Pediatric Dentistry of Columbia

(410) 740-0144
10632 Little Patuxent Parkway, Suite 337
Columbia, MD 21044

Growing happy, healthy smiles for infants, children, and adolescents

Pediatric Dentistry of Columbia

Restorative Care

Several factors influence the performance, durability, longevity and expense of dental restorations:

  • The components used in the filling material
  • The amount of tooth structure remaining
  • Where and how the filling is placed
  • The chewing load that the tooth will have to bear
  • The length and number of visits needed to prepare and adjust the restored tooth.

Ultimately, the decision about which filling material should be used is best determined in consultation with Dr. Doshi. Before your treatment begins, please feel free to discuss the options with her.

Composite Resin (Tooth Colored Fillings)

Composite resins (tooth colored fillings) are used to restore front teeth or where a natural or cosmetic appearance is important.

They can be used on the back teeth as well, depending on the location and extent of the tooth decay. Most composite resins require superb moisture control and work best in areas of decay that are small, and low stress bearing areas.

Some tooth colored materials (called Glass Ionomers) even release fluoride and help make the tooth more resistant to cavities. Furthermore, composite resins require excellent hygiene and a careful diet following placement on teeth.

Stainless Steel Crowns

These are silver “caps” that are used to restore back teeth that are too badly decayed to hold fillings or have pulpal (nerve) treatment as the tooth becomes fragile after.

Pulpal Therapy (Root canal)

Pulp therapy is the removal of part (pulpotomy) or all (pulpectomy) of the nerve of the tooth. It is necessary when decay has spread to the nerve of the tooth or due to severe trauma to the tooth causing damage to the nerve. The procedure consists of treating the nerve of the tooth to avoid extracting the tooth.


Extractions are done only as a last resort. If a primary molar (back tooth) is removed prematurely, a space maintainer should be placed to keep the space for the permanent tooth coming behind it. Teeth may also be extracted for orthodontic reasons as well.

Space Maintainers

Space maintainers are appliances that are used to hold space for the permanent tooth when a primary tooth has been lost prematurely. If space is not maintained, teeth on either side of the extraction site can drift into the space and prevent the permanent tooth from erupting in the proper position.

Nitrous Oxide (“Laughing Gas”)

Nitrous Oxide (laughing gas) is a combination of Nitrous Oxide and Oxygen to help your child's body achieve a relaxed state. This is the most popular form of anxiolysis used in pediatric dentistry today. The majority of children benefit from the use of nitrous oxide during their dental treatment as it makes for an overall calmer and more pleasant experience.

Nitrous Oxide is a colorless and faintly sweet smelling gas that is administered in the office via a mask on the nose. It is absorbed rapidly, which allows a very fast onset. If your child is crying and unable to adequately breathe through their nose due to a stuffy nose, etc., the effects of Nitrous Oxide may be diminished.

Children on Nitrous Oxide continue to respond appropriately to verbal commands and are able to carry on a conversation. It makes them more relaxed and open to suggestion. They feel as if their hands and feet are tingly, they are flying, or they are in a dream. For the most part, children return to pre-procedure mobility and cognition with a speedy recovery of about five minutes (with 100% Oxygen).

Nitrous Oxide is a mild analgesic and helps to suppress a strong gag reflex, which in turn makes for a smoother visit for many children. Therefore, Dr. Doshi may recommend the use of Nitrous Oxide during restorative treatment to relax very apprehensive patients and patients with severe gag reflexes to aid in a successful restorative visit.

General Anesthesia

Children with extensive dental needs or special medical conditions may require treatment in the hospital, under general anesthesia.

Advanced caries through the enamel is irreversible and should be restored due to the possibility of dental pain, infection, and early tooth loss. Children that have caries that are irreversible, must have their caries treated in order to remain healthy.

The child that needs dental treatment, but cannot tolerate it in the dental office may require general anesthesia to complete the dental treatment needed. Examples may include toddlers with early childhood caries or multiple carious lesions, older children who are unable to tolerate in-office treatment, or children with special needs – autism, cerebral palsy, various syndromes, etc.

We understand that the thought of taking your child to the hospital for dental treatment is scary. Therefore, we have provided some further information regarding hospital dentistry with anesthesia below.

Some risks of treatment under General Anesthesia:

When a child is deeply sedated, breathing slows down. As breathing slows, the risks of airway complications rise. For this reason, the anesthesiologist controls the breathing of the child. This control minimizes airway complications and allows for surgeries to be done predictably and as safe as possible.

Benefits of treatment under General Anesthesia:

Treating children in a painless, non-traumatic setting has many long-term benefits as stated below:

  • Restraint of children for dental work can be unsafe for the child and dentist.
  • Your child receives all dental work at one time, eliminating the trauma of multiple dental visits and decreasing the amount of time out of the parent’s schedule.
  • Your child is allowed to stay positive about the dentist, which has been shown to promote a long-term positive attitude about dental care.
  • Treatment is done with the highest quality in mind, allowing for long lasting restorations. Restraint of children for dental work leads to lower quality restorations, which have a higher chance of failure and re-treatment. Under general anesthesia, practitioners can be meticulous.
  • Natural looking restorations require cooperation. General anesthesia allows for excellent aesthetics and longevity.

Initial evaluation is crucial for discussion of treatment options for your child. At that time, Dr. Doshi will determine your child’s comprehensive dental needs, and discuss the best treatment options with you. We understand that every child is different and deserves to be treated as an individual.