Dental Procedures at Green Apple

Ozone gas can be used for well-behaved children who can sit on their own for the length of the ozone application treatment. The dentist applies the gas to surfaces where decay has not yet damaged the dentin.

However, this is not recommended for children who are fidgety or uncooperative, as there is a risk of pure ozone inhalation. If ozone is accidentally inhaled, severe irritation occurs resulting in cough for more than 30 minutes, and difficulty breathing.

Because we have dental ozone available, we can sometimes prevent a tooth from needing a pulpotomy or baby root canal, and perform an indirect pulp cap (IPC) instead. This is because ozone therapy helps us to remove harmful bacteria located close to the nerve, as the ozone penetrates the layers of the tooth.

We can then place a sealer over the area to stimulate secondary dentin formation and help the tooth heal itself. In cases of advanced decay, however, a pulpotomy is the only option to save a primary tooth until it is ready to fall out naturally.

When decayed teeth still have enough healthy tooth structure, white composite resin fillings can be placed, sometimes in combination with an IPC, instead of a crown. We try to restore teeth in this biocompatible way rather than with the standard pulpotomy and crown.

Again, this is not always possible, but it is preferred.

Dr. Evy has personally known the ramifications of MTHFR mutations, and this discovery many years ago led to the implementation of added precautions for children requiring nitrous oxide during dental treatment. We offer a specially formulated Vitamin/Antioxidant Cocktail designed to support all children during dental treatment, with particular benefits for those who have or are suspected to have the MTHFR gene mutation. This cocktail helps support the body's natural ability to detoxify and heal, which is important during dental procedures.

The blend includes:

• Methyl B Complex: Folate is essential for healthy cell function and DNA repair. It can be depleted by nitrous oxide used in some dental treatments. This complex also contains other B vitamins and milk thistle extract, which support the liver's natural detoxification pathways.
• Glutathione: Glutathione is a powerful antioxidant naturally produced by the body to assist in detoxification. Supplementing it provides an extra boost to help clear toxins and support immune health.
• Vitamin C: Vitamin C is a strong antioxidant that supports the immune system, enhances tissue healing, and helps protect cells from damage.
• Other: Dr. Evy may add other personalized recommendations pre- and post-dental treatment to help your child detoxify and heal.

This cocktail is carefully designed to help children's bodies handle treatment more comfortably and promote faster recovery, especially for those with unique metabolic needs.

We understand that children with special needs require extra attention and a tailored approach to dental care. Our practice specializes in caring for children with conditions such as autism spectrum disorder, Down syndrome, sensory processing disorder, PANS/PANDAS, ADD, ADHD, and other developmental or neurological challenges.

Our team is trained to provide compassionate, patient-centered care that respects each child's individual sensitivities and communication styles. We use gentle techniques, sensory-friendly environments, and customized behavior management strategies to reduce anxiety and make dental visits positive experiences. This approach helps build trust and cooperation, making it easier to maintain your child's oral health over time.

We also collaborate closely with families and healthcare providers to ensure comprehensive care that supports your child's overall well-being. Our goal is to empower children and their caregivers with the knowledge and tools needed for successful, stress-free dental care.

When it comes to restoring damaged or decayed teeth, we offer custom-made crowns crafted from advanced, high-quality materials, including VOCO Admira Fusion and ceramic composites. Unlike traditional plastic or stainless steel crowns, these materials provide superior strength, durability, and aesthetics.

• VOCO Admira Fusion: This is a bioactive, nano-hybrid ceramic restorative material that combines the strength of ceramics with the flexibility of composites. It is highly biocompatible, meaning it works well with the body's natural tissues and reduces the risk of allergic reactions or irritation.
• Ceramic Crowns: Made from dental-grade ceramics, these crowns mimic the natural translucency and color of teeth, offering a seamless, natural appearance. Ceramic is resistant to staining and wear, making it an excellent choice for long-lasting restorations.
• Both materials are metal-free and free from plastic components, aligning with our holistic approach to dentistry by minimizing exposure to potentially harmful substances.

Custom fabrication ensures that each crown fits precisely, restoring tooth function and appearance while supporting healthy bite alignment. These crowns are ideal for children who need strong, safe, and aesthetically pleasing restorations that promote long-term oral health.

There are a few procedures for which there are NO alternatives, including nitrous oxide ("laughing gas") and IV sedation. It is important to understand that these sedation modalities are used to manage the patient's anxiety and behavior to allow for successful treatment. They are not normally needed for older and very cooperative kids unless the procedures are surgical.

Also, when teeth need to be numbed, there is no homeopathic alternative to local anesthetic.

Most orthodontic appliances or braces are not metal-free but are very predictable in correcting crowding, crossbites, narrow or high palate, and other bite problems. Metal-free appliances such as Clear Aligners and other silicone plastic devices are available and have their own applications, with advantages and disadvantages.

Additionally, we have yet to find a good metal-free option for space maintainer devices, which are used when a patient has lost a baby tooth prematurely. A space maintainer holds the space for the upcoming permanent tooth so crowding is prevented in that area. Zirconia appliances are metal-free but subject to breakage when the child bites on something hard. We continue to look for alternatives and designs for metal-free space maintainers.

This is an alternative to metal crowns. They usually come in different sizes to fit the size of your child's tooth.

Sometimes a pulpotomy treatment is needed when a zirconia crown is placed on a tooth. The doctor will let you know if the patient is a candidate for zirconia crowns.

Chronic mouth breathing changes the oral environment drastically. It alters saliva production, salivary flow, and the saliva coating the teeth — promoting harmful bacterial overgrowth, acidity, dryness, and a lack of nitric oxide production and inhalation.

Nitric oxide vasodilates blood vessels, improves oxygen exchange, fights inflammation in the mouth (and the rest of the body), disinfects inhaled air from harmful pathogens, and supports heart function.

Saliva also contains antibodies like IgA and signaling proteins that help control bacteria and viruses and support the immune defense of the mouth. Mouth breathing carries significant ramifications and does contribute to cavities.