Our Services

Oral Health Appointments

We recommend that children see a dentist by their first birthday. This is important for your child to begin good dental habits and establishes a relationship between your child and your child's dentist. Appointments include a review of dental/medical history, soft tissue examination, cleaning, x-rays (if necessary), flouride treatment, oral hygiene instruction, dental development evaluation, nutritional counseling and education.

Regular return visits to our office are an important part of your child's oral health. Check up appointments will include some of same services listed above and are either suggested every 6 months or once a year.


Special Needs Patients

Pediatric dentists have two or more years of advanced training beyond dental school and focus on care for children with special needs. In addition, our office is designed to be physically accessible for special needs patients.

We realize that special needs children have special dental needs also. Some special children are very susceptible to tooth decay, gum disease or oral trauma while others require medication or a diet that is detrimental to dental health. Some special needs children have physical difficulty performing good dental habits at home. We take all these factors into account to provide the very best dental health care for your child.


General Anesthesia

Sometimes due to the age of a child or conditions where children are not able to cooperate through the course of a dental treatment, general anesthesia is advised. General anesthesia may also be recommended due to the amount of dental work required. The risks of anesthesia will be discussed with you prior to your decision to treat your child. Your child's safety and comfort are very important to us and we follow the sedation guidelines set by the American Academy of Pediatric Dentistry and the American Society of Anesthesiology.

Procedures or circumstances requiring general anesthesia can be performed in our offices rather than in a hospital or surgery center, which not only is convenient, but saves 10% off the cost of receiving it in the hospital. Roanoke Pediatric Dentistry utilizes the same Anesthesiologists that provide their services to Roanoke Memorial Hospital, Roanoke Community Hospital and Roanoke Ambulatory Surgery Center. You can learn more about ACV Anesthesiologists at http://www.acv-virginia.com.

The anesthesia is administered by board a certified Anesthesiologists who Dr. Sheppard has a long-term working relationship with, in the hospital and office environment. Through his medical experience, Dr. Sheppard believes that safety lies at each end of the sedation spectrum. When general anesthesia is indicated, an experienced Anesthesiologist manages the child's care such that their breathing and airway are controlled.


Preventative Treatments

Fluoride is a compound that contains fluorine which is a natural element. Using small amounts of fluoride regularly can help prevent tooth decay. Most localities add flouride to community water supplies and it's found in toothpaste and mouth rinses as well. We offer a topical fluoride treatment that is applied to the tooth's enamel to help maintain the enamel's strength.

Sealants are applied onto the back teeth which are grooved and pitted and where most cavities in children are found. Sealants are a clear plastic that can last for many years to
protect your child during the most cavity-prone years. The teeth most at risk are the six-year and twelve-year molars but the premolars and primary molars may also benefit from sealants. We will advise you on which sealants are best and when they are recommended based on your child's unique dental needs.



When a tooth has decayed, we utilize various procedures to treat the tooth depending on the severity of the decay. The methods used are as follows:

Tooth-Colored fillings are similar in color and texture to natural teeth, making the fillings less noticeable. These fillings are made from durable composite resins. Tooth-colored fillings are also compatible with dental sealants so a tooth can be filled and sealed at the same time to prevent further decay. This type of filling is usually used for small tooth restorations and low-stress areas and cost more than silver fillings.

Amalgam or Silver Fillings. Because of their metal content, amalgam fillings are strong and can withstand heavy biting pressure. Silver fillings are primarily used for the back teeth.



A dental crown is a tooth-shaped cap that is placed over a tooth to restore it's shape, size, strength or appearance. A dental crown may be used to protect a tooth weakened from decay or to restore a broken tooth. A crown is best suited to seal the nerve of a tooth that has had pulpal therapy, from oral bacteria, as well as holding needed space for developing permanent teeth.


Space Maintainers

If a child looses a baby tooth too early, a space maintainer is sometimes recommended to hold the space open for the permanent tooth to come in. Once the permanent tooth begins to erupt, we will remove the space maintainer. Without a space maintainer, the remaining teeth can move and take the position of the lost baby tooth. When the permanent teeth come in, they are crowded and may be crooked. Space maintainers are made of metal or plastic and are custom fit to your child's mouth.


Pulpal Therapy

Sometimes children can have painful inflammation or infection of the dental nerve and pulp, or inner core, of the tooth due to decay or injury. To maintain the vitality of the affected tooth, we will perform a pulpotomy or a pulpectomy. In a pulpotomy the diseased pulp tissue is removed then an antibacterial medicine is placed in the remaining nerve and a crown is placed to seal the tooth. In a pulpectomy, the diseased pulp tissue is completely removed from the crown and the root of the tooth. The canals are cleaned, disinfected and filled with resorbable materials in the case of a baby tooth or a non-resorbable material for a permanent tooth. A crown is placed to protect the tooth from fracturing and from oral bacteria affecting the treating nerve.