Dental FAQ
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. First, only the top 10% of dentists obtaining a four-year dental degree are accepted into the dental specialty programs. Second, pediatric dentists must train an additional two or three years at an accredited pediatric dental program in order to receive a graduate certificate in pediatric dentistry. Plus, pediatric dental offices include toys and are brightly colored to create a non-threatening environment. Some pediatric dentists practice general dentistry before specializing, giving them a unique perspective. They learn how to deal with the behavioral aspects of children, how to make them feel comfortable, and to make the experience pleasant. They also are trained and qualified to treat special needs patients.
Pediatric dentists care for children of all ages. From first tooth to adolescence, they help your child develop a healthy smile until they’re ready to move on to a general dentist. Pediatric dentists have had 2-3 years of special training to care for young children and adolescents.
Your child’s first tooth will typically erupt between 6 and 12 months, although it is common to occur earlier. Usually, the two bottom front teeth – the central incisors – erupt first, followed by four upper front teeth – called the central and lateral incisors. Your child should have their first full set of teeth by their third birthday.
Permanent teeth start to appear around age 6, beginning with the first molars and lower central incisors. The age of 8, is generally when the bottom 4 primary teeth (the lower central and lateral incisors) and the top 4 primary teeth (the upper central and lateral incisors) begin to fall out and permanent teeth take their place. The rest of the permanent teeth will start to come in around age 10. Permanent teeth can continue to erupt until approximately age 21. Adults have 32 permanent teeth including the third molars (called wisdom teeth).
Research has shown that mothers with poor oral health may be at a greater risk of passing cavity-causing bacteria to their children, and periodontal disease can increase the risk of preterm birth and low birth weight. The American Academy of Pediatric Dentistry (AAPD) recommends that all pregnant women continue to visit the dentist for checkups. during pregnancy.
To decrease the risk of spreading the bacteria, mothers should visit their dentist regularly, brush and floss on a daily basis, and maintain a healthy diet full of natural fiber, and reduce sugary foods. Additionally, increasing water intake and using fluoridated toothpaste helps prevent cavities and improves oral health.
Baby teeth are temporary; however, if a baby tooth is lost too soon (either from an accident or decay), it can lead to other teeth crowding the vacant spot. This can cause alignment issues when the permanent tooth begins to emerge, and could cause crooked teeth and biting problems. Baby teeth are important to help with chewing and eating leading to proper nutrition. Finally, teeth play an important role in developing self-confidence and self esteem, even in young children.
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.
One of the most common forms of early childhood caries is “baby bottle tooth decay,” which is caused by the continuous exposure of a baby’s teeth to sugary drinks. Baby bottle tooth decay primarily affects the upper front teeth, but other teeth may also be affected.
Early symptoms of baby bottle tooth decay are white spots on the surface of teeth or on the gum line, and tooth sensitivity. More severe symptoms can appear in advanced stages of baby bottle tooth decay, and include: brown or black spots on teeth, bleeding or swollen gums, fever, and bad breath. If your child shows any of these symptoms, you need to see your pediatric dentist immediately to prevent further, more complicated problems from occurring.
1 – Don’t send your child to bed with a bottle of anything EXCEPT water.
2 – Clean your baby’s gums after each meal.
3 – Gently brush your child’s first tooth.
4 – Limit sugary drinks and food
Only give breast milk, formula milk, or water to your baby. Avoid sugar filled drinks such as, fruit juice, flavored milk, and carbonated drinks. Provide your baby with a healthy, balanced diet. Make sure he or she is getting lots of vegetables, and don’t add sugar to food. If you give your baby prepared foods, check that they are sugar-free or do not contain added sugars. Sugars such as lactose, fructose, and glucose are just as harmful. Brush and floss your baby’s teeth twice a day, and make sure they are drinking plenty of water.
A few other recommendations include:
-Brushing and flossing your child’s teeth for them until at least age seven.
-Regular six-month pediatric dental check-ups.
-Remember, preventative care! Sealants around age six.
-Orthodontic treatment whenever indicted by your pediatric dentist.
These are just a few tips and recommendations to help keep your baby’s teeth strong and healthy. Make sure to visit your pediatric dentist for more tips on preventative care and keeping your child’s teeth healthy! You don’t want to disappoint the tooth fairy with unhealthy teeth!
The American Academy of Pediatric dentistry recommends parents take their child to see a pediatric dentist by the eruption of their first tooth at around 6 months or when the child reaches 1 year of age, whichever come first.
