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Specialized in Pediatric and Laser dentistry

Smile Wonders

When your child needs extensive dental work or they are too young to have more advanced dental work, parents are often concerned about how their child will be safely stabilized for the procedure.
For 90% or the procedures at Smile Wonders procedures can be done with just the use of waterlase without using any local anesthetic injection or need for sedation. We often use distractions, such as counting games or silly songs or even use the TV installed in our ceiling with headphones to make the dental appointment fly by. However, in some cases, children maybe too young to understand directions or overly fearful and the needs are too extensive that either IV sedation or general anesthesia maybe required to complete the needed work safely and thoroughly. Let’s look at the differences between the two options.


IV Sedation
IV (Intravenous) sedation is provided right in our pediatric dental office, and administered by a board-certified anesthesiologist. This option is best for healthy children that just need some help with cooperation. We can use nitrous oxide or IM pre-medication to get the child calm and comfortably asleep. Then an IV will be placed and monitored for continuous anesthesia administration during the dental procedure. The children maintain their own reflexes and breathing, and the anesthesiologist has the ability to custom-titrate the medications to safely produce the best effects. Children can return to normal school or play activity the very next day.

General Anesthesia
General anesthesia is usually required for children who have certain respiratory or neurological special needs that necessitate care in a hospital setting. It is provided using a combination of intravenous drugs and inhaled gases, and puts a patient into a completely-unconscious state. A breathing tube is inserted to control the airway with use of respiratory machines. Dr. Rishita Jaju maintains medical privileges at Children’s National Medical Center in Washington, DC and is able to provide care for her most fragile patients at that facility.
Those children who have an advanced medical history with things such as diabetes, cleft lip and palate, sleep apnea, or cerebral palsy, for example, would most likely require General Anesthesia for dental needs such as extensive, complicated or multiple procedures that need to be provided in collaboration with other surgeons such as those in orthopedics, general surgery, plastic surgery, ENT, etc.

For Both Sedation Types
Prior to their child’s sedation procedure parents will be given fasting guidelines at home. We will also discuss any restrictions they might have following their dental work, and schedule follow-up visits. We know that any time someone is sedated it can be scary, but we encourage parents not to frighten children about an upcoming procedure. We’ll try to make it as fun and easy as possible for them.

Contact Smile Wonders
Reston pediatric dentist Dr. Rishita Jaju of Smile Wonders specializes in pediatric oral health. Contact us at 571-350-3663.

A pediatric dentist works with the general population of children, yet within that population there are segments that sometimes need just a little extra loving care, which we are trained for, and glad to provide. We refer to these as our special needs patients.

Almost 20% of children in the U.S. have special health care needs that run the gamut from medical to developmental to behavioral, and encompass, but are not limited to:

  • Nonverbal
  • Down’s Syndrome
  • Cerebral Palsy
  • Autism Spectrum Disorders
  • Epilepsy
  • ADHD
  • Anxiety
  • Cleft Lip and Palate
  • Traumatic Brain Injury
  • Liver Cirrhosis

Dental Care for Children with Special Needs

We encourage the family to attend a desensitization appointment as a “meet and greet” consultation to allow the child to experience the dentist in a non-threatening first meeting and prepare for their upcoming dental appointment. When dental procedures such as cleanings, cavity fillings or other work are needed, we customize them to the child’s tolerance and needs. We find that scheduling more-frequent low-pressure visits are easier to handle than one large appointment. Parents and caregivers are encouraged to accompany their child in the treatment areas for comfort and familiarity.

Some patients may benefit from early morning appointments so that they are fresh, most rested, and relaxed. Some patients do better mid-day as their normal medications may get a chance to work and we do not interrupt their morning routine. While, some patients would like to come at a time when there are no other patients in the reception area. We take all the preferences in consideration to set up for the most successful dental visit.

Quiet Room
Many children with special needs feel safe in their own room and defined safe space at Smile Wonders. There are no other children playing and distracting or causing over stimulation. They can wear headphones and connect to televisions mounted to the ceiling or listen to their favorite music. It helps them to relax and avoid having to listen to the normal sounds associated with a dental office. They are also free to enjoy our other play areas.

Specialized Equipment
The dental equipment and techniques are also adapted for children with special needs, such as those who cannot stand or sit motionless, creating a more pleasant visit to the dentist. Recommendations for modified brushing routine and tricks, as well as frequency schedule are provided for each child.

