. It has a rapid onset, is reversible, can be adjusted in various concentrations, and is non-allergenic.

Nitrous Oxide in a dental office is never used as a general anesthetic and is not intended to put the patient “to sleep.” Depending on the procedure, local anesthetic may still be necessary. Uncommon side effects may include but are not limited to nausea, vomiting, headache and/or slight sleepiness or disorientation.

For nitrous oxide to be effective, the patient should be feeling well and able to breathe easily through the nose. The patient should also refrain from eating a large meal prior to breathing nitrous oxide. If the patient has a cold, fever, ear infection or stuffy nose please contact us to possibly reschedule the appointment.

Recovery from nitrous oxide is fast because it is quickly eliminated from the body. The patient will breathe oxygen for five minutes following the procedure so that there are no restrictions for aftercare.

If you have any concerns or questions with the use of nitrous oxide, please free to ask our pediatric dentists or trained staff.

We perform a pulpotomy to repair and save an infected or damaged tooth. When a cavity is very big and the bacteria has affected the nerve, the dentist will remove the infection portion of the nerve and disinfect it with the use of antimicrobials. The tooth is then restored with a stainless steel crown. Left untreated, the tooth may become infected and could cause abscess.

What do Tom Brady and Derek Jeter have in common? They’re both pro athletes. They also both wear mouthguards and so should your young athlete!

Mouthguards usually cover the upper teeth and protect your child’s primary and adult teeth from damage due to impact. We recommend them for high contact sports like football, basketball, baseball, hockey, lacrosse, and soccer during games, practice and scrimmages. Be like Tom—wear a mouthguard.

In the event a tooth is badly damaged and can’t be repaired with traditional methods, your child may need to have the tooth pulled or extracted.

A dental extraction is the removal of teeth from the socket in the alveolar bone. Extractions are performed for a wide variety of reasons, but most commonly to remove teeth which can no longer be restored due to tooth decay, periodontal disease, dental trauma or orthodontic needs.
After an extraction, it is most important to stop the bleeding. The most effective recommendation is positive pressure. This can be accomplished by having the child bite tightly on a piece of cotton gauze for 15-30 minutes. If your child is too young to do this, hold the gauze tightly against the extraction site with your finger for the same length of time. Even after long pressure, the extraction site may bleed slightly for several hours and may even stop and start again. Further pressure will usually solve the problem.

Normally, only slight discomfort will be experienced after an extraction unless the child bites the tongue or cheek while numb. If pain is present, we recommend Tylenol or Motrin in the appropriate dose for the size of your child rather than aspirin. If the pain is severe, call the office for guidance.

Avoid straws and forceful spitting on the first day. Crunchy foods (peanuts, pretzels, potato chips, etc.) should be avoided for the first day or two. Brush gently in the area and keep the area clean to promote healing.

A dental crown is a restoration that covers or “caps” a tooth, restoring it to its normal size and shape while strengthening and protecting it from further cracking or breakage. Crowns are necessary when a tooth is damaged by decay to the point that a filling is no longer a treatment option. Sometimes when a dentist removes significant tooth decay or performs a nerve treatment, he or she will recommend crowning the child’s affected tooth with a crown.

Stainless steel crowns are silver caps that cover the back teeth and preserve more of the tooth structure than other types of crowns. They withstand biting and chewing forces well and rarely chip or break.

White crowns are used to strengthen decayed front teeth. They are commonly referred to as strip crowns, made of a composite resin.
Dental crowns for children are generally completed in one visit, and will usually last until they are replaced by adult teeth.

White crowns that are used on back teeth of older patients are made of a porcelain fused to metal material. These crowns are more commonly used for adult teeth and are made by a general dentist. They are more rigid and work better when a mouth has stopped growing. White crowns are close in color to the natural teeth, so they are more cosmetically pleasing.