Your child’s teeth begin forming before birth and continue forming until late in the teenage years. The diagram below illustrates the AVERAGE months and/or years these teeth erupt.
Probably not as the expected eruption of teeth are in averages and not absolutes. The general rule of thumb is up to +/- 8 months from the expected average eruption time is not of concern.
If you child experiences a cut on their tongue, cheek or lip, bleeding can usually be stopped by applying clean gauze to the affected area. You can also apply ice to the area to help stop the bleed. If you cannot stop the bleeding, call your pediatric dentist or visit the emergency room. . If your child has an open oral wound, for a long period of time they can be susceptible to infection.
If your child has a toothache, then have them rinse their mouth with warm water to ease the pain. If the pain persists for more than 24 hours, contact your pediatric dentist. Persistent toothaches can indicate more serious problems that need to be observed by a dental professional.
A baby tooth should not be replaced. You should visit Dr. Alex.
The tooth/teeth should be found and kept in Hanks Balanced Solution or cold whole milk. If you feel that the child can safely keep the tooth by his/her cheek inside the mouth, he/she can. The tooth should be handled by the part of the tooth that can be seen in the mouth and not the root. If there are other injuries, the patient should seek additional medical attention.
X-rays are valuable aids to help dentists diagnose and treat conditions that cannot be visibly seen. X-Rays can detect much more than cavities. X-Rays can show erupting teeth, diagnose bone diseases, measure the damage of an injury, or help with planning of orthodontic treatment. If dental problems are found and treated early, dental care is more comfortable for your child and more affordable for you.
Dental X-Rays are very safe and the amount of radiation from dental X-Rays is very small. Today’s equipment filters out unnecessary x-rays and restricts the x-ray beam to the area of interest. Dental X-Rays are designed to limit the body’s exposure. Pediatric dentists are very careful to minimize the exposure of their patients to radiation. In fact, dental radiographs represent a far smaller risk than an undetected and untreated dental problem.
Orthodontic Treatment can be recognized as early as 2-3 years of age. Often, preventative steps can be taken to help reduce the need for major orthodontic treatment later on.
From ages 2 to 6, the main concern would be habits such as finger or thumb sucking, underdeveloped dental arches, and early loss of primary teeth.
From ages 6 to 12, treatment options deal with jaw and dental alignment problems. This is a great time to start treatment, as your child’s hard and soft tissues are usually very responsive to orthodontic or orthopedic forces.
When adult teeth come in behind the baby teeth can be called “Shark Teeth” It is common, and occurs as the result of a lower baby tooth not falling out when the permanent tooth is arriving. In most cases, the baby tooth will fall out on its own within a couple months. If it doesn’t fall out on its own contact your pediatric dentist.
The brand of the toothbrush is not as critical as the type of bristle and the size of the head. A soft toothbrush with a small head is recommended because medium and hard brushes tend to cause irritation and contribute to recession of the gums, and a small head allows you to get around each tooth more completely and is less likely to injure your gums. It’s unnecessary to “scrub” the teeth as long as you are brushing at least twice a day and visiting your dentist at least twice a year for cleanings.
Grown ups should floss for their children until 8 or around the time they’re able to confidently tie their shoes according to the American Association of Pediatric Dentistry. Floss-pick is okay.
SSC’s , also known as “caps”, are full coverage crowns that protects the entire tooth from further decay. SSCs are a superior restoration to composites and they provide the greatest durability, longevity, and protection from future cavities. The only drawback to SSCs are their aesthetics as some parents object to their silver appearance.
SSCs are placed for several reasons. When the cavities are too big to support a composite filling; or after a nerve treatment; to cover multiple surfaces on high-risk patients; or to support a space maintainer. These are just a few of the reasons we place SSCs. Because we strive to only work on a baby tooth once, SSCs are often the treatment of choice and are usually in the best interest of the child.
No. Dr. Alex understands the esthetic demands of parents and patients alike. For decayed teeth in front we have several esthetic options such as composite fillings and tooth colored dental crowns
We make every attempt to save baby teeth since they are very important in the normal eruption of the permanent teeth. However there are times where removing a baby tooth is the best (or only) option. A few reasons for this are: Infected teeth; heavily decayed teeth that can not be restored; or due to crowded permanent teeth erupting in the wrong position.