Collaboration with Other Providers
Dr. Rishita at Smile Wonders works with area Developmental Pediatricians, Occupational therapists, or Speech Language Pathologists to provide a ‘Visual Social Schedule’, at home ‘Oral stimulatory exercises’ or coordinates appointment with ‘Sensory Diet’ prior to dental appointments. This personalized activity plan gives children the sensory input they need to reduce anxiety, remain attentive, focused and organized throughout their day.

At Smile Wonders, children with special needs and their parents are treated with care and compassion, and receive the same high level of dental care as all our patients. We love your child like you do, and through proper oral hygiene and regular dental visits can help ensure a healthy and happy smile throughout the child’s life.

Contact Smile Wonders
If you are looking for a pediatric dentist experienced with special needs children, schedule your appointment with Dr. Rishita Jaju at Smile Wonders today. Our practice is conveniently located in Reston, Virginia.


Digital advances in pediatric dentistry are amazing. Not only do they provide for patient comfort, they create opportunities for pediatric dentists to provide better treatment.

Digital X-Rays
The cutting-edge technology of digital X-rays, also known as digital radiography, enables the pediatric dentist to take crisp X-ray images of the teeth, supporting bone and gums and download them instantaneously into the computer without delay, thus eliminating the need for environmentally-harmful film and chemical development. It also allows dentists to magnify and enhance images to review specific dental issues, and instantly transfer them to a patient’s file or dental specialist such as the child’s orthodontist.

Digital X-rays are faster and safer than traditional X-rays, reducing the exposure to radiation by up to 90%.

Digital Photography
The intra-oral camera allows a patient to see what the dentist sees: their mouth from the inside. These photographs can also be enlarged and enhanced to show detail, creating better means of communication and documentation. Since they are not X-rays, there is no radiation involved. The camera is additionally used for “before” and “after” photos, presentations, enhanced diagnosis, insurance claims, and education or monitoring with parents and patients concerning overall dental health.

Digital Panoramic X-Rays
Panoramic digital X-rays show the health status of all the teeth in one film. Used primarily to show the upper and lower jaw, the TMJ and the sinus areas, to record existing condition and detect abnormalities of the developing teeth, salivary glands, cysts, displaced teeth follicles, etc.

They are especially helpful for children who have orthodontic problems, or those who have medical or behavioral special needs that interfere with their ability to cooperate for intra-oral x-rays. Images are taken externally, and no film is required to be put into the mouth.

In addition, there are ways pediatric dentists use digital technology that you might not have thought about:

Digital/Electronic Dental Records
Use of technology also makes it easier to manage our pediatric dental practice using digital files, file-sharing capabilities, scheduling, records management, and insurance filing. Our paperless practice and electronic software enables patients to thoroughly complete their paperwork right from home rather than having to feel rushed or distracted after arriving at the dental office. This saves time and allows for more detailed conversations with the dentist. The dentist also has access to the paperwork and can review your medical history details ahead of time.

Digital Entertainment
Pop into Virginia’s Smile Wonders and you’ll find plenty of entertainment options for young patients in the form of Wi-Fi, iPads in the children’s play area, and TVs at every chair. These devices not only make a visit to the dentist more enjoyable, they can serve as a comforting distraction.

Schedule Your Appointment with Smile Wonders
Helping our young patients enjoy going to the dentist is what we love to do. For expert pediatric dentistry in Northern Virginia, schedule your next appointment with Dr. Rishita Jaju at Smile Wonders today.

Age 1: Your Child’s First Visit to the Pediatric Dentist

New parents may wonder, “When should I take my child to the pediatric dentist for the first time?” The simple answer is “By their first birthday,” for what we call the Age 1 dental visit. The American Academy of Pediatric Dentistry (AAPD) recommends scheduling your child’s first appointment within six months of the first tooth and no later than age one.

One reason to begin early dental care is because children can get cavities early; tooth decay can occur as soon as the first tooth erupts. By age 1, most children have between four and six teeth, and what do we do—we buy them a nice, sugary birthday cake.

Even though children will lose baby teeth, front teeth don’t fall out until between ages five and seven, and they are needed for chewing and speech development. Baby molars don’t fall out until ages 10-12, and are key to proper bite development and nutrition. Decay in primary teeth can result in a higher risk of decay in permanent teeth, so learning how to prevent cavities in children is something we at Smile Wonders review with parents at each visit.

