Behavior Manage M ent - Pediatric Dental Care & …pediatricdentalcare.org/content_documents/12/PDCNPOP(rev).pdfPediatric dentistry is an area of specialization that focuses on the

Behavior ManageMent

Dealing with the behavior of young, immature and sometimes frightened children as well as those who may be physically or mentally challenged is an area that is unique to pediatric dentistry. It requires an understanding of child psychology, pharmacology and child development mixed with patience, love and discipline. In Pennsylvania, the use of laughing gas and other sedative agents requires both extensive additional education, such as that received by oral surgeons and pediatric dentists, as well as a state licensing procedure. The licensing process involves a team of trained professionals observing the doctors actually sedating patients in their office, as well as certifying that the office itself is equipped with advanced monitoring and emergency equipment and the training and knowledge of how to use it. In our office, we do not sedate every child who needs work done on their teeth. Our goal is to treat the child in the safest, least invasive manner possible as the use of any medication always carries with it some risk of a bad reaction. We make every attempt to use our best judgment in determining which children need some form of sedation.

Our decisions on how to treat a child are dictated by what is in the best interest of the child, not what is most convenient for the doctors or the parents/guardians. Please keep this in mind as you visit our office. Our goal is to facilitate a pleasant experience that does not cause your child a lifetime of fearing the dentist. We want to make the dental experience easy for them first, and then, as a secondary goal, as easy for you and us possible.

Pediatric dentists are trained in many methods to help children feel comfortable with dental treatment. For example, in the “Tell-Show-Do” technique, a pediatric dentist might name a dental instrument, demonstrate the instrument by using it to count your child’s fingers, and then use the instrument in treatment.

The modeling technique pairs a timid child in dental treatment with a cooperative child of similar age. Coaching, distraction, and good old TLC are other possibilities to give your child confidence in dentistry. But by far the most preferred technique is praise. Every child does something right during a dental visit, and pediatric dentists let children know that.

The majority of the time when the non-pharmacological techniques are not successful, all that is needed is some laughing gas (Nitrous Oxide). This involves the child selecting a flavored nosepiece to breathe through, and simply placing the nosepiece on their face. The child is not “put to sleep,” however they do usually feel somewhat “tingly,” and “giggly.”

Beyond the use of nitrous oxide/laughing gas, there are several other methods of conscious sedation that can be used. They may be administered either orally in the form of a syrup to drink, or as an injection. The details of these forms of sedation are best discussed with the doctors on your first visit to our office, as there can be additional risks in administering them to a child.

Depending upon the level of sedation that is required, your child will be monitored throughout his/her appointment with some combination of a pulse oxymeter (heart rate and oxygen level of the blood), a capnographer (the depth and quality of breathing), a stethoscope, a blood pressure cuff and clinical observation. All of these monitors are used to better assure the safety of your child. A complete array of emergency medications are always in the room with any sedated child and both the doctors and their staff are fully trained in their use.

428 Windmere Drive, Suite 200, State College, PA 16801814.238.7120 fax 814.238.2981 www.pediatricdentalcare.org


aBout our Doctors

Dr. John Kelly:

Dr. Kelly is originally from Baltimore, Maryland. He attended Johns Hopkins University where he played on three national championship lacrosse teams and graduated as president of his class. In 1973 he graduated number one in class from the University of Maryland Dental School and received his pediatric dental specialty training at the University of Kentucky. He served in US Army as Chief of Pediatric Dentistry at Ft. Knox Kentucky from 1975-1977. He has been in private practice in State College since 1977. Dr. Kelly has authored a dozen publications in professional journals in the area of dental trauma, oral pathology, treating patients with special needs and practice management. Dr. Kelly and his wife Carol have been married for thirty-nine years and have two grown sons and two grandsons. Dr. Kelly is active in his church and serves on the board of directors of several organizations that serve underprivileged children and people with special needs. In his spare time he runs a restaurant, Kelly’s Steak and Seafood, with his son Sean; he collects rare books, particularly bibles; and travels to the Dominican Republic several weeks a year as part of a dental missions team.

