Holistic Pediatric Dentistry
The American Academy of Pediatric Dentistry recommends that you take your child for the first dental visit as early as 6 months of age, 6 months after the first tooth erupts and no later than your child’s first birthday.
As a Board Certified pediatric dentist, Dr. Evy has received extensive training so she can treat the dental, developmental, emotional, and behavioral needs of your growing child. She has treated babies as young as a few hours old to revise a tongue tie or lip tie that were causing breastfeeding problems, extract natal teeth (teeth a child is born with), and numerous babies and infants as early as 12 months of age (before their upper front baby teeth were fully erupted) for early childhood caries. She also provides comprehensive pediatric dental treatment for children of all ages including pre-teens and teenagers up to 18 years of age.
Our office philosophy is designed to address the needs of parents specifically seeking a doctor who will be receptive to their needs, will listen to their concerns, and who can provide different alternatives, when applicable, to treat dental decay while adhering to the standard of care set forth by our State Dental Board.
Our office is designed for all children and all parents. Therefore we are able to treat children whose parents seek traditional dental treatment or dental treatment with a holistic approach. Dr. Evy is the only pediatric dentist with a holistic approach practicing in the Austin and Central Texas area. Our office attracts patients from all over Texas as far south as Harlingen, as far west as Midland, as far north as Dallas, as far east as Houston, and the geographical areas in between.
What to Expect – First Visit
Once you have completed the check-in process, a Dental Assistant will greet you and your child, take his/her weight, ask some general questions, and take any X-rays Dr. Evy has ordered for your child. The X-rays are necessary in order to diagnose any tooth decay, pathology, and to check the progress of tooth development. Note: We fully understand the effect of additive radiation exposure during the lifetime of a person. We know there are different types of radiation we are exposed to on a daily basis, including but not limited to, electronic devices (cell phones, tablets, ipads, microwaves), air travel, power lines, & wifi signals among other sources. Therefore we use digital sensors and digital X-ray equipment set to the lowest possible effective setting to obtain dental X-rays. We also use lead aprons with a thyroid shield to protect your child’s body as best as possible. It is important to note that it is the standard of care to obtain X-rays of new patients based on their age and cooperation. We review your child’s medical history to ensure there are no contraindications to dental radiographs. Only in a few cases do we omit the X-rays in the first visit for patients who are cooperative. For established patients, the X-rays ordered are based on their caries risk established at the first visit. The caries risk is based on the following: decayed teeth, incipient decay, decalcification of the teeth, enamel hypoplasia, family history of decay, oral hygiene status, gum inflammation, dietary habits, and any other factors specific to a child.
Dr. Evy will review your child’s medical and dental history. She will come into the exam room and greet you and your child on your first visit and ask you to provide her with a brief description of your primary chief complaint. She will then conduct a gentle examination of your child’s head and neck area, soft tissues of the oral cavity, jaws, teeth, and gums. She will also examine for any tongue or lip frenulums (tongue-tie or lip-tie) as these are two anatomical attachments that are very often not examined, diagnosed, and or treated. We may utilize an ipad and/or an intraoral camera to obtain additional images of your child’s oral cavity. Dr. Evy finds that by sharing what she is able to see in your child’s mouth provides a better understanding of the diagnosis and the treatment needed.
We invite you to stay with your child during the initial examination. [For subsequent treatment appointments, if your child is old enough, we invite you to let your child experience the dental visit on their own to help us establish a closer rapport with them. We intend to gain your child’s confidence and help overcome any apprehension, so we can guide him or her through the process of each procedure in terms he or she can understand.] Dr. Evy will resort to different techniques in order to help your child cooperate during the visit. It is important you share any information that may be helpful in getting your child to cooperate and help him/her have the best visit possible.
Depending on behavior and cooperation, we may clean your child’s teeth and discuss appropriate brushing techniques, nutrition, natural remineralizing toothpaste choices, probiotics, and other specific recommendations as part of a preventive plan against tooth decay. Dr. Evy will ask about medical conditions your child has or may have and determine if there could be a link to the disease present in the mouth. She will also discuss information on healthy dietary lifestyle options, oral hygiene habits, and other related topics. Dr. Evy believes nutrition or lack of nutrition is primarily responsible for tooth decay. At times it can be combined with certain medical conditions affecting the absorption of nutrients and/or with poor oral hygiene habits.
If treatment is needed, Dr. Evy will show you where the decay is present, the status of the decay (early stages vs advanced stages), & discuss the recommended treatment with you.
If it is your first visit at our practice and there are multiple problems to be addressed, please come predisposed to receive information on all of the above items. For some patients, Dr. Evy may break down the amount of information given at the first appointment to focus on restoring your child’s mouth back to becoming cavity-free and provide preventive information at subsequent appointments.
Preventative Pediatric Dental Services:
- Dental exams and cleaning (prophylaxis)
- Digital dental x-rays (homeopathy for dental X-rays available upon request)
- Fluoride-free, BPA-free, bonded dental sealant
- Preventive resin restorations for molars with deep stained grooves
- Upper lip tie and tongue tie assessment
- Dietary counseling for good oral health
- Age-appropriate oral hygiene recommendations
- Probiotic recommendations
- Remineralizing toothpaste options
- Preventative services for special care needs patients
Restorative Pediatric Dental Services:
- Biocompatibility testing kits for dental materials available through an non-affiliated lab
- Resin composite fillings (BPA-free white fillings, no filling material containing mercury is ever used at our office)
- Crowns (Nusmile zirconia crowns, nusmile pre-veneered crowns, resin composite crowns, stainless steel crowns)
- SMART certified through the IAOMT
Specialized Pediatric Dental Services:
- Ozone therapy used in most dental procedures
- SMART Certified
- Non-invasive dental laser treatment options (for ulcers, fever blisters, etc.)
