Pediatric Dentistry


Why a Pediatric Dentist?

Our pediatric dental specialists and team members love children and are specially trained to put them at ease. Our office provides a child-friendly environment and is specially designed to make patients and our parents more comfortable. Has your child ever asked to stay longer at the dental office? Has your child ever looked forward to their next check-up? Impossible you say? Come find out how!”

What is a Pediatric Dentist?

In the same way that pediatricians are trained to meet a child’s medical needs, our pediatric dental specialists are uniquely qualified to protect your child’s oral health using the most advanced techniques and materials. Pediatric dentists have an additional two to three years of specialty training in addition to four years of dental school and four years of college study. Pediatric dentists are primary and specialty oral care providers for infants and children through adolescence, including those with special health needs.

Why are baby teeth so important?

Primary teeth are important because they help maintain good nutrition with proper chewing and eating. They help in speech development in allowing good pronunciation and speech habits. They add to an attractive appearance by helping children feel good about the way they look. Healthy primary teeth allow normal development of the jaw bones and muscles and help guide the proper eruption of the permanent teeth into the right place. Early loss of primary teeth can ultimately lead to crooked teeth and the need for braces. Decayed baby teeth can cause pain, abscesses, infections, and can spread to the permanent teeth. It is also important to remember the front/anterior teeth last until 6-8 years of age and the back/posterior molars are not replaced until 10-14 years of age.

When should my child first see a dentist?

Your child should visit the dentist by his/her first birthday or when the first tooth comes in, usually between six and ten months of age. Early examination and preventive care will protect your child’s smile now and in the future. The Academy of Pediatric Dentistry recommends that your child should visit a pediatric dentist by their first birthday.

What should I tell my child about the first dental visit?

We suggest you prepare your child the same way that you would before their first hair-cut or trip to the shoe store. This will not be the frightening experience you may remember from your youth. Children are keen and can see if you are nervous or display anxiety. You can make the first visit to the dentist enjoyable and positive by explaining what we do. Your child’s dentist should be an important and fun adventure. If they know that you are relaxed and positive about this experience it will help them feel relaxed and positive too. Books and videos are available at most bookstores to also help with the first visit. Your child’s reaction to his/her first visit to the dentist may surprise you.

When do their teeth erupt?

Children’s teeth begin forming before birth. The first baby teeth that come into the mouth are the two bottom front teeth. You will notice this when your baby is about 6-8 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 three years old. The pace and order to their eruption also varies.

The first permanent teeth will begin to erupt between the ages of 5 and 6 starting with the first molars and lower central incisors. Some of the permanent teeth replace baby teeth and some don’t. This process will continue until approximately age 16-18. Adults will eventually end up with 32 permanent teeth including the wisdom teeth.

Don’t worry if some teeth are a few months early or late as all children have different eruption patterns.

What problems could my child have?

Some dental problems begin very early in life. Tooth decay continues to be the most common chronic disease of childhood. One big concern is Early Childhood Caries (ECC) also known as baby bottle tooth decay. Children risk severe tooth decay from using a bottle at night. Untreated caries in the young child could exacerbate and may cause infection and threat to the health of children.

What causes tooth decay?

Several specific types of bacteria that live on the teeth cause decay. When sugar is consumed the bacteria use the sugar and then manufacture acids that dissolve the teeth and cause an infection in the tooth. This infection is called decay.

What is "baby-bottle" tooth decay?

Babies who go to bed with a bottle of milk, formula or juice are more likely to get tooth decay. Because the sugar in formula, milk or juice stays in contact with the teeth for a long time during the night, the teeth can decay quickly.

Here are some tips to avoid baby-bottle tooth decay:

  • Put your child to bed with a bottle of plain water, not milk or juice.
  • Stop nursing when your child is asleep or has stopped sucking on the bottle.
  • Try not to let your child walk around using a bottle of milk or juice as a pacifier.
  • Start to teach your child to drink from a cup at about 6 months of age. Plan to stop using a bottle by 12 to 14 months at the latest.
  • Don't dip your child's pacifier in honey or sugar.

How Can I Care for my Child’s Teeth?

Tooth Brushing

Children’s hands and mouths are different than adults. They need to use toothbrushes designed for children. Both adults and children should use brushes with soft, rounded bristles for gentle cleaning. Change to a new brush about every three months.

Wipe infant’s teeth gently with a moist, soft cloth or gauze square. As babies grow, use a child’s toothbrush with a small, pea-sized dab of toothpaste. By age 2 or 3 begin to teach your child to brush. You will still need to brush where they miss. Dentists and hygienists often advise children to use a gentle, short, back and forth motion to remove plaque. When children are older they can switch to this method.

Hold the brush at an angle (45 degrees) towards teeth and gums. Move brush back and forth with short strokes, about a half tooth wide.

Brush the inside and outside surfaces of each tooth, top and bottom.

Hold the brush flat on top of the teeth and brush the chewing surfaces.

Gently brush the tongue to remove debris.

Floss between teeth daily.