Your First Visit to a Pediatric Dentist

In your first visit to Smile Wonders, we perform an oral exam of the child’s teeth and gums, and look for decay or other problems. We also discuss with parents:

  • Proper care of an infant’s mouth
  • Cavity risks
  • How and why to use topical fluoride properly
  • Teething and developmental milestones

We’ll also bring up topics like:

  • Thumb sucking
  • Oral habits
  • Oral health and diet
  • Trauma prevention

This first appointment helps us establish a baseline on your child’s dental health and educate parents on the best way to maintain good oral health in their child, and it allows parents the opportunity to ask questions. Following this first appointment, a regular schedule of appointments – normally every six months – is established.

Pediatric dentists engage in several years of education beyond regular dental school, learning the intricacies of children’s dental health, as well as issues surrounding children at any age, including developmental and behavioral ones. A pediatric dentist is also child-friendly, with a trained staff, colorful, engaging surroundings and kid-sized, non-frightening equipment, and techniques.

When visiting your pediatric dentist for the first time, bring along a child’s favorite teddy bear, toy or blanket, and don’t present the visit as something scary or use it as a threat. Make it a normal part of a child’s routine. They may even find it exciting to visit a new place. Also, try not to schedule your appointment around children’s normal naptimes; mornings are often best.

If you live in the Reston area or in Northern Virginia, make Smile Wonders your pediatric dentist. Kids love Dr. Rishita Jaju and her entire staff. Call us today to set your child’s Age 1 appointment.


Tooth decay is the most common chronic childhood illness, with the National Institute of Dental and Craniofacial Research reporting as many as 42% of children ages two to eleven having cavities. Cavities can often be overlooked by parents, since they are usually located in areas not obviously evident, such as close to gums, between teeth, or in back molars.

When cavities are caught when they are small, treatment is much easier than if a cavity is large or a tooth is broken or decayed beyond repair. It can mean the difference between a filling, a crown, or even extraction of the tooth.

Let’s talk about why each of these treatments might be needed:


A filling is used to patch or fill in a hole left in a tooth after decay is removed. The pediatric dentist removes the decay and fills the hole with a tooth-colored composite resin, then smooths and polishes the tooth. Without repair, cavities will continue to decay, and food, plaque and bacteria will collect in the hole, causing further damage.

The pros of fillings are that they are less-expensive than crowns, and tooth-colored options are available. They are not, however, a good option for large or multiple fillings in the same tooth, or for decay that is located close to the nerve.


A crown is a tooth-shaped cap that covers and protects the entire tooth. Available in two options: stainless steel or tooth-matching porcelain, crowns are generally preferred for larger repairs, such as multiple fillings in the same tooth or broken teeth. More durable than fillings, crowns are used to help keep baby teeth healthy until the tooth is ready to fall out, and in most cases, offer a good way to protect back molars, which fall out around age 12 or so.

Crowns may be more expensive short term, but can be more cost-effective in the long run. The downside of crowns is that more of the original tooth structure must be removed to fit the crown into the existing bite. In addition, their size can be unsightly (as with stainless steel crowns) and porcelain crowns can chip.


If decay is so severe that it causes infection to surrounding gums and bone, teeth may need to be extracted (removed). This helps ensure that the health of the permanent tooth is preserved, as the adult tooth bud is growing between the roots of the baby tooth.

Consider dental sealants

Dental sealants are invisible plastic resin coatings that can be “painted” onto back teeth to smooth out the deep grooves of chewing surfaces, the place where your child is most likely to get cavities. With a sealant, a tooth is far less likely to develop a cavity.

When should you begin to visit your pediatric dentist?

You should schedule your first visit to your pediatric dentist when the first tooth appears, generally when your child is between six months and a year old. From there, schedule a twice-a-year visit to your pediatric dentist for a professional cleaning and dental exam, along with fluoride treatments to prevent problems or catch them before they become large.

In addition to regular exams, you should contact your pediatric dentist if you notice a change in your child’s teeth, like a cavity or when a trauma such as a broken tooth occurs. Children may not necessarily complain, so watch for changes in their behavior like avoiding eating or drinking, chewing on one side of their mouth only, or a different in their speech.

Contact Smile Wonders

Dr. Rishita Jaju is a board-certified pediatric dentist and recognized dental laser expert located in Reston, Virginia. Call Smile Wonders today to schedule your appointment.

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