Frequently Asked Questions
Why visit a Pediatric Dentist?
A pediatric dentist receives an extra 2 years of specialty training in dental school. He/she is dedicated to the oral health of children from infancy through the teenage years. The very young patients and teenagers all require different approaches when handling their dental and behavioral needs. It is important to supervise and guide their dental growth and development to avoid future dental problems. A pediatric dentist is the most qualified to meet these needs.
What should I tell my child about their first dental visit?
We suggest you prepare your child the same way that you would before their first haircut or trip to the shoe store. 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 questions.
It is best if you refrain from using words around your child that might cause unnecessary fear such as needle, pull, drill, or hurt. Pediatric dental offices make a practice of using words that convey the same message, but are pleasant and non-frightening.
According to the American Academy of Pediatric Dentistry (AAPD), you child should visit the dentist by his/her 1st birthday.
When will my baby start getting teeth?
The first baby teeth that come into the mouth are the two bottom front teeth. You will notice this when your baby is about six to eight months old. Next to follow will be the four upper front teeth and the remainder of your baby’s teeth will appear periodically. They will usually appear in pairs along the sides of the jaw until the child is about 21/2 to 3 years old.
At around 21/2 to 3 years old, your child should have all 20 primary teeth! Between the ages of five and six, the first permanent teeth will begin to erupt. Some of the permanent teeth replace baby teeth and some don’t. Don’t worry if some teeth are a few months early or late as all children are different.
Baby teeth are important as they not only hold space for permanent teeth, but they are also important for chewing, biting, speech, and appearance. For this reason it is important to maintain a healthy diet and daily hygiene.
Permanent teeth begin appearing around age 6, starting with the 1st molars and lower central incisors. This process continues until approximately age 21.
Adults have 28 permanent teeth, or up to 32 including the 3rd molars (wisdom teeth).
Why are Primary Teeth (baby teeth) so important?
Primary teeth are important because they help with proper chewing and eating, help in speech development, and add to an attractive appearance. A child who can chew easily, speak clearly, and smile confidently is a happier child.
Healthy primary teeth allow normal development of the jaw bones and muscles, save space for the permanent teeth, and guide them into place. If a baby tooth is lost too soon, permanent teeth may come in crooked.
Decayed baby teeth can cause pain, abscesses, infections, and can spread to the permanent teeth. Also, your child’s general health can be affected if diseased baby teeth aren’t treated. Remember, some primary molars are not replaced until age 10-14, so they must last for years.
When to begin brushing?
Once your child’s teeth begin erupting, you can begin cleaning them by wiping them with a moist washcloth. As your child gets more teeth, you can begin to use a soft child’s toothbrush.
bull;The AAPD encourages the brushing of teeth with appropriate amounts of fluoride toothpaste (e.g. no more than a smear or rice-sized amount for children less than three years of age; no more than a pea-sized amount for children aged three to six), twice daily for all children.
For most toddlers, getting them to brush their teeth can be quite a challenge. Some suggestions for making tooth brushing less of a battle can include:
Let your child brush your teeth at the same time.
Let your child pick out a few toothbrushes with their favorite characters and give him/her a choice of which one they want to use each time (this will give the child some feeling of control over the situation).
Let your child brush his/her own teeth first (you will likely have to “help out”).
Let your child have some children’s books about tooth brushing.
Have everyone brush their teeth at the same time.
To help your child understand the importance of brushing, it can be sometimes fun and helpful to let them eat or drink something that will stain their teeth temporarily and then brush them clean.
It can also be a good idea to create a “tooth brushing routine” and stick to the same routine each day.
What is the best toothpaste for my child?
Tooth brushing is one of the most important tasks for good oral health; however many toothpastes, and/or tooth polishes, can damage young smiles. They contain harsh abrasives which can wear away young tooth enamel. When looking for a toothpaste for your child, make sure to pick one that is recommended by the American Dental Association. These toothpastes have undergone testing to ensure they are safe to use.
• Remember, children should spit out toothpaste after brushing to avoid getting too much fluoride. If too much fluoride is ingested, a condition known as fluorosis can occur. Follow the recommendation of the AAPD, which encourages the brushing of teeth with appropriate amounts of fluoride toothpaste (e.g., no more than a smear or rice-sized amount for children less than three years of age; no more than a pea-sized amount for children aged three to six), twice daily for all children.
Why are radiograghs (x-rays) important?
Radiographs (x-rays) are a vital and necessary part of your child’s dental diagnosis process. Without them, certain dental concerns can and will be missed. Dental radiographs detect much more cavities than the naked eye. For example, radiographs may be needed to survey erupting teeth, diagnose bone diseases, evaluate the result of an injury, or plan orthodontic treatment. Radiographs allow the dentist to diagnose and treat dental health conditions that cannot be detected during a clinical examination. If dental problems are found and treated early, dental care is more comfortable for your child and more affordable for you.
The American Academy of Pediatric Dentistry recommends radiographs and examinations every six months for children with a high risk for tooth decay. On average, most pediatric dentists request radiographs approximately once a year. Approximately every three years, it is recommended to obtain a complete set of x-rays, either a panoramic x-ray and bitewings or periapicals and bitewings.