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. You should use just a pea-size amount of a fluoride toothpaste or a non-fluoride toothpaste (like Baby OraGel) until your child is able to spit it out (too much fluoride can stain their teeth).

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:

  • letting him brush your teeth at the same time
  • letting him pick out a few toothbrushes with his favorite characters and giving him a choice of which one he wants to use each time (this will give him some feeling of control over the situation)
  • let him brush his own teeth first (you will likely have to "help out").
  • read some children's books about tooth brushing.
  • Or have everyone brush their teeth at the same time.

To help him understand the importance of brushing, it can be sometimes fun and helpful to let him eat or drink something that will 'stain' his teeth temporarily, and then let him brush them clean.

It can also be a good idea to create a "tooth brushing routine" And stick to the same routine each day.

How Often Are X-Rays Taken and Are They Safe?

X-Rays to tooth pictures are taken as part of your child’s dental diagnostic exam. X-Rays not only detect cavities but also survey erupting teeth, diagnose bone diseases, evaluate the results of an injury, or plan orthodontic treatment. X-Rays allows us to properly diagnose health conditions that cannot be detected with just a clinical examination.

The frequency of x-rays is determined by your child’s individual needs. The American Academy of Pediatric Dentistry recommends X-rays every six months for children with a high caries risk. However, the majority of children usually need x-rays approximately once a year.

We are particularly careful to minimize the exposure of patients to radiation.

With contemporary safeguards, high-speed film and proper shielding, the amount of radiation in a dental x-ray is extremely small. The risk is negligible. It is a far smaller risk than an undetected and untreated problem.

What is fluoride?

Flouride is an element which helps make teeth strong and prevent tooth decay. Flouride supplements are sometimes prescribed to patients who might be in higher caries risk and not getting enough fluoride from other sources.

At the same time, excessive fluoride or flourosis can lead to permanent defects and brown discoloration of permanent teeth. Therefore, it must first be determined how much fluoride a child is getting from other sources such as water, toothpaste, multi-vitamins, rinses and other hidden sources.

Will Teething make my child ill?

Many children do become irritable, run a fever and have other symptoms when they are teething. These are to be expected and should not cause worry. Teething itself is not the cause of any childhood illness. The best things to do to aid discomfort is clean your baby’s mouth with a damp gauze pad and giving your baby a teething ring to chew on.

Is Thumb-Sucking harmful?

Sucking is a natural reflex in which infants and children may use thumbs, fingers, pacifiers and other objects on which to suck. This brings about a feeling of security especially during difficult periods. It is perfectly normal for infants. Most stop by age 2 and should be discouraged if not be age 4.

Prolonged thumb-sucking can cause crowded crooked teeth, or bite problems. This results from the frequency, duration, intensity and position of the thumb in the child’s mouth.

Breaking the Habit:

  • Wait till the time is right. (low stress)
  • Praise them when they are not
  • Focus on the cause (underlying anxiety)
  • Motivate your child
  • Use a reward system
  • Reminders (band-aid around the thumb)

How Can Cavities be Prevented?

Proper preventive dentistry includes brushing, flowing, dental development, fluorides, oral habits, orthodontics, parent involvement, proper diet, sealants and sports safety.

Tooth decay and children no longer have to go hand in hand. At our office, we are most concerned with all aspects of preventive care which starts with the first tooth. The earlier the dental visit, the better the chance of preventing dental disease and helping your child achieve a healthy smile.

How will Diet effect my child’s teeth?

Most of the time cavities are due to a diet high in sugar and a lack of brushing. Limiting sugar intake and brushing regularly, of course, can help. However, it is important that your child receives a naturally balanced diet that includes the most important nutrients your child needs in order to grow.

A balanced diet includes the following food groups of Meat, Fish and Eggs, Vegetables and Fruits, Breads and Cereals as well as Milk and other Dairy Products. A child must also have a balanced diet for their teeth to develop appropriately and for healthy gum tissue around the teeth. Please note that a diet high in sugar and other forms of carbohydrates may increase the probability of tooth decay.

Frequently Asked Questions Regarding Diet and Cavity Prevention

How do I know if my child is getting the appropriate amount of fluoride in their diet?

If you do not reside in a community that has fluoridated water or have the appropriate amount of natural fluoride in your well water, your child will need some sort of supplement in their diet. We can help you determine how much of a supplement your child needs based upon their weight, age, current water fluoride levels and brand of toothpaste.

What is an appropriate diet for my child?

It is important that your child receives a naturally balanced diet that includes the important nutrients your child needs in order to grow. A daily diet that includes the major food groups of Meat, Fish and Eggs, Vegetables and Fruits, Breads and Cereals as well as Milk and Other Dairy Products.

Can my child’s diet affect their dental health?

Absolutely. It is important that you initiate a balanced diet for your child so that their teeth develop appropriately. In addition, this will positively affect healthy gum tissue surrounding the teeth. Please note that a diet high in sugar and other forms of carbohydrates may increase the probability of tooth decay.

How do I create a diet safe my child’s teeth?