Dr. Robert Kilareski:

Dr. Bob, as he is known to his patients, is a State College native, graduating from State High in 1991. He obtained his D.D.S. degree from Northwestern University Dental School and completed his pediatric residency at Long Island Jewish Medical Center/Schneider Children’s Hospital in Queens, NY. While at LIJ, Dr. Bob was selected as Chief Resident of Pediatric Dentistry. Dr. Bob was an original Board member of Centre Volunteers in Medicine, and is still proud to be a professional and personal supporter of CVIM. Dr. Bob is a member of the ADA, is a Fellow of the American Academy of Pediatric Dentistry, and a Diplomate of the American Board of Pediatric Dentistry. He lives in State College with his wife Laura and their children, Joshua, Abigail and Samuel. He enjoys spending time with his family, golfing and Penn State football and basketball.

Dr. G. Matthew Kremser:

“Dr. Matt” grew up in a military family, traveled the country, and finally settled in State College in 1993. He graduated from State High in 1996, and completed four years of undergraduate education at the Pennsylvania State University. Dr. Matt pursued his D.M.D. degree at the University of Pittsburgh School of Dental Medicine, and completed his residency in pediatric dentistry at the Children’s Hospital of Wisconsin. His professional interests lie in managing the anxious or fearful child through the dental experience, using both non-pharmacological and pharmacological behavior modification techniques. Dr. Matt is a member of the Golden Key National Honors Society, the Pierre Fouschard Academy, the American Dental Association, and the American Academy of Pediatric Dentistry, and has been a presenter during the academy’s annual session. When Dr. Matt is not working, he enjoys spending time in the outdoors, archery hunting, fly-fishing, camping, and hiking. He is also active in his church, and enjoys accompanying Dr. Kelly on dental mission trips to the Dominican Republic.


Patient Protection

In the last few years, patient protection has become an issue of public concern. It has become necessary for health care facilities to consistently apply state-of-the-art sterilization and disinfection techniques to provide patients with maximum protection.

In our office, your child’s safety is our highest priority. Infection control protects your child, our patient, and our staff from disease transmission. In addition to routine precautions, we take extra care to follow standards established by the American Dental Association (ADA) and the Centers for Disease Control (CDC) to control the spread of infection. Throughout the day, we continuously and thoroughly sterilize our equipment for your protection. Our protocol for sterilization includes the following:

Before and after each patient appointment, all treatment surfaces (e.g., countertops, chair surfaces, lights, x-ray machines, and trays) are disinfected with the most effective and safest products available. We always wash our hands and change gloves, keep our operatories clean, use disposable items, wear protective clothing and eyewear, and dispose of waste properly. All staff members are updated annually in proper patient protection procedures and have been vaccinated against the Hepatitis-B virus.

To ensure your child’s safety, we follow a number of standard sterilization procedures with all instruments and hand pieces. First, they are brought into our sterilization room and placed in an ultrasonic cleaner to remove even microscopic debris. The instruments and hand pieces are then rinsed thoroughly before beginning sterilized in a Statim (heat-sterilization), which reaches 400-425 degrees, thereby destroying all bacteria and all viruses. This is done between each patient use. Our Statim is monitored regularly to ensure their effectiveness and safety. Those few items that cannot be heat-sterilized are cleaned and disinfected.

Healthcare safety is an important part of our job and we are proud of the standards we maintain.


PeDiatric Dental services

We at Pediatric Dental Care are please to be able to offer dental services for infants, children and adolescents. Pediatric dentistry is an area of specialization that focuses on the treatment of children from birth to adolescence with a concentration on growth, development, and behavioral guidance for both healthy and special needs children. Drs. Kelly, Kilareski & Kremser are specially trained to care for children using methods that promote strong foundations in prevention and home care. Prevention and education are important in our practice, and we take seriously that you and your child need to understand how to take charge of and protect your child’s oral health. We are always available to answer questions about your child’s dental needs and the services we can provide for your child’s ideal treatment. We offer a wide range of services to meet the needs of your child, including:

Comprehensive Examinations Emergency Care Diagnostic and Preventative Services Habit & Athletic Appliances Restorative Procedures Early Orthodontics Cosmetic Procedures In-Office Conscious Sedation

Your child should have a comprehensive dental examination every 6 months, which includes a thorough exam of the teeth and gums. We use the findings from our examination to formulate a complete diagnosis and comprehensive treatment plan for your child.

