What Is a Pediatric Dentist?
The pediatric dentist has an extra two years of specialized training and is dedicated to the oral health of children from infancy through the teenage years. The very young, pre-teens, and teenagers all need different approaches in dealing with their behavior, guiding their dental growth and development, and helping them avoid future dental problems. The pediatric dentist is best qualified to meet these needs. A pediatric dentist is also trained to treat children who are medically, physically and or cognitively disabled or delayed.
Can I Stay With My Children During His/Her Appointment?
Absolutely! Parents are always welcome to accompany their children for their dental visits. During your child’s appointment, our staff will present the option to you of whether to accompany your child in the appointment or stay behind in our reception area. The American Academy of Pediatric Dentistry recommends that parents of older children remain in the reception area when children are brought into the dental appointment. Babies and some young children may benefit from having one of their parents in the appointment with them, but it’s usually in a child’s best interest to be treated without parental interference. Studies have shown that children over the age of 3 often respond better to dental treatment when their parents aren’t in sight. Our dentists have experience treating the smallest of children as well as patients with severe disabilities. Ultimately, the decision to accompany your child during each appointment is always yours to make
Why Are the Primary Teeth So Important?
It is very important to maintain the health of the primary teeth. Neglected cavities can and frequently do lead to problems which affect developing permanent teeth. Primary teeth, or baby teeth are important for (1) proper chewing and eating, (2) providing space for the permanent teeth and guiding them into the correct position, and (3) permitting normal development of the jaw bones and muscles. Primary teeth also affect the development of speech and add to an attractive appearance. While the front 4 teeth last until 6-7 years of age, the back teeth (cuspids and molars) aren’t replaced until age 10-13.
Why are Dental X-Rays Necessary?
Radiographs (X-Rays) are a vital and necessary part of your child’s dental diagnostic process. Without them, certain dental conditions can and will be missed.
X-Ray’s detect much more than cavities. For example, X-Rays may be needed to survey erupting teeth, diagnose bone diseases, evaluate the results of an injury, or plan orthodontic treatment. X-Rays allow 
dentists to diagnose and treat 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 X-rays and examinations every six months for children with a high risk of tooth decay. On average, most pediatric dentists request radiographs approximately once a year. Approximately every three years it is a good idea to obtain a complete set of radiographs, either a panoramic and bitewings or periapicals and bitewings.
Pediatric dentists are particularly careful to minimize the exposure of their patients to radiation. With contemporary safeguards, the amount of radiation received in a dental x-ray examination is so small that the risk is negligible. In fact, the dental X-rays represent a far smaller risk than an undetected and untreated dental problem. Lead body aprons and shields will protect your child. Today’s equipment filters out unnecessary X-rays and restricts the X-ray beam to the area of interest. High-speed film and proper shielding assure that your child receives a minimal amount of radiation exposure.
How Should I Care for My Child’s Teeth?
Starting at birth, clean your child’s gums with a soft infant toothbrush, or cloth and water. Parents should use a tiny smear of fluoride toothpaste to brush baby teeth twice daily as soon as teeth erupt and a soft, age-appropriate sized toothbrush. Once children are 3 to 6 years old, the amount of fluoride toothpaste should be increased to a pea-sized dollop and you should perform or assist your child’s tooth brushing. Remember that children do not have the ability to brush their teeth effectively until approximately eight years of age. The benefits of utilizing fluoride toothpaste outweighs any potential risk of ingestion when the correct amount of toothpaste is used.
Proper brushing removes plaque from the inner, outer and chewing surfaces. When teaching children to brush, place toothbrush at a 45 degree angle; start along gum line with a soft bristle brush in a gentle circular motion. Brush the outer surfaces of each tooth, upper and lower. Repeat the same method on the inside surfaces and chewing surfaces of all the teeth. Finish by brushing the tongue to help freshen breath and remove bacteria.
Flossing removes plaque between the teeth where a toothbrush can’t reach. Flossing should begin when any two teeth touch. You should floss the child’s teeth until he or she can do it alone. Use about 18 inches of floss, winding most of it around the middle fingers of both hands. Hold the floss lightly between the thumbs and forefingers. Use a gentle, back-and-forth motion to guide the floss between the teeth. Curve the floss into a C-shape and slide it into the space between the gum and tooth until you feel resistance. Gently scrape the floss against the side of the tooth. Repeat this procedure on each tooth. Don’t forget the backs of the last four teeth. Flossing ideally should be done once a day. At nighttime prior to bed and before brushing is the perfect time to floss.
