Frequently Asked Questions

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.

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.

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).

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.

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.

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.

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.

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).

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.

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.

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.

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.