Children’s Dentistry

Children's Dentist in central LondonDr Sara Johnstone Specialist in paediatric dentistryDentistry for children is different from that for adults. Joanna Johnson and Sara Johnstone, our specialist paedodontists, only treat children and have developed the special skills necessary for successful treatment.

Children who might otherwise find treatment challenging respond well to their management techniques and cheerful, child-centred approach.

Pain-free treatment

They will always ensure pain-free treatment, but as a distraction children often watch their favourite cartoons projected onto the ceiling.  When it is necessary for them to numb a tooth, they will always use an anaesthetic gel on the gum first so that the actual injection is not felt  – and with attention distracted by the cartoons, it is often not even noticed.

For children of five to six years and older, they can also offer ‘inhalation sedation’. This gives a pleasant feeling of relaxation and is particularly useful for apprehensive children and when a longer treatment session is needed. It is administered through a tube which is first held near the nose, then placed gently over the nose after a few minutes when it has started to take effect. Children can choose which ‘flavour’ they would like – we usually offer strawberry or grape – which helps to give the child a nice feeling of being in control.

The sedation does not control pain, so is usually used in conjunction with local anaesthesia, given by injection. The sedation is administered first, then the dentist will wait for as long as necessary until it has taken effect and the child is calm, relaxed and sleepy before proceeding. For nearly all children, inhalation is very effective, but each child is an individual and we cannot guarantee the result.

For younger children who need extensive treatment and for whom it would be unrealistic to expect the necessary level of co-operation, our specialist paedodontists can arrange a referral for treatment with a general anaesthetic in a hospital environment. (We cannot give general anaesthetic here.)

Treatment types

Jo and Sara’s treatments are always planned in discussion with the child’s parents, and with each child’s tolerance level taken into consideration.

Restoration of teeth with cavities

For younger patients with decay in their primary teeth, gentle treatment by hand is often the best approach.

Teeth are restored with either glass ionomer material, composite material or stainless steel crowns, depending on the depth of the decay.

Glass ionomer is a useful material when conditions are less than perfect – for instance when it is not possible to keep a tooth perfectly dry for as long as necessary.

Composite material is tooth coloured and is the material of choice in many cases  – but it can only be used when co-operation is good and the tooth can be kept dry during the whole process of the restoration.

For the successful restoration of larger cavities, our specialist paedodontists will usually recommend stainless steel crowns (silver colour). They fit right over the tooth and give the necessary level of extra protection for teeth for which composite material would not be suitable. Most children are often delighted to have a shiny new silver tooth.

Broke teeth, trauma

Jo and Sara are very experienced with the treatment of teeth which have been damaged in an accident. It is usually important for the tooth to be assessed with an X-ray as soon as possible, then monitored carefully over the following weeks/ months.