Restorative & Surgical Care
Comprehensive pediatric dentistry has arrived in Hamilton County.
Specialist Pediatric Services
Using modern technology, our Carmel dental team is able to restore your child's smile back to full health.
When a tooth infection reaches the inside of the tooth (pulp) it can affect the nerve and blood vessel. If left untreated this can cause severe pain, inflammation, and even tooth loss. In order to prevent spreading infection, Dr. Juntgen may recommend pulp therapy (pulpectomy or pulpotomy).
As always, we start treatment conservatively. Dr. Juntgen may begin by removing decay and applying medication directly to the nerve. This helps to relieve pain and evaluate the effectiveness of treatment and health of the tooth. She uses x-rays at follow-up visits to see how the tooth is healing and determine if further care is required.
If the decay is extensive, then our caring Carmel dentist may need to remove a portion of the infected nerve or the entire nerve. A crown is then placed to protect the tooth and return it to functionality. After this treatment, our team explains how to ensure the healing process goes smoothly.
Misalignment of teeth can cause a lot of future dental problems, which is why we offer interceptive or early orthodontic treatment. During your child’s regular check-up, we look for complex problems such as:
- Excessive spacing
- Blocked teeth
- Crossbite or underbite
- Misaligned teeth
There is no quick fix when an orthodontic issue occurs. Our interceptive treatment is aimed at quickly adjusting growth. Then long-term management is used to help guide permanent teeth into a better position. At the appropriate stage of development, we refer our patients to an orthodontist for refinement of permanent tooth positioning.
Common early orthodontic treatments include appliances, retainers, spacers, or braces. We’ll work with you and your child to decide the best course of treatment with the ultimate goal of guiding permanent teeth into position.
When a cavity starts to take shape, Dr. Juntgen may recommend a dental filling. A filling replaces the decayed portion of the tooth in order to restore normal function. We offer three types of dental fillings at our office, amalgam, composite, and glass ionomer. Here is what parents need to know about each option:
Amalgam (silver): Amalgam fillings are ideal for back teeth as they are more durable and resistant to wear. Silver fillings are less sensitive to moisture while being placed, making them a great choice for wiggly kiddos and areas with excess gum tissue. Although amalgam does contain mercury, clinical trials continue to reaffirm its safety. Plus, our team takes great care to minimize your child’s exposure to mercury during placement or removal.
Composite (white): For a more natural finish, Dr. Juntgen may suggest a composite filling. These restorations match the color of your child’s tooth. An advantage of the composite material is that it bonds to your child’s tooth, allowing Dr. Juntgen to place a smaller, more conservative filling. They are mercury free and a great choice for both baby teeth and adult teeth.
Glass Ionomer: For our younger patients, we may recommend a glass ionomer filling. These fillings chemically bond to the tooth and continuously release fluoride, allowing them to help prevent future decay. They are more easily placed and less sensitive to moisture, but are not as strong and long-lasting as amalgam or composite. Glass ionomer may also be used on adult teeth as a temporary filling when sensitivity or gum tissue prevents the placement of a traditional amalgam or composite filling.
Dr. Juntgen evaluates each cavity and recommends the best choice of filling material for each particular child. She is happy to discuss the advantages and disadvantages of each material so parents feel informed and confident in their decision.
Crowns are placed when a cavity is very large and a significant amount of the tooth must be removed. They are also used following pulp therapy or when a substantial portion of the tooth is lost due to injury.
Composite crowns (tooth-colored) are used to treat front teeth, while stainless steel crowns (silver) are used to treat back teeth. Composite crowns are made from the same material as white-colored fillings. They are very esthetic but more prone to staining and fracture. The technique for placing a composite crown is very sensitive and requires your child to remain very still. Therefore, we often recommend a mild sedation medication to make the experience more pleasant for your child.
Stainless steel crowns are very durable and often remain in place until the baby tooth is lost. Silver crowns come in a variety of sizes, and they can often be placed in a single visit. On high-risk and cavity-prone children, Dr. Juntgen may recommend a stainless steel crown instead of a filling. A crown covers the entire surface of the tooth, and it offers more long-term protection against future decay.
Both of my girls, ages 1 and 4 were scared at their first appointment and the staff of HCPD did a wonderful job taking care of my sweet girls! My oldest loved that Dr. Juntgen sang songs from Frozen!
Jessica D. (Actual Patient's Mom)
Kids Dental Surgery
As moms, we know the word “surgery” is scary. Our job is to put parents and kids at ease. Our comfortable dental office has two individual suites used for private, one-on-one surgical treatments. We also use private operating rooms in the adjoining hospital for more advanced procedures. In either location, Dr. Juntgen and her team provide compassionate treatment.
Dr. Juntgen is happy to answer any questions about the following services:
Although we work hard to save all teeth, some situations call for the removal of a tooth. A tooth may require extraction if it is severely decayed or causing infection (abscess) of the surrounding gum tissue and bone. Infection related to a decayed tooth is serious and, left untreated, can lead to facial swelling and severe pain. Some permanent teeth are also removed at the request of an orthodontist to assist in tooth alignment.
Our team at Hamilton County Pediatric Dentistry works hard to make each and every appointment pleasant, including extraction appointments! However, the removal of a baby tooth or permanent tooth may worry you and your child. Remember that children sense a parent’s anxiety, so try to remain calm and relaxed! We avoid “trigger words” such as pain, pull, needle, and shot to help reduce anxiety. Our team is also highly trained in “dental slight of hand” to keep the anesthetic out of sight! We also use topical numbing jelly and laughing gas to make the administration of sleepy juice as pleasant as possible.
After an extraction appointment, follow the instructions below to ensure proper healing and comfort:
- Avoid eating until the anesthetic (numbing medication) has completely worn off and feeling has returned to the lip, tongue, and cheek
- Avoid chewing, sucking, scratching or picking at the lip, tongue, and cheek while these tissues are still numb
- Avoid touching the extraction site with fingers
- Avoid straws, sippy cups, bottles, and pacifiers for the first 24 hours
- Avoid forceful spitting for the first 24 hours
- Avoid hard or crunchy foods for the first several days
- Avoid high intensity/strenuous activities such as gym class, sports, and rough-housing for the remainder of the day
- Continue to bite on gauze until the bleeding is controlled
- Provide over-the-counter pain medication (such as Advil, Motrin, or Tylenol) as necessary for pain or discomfort
- Place an old towel or rag on the couch or pillowcase to prevent staining
- Alert the Tooth Fairy!
Contact our office if pain or bleeding continues.
The soft tissue attachment below the tongue and between the two front teeth is called a frenum. Occasionally this tissue is too strong or thick to allow for normal tongue movement, lip movement, and/or tooth alignment. The removal of this tissue is referred to as a frenectomy. Our dentist will evaluate each child at every recall appointment for any frenectomy needs.
Lumps and bumps occasionally surface within the mouth. In most cases, such lesions can be identified visually and treated (if they need treatment at all). However, persistent oral lesions that do not respond to medication, oral hygiene modification, and/or healing time should be removed and submitted for biopsy. Our dentist utilizes Indiana University for all biopsy submissions, and results are discussed in a timely manner.