What Are Good Snacks for My Child?
Healthy eating habits lead to healthy teeth. Like the rest of the body, the teeth, bones and the soft tissues of the mouth need a well-balanced diet. Children should eat a variety of foods from the five major food groups. The more frequently a child snacks, the greater the chance for tooth decay. How long food remains in the mouth also plays a role. For example, hard candy and breath mints stay in the mouth a long time, which cause longer acid attacks on tooth enamel.
Although many popular snacks that children like to eat (fruit snacks, salty chips, or snack cakes) can make teeth prone to cavities, healthy snacks that are beneficial for teeth can also be a yummy snack substitute.
Apples, for example, are a fibrous food and a great source of both vitamin C and various antioxidants. Due to their high amount of fiber, apples actually clean the teeth as they are being consumed! Consuming apples helps to fight off plaque build-up and remove surface stains from teeth. Apples also remove traces of plaque build up and residue towards the back of the tongue, which helps keep breath fresh!
Raw vegetables that are considered crisp and texturally similar to apples are extremely beneficial to one’s health. Raw veggies are low in calories, provide the body with numerous vitamins and minerals, and also clean teeth while consuming. Eating raw veggies also helps to stimulate the gums and improve oral health.
Nuts are another snack that can promote a healthy mouth and be valuable to a well-balanced diet. Nuts are a protein-rich food, which helps build and maintain strong teeth. The vigorous amount of chewing required to break down nuts promotes saliva production, which in turn protects and rids your teeth of debris and acid-buildup in the mouth.
How Do I Prevent Cavities?
Four things are necessary for cavities to form: 1) a tooth, 2) bacteria, 3) sugars or other carbohydrates; and 4) time. We can share with you how to make teeth strong, keep bacteria from organizing into harmful colonies, develop healthy eating habits, and understand the role that time plays. Remember dental decay is an infection of the tooth. Visiting us early and regularly can help avoid unnecessary cavities and dental treatment.
The pediatric dental community is continually doing research to develop new techniques for preventing dental decay and other forms of oral disease. Studies have shown that children with poor oral health have decreased school performance and poor social relationships. Children with poor oral health are three times more likely to miss school as a result of dental pain and more than 40% of children have dental cavities by the time they reach kindergarten.
For older children, brush their teeth at least twice a day. Also, watch the number of snacks containing sugar that you give your children.
The American Academy of Pediatric Dentistry recommends six month visits to the pediatric dentist beginning at your child’s first birthday. Routine visits will start your child on a lifetime of good dental health.
Your pediatric dentist may also recommend protective sealants or home fluoride treatments for your child. Sealants can be applied to your child’s molars to prevent decay on hard to clean surfaces.
What Are Sealants?
A sealant is a clear or shaded plastic material that is applied to the chewing surfaces (grooves) of the back teeth (premolars and molars), where four out of five cavities in children are found. This sealant acts as a barrier to food, plaque and acid, thus protecting the decay-prone areas of the teeth.
What Is Baby Bottle Tooth Decay?
One serious form of decay among young children is baby bottle tooth decay. This condition is caused by frequent and long exposures of an infant’s teeth to liquids that contain sugar. Among these liquids are milk (including breast milk), formula, fruit juice, even watered down fruit juice, and other sweetened drinks.
Avoid putting anything other than water in a child’s bed-time bottle. Starting at birth, clean your child’s gums with a soft infant toothbrush or cloth and water, particularly following a feeding or before your child sleeps. The easiest way to do this is to sit down, place the child’s head in your lap or lay the child on a dressing table or the floor. Whatever position you use, be sure you can see into the child’s mouth easily. Also, learn the proper way to brush and floss your child’s teeth. Take your child to our office regularly to have his/her teeth and gums checked. The first dental visit should be scheduled by your child’s first birthday.
When Will My Baby Start Getting Teeth?
Teething, the process of baby (primary) teeth coming through the gums into the mouth, is variable among individual babies. Some babies get their teeth early and some get them late. In general the first baby teeth are usually the lower front (anterior) teeth and usually begin erupting between the age of 6-8 months.
When Do Children Get Their Grown-Up Teeth?