As pediatric dentists, one of our major concerns and goals is to help guide the permanent teeth into position. When some baby teeth have to be removed prematurely, space loss can occur which can cause major problems in the future. We often place fixed space maintainers to prevent this.
Pulpotomies involve treating decay within the inside of the tooth. If the inside of the tooth, known as the dental pulp, is damaged it will gradually decay if left within the tooth. The process involves removing the pulp, cleaning out the chamber and packing the pulp with material that will help restore the tooth until it is time for it to exfoliate (or fall out on its own naturally).
A space maintainer is an appliance used to hold much needed space for the developing permanent teeth. As children age the posterior teeth are constantly trying to move toward the front of the mouth. If a child loses a baby molar early space maintainers may be required to hold the space for the developing permanent tooth underneath and not yet erupted. A failure to address space maintenance can lead to severe problems with crowding in the permanent dentition.
In pediatric dentistry patients, mild sedatives are used to calm children with anxiety or special needs. Sedation dentistry may also be used if your child undergoes several procedures at a time in order to avoid a gag reflex, or protect fidgeting children from harming themselves during the procedure. While the sedation medication does not alleviate pain or discomfort, it does provide a calming affect. After sedation has been applied, your dentist will administer an injection to numb the area in question allowing for a comfortable, pain-free experience. There are many types of sedation, so be sure to discuss the safest option with your pediatric dentist As patients get older, we replace light sedation for Nitrous (laughing gas) Sedation will not put a child to sleep, but allow them to remain calm throughout the visit Your pediatric dentist will be the person to administer sedation. There may be some rules and guidelines for post procedure care. Ensure that you and your pediatric dentist discuss everything to be expected after receiving sedation
Bruxism is more commonly known as teeth-grinding, and a surprising number of children suffer from it – around 3 in 10. Teeth-grinding usually occurs while children are asleep, and it can become a dental problem if left unchecked. Regular teeth-grinding can wear down tooth enamel, reinforce improper bite patterns, and leave teeth more susceptible to cavities and decay.
Bruxism can cause headaches, earaches, facial pain and bite and jaw problems.
If your child’s teeth-grinding is ongoing, then their dentist may prescribe a night guard to protect their teeth and mouth. A night guard helps ease the pain of tooth grinding, and protects tooth enamel from being worn away.
Thumb sucking, finger sucking and pacifier use are habits common in many children. In fact, nearly one third of all children suck on their thumbs, fingers or pacifiers in their first year of life. Thumb sucking, finger sucking and pacifier use can lead to many oral developmental issues that negatively affect the development of the mouth. These habits can cause problems with the proper alignment of teeth and can even affect the roof of the mouth.
Boredom, anxiety, anger, hunger, or even sadness can all cause children to suck on their fingers for comfort. Children mostly suck on their fingers for comfort from an uncomfortable emotional state or stressful situation.
If your child hasn’t stopped sucking their fingers by age 5, then you must wean them from the habit so that they can develop a healthy young smile. By5 years of age, your child’s mouth will be rapidly developing and thumb sucking, finger sucking or pacifier use can interfere with that process.
Some dental problems begin very early in life. One concern is early childhood tooth decay, a serious condition caused by a child staying on the bottle (or breast) too long. Oral habits (such as digit sucking) should also be checked. The earlier the dental visit, the better the chances of preventing problems. Strong, healthy teeth help your child chew food easily, speak clearly, and feel good about his or her appearance.
We are asked this question many times. We suggest you prepare your child the same way that you would before their first haircut or trip to the shoe store. This will not be the frightening experience you may remember from your youth. If you are nervous about the trip, then the less you say the better. You cannot hide your anxiety from a child (they have radar for these things). We will send you an activity/coloring book before the appointment that will explain everything. Have fun going through it with your child. Your child’s reaction to his first visit to the dentist may surprise you.
The first step in cavity prevention is good oral hygiene. Brushing and flossing helps to remove bacteria and plaque from around your child’s teeth and gingiva. At the first sign of teeth, it is important to begin brushing. At this point, you only need to be using water on the toothbrush. The amount of time that teeth are exposed to cavity-causing foods and drinks determines the risk of future cavities. This is why it is important to provide juice and milk at meal times only. The rest of the time, your child should drink plain water. Once teeth have been brushed for the night, only water should be provided. Very young infants need to eat more frequently. Many may eat once or twice during the night. If this is the case, the teeth should be brushed before putting your child back into bed. As children age, they can help to brush their teeth but it is essential that you follow up after their brushing until you have determined that they are doing an adequate job. For older children, teeth should also be brushed at least twice a day. Begin flossing your child’s teeth once contact between teeth is seen. Limiting snacks is essential in decreasing the chance of cavities. It is recommended by the American Academy of Pediatric Dentistry that your child visit a pediatric dentist every six months. Visits should begin at age one (1) or within 6 months of the first tooth erupting. Routine visits help you and your child become familiar with the dentists and help to prevent future tooth decay.