Pediatric dentists are particularly careful to minimize exposure of their patients to radiation. With contemporary safeguards, the amount of radiation received in a dental x-ray examination is extremely small. The risk is negligible. In fact, the dental radiographs represent a far smaller risk than an undetected and untreated dental problem. Lead body aprons and shields will protect your child from radiation. Today’s advanced equipment filters out unnecessary x-rays and restricts the x-ray beam to the area of interest.
What is Pulp Therapy?
The pulp of a tooth is the inner central core of the tooth. The pulp contains nerves, blood vessels, connective tissue, and reparative cells. The purpose of pulp therapy in Pediatric Dentistry is to maintain the vitality of the affected tooth (so the tooth is not lost.)
Dental caries (cavities) and traumatic injury are the main reasons a tooth requires pulp therapy. Pulp therapy is often referred to as a “nerve treatment,” “baby root canal,” or “pulpotomy”.
The pulpotomy removes the diseased pulp tissue within the crown portion of the tooth. Next, an agent is placed to prevent bacterial growth and to calm the remaining nerve tissue. This is followed by a final restoration (usually a stainless steel crown).
Questions Regarding Flouride
Fluoride: Nature’s Cavity Figher
Fluoride is a mineral that occurs naturally in all water sources, including the oceans. Research has shown that fluoride not only prevents cavities in children and adults, it also helps repair the early stages of tooth decay even before the decay is visible. During childhood, when teeth still are forming, fluoride works by making tooth enamel more resistant to the acid that causes tooth decay. For adolescents and adults, the benefits are just as great. Fluoride helps repair, or rematerialize, areas where the acid attacks have already begun.
How is Fluoride used?
Fluoride is obtained in two forms: topical and systemic. Topical fluorides may be found in toothpastes, mouth rinses, and fluoride applied in the dental office. Systemic fluorides are those that are swallowed. They include fluoridated water and dietary fluoride supplements in the form of tablets, drops, or lozenges. The maximum reduction in tooth decay is achieved when fluoride is available both topically and systemically.
Is Fluoride safe?
More than 60 years of research and studies have shown that optimal levels of fluoridated water do not harm people or the environment. Fluoridation of community water supplies is supported by the American Dental Association, the U.S. Public Health Service, the American Medical Association and the World Health Organization.
What are some other sources of Fluoride?
Not everyone lives in a community with a fluoridated water source. For those individuals, fluoride is available in other forms. Dietary fluoride supplements (tablets, drops or lozenges) are available by prescription and are intended for use by children ages six months to 12 years who live in non-fluoridated areas. For maximum effectiveness, fluoride supplements require long-term compliance on a daily basis.
Your dentist or your child’s physician can prescribe the appropriate dosage of dietary fluoride. The dosage is based on the natural fluoride concentration of the child’s drinking water and the age of the child. If the fluoride level of the home’s drinking water is unknown, the water should be tested for fluoride content before supplements are prescribed. Contact your local or state health department for information on testing your water supply.
Fluoride toothpastes and mouth rinses with the ADA Seal of Acceptance help prevent tooth decay in both children and adults. When you shop for dental products, look for the ADA Seal. It is your assurance that a product has met ADA criteria for safety and effectiveness.
Parents and caregivers should judiciously monitor the use of all fluoride-containing dental products by children under the age of six. Ingestion of higher than recommended levels of fluoride by children has been associated with an increased risk of very mild to mild dental fluorosis in developing, unerupted teeth.
• The AAPD encourages the brushing of teeth with appropriate amounts of fluoride toothpaste (e.g., no more than a smear or rice-sized amount for children less than three years of age; no more than a pea-sized amount for children aged three to six), twice daily for all children.
Check out www.ada.org for the latest information about fluoride and fluoridation.
Cavities used to be a fact of life, but during the past few decades, tooth decay has been dramatically reduced. The key reason: fluoride.
Questions Regarding Sealants
What is a sealant?
Tooth sealant refers to a plastic that a dentist bonds into the grooves of the chewing surface of a tooth as a means of helping prevent the formation of tooth decay.
How do sealants work?
In many cases, it is nearly impossible for children to clean the tiny grooves between their teeth. When a sealant is applied, the surface of the tooth is somewhat flatter and smoother. There are no longer any places on the chewing part of the tooth that the bristles of a toothbrush can’t reach and clean. Since plaque can be removed more easily and effectively, there is much less chance that decay will start.
What is the life expectancy of tooth sealants?
The longevity of sealants varies. Sealants that have remained in place for three to five years would be considered successful, however, sealants can last much longer. It is not uncommon to see sealants placed during childhood still intact on the teeth of adults. Our office will check your child’s sealants during routine dental visits and will recommend repair or reapplication when necessary.
Which teeth should be sealed?
Any tooth that shows characteristics of developing decay should be sealed. The most common teeth for a dentist to seal are a child’s back teeth, and of these teeth, the molars are the most common teeth on which dental sealants are placed. The recommendation for sealants should be considered on a case-by-case basis.
What is the procedure for placing sealants?