Children’s teeth begin forming before birth. As early as 4 months, the first primary (or baby) teeth to erupt through the gums are the lower central incisors, followed closely by the upper central incisors. Although all 20 primary teeth usually appear by age 3, the pace and order of their eruption varies.
Permanent teeth begin appearing around age 6, starting with the first molars and lower central incisors. This process continues until approximately age 21.
Adults have 28 permanent teeth, or up to 32 including the third molars (or wisdom teeth).
What Are Common Dental Emergencies?
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What Is Fluoride?
Fluoride is an element, which has been shown to be beneficial to teeth. However, too little or too much fluoride can be detrimental to the teeth. Little or no fluoride will not strengthen the teeth to help them resist cavities. Excessive fluoride ingestion by preschool-aged children can lead to dental fluorosis, which is a chalky white to even brown discoloration of the permanent teeth. Many children often get more fluoride than their parents realize. Being aware of a child’s potential sources of fluoride can help parents prevent the possibility of dental fluorosis.
Some of these sources are:
- Too much fluoridated toothpaste at an early age.
- The inappropriate use of fluoride supplements.
- Hidden sources of fluoride in the child’s diet.
Two and three year olds may not be able to expectorate (spit out) fluoride-containing toothpaste when brushing. As a result, these youngsters may ingest an excessive amount of fluoride during tooth brushing. Toothpaste ingestion during this critical period of permanent tooth development is the greatest risk factor in the development of fluorosis.
Excessive and inappropriate intake of fluoride supplements may also contribute to fluorosis. Fluoride drops and tablets, as well as fluoride fortified vitamins should not be given to infants younger than six months of age. After that time, fluoride supplements should only be given to children after all of the sources of ingested fluoride have been accounted for and upon the recommendation of your pediatrician or pediatric dentist.
What’s the Best Toothpaste for my Child?
Tooth brushing is one of the most important tasks for good oral health. Many toothpastes, and/or tooth polishes, however, 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 insure they are safe to use.
Brush at least 2 times daily using an appropriate-sized toothbrush with fluoride-containing toothpaste approved by the ADA Council on Dental Therapeutics. For children under 2 years old, use a grain of rice sized smear of fluoridated toothpaste. For those aged 2 to 5 years, a pea-sized amount is recommended. An adult should brush for the child once a day until the child reaches age 7-8. Nighttime brushing is most important.
Why Does My Child Grind His Teeth at Night?
Parents are often concerned about children grinding their teeth, (bruxism), at night. Often, the first indication is the noise created by the child grinding their teeth during sleep. Or, the parent may notice wear (teeth getting shorter) to the dentition. One theory as to the cause involves a psychological component. Stress due to a new environment, divorce, changes at school; etc. can influence a child to grind their teeth. Another theory relates to pressure in the inner ear at night. If there are pressure changes (like in an airplane during take-off and landing when people are chewing gum, etc. to equalize pressure) the child will grind by moving his jaw to relieve this pressure. Another theory, and perhaps the most common, is that bruxism aids in the eruption of the permanent teeth that are developing under the primary teeth since most children grind their teeth while sleeping.
The majority of cases of pediatric bruxism do not require any treatment. If excessive wear of the teeth (attrition) is present, then a mouth guard (night guard) may be indicated, however, this is rarely prescribed by a pediatric dentist.
The good news is most children outgrow bruxism. The grinding gets less between the ages 6-9 and children tend to stop grinding between ages 9-12. If you suspect bruxism, discuss this with your pediatrician or pediatric dentist.
Is Thumb Sucking Bad?
Sucking is a natural reflex and infants and young children may use thumbs, fingers, pacifiers and other objects on which to suck. It may make them feel secure and happy or provide a sense of security at difficult periods. Since thumb sucking is relaxing, it may induce sleep.
Thumb sucking that persists beyond the eruption of the permanent teeth can cause problems with the proper growth of the jaws and tooth alignment. How intensely a child sucks on fingers or thumbs will determine whether or not dental problems may result. Children who rest their thumbs passively in their mouths are less likely to have difficulty than those who vigorously suck their thumbs.
Children should cease thumb sucking by the time their permanent front teeth are ready to erupt. Usually, children stop between the ages of two and four. Peer pressure causes many school-aged children to stop.
