What makes a child a candidate for a white crown or a silver crown (made of stainless steel)? 
Why would your child even need a crown for "just a baby tooth?" 

Baby teeth are inherently different from permanent teeth, they have less enamel so that means that cavities progress faster in baby teeth than in permanent teeth! What you may see as a parent as a small area in the mouth usually means it's much bigger clinically and will need a restoration that fully covers the tooth to protect it from fracturing.

In the x-ray above, the tooth in the middle has a large cavity inbetween the teeth that almost goes into the nerve of the tooth, so this would tooth would be better served by a crown vs. a large filling. 

In this picture above, can you tell which teeth have crowns vs. natural teeth? That is what is great about zirconia or tooth-colored crowns. It's hard to tell! All the teeth on the top other than the one on the left is a crown (the one that looks more yellowish!) And as you can see the back molars have stainless steel crowns on them. Usually, multiple crowns that we need to place on the front teeth need to be done with children under sedation as they are quite technique sensitive.

The tooth-colored crowns I place are made of zirconia, which is a type of white porcelain. There is no metal in this material at all. That is not to say that there is not a place for stainless steel crowns which have been the gold standard in pediatric dentistry but as of 2010, zirconia crowns started to be available as a more esthetic option.

The way that I determine if a child is able to cooperate for a zirconia crown is their behavior. If your child is uncooperative, they may need to be sedated for treatment in order to have a zirconia crown, versus sometimes what is easier could be for me to mold a metal crown in order to fit the tooth quicker. It takes me about 2-3 times longer to prepare a tooth for a white crown vs. a silver crown, so if a child is young or has a hard time sitting still, a stainless steel crown may be the best option! If your child is a champ at dental treatment and historically has done great for dental work, they may be a good candidate for this treatment option.

While zirconia crowns are great options, I need to assess your child to make sure they would be a good candidate for this option, but I'm very excited to offer this service at Cultivate Kids Dentistry. Please feel free to ask more questions at your consultation appointment! 
-Dr. Gazdeck

So, put your seat belts on folks, because this is gonna be a post you want to sit down for... There is the common misconception that dentist and insurance companies are friends. Why? Well, because the first thing almost all parents ask is...do you take my insurance? The answer is: "We are not in-network, but we work with all insurances."

So, what does it mean to be "in-network"? 
To be an in-network dentist means that you sign up with a variety of dental insurances to accept discounts to your fees (sometimes very large ones - 50% off!) in order to be part of that insurance. In order to make up for these discounted fees, generally in-network dentists need to see a lot more patients to make up for these severely discounted fees, and they can sometimes force dentists to cut corners which it comes to dentistry. 

FUN FACT: 
Did you know that employers spend $95 billion on dental insurance premiums annually, but only 60% goes to dental care? 

Why are you an "out-of-network" dentist?

• I have decided to be "out-of-network" because I want to offer my patients a more individualized approach and more time per patient. I used to take my children to a very large pediatrician office. They saw a different nurse every time we went and it was difficult to be scheduled with the same pediatrician. While it was incredibly convenient, I really felt they weren't getting the attention that they needed, and thus I switched them to a smaller office. I felt so strongly that I wanted them to see the same person every single time, and I believe that many parents enjoy that continuity of care and find it important. 
• Insurances are NOT dentists, yet they dictate treatment, and I want to be the one making the best decision for your child (irregardless of what coverage your insurance has!) Also, as a small practice, we would need to hire a service in order to help with verifying insurance and eligibility (which a lot of large dental practices do), but we simply don't want to do that because that would actually increase our fees. We want to keep our costs low by keeping things simpler. 

Isn't an "out-of-network" dentist more expensive?

• Yes, it is true that your insurance may cover less of a percentage of the dental work coming to see us. However, a lot of the preventative coverage is covered at similar percentages. Also, dental work is an investment, and if poor work is done by an in-network dentist (who often times is running around with a schedule of a ton of patients), your child may need to get dental work done more than once, which means that while the dentistry seemed cheaper at the start, it can end up more expensive if work needs to be re-done. 
• I offer specific treatments that many other pediatric dentists do not offer in the area - pulpectomies (baby teeth root canals), and zirconia (white) crowns, and I pride myself on successful dental treatment so that we don't have to keep re-doing dental work over, and over again. I have been treating kids since 2013, and been out of pediatric residency since 2017, so I have the experience and the knowledge to treat your children at the highest level. 

What if I don't have insurance?

• We offer a membership plan through a company called Kleer. Plans start at $25/month and is our way of offering an affordable way of receiving top-notch dental care. We want to simplify this process versus going through a 3rd party like a dental insurance company. Please visit our INSURANCE page to learn more. 

I get this question from parents all the time. Sometimes the next statement is..."I don't understand, I've never had cavities, how is my child getting cavities?" 

Thankfully, due to great public health initiatives and general knowledge, many parents know already to brush their kids teeth twice a day, for 2 minutes (which, by the way, we'll talk about later because I definitely do not do a full 2 minutes for my 2 toddlers...