It’s never too early to begin a healthy oral care routine. In fact, you should begin caring for your child’s gums long before their first tooth emerges, which is usually around the six-month mark of their life. Healthy gums are an important predicator of healthy teeth, and maintaining clean gums will help ensure that your child has healthy, cavity-free baby teeth.
You can clean your infant’s gums – or their first teeth – by simply using a cold, clean washcloth. Simply rinse a clean, soft washcloth with cool water and wring it out. After your child has finished eating, or drinking a sugary drink, use the damp washcloth to gently wipe out their mouth. This will remove any sugar or acid that’s left by their food, and help prevent early cavities.
Once your child has a few more baby teeth – usually between 8 and 12 months – then you can graduate from a washcloth to a toothbrush designed for toddlers. There are a lot of toothbrushes designed for babies and toddlers from which to choose. Generally speaking, toothbrushes designed for babies have much softer bristles and a smaller head than those meant for older children.
Use only a smear of toothpaste – about the size of a grain of rice – to brush their teeth. When they’ve gotten older and have more teeth, use a pea-sized amount of toothpaste. Always be sure to rinse their mouth out with cool water after you’re done brushing, and try to keep them from swallowing any toothpaste.
Flossing is also important for baby teeth. Flossing helps remove the plaque and food that can become lodged between teeth. Be sure to floss your child’s teeth daily.
Children should eat a variety of foods including grains, fruits, protein, vegetables, and low-fat dairy.raw vegetables like carrots, celery and bell pepper are excellent snacking alternatives to unhealthy chips and crackers. Starchy carbs like potato chips and crackers can stick to teeth and cause unhealthy buildup, which can lead to cavities. Fibrous vegetables like celery can actually clean your teeth as you eat them! That is also true of fibrous fruits like apples, strawberries and kiwi.
So choose raw fruits and vegetables instead of chips, they are better for your overall health, and they won’t stick to your teeth like starchy carbs and sugars.
Dental sealants work to prevent cavities by sealing pits and fissures that naturally occur in molars. Sealants “seal off” the pit and fissure of your molars to prevent food and plaque from collecting and forming cavities.
Fluoride is considered to be nature’s own cavity fighter. Fluoride is naturally found in all sources of water such as lakes, rivers and even the ocean. Fluoride is added to most public water supplies, so the tap water in your home has fluoride added to it. Fluoride helps build tooth enamel which helps protect your teeth from tooth decay.
For more than half a century, the ADA has recommended using toothpaste containing fluoride to prevent cavities. Fluoridated toothpaste does an excellent job of cleaning teeth, but make sure that your child spits all of it out and rinses their mouth thoroughly after brushing since ingesting excessive fluoride can lead to a condition called fluorosis. Fluorosis is faint white lines on the teeth.
Xylitol has the sweet benefits of traditional sugar, but it doesn’t have the negative effects on teeth like sugar. The natural sugar alcohol, Xylitol, actually helps prevent cavities by inhibiting the growth of bacteria that causes cavities. You can find natural xylitol in some fruits and berries. Xylitol can most often be found in gums and mints.
The American Academy of Pediatric Dentistry (AAPD) recognizes the benefits of xylitol for the oral health of infants, children, adolescents, and persons with special health care needs
Did you know that sports drinks can contain more sugar than leading cola beverages, with as much as 19 grams of sugar per serving? The sugars increase the acidity in your mouth which attracts tooth enamel destroying bacteria. Sugar increases the acidity in your mouth which helps give bad oral bacteria the fuel it needs to create cavities.
Mouth guards – sometimes called mouth protectors – work by helping cushion a blow to the face, and minimizing the risk of broken teeth, or lacerating a lip, tongue or cheek. Did you know that the CDC estimates that more than 3 million teeth are knocked out at youth sporting events? Mouth guards work to prevent tooth loss and other facial injuries. Mouth guards come in a variety of shapes, sizes, and are designed for multiple sports.