Pacifiers are no substitute for thumb sucking. They can affect the teeth essentially the same way as sucking fingers and thumbs. However, use of the pacifier can be controlled and modified more easily than the thumb or finger habit. If you have concerns about thumb sucking or use of a pacifier, consult your pediatric dentist.
A few suggestions to help your child get through thumb sucking:
- Instead of scolding children for thumb sucking, praise them when they are not.
- Children often suck their thumbs when feeling insecure. Focus on correcting the cause of anxiety, instead of the thumb sucking.
- Children who are sucking for comfort will feel less of a need when their parents provide comfort.
- Reward children when they refrain from sucking during difficult periods, such as when being separated from their parents.
- Your pediatric dentist can encourage children to stop sucking and explain what could happen if they continue.
- If these approaches don’t work, remind the children of their habit by bandaging the thumb or putting a sock on the hand at night.
- Lastly, your pediatric dentist may recommend the use of a mouth appliance to help your child stop their habit if it continues or if significant changes in the jaw structure are seen.
What Are the Dangers of Tongue Piercing?
You might not be surprised anymore to see people with pierced tongues, lips or cheeks, but you might be surprised to know just how dangerous these piercings can be.
There are many risks involved with oral piercings including chipped or cracked teeth, blood clots, or blood poisoning. Your mouth contains millions of bacteria, and infection is a common complication of oral piercing. Your tongue could swell large enough to close off your airway!
Common symptoms after piercing include pain, swelling, infection, an increased flow of saliva and injuries to gum tissue. Difficult-to-control bleeding or nerve damage can result if a blood vessel or nerve bundle is in the path of the needle.
So follow the advice of the American Dental Association and give your mouth a break – skip the mouth jewelry.
Is Tobacco Bad News in Any Form?
Tobacco or nicotine in any form can jeopardize your child’s health and cause incurable damage. Teach your child about the dangers of tobacco.
Smokeless tobacco, also called spit, chew or snuff, is often used by teens who believe that it is a safe alternative to smoking cigarettes. This is an unfortunate misconception. Studies show that spit tobacco may be more addictive than smoking cigarettes and may be more difficult to quit. Teens who use it may be interested to know that one can of snuff per day delivers as much nicotine as 60 cigarettes. In as little as three to four months, smokeless tobacco use can cause periodontal disease and produce pre-cancerous lesions called leukoplakias.
Another form of tobacco that has become widely popular with adolescents and teens is the new vaping craze. Vaping pens don’t produce tobacco smoke, cause bad breath, or ashes, but addiction can still form just like cigarettes. A common misconception with vaping is that since it is water vapor and not smoke, it’s not nearly as bad for you as regular cigarettes. Whether they contain nicotine or are nicotine-free, this false belief can still expose users to a handful of harmful chemicals, including formaldehyde, acrolein, benzene, and metals like nickel and lead.
If you suspect that your child is a tobacco user or participates in vaping, you should watch for the following that could be early signs of oral cancer:
- A sore that won’t heal.
- White or red leathery patches on the lips, and on or under the tongue.
- Pain, tenderness or numbness anywhere in the mouth or lips.
- Difficulty chewing, swallowing, speaking or moving the jaw or tongue; or a change in the way the teeth fit together.
Because the early signs of oral cancer usually are not painful, people often ignore them. If it’s not caught in the early stages, oral cancer can require extensive, sometimes disfiguring, surgery. Even worse, it can kill. Help your child avoid tobacco or smoking in any form. By doing so, they will avoid bringing cancer-causing chemicals in direct contact with their tongue, gums and cheek.
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. Since pediatric dentists see children at an early age, Stage I treatment is often performed by the pediatric dentist. Stage II and III are oftentimes best treated by an orthodontist.
Stage I – Early Treatment: This period of treatment encompasses ages 2 to 6 years. 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 years, with the eruption of the permanent incisor (front) teeth and 6 year molars. Treatment concerns deal with jaw malrelationships 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.
Should My Child Wear a Mouthguard?
When a child begins to participate in recreational activities and organized sports, injuries can occur. A properly fitted mouth guard, or mouth protector, is an important piece of athletic gear that can help protect your child’s smile, and should be used during any activity that could result in a blow to the face or mouth.
Mouthguard help prevent broken teeth, and injuries to the lips, tongue, face or jaw. A properly fitted mouth guard will stay in place while your child is wearing it, making it easy for them to talk and breathe.
Ask your pediatric dentist about custom and store-bought mouth protectors.