As we stated earlier, initiate a balanced diet. Analyze the frequency in which starch based foods are eaten. These types of foods include breads, pasta, potato chips, etc. In addition, sugar is found in more than just candy. All types of sugars can promote tooth decay. For example, most milk-based products contain sugar. A Peanut butter and jelly sandwich is a favorite for bag lunches. Unfortunately, it includes sugar not only in the jelly, but also in the peanut butter. For less sugar and more flavor and nutrients, try replacing jelly with fresh fruit slices (apples, pears, or bananas) or chopped dried fruit. Go easy on the peanut butter, though—it’s high in fat. Choose the “no-salt-added” kind for less sodium.

Should I eliminate all sugar and starch from my child’s diet?

Of course not. Many of these foods are incredibly important to your child’s health. Starch based foods are much safer to eat for teeth when eaten with an entire meal. Foods that stick to teeth are also more difficult to wash away by water, saliva or other drinks. Its important you talk to our staff about your child’s diet and maintaining proper dental care.

What helpful information can you give me regarding tooth decay in infants?

Most importantly, don’t nurse your children to sleep. Nor should you put them to bed with a bottle of mile, juice or formula. When a child is sleeping, any liquid that remains in the mouth can support the bacteria that produce acid and harms the teeth. A simple pacifier or bottle of water is fine.

Cavity prevention

Most of the time cavities are due to a diet high in sugary foods and a lack of brushing.

Limiting sugar intake and brushing regularly, of course, can help. The longer it takes your child to chew their foods the longer the residue stays on their teeth, the greater the chances of getting cavities.

Every time someone eats, an acid reaction occurs inside their mouth as the bacteria digests the sugars. This reaction lasts approximately 20 minutes. During this time the acid environment can destroy the tooth structure, eventually leading to cavities.

Consistency of a person's saliva also makes a difference, thinner saliva breaks up and washes away food more quickly. When a person eats diets high in carbohydrates and sugars they tend to have thicker saliva, which in turn more of the acid-producing bacteria that causes cavities.

Tips for cavity prevention:

  • Limit Frequency of meals and snacks.
  • Encourage brushing, flossing and rinsing.
  • Watch what you drink.
  • Avoid sticky foods.
  • Make treats part of meals.
  • Choose nutritious snacks.

The first baby teeth come into the mouth are the two bottom front teeth. You will notice this when your baby is about 6-8 months old. Next to follow will be the 4 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 2 1/2 years old.

At around 2 1/2 years old your child should have all 20 teeth. Between the ages of 5 and 6 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 important to chewing, biting, speech and appearance.

For this reason it is important to maintain a healthy diet and daily hygiene.

What are sealants?

Tooth Sealants refer to a plastic which a dentist bonds into the grooves of the chewing surface of a tooth as a means of helping to prevent the formation of tooth decay. In many cases, it is near 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 are mouth guards?

Athletic mouth protectors are comprised of soft plastic. They come in standard or custom fit to adapt comfortably to the upper teeth. Mouth guards protect the teeth from possible sport injuries. They not only protect the teeth, but the lips, cheeks, tongue and jaw bone as well. They 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.

What causes Bruxism? (Teeth Grinding)

Parents are often concerned about the nocturnal grinding of teeth. The first signs of this habit are noise created by the grinding and wearing of the teeth. Theories on the cause of grinding range from stress to ear pressure at night. However, the majority of children who grind do not require any treatment. Most children outgrow bruxism as they get older.

What are Space Maintainers?

Space maintainers are placed to hold open the space left by a loss primary tooth. They steady the remaining teeth, preventing the movement until the permanent tooth takes its natural position in the jaw. Space maintainers are removed once the permanent tooth is near eruption. It is much easier to keep teeth in normal positions with a space maintainer than to move them back in place with orthodontic treatment.

What kind of fillings are there?

Most cavities can be restored with tooth-colored fillings or composites. Recent advances have made them the restorative material of choice for our practice because they are mercury-free, require less removal of healthy tooth structure, strengthen the tooth by its bonding properties and are esthetically more pleasing. When the back primary molars require a pulpotomy (baby root canal) or is severely decayed, a crown is usually placed to ensure full coverage protection. If the anterior teeth require treatment, only tooth-colored filling or crowns are used.

Will my child feel any pain during dental treatment?

We make every effort to administer local anesthesia in a slow, gentle and comfortable manner, thus eliminating any pain that may accompany dental treatment. The duration of numbness after treatment varies from patient to patient and what drug was used. Generally the numbness wears off after 2 to 3 hours. Parents must be careful to watch their child for chewing or biting of inner cheeks or tongue which can become injured.

How do you handle a nervous child?

Because our practice is limited to pediatric dentistry, we try to provide a child-friendly environment for you and your family. We are able to treat most of our patients using the Tell-Show-Do- technique which is the cornerstone of behavior management. It is the process of explaining to children each procedure by telling, showing, and doing before the actual application. Each step is explained in a positive and child-friendly manner in order to earn your child’s trust. We also use euphemisms or word substitutes in order to communicate better to our young patients. Using this approach along with our gentle touch enables us to successfully treat the majority of our patients. For patients who cannot be treated in a conventional manner, sedation and anesthesia options are available.

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