Children’s Dental Services • Silverdale, WA

Dental Procedures for Children
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Radiographs (x-rays) are vital to ensure a thorough dental examination for your child.

Radiographs are used to detect cavities, evaluate the eruption of teeth, evaluate teeth and the supporting bone following trauma, plan for orthodontic treatment, and detect any disease of the bone. Without the use of x-rays many dental conditions are not visible until they become a more serious problem.

The American Academy of Pediatric Dentistry recommends children receive radiographs every 6-12 months depending on their risk for cavities. As your child’s permanent teeth begin to erupt a larger, panoramic radiograph is recommended. This allows your dentist to evaluate all existing and developing teeth, bone, and other orofacial structures.

Pediatric dentists take every precaution possible to minimize radiation exposure for patients and employees. Our office is pleased to offer digital radiographs which lower the radiation exposure for your child compared to conventional radiographs. This coupled with the use of a lead apron and collar exposes your child to minimal radiation.

Silver Diamine Fluoride

Silver diamine fluoride is a non-invasive treatment option for some cavities. Not all teeth are candidates for this material but, when used correctly, it can stop active decay and also prevent future decay in the treated tooth. Silver Diamine Fluoride, or SDF, received FDA approval in 2014. Since coming on the market it has been an incredible aid in helping address decay in children and adults. With dental cavities continuing to be the most common chronic childhood illness, we are excited to offer an alternative to the traditional “drill and fill” approach to managing dental cavities.
Pros of SDF:

  • Quick and painless application
  • Helps relieve sensitivity
  • Arrests 80% of dental decay
  • It helps arrest current caries activity and helps promote remineralization of natural tooth structure

Cons of SDF:

  • Permanently stains any decayed portion of the tooth black
  • Cavitated teeth, or teeth with holes, will still require a restoration to prevent food from packing in the area
  • SDF is not a treatment for certain teeth such as those with deep cavities
  • SDF is not a cure for dental decay, it is a treatment option


When your pediatric dentist detects a cavity during their examination they will recommend a means to restore the tooth in both form and function. Depending on the size of the cavity the area may be numbed to ensure your child is comfortable throughout the procedure. Often a “raincoat” or non-latex rubber dam is placed to protect your child from any debris during the cavity removal. Once the cavity is removed the tooth will be restored.

Depending on the size of your child’s cavity your pediatric dentist may recommend a crown, or “cap”, to protect their teeth. Baby teeth are small and often a cavity is large enough that the remaining tooth structure is insufficient to hold a filling. These caps are silver; however, white crowns are available to meet more aesthetic needs.

Pulpal Therapy

Baby teeth are small but the nerve and blood vessels, or ‘dental pulp’, inside them are much larger in proportion than in adult teeth. Often cavities in baby teeth progress quickly towards the pulp and cause pulpal inflammation in the area. Sometimes this can cause some discomfort on that tooth, other times your child will have no symptoms.

The purpose of pulpal therapy is to remove the affected pulpal tissue and place an inert material inside the tooth that allows the tooth to remain in the mouth until it is naturally lost. These procedures are often called a “baby root canal”, “indirect pulp cap”, “pulpotomy”, or “pulpectomy”.


A pulpectomy is the removal of all pulpal tissue from the crown and root of the tooth. The space is then disinfected and a restorable material placed to allow normal eruption of the permanent tooth underneath.


A pulpotomy removes the affect portion of the pulp and places an agent that calms the remaining nerve and removes any residual bacteria. The tooth is restored with a full coverage stainless steel crown to help seal the pulp from further injury.

Indirect Pulp Cap

An indirect pulp cap is the removal nearly all of the cavity leaving small portion over the nerve of the tooth. A medicine is placed that allows the tooth to heal itself from the inside out and prevents further growth of the bacteria. The tooth is then filled with a restoration to help prevent bacteria from re-invading the tooth.

Dental Extractions

We make every attempt to save teeth here at Silverdale Dental Center; however, there are times when the removal of a tooth is recommended. Teeth which have a large cavity that would prohibit the placement of a filling or crown, have a large infection, or have had trauma that makes them unsafe to remain in the mouth are all possible candidates for a necessary extraction. Since baby teeth are a placeholder for permanent teeth we often place an appliance to save the space for the developing tooth to erupt.

Children’s Dental Services

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COVID-19 Status Message

As of May 19th we are open for full-service, non-urgent dental treatment.

Our community has been through a lot over the last few months, and all of us are looking forward to resuming our normal habits and routines. While many things have changed, one thing has remained the same: our commitment to your safety.

Infection control has always been a top priority for our practice and you may have seen this during your visits to our office. Our infection control processes are made so that when you receive care, it’s both safe and comfortable. We want to tell you about the infection control procedures we follow in our practice to keep patients and staff safe.

Our office follows infection control recommendations made by the American Dental Association (ADA), the U.S. Centers for Disease Control and Prevention (CDC) and the Occupational Safety and Health Administration (OSHA). We follow the activities of these agencies so that we are up-to-date on any new rulings or guidance that may be issued.

You may see some changes when it is time for your next appointment. We made these changes to help protect our patients and staff. For example:

Thank you for being our patient. We value your trust and loyalty and look forward to welcoming back our patients, neighbors and friends.

Dr. Jason Niemeyer, Dr. Jeffrey Phillips and the rest of the SDC team