The main reasons for why kids get cavities are a mix of 2 primary reasons - 1) oral hygiene aka how clean are we keeping the teeth? and 2) dietary habits. Is it true that there are some children that have anatomical defects in the teeth that may them slightly more predisposed to cavities but this is not the norm! 

If I'm seeing a child whose teeth are really clean and parents endorse that they are brushing and flossing daily, my next question is regarding their child's eating habits. What we know is that children who tend to snack more, and "graze" throughout the day tend to have an increased risk for cavities because the mouth doesn't have time to cleanse itself inbetween! (Our spit and our tongue cleans out our mouth inbetween "feeds", and if we don't give our mouth a break and constantly feed it, that will increase our risk for cavities. So frequency of eating is one risk factor in increasings the risk of cavities, and the other is what the child is eating. 

When I go grocery shopping, almost all children's snacks are highly cariogenic (causes cavities!) Many children snack on dried carbohydrates (Cheez-its, goldifsh, pretzels, veggie sticks), and I have literally seen goldfish particles in my own toddler's teeth hours, yes HOURS after! So what is the harm regarding dried carbohydrates? It's not candy...however, carbohydrates break down into sugar, which is a food source for our oral bacteria, and the longer the food stays on the teeth, well the sugar bags have a feast, and as they break down the sugar, the byproduct is...sugar bug poop as I like to call it to the kiddos, or cavities. 

What can you do as a parent or guardian to help prevent cavities? 
1. Bring your child to the pediatric dentist starting at age 1. Prevention is key! 
2. If you have a toddler (or 2 like me!) if you can at least brush their teeth with a smear of fluoridated toothpaste once a day for 20 seconds, that's awesome! (When kids turn 3 they can have a pea-sized amount!)
3. Floss your child's teeth when their teeth touch (most important to get to those back molars which usually start to contact/kiss at age 3!)
4. Limit snacking to twice/day. Have organized meal and snack times. Great snacks for your kids that are Dr. Gazdeck approved: cheese, yogurt, applesauce, meat (chicken nuggets!), nuts, fresh fruit.
5. Anything that is not water have your child drink it through a straw so it doesn't touch the teeth as much. Also teeth love WATER the most! The only 2 drinks my children get unless it is a special occasion are water and milk. Bubbly water is NOT the same thing as water. Anything carbonated increases our risk for cavities! 
6. Avoid sticky candies/granola bars. Dr. Gazdeck has a sweet tooth though...and the sweets you want to veer your children to are straight chocolate (no caramels in the middle!), and ice cream as it melts off the teeth. 

Would you like more reading on this topic? 
I Love love love this book called: More Chocolate, No Cavities. It is written by a colleague of mine Dr. Roger Lucas who is not only a pediatric dentist but also a biochemist who writes in a very easy-to-read way on how to practically keep your child cavity-free! 
-DR. LYG

 

Hi everyone! So funny story when I was in high school one of my friends actually set up me up a website and I had a blog that I updated almost everyday. Funny how things come full circle and here I am, a mom of 2, opening my office and blogging again. I know you came here for dental knowledge, but I thought it might be nice to share a little about myself first...and my story! 

As we all know this past year has been tough all around. But instead of focusing on the negatives, something really beautiful came out of the pandemic for me. In March 2020, I had already planned to take 4 months of maternity leave with my 2nd born son, so I was at home and got to thinking a lot on what I saw my life looking like. I was an associate at an office, and I liked it, but I was coming home and feeling like...what is my next challenge, what am I working for, and do I see myself as an associate for the rest of my career?

It was during this time that I did a lot of praying, soul searching and realizing that I wanted to open Cultivate Kids. It is my 3rd baby. I love being a mom, but I also love being a pediatric dentist and I felt in a sense I had lost myself a bit after having kids. Does anyone else feel this way?

Who was I anyways? What were my interests and what did I want to pursue? 

This beautiful opportunity came a'knockin' and I am taking it by the horns and running with it! I hope you come alongside me and see how passionate I am about what I do and how I really believe that all kids can have no cavities in their whole childhood and let's partner together in this. 

Everyone asks me, why Knightdale?? (well, those people who have no idea where Knightdale is..it's closer to Raleigh than you might think!) I feel incredibly called to his profession and this community. I fell in love with Knightdale the first time I took a walk in Knightdale Station Park and every. single. person. said hi to me. The friendliness, the small-town charm, it just clicked.

I want to give a special shoutout to Drs. Martin and Bumgarner for entrusting me and sharing their space with me, Dr. Ketan Jumani who went to pediatric residency with me for your start-up prowess, Dr. Cook for all his one-liners and mentorship from my residency days, and my local pediatric dentists who have been my colleagues and supporters- Dr. Shraddha Patel and Dr. Bobby Elliott to name a few. I am also so thankful for having the most supportive husband who literally hand-picked Knightdale from us looking at Google Maps one day and also for my 2 kids...I want them to see a mom who goes after her dreams and makes a difference in her community, but who also prioritizes family time too! 

I'm looking forward to meeting ALL of you and your children. I'm pretty much an open book so feel free to comment on any questions or any blog posts you'd like to see!