- Early interceptive orthodontics & habit solutions
- Intervention of sleep breathing disorders through fixed appliances
Pediatric Dental Surgical Services we Offer:
- Lip tie and tongue tie laser frenectomy- extensive experience, more than 4000 frenectomies performed
- Removal of an extra tooth (Supernumerary)
- Removal of an extra tooth located between upper front teeth (Mesiodens)
- Removal of fractured primary tooth roots
- Removal of problematic newborn teeth (natal and neonatal)
- Removal of most soft tissue lesions or abnormalities (mucocele, eruption cyst, papilloma, overgrown gums, warts in the mouth or lip area, inflamed gum tissue over erupting molars, etc.) Note: Soft tissue services are provided with the help of a soft tissue laser.
- Frenectomy/Frenulectomy — Lip-tie and tongue-tie correction
Note: we only do revisions with a soft tissue laser.
Here are some informational videos on the Frenectomy/Frenulectomy procedure.
Sedation & Anesthesia Services
Our top priority is to address your child’s dental decay and surgical needs in a manner that reduces the likelihood of a traumatic experience. We prefer not to have children grow up to be afraid to go to the dentist as adults. It is important to be aware that the behavior and emotional expression of children varies depending on their age, emotional maturity, temperament, history of dental pain, history of an unpleasant dental visit, the attitude of the dentist towards the child, parenting styles, and family environment.
It is important that both the dental team treating the child and the family of a child become an active participant to lessen the severity of dental fear and anxiety for the child. The family of a patient has a significant influence on a child’s response during their dental visit. Children are very sensitive and pick up on the emotional state of everyone around them.
At our office we utilize the following sedation and anesthesia techniques to successfully render dental treatment to patients for whom other techniques are not successful or indicated.
Nitrous oxide sedation (laughing gas)
Indicated for patients who have mild anxiety, mild fearfulness, or having a procedure that is surgical in nature. It helps reduce anxiety, untoward movement and reaction to dental treatment, enhances communication & cooperation, raises pain reaction threshold, increases tolerance for sitting on the dental chair long enough for treatment, reduces gagging, and it complements the effect of the local anesthetic for better numbness.
Oral conscious sedation
When our efforts to guide the patient with behavior management techniques, non-pharmacologic therapies, or nitrous gas, have not been successful, we often resort to oral sedation. In addition, when a child has moderate to severe anxiety, urgent treatment, or extensive amount of treatment needed, we also resort to oral sedation to help assist the patient undergo dental treatment. The goal of oral sedation is to minimize physical discomfort and pain; to control anxiety and reduce the likelihood of a child having a traumatic experience; to maximize the potential for amnesia (forgetfulness); and to allow the child to sit still long enough for the treatment to take place. During this sedation, the goal is for the patient to be relaxed watching TV while allowing treatment to take place with minimal objections.
IV Sedation provided in-office through PDAA (Pediatric Dental Anesthesia Associates)
As PDAA states, “very young, fearful, or uncooperative children may require sedation. IV sedation is a deep sleep that insulates your child from the stress and discomfort associated with dental procedures.” We reserve this type of sedation for patients for whom oral sedation is not indicated and for whom we are seeking to avoid general anesthesia. These children vary in age and amount of treatment that is needed, from one to many teeth requiring treatment. The most common reasons children need IV sedation is usually overt anxiety, very fearful, inability to cooperate, refusal to cooperate, very mobile and hyperactive, unable to sit still, a procedure surgical in nature, or a tooth/teeth with severe infection for which adequate anesthesia is needed to prevent child from feeling pain. During this type of sedation, children are in a deep sleep, breathing on their own, medications are given through the IV, and nitrous gas may also be added for a complementary sedation effect. This sedation is provided in our office by Dr. Clarke, a medical physician with a specialty in pediatric anesthesiology. Visit their website for detailed information and to get an idea about the usual process of IV sedation. http://pediatricsedation.com/our-doctors/
General anesthesia for comprehensive dental treatment provided at Surgicare of South Austin
At our office, most (but not all) of the children requiring general anesthesia are of preschool age. General anesthesia for these children is utilized for different reasons including but not limited to, extent of dental decay present, urgency of dental treatment, number of teeth requiring treatment, lack of cooperation, number of years before the teeth are naturally exfoliated, surgical nature of procedure, a medical condition contraindicating other types of sedation & type of restorations requested among other factors.
A smaller percentage of children who are older, sometimes require general anesthesia for dental treatment as well. Anesthesia for these children is utilized for different reasons as well, most commonly due severe anxiety or fearfulness for which behavior management techniques, nitrous gas, or oral sedation have not been successful. Additional reasons for utilizing general anesthesia for these children are certain medical conditions, extent of dental decay present, urgency of dental treatment, number of teeth requiring treatment, severe fear and anxiety, number of years before the teeth are naturally exfoliated, surgical nature of procedure, and special needs in a patient.