Dental Topics

What is a Pediatric Dentist?

In the same way that pediatricians are trained to meet a child’s medical needs, pediatric dental specialists are uniquely qualified to protect your child’s oral health, using the most advanced techniques. Pediatric dentists have an additional 3 years of training, in addition to 4 years of dental school and 4 years of college study. Pediatric dentists are also trained and qualified to treat patients with special medical needs.

When should my child first see a Dentist and Why?

The ideal time as recommended by the American Academy of Pediatrics (AAP), American Academy of Pediatric Dentistry (AAPD) and the American Dental Association (ADA) is at approximately one year of age. This is an ideal time for the dentist to carefully examine the development of your child’s mouth. Because dental problems often start early, the sooner the visit the better. To safeguard against problems such as baby bottle tooth decay, teething irritations, gum disease, and prolonged thumb-sucking, the dentist can provide or recommend special preventive care.

You can make the first visit to the dentist enjoyable and positive. If old enough, your child should be informed of the visit and told that the dentist and their staff will explain all procedures and answer any questions. The less to-do concerning the visit, the better.

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 to the child.

Why should I take my child to a Pediatric Dentist?

Pediatric dentists are specially trained to understand children’s dental development and qualified to diagnose and treat children’s dental health needs. Just like you take your child to a pediatrician for medical related checkups and treatment, it is good practice to take your child to a pediatric dentist for any dental related checkup and treatment. This will guarantee that your child gets proper care from a specialist who is qualified to treat children’s dental health needs.

Do I need a referral from a General Dentist to take my child to a Pediatric Dentist?

No, you do not need a referral from a general dentist to take your child to a pediatric dentist. You can directly call a pediatric dentist to make an appointment for your child’s dental visit. A pediatric dentist specializes in providing dental care to children and usually is the dental care provider for a child until the age of 18.

Why Are The 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 jawbones 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 ten to fourteen, so they must last for years. 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.

Eruption Of Your Child’s 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 guidelines will help children remain cavity free?

The American Academy of Pediatric Dentistry recommends:

Brush with a fluoride toothpaste twice a day.
Floss children’s teeth atleast once a day.
Visit your pediatric dentist regularly.
Get enough fluoride through drinking water, fluoride products and fluoride supplements, if necessary.
Have sealants applied to the chewing surfaces of permanent back teeth or molars.
Snack moderately-no more than twice a day.

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 as shown on the box and tube. These toothpastes have undergone testing to insure 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. If your child is too young or unable to spit out toothpaste, consider providing them with a fluoride free toothpaste, using no toothpaste, or using only a “pea size” amount of toothpaste.

Dental Radiographs (X-Rays)

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.

Radiographs detect much more than cavities. For example, radiographs may be needed to survey erupting teeth, diagnose bone diseases, evaluate the results of an injury, or plan orthodontic treatment. Radiographs 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 radiographs 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 3 to 5 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 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. Today’s digital x-ray 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.

Our office uses digital x-rays technology reducing your child’s radiation exposure up to 90% and completely eliminates the use of chemicals. It’s better for kids. It’s better for the environment!

Does Your Child Grind His/Her Teeth At Night (Bruxism)?

Parents are often concerned about the nocturnal grinding of teeth (bruxism). Often, the first indication is the noise created by the child grinding on 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.

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. The negatives to a mouth guard are 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 most children outgrow bruxism. The grinding decreases 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.

Thumb Sucking

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 mouth 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. Your pediatric dentist m

Early Childhood Tooth Decay

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 infant tooth decay?

Now known as Early Childhood Caries (ECC), infant tooth decay results when babies fall asleep with breast milk or milk, formula and juice from a bottle on their teeth. Babies are not able to clear the pooling liquid from their mouths.
Because the sugar in formula, milk or juice stays in contact with the teeth for a long time during the night or at nap-time, the teeth can decay quickly.