Recommendations for treatment are explained at a consultation time set aside specifically for you and your child. The consultation can take place during the initial appointment or can be scheduled as a separate appointment at the doctors request. Our goal is to ensure that you receive the best possible information concerning your child’s treatment options. The time we invest in patient education enables us to deliver the best possible outcome for your child’s dental treatment.


Financial oPtions

Payment Options:

We are committed to providing excellent dental care and guiding parents in choosing the best payment option for their child’s needs. We accept cash, personal checks, Visa, MasterCard, American Express, Discover, as well as offer Citi Healthcard and Care Credit (a health care credit plan).

Dental Insurance:

Your insurance is a contract between your employer and a dental insurance company. Benefits received are based on the terms of the contract negotiated between your employer and the dental insurance company, and not the dental office. The goal of most dental insurance policies is to provide only basic care for specific dental services and typically have little to do with your child’s needs or achieving a high-quality, complete result. Many needed services may not be covered.

Our office will do everything possible to help you understand and make the most of your dental benefits. As a courtesy, our office will complete and submit your insurance forms to achieve the maximum reimbursement to which you are entitled. Please remember that we request the payment in full when services are rendered. We urge you to read your insurance policy so that you are fully aware of coverage and any limitations of the benefits provided.


in case oF eMergency

Emergency care is always a priority. We hope that your child will never experience a dental emergency, but if it happens, we want you to know that we are always available. We maintain 24 hour/seven day/week coverage for our patients.

If your child is experiencing severe pain, bleeding, swelling or trauma – please call our office immediately at 814-238-7120 so that appropriate treatment can be arranged.


Your Child’s First Visit

We ask that you please complete the enclosed forms using either blue or black ink, and return them to our office prior to your child’s first dental appointment. These forms enable our staff to better understand your child’s medical history and attain the necessary parental information. We have also enclosed a return envelope for your convenience. If you arrive at your child’s first visit not having forms properly completed, it may be necessary to reschedule the appointment.

Our office, as well as the American Academy of Pediatric Dentistry, recommends that your child visit the dentist by his/her first birthday. You can make the first visit to the dentist enjoyable and positive. Your child should be informed of the visit and told that the dentist and their staff will explain all procedures and answer any questions. The less to-do concerning the visit, the better.

It is best if you refrain from using words around your child that might cause unnecessary fear, such as “needle”, “shot”, “pull”, “drill” or “hurt”. The office makes a practice of using words that convey the same message, but are pleasant and non-frightening to the child.

If your child is over the age of 3, we ask that you allow them to accompany our staff through the dental experience. We are all highly experienced in helping children overcome anxiety. Separation anxiety is not uncommon in children, so please try not to be concerned if your child exhibits some negative behavior. This is normal and will soon diminish. Studies and experience have shown that most children over the age of 3 react more positively when permitted to experience the dental visit on their own and in an environment designed for children.


WelcoMe & PhilosoPhy

Welcome to Pediatric Dental Care. Our office is a place where children feel at home and start their journey for a lifetime of good oral health. The dental needs of young children are very specific and they have special emotional needs as well. Our practice has the experience and compassion to tend to both aspects. We build trust and confidence with our patients as well as educate parents and caregivers – a combination that leads to fantastic results. Thank you for considering us for your child’s dental care.

It is the philosophy of our office to provide the highest possible degree of professional care to your child and the family. We are very confident in our ability to make dentistry an enjoyable, comfortable experience for your child. We ask you to be completely at ease with communicating any concerns, questions or desires to us. If at any time you have a question regarding a treatment, fee or service, please discuss them with us promptly and frankly. The doctors have the answers about your child’s dental care and behavior management, but the business office staff is the most qualified to answer questions about insurance, fees and your account status. We will make every effort to avoid a misunderstanding, to rectify an injustice and to preserve a friendship.

Behavior Manage M ent - Pediatric Dental Care & …pediatricdentalcare.org/content_documents/12/PDCNPOP(rev).pdfPediatric dentistry is an area of specialization that focuses on the

Documents