Generally the procedure takes just one visit. Placing dental sealants can be a very easy process. The tooth is cleaned, conditioned, and dried. The sealant is then flowed onto the grooves of the tooth where it is hardened with a special blue light and then buffed. All normal activities can occur directly after the appointment.
Most Common Dental Emergencies
What should I do if my child’s baby tooth is knocked out?
Contact our office as soon as possible.
What should I do if my child’s permanent tooth is knocked out?
Handle the tooth by the crown, not the root portion. Rinse the knocked out tooth in cold water. Do not scrub the tooth. If possible, replace the tooth in the socket and hold it there with clean gauze. If you cannot reinsert the tooth back into the socket, place the tooth in a container of milk (if milk is not available, place tooth in a cup of water or a cup of the patient’s saliva). Come to our office immediately. Feel free to call our emergency number if it is after hours. The tooth has a better chance of being saved if you act immediately. Always hold the tooth by its crown.
What should I do if my child’s tooth is fractured or chipped?
Contact our office as soon as possible. Time is of the essence! Our goal is to save the tooth and prevent infection. Rinse the mouth out with water and apply a cold compress to reduce swelling. In some cases, it is possible that the broken tooth fragment can be bonded back to the tooth.
What do I do if my child has a toothache?
Call our office as soon as possible to schedule an appointment. To help comfort your child, rinse out the mouth with warm water or use dental floss to dislodge impacted food or debris. DO NOT place aspirin on the aching tooth. If the face is swollen, apply cold compresses and contact your dentist immediately.
What do I do if my child has a cut or bitten tongue, lip, or cheek?
Apply ice to bruised areas. If there is bleeding, apply firm but gentle pressure with gauze or cloth. If bleeding does not stop after 15 minutes or it cannot be controlled by simple pressure, take the child to the hospital emergency room.
How can we prevent dental injuries?
Simple. Sport related dental injuries can be reduced or prevented by wearing mouth guards. Child proofing your home can help reduce injuries at home. In addition, regular dental check-ups will contribute to preventative care.
What is a mouthguard?
A mouth guard is comprised of soft plastic. They come in standard or custom fit to adapt comfortably to the upper teeth.
Why is a mouth guard important?
A mouth guard protects the teeth from possible sport injuries. It does not only protect the teeth, but the lips, cheeks, tongue, and jaw bone as well. It can contribute to the protection of a child from head and neck injuries such as concussions. Most injuries occur to the mouth and head area when a child is not wearing a mouth guard.
When should my child wear a mouth guard?
It should be worn during any sport-based activity where there is risk of head, face, or neck injury. Such sports include hockey, soccer, karate, basketball, baseball, skating, skateboarding, as well as many other sports. Most oral injuries occur when children play basketball, baseball, and soccer.
How do I choose a mouth guard for my child?
Choose a mouth guard that your child feels is comfortable. If a mouth guard feels bulky or interferes with speech to any great degree, it is probably not appropriate for your child.
There are many options available for mouth guards. Most guards are found in athletic stores. These vary in comfort and protection as well as cost. The least expensive tend to be the least effective in preventing oral injuries. Customized mouth guards can be provided through our practice. They may be a bit more expensive, but they are much more comfortable and shock absorbent.
Tooth Grinding at Night (Bruxism)
Often the first indication is a noise created by the child grinding their teeth during sleep. One theory about the cause of tooth grinding involves a psychological component. Stress due to a new environment, such as divorce, changes at school, etc. can influence a child to grind their teeth. Another theory relates to pressure in the inner ear at night. The child will grind by moving his jaw to relieve this pressure.
The majority of pediatric bruxism cases do not require any treatment. If excessive wear of the teeth (attrition) is present, a mouth guard (night guard) may be recommended. The disadvantage of a mouth guard is the possibility of choking if the appliance becomes dislodged during sleep and it may interfere with growth of the jaws. The positive is obvious by preventing wear to the primary dentition.
The good news is that most children outgrow bruxism. Between ages 6-9, children begin to grind their teeth less. By age 9-12, children tend to stop grinding altogether. If you suspect bruxism, discuss this with your pediatrician or pediatric dentist.
What is the best time for Orthodontic Treatment?
Developing malocclusions, or bad bites, can be recognized as early as 2-3 years of age. Often, early steps can be taken to reduce the need for major orthodontic treatment at a later age.
Stage I – Early Treatment:
This period of treatment encompasses ages 2 to 6. At this young age, we are concerned with underdeveloped dental arches, the premature loss of primary teeth, and harmful habits such as finger or thumb sucking. Treatment initiated in this stage of development is often very successful and many times, though not always, can eliminate the need for future orthodontic/orthopedic treatment.
Stage II – Mixed Dentition:
This period covers the ages of 6 to 12, with the eruption of the permanent incisor (front) teeth and 6 year molars. Treatment concerns deal with jaw mal relationships and dental realignment problems. This is an excellent stage to start treatment, when indicated, as your child’s hard and soft tissues are usually very responsive to orthodontic or orthopedic forces.
Stage III – Adolescent Dentition:
This stage deals with the permanent teeth and the development of the final bite relationship.