info@dinokidsdentistry.com
We treat your child the way we’d want ours treated: carefully, conservatively, and never more than they need.
What does conservative care mean?
The traditional model of dentistry was “cavity → drilling and filling.” Modern pediatric dentistry uses a different model: minimally invasive dentistry. A cavity isn’t an event — it’s a dynamic process, the hard mineral structure of a tooth being broken down (demineralized) by cavity-causing bacteria.
Some cavities need traditional treatment, because they’re on permanent teeth or on baby teeth that won’t fall out soon and will cause harm if left alone. Others can be monitored, using tools like good brushing and flossing, topical fluorides, less sugar and simple carbohydrates in the diet, drinking water throughout the day, and regular checkups to keep them from becoming a problem.
One more tool: silver diamine fluoride, a cavity-fighting liquid painted onto a cavity to harden it and kill the bacteria causing it. It’s a “diamond in the rough” — it turns the cavity black, but it’s effective at stopping it. It isn’t right for every cavity or child, but we’re happy to talk through it as an option. Some cavities do need treatment, and we’ll help you decide which ones.
Building confidence, not bypassing it.
Parents often ask about general anesthesia. Most kids need neither sedation nor anesthesia — they get through their dental care with patience, a calm room, and a customized approach: time to explain and demonstrate what’s happening, treatment paced across multiple appointments, and minimally invasive procedures that reduce or eliminate shots and drilling.
That approach is slower. It’s also how a child learns they can do something that scared them — worth more than any single appointment. A child being anxious or needing extra time is not, by itself, a reason for anesthesia. General anesthesia may be the easiest way for us to manage an anxious child’s care, but it isn’t always the best way for the child and family.
Sedation and anesthesia, taken seriously.
When we do use conscious “awake” sedation, we keep it minimal — a single mild oral medication for the select child who needs it, not a multiple-sedative “cocktail,” and never routine.
General anesthesia is a different order of decision, and we treat it that way — weighing risk against benefit every time, for that specific child. It carries small but real risks. Sometimes the benefit clearly outweighs them: children with extensive treatment needs, very young children who need care, and children with certain special health care needs. General anesthesia lets us deliver high-quality care safely and humanely in those situations. Sometimes the risks outweigh the benefit to the child, and we say so.
Both of us are residency-trained pediatric dentists with additional training in treating children under sedation and general anesthesia, including a rotation in a hospital anesthesia department, and we work only with board-certified, residency-trained anesthesiologists. General anesthesia is a recommendation we make only when we believe it’s best for that child — never as a convenience for us.
Only the procedures a child actually needs.
Any time we’re considering an invasive procedure — a filling, a crown, oral surgery — we weigh its risks and benefits. Procedures should have an indication, not just an opportunity. A slightly tight lower frenum under the tongue, for instance, doesn’t automatically mean surgery is necessary. Sometimes it is; often it isn’t. We’ll talk it through and decide together.
Second opinions are welcome, including from us.
We’re happy to evaluate your child and give a second opinion on a treatment plan from elsewhere, or to send your child’s X-rays to another office if you’d like one on ours. We stand behind our work, but there’s more than one way to do good dentistry — if another doctor is a better fit, let us know. No hard feelings.
Training and credentials.
Dr. Richman and Dr. Akabike are both residency-trained pediatric dentists, meaning each completed a 2- or 3-year residency in pediatric dentistry after dental school. Dr. Richman also holds a Master’s degree in Public Health.
Dr. Richman is board certified — she passed both the written and oral exams through the American Board of Pediatric Dentistry, completes CE every year, and renews her certification every 10 years on schedule. Dr. Akabike is board eligible: she’s passed the written exam and is preparing for the oral exam.
Working with your family dentist.
We collaborate with general dentists, not against them. Your child’s family dentist may be the one who referred you to us after a difficult appointment, or the one you decided wasn’t quite kid-friendly enough — that’s okay. Not every general dentist enjoys or is prepared to see children, and many kids do best with a pediatric dentist while young, anxious, or in need of treatment.
We’re glad to see your child from early childhood through adolescence, with the goal of sending them back to a general dentist as an adult — happy, confident, and with good memories of their pediatric dental office.
If you’re choosing a dentist for your child, ask us anything, including where we trained and how we’d approach your child’s care. Reach out today at 253-220-7345 to speak with our Covington, WA, dentists and team!