Following are some tips to avoid Early Childhood Caries:

Brush your baby’s teeth at least twice a day.
Put your child to bed with a bottle of plain water, not milk or juice.
Stop nursing when your child is asleep and wipe the teeth with a clean washcloth.
Try not to let your child walk around using a bottle or sippee cup of milk or juice as a pacifier.
Start to teach your child to drink from a cup at about six months of age. Plan to stop using a bottle by twelve to fourteen months at the latest.
Don’t dip your child’s pacifier in honey or sugar.
Read, sing or rock your child to sleep as an alternative to continuous feeding.

Bottle feeding past 12 months of age leads to a drastically increased caries risk.

Infants should not be put to sleep with a bottle containing a liquid other than water.
Infants should be encouraged to drink from a cup prior to their first birthday.
Infants should be weaned from the bottle at 12-14 months of age.
Infants should start to supplement their diet with non-liquids at 4-6 months of age.
Juices should only be offered from a cup.
Oral hygiene should be started with eruption of the first primary tooth.
Within six month of eruption of the first tooth (no later than the first birthday) it is time for the first dental visit.

How important is a child’s diet in the prevention of cavities?

Although a well-balanced diet is important in preventing cavities and to ensure good general health, cavities are not only the result of what children eat but also the frequency of meals. Frequent snacking without brushing leaves food on the teeth longer and increases the likelihood of a cavity developing. Additionally, frequent “sipping” on sugar-drinks (including juice and soda) in a baby bottle, “sippy” cup, or re-sealable bottle can cause widespread dental cavities.

Sedation

In dentistry, even with the best intentions and chairside manner of the dentist and dental team, some children and young adults are so apprehensive and fearful that no amount of talking or calming by the dental team will allow the treatment to be completed. These patients can be helped with sedation dental appointments. Dentistry has come a long way to help children and young adults complete their needed dental care. For those children who just cannot handle regular dental appointments, there is hope with sedation dentistry. Following are typical methods used for sedation.

Nitrous Oxide

Some children are given nitrous oxide/oxygen, or what you may know as laughing gas, to relax them for their dental treatment. Nitrous oxide/oxygen is a blend of two gases, oxygen and nitrous oxide. Nitrous oxide/oxygen is given through a small breathing mask which is placed over the child’s nose, allowing them to relax, but without putting them to sleep. The American Academy of Pediatric Dentistry, recognizes this technique as a very safe, effective technique to use for treating children’s dental needs. The gas is mild, easily taken, then with normal breathing, it is quickly eliminated from the body. It is non-addictive. While inhaling nitrous oxide/oxygen, your child remains fully conscious and keeps all natural reflexes.

Conscious Sedation

Conscious Sedation is recommended for apprehensive children, very young children, and children with special needs. It is used to calm your child and to reduce the anxiety or discomfort associated with dental treatments. Your child may be quite drowsy, and may even fall asleep, but they will not become unconscious.
There are a variety of different medications, which can be used for conscious sedation. The doctor will prescribe the medication best suited for your child’s overall health and dental treatment recommendations. We will be happy to answer any questions you might have concerning the specific drugs we plan to give to your child.

Outpatient General Anesthesia

Outpatient General Anesthesia is recommended for apprehensive children, very young children, and children with special needs that would not work well under conscious sedation or I.V. sedation. General anesthesia renders your child completely asleep. This would be the same as if he/she was having their tonsils removed, ear tubes, or hernia repaired. This is performed in a hospital or outpatient setting only. While the assumed risks are greater than that of other treatment options, if this is suggested for your child, the benefits of treatment this way have been deemed to outweigh the risks. Most pediatric medical literature places the risk of a serious reaction in the range of 1 in 25,000 to 1 in 200,000, far better than the assumed risk of even driving a car daily. The inherent risks if this is not chosen are multiple appointments, potential for physical restraint to complete treatment and possible emotional and/or physical injury to your child in order to complete their dental treatment. The risks of NO treatment include tooth pain, infection, swelling, the spread of new decay, damage to their developing adult teeth and possible life threatening hospitalization from a dental infection.