Frequently Asked Questions
- Why see a Pediatric Dentist?
- So, when should my child's first dental visit be?
- When should I start brushing my child’s teeth?
- When should I start flossing?
- What is Early Childhood Caries (ECC)?
- Why are baby teeth so important?
- Why are my child's permanent teeth coming in "yellower" than his/her baby teeth?
- Why is my child's front tooth turning gray?
- Why does my child have a tooth coming in behind the other?
- Will my child need braces?
- Does my child need fluoride supplements?
- When should my child wear a mouthguard?
- Why does my child need sealants?
- Is my child’s pacifier or thumbsucking habit harmful? At what age should I begin to worry if he/she does not stop?
- My child grinds his teeth, is there anything that can be done?
- What are fluoride varnishes?
Pediatric dentists are dental specialists with additional years of training. Along with specialized technical skills, they also possess a thorough understanding of the needs and development of children. Pediatric dentists care for infants, children, adolescents and teenagers. They have also acquired specialized training in treating patients with special needs. Patient behavior management is a large part of the dentist and his or her staff’s expertise. In fact, it is perhaps the most important part of pediatric dentistry. In addition, most pediatric dentists have received specialized training in the appropriate use of sedation techniques, such as nitrous oxide and oral conscious sedation. In collaboration with an anesthesiologist, pediatric dentists can provide dental treatment under intravenous anesthesia and hospital general anesthesia. With these treatment modalities, our practice is able to tailor your child’s treatment to his or her individual needs. This expertise allows your child to develop a positive outlook towards dentistry, as well as form a bond of trust and acceptance with the doctor and his or her staff.
The American Academy of Pediatrics and the American Academy of Pediatric Dentistry recommend for an infant to be seen shortly after the first tooth erupts and no later than their first birthday.
The earlier you start the better chance we have to prevent any potential problems. In addition to checking for decay and other problems, our staff will teach you how to properly clean your child's teeth, identify your child's fluoride needs, and offer you helpful advice that will help your child build a lifetime of good dental habits.
As soon as your child's first tooth appears, begin using a soft-bristled
toothbrush once in the morning after breakfast, before naps, and most
importantly at night before your child goes to bed. Use only a tiny bit of
toothpaste, a pea-sized amount is sufficient and will not be harmful if
swallowed. Do not be discouraged if your child refuses or becomes fussy during
the brushing of his/her teeth. Children do very well with routines. As this is
done on a "routine" basis your child will become desensitized to
If your child doesn't seem to like the taste of toothpaste, just use water. Toothpaste is not a necessity for most infants under 24-36 months of age.
Flossing should be introduced when primary (“baby”) teeth have come into the mouth, usually by age 3, and if there is contact with other teeth.
Early Childhood Caries (a.k.a. “nursing bottle caries”) is the most common preventable form of tooth decay. Other commonly used terms for this condition are “bottle rot, or baby bottle tooth decay”. This condition can occur when a child, who has the cavity causing bacteria in his saliva, is allowed to nurse continually from the breast and/or from a bottle with milk, formula, juice, or other sugary substances during the night and even during naptime. As you begin to fall asleep your saliva glands slow down. Saliva helps fight the acid and toxins created by specific bacteria that cause tooth decay. Thus, by allowing these liquids to pool around your child's teeth during sleeping periods, the bacteria can attack healthy enamel, which can result in serious dental decay such as early childhood caries. As soon as the first tooth erupts and every tooth thereafter, the level of decay causing bacteria will increase if present. If your child must have a bottle at naptime or bedtime, it is recommended that it contain 100% water to prevent decay.
Many parents have been led to believe that baby teeth don't need to be restored if affected by decay. Yes, these teeth will eventually fall out. However, the average age for a child's first primary tooth to fall out is 6-8 years of age and the last one between 11-13 years of age. If a primary tooth has been affected by decay and not treated properly it can result in the damage of a permanent tooth. Primary teeth play a vital role in your child's growth and development. These teeth act as a guide for the permanent teeth to come into the mouth in the best possible position. If a tooth is prematurely lost before the permanent tooth is ready to come in, the nearby teeth can tip or move into the vacant space. When this happens, the permanent teeth may come in malpositioned.
At approximately 6 to 7 years of age, parents begin to notice the new permanent teeth are coming in darker than the baby teeth. Our permanent teeth have a greater amount of dentin, which is yellow in color. Since the enamel is translucent, the color of the dentin shows through. When all the permanent teeth have erupted, the color will blend and appear uniform.
Many times, due to an injury, the nerve inside the tooth may be bruised or infected causing a grey discoloration. With time, usually within a month or so, the tooth may lighten up or may become darker. Anytime there is an injury to the mouth you need to have your child evaluated by a dentist so it can be determined whether the tooth may need to have a nerve treatment.
Overcrowding may be caused by a small jaw, big teeth, or a combination of both. This can result in a permanent tooth coming in behind the baby tooth in the lower jaw. In the upper jaw, a permanent tooth may arise in front of the baby tooth. If a child's mouth is overcrowded, a permanent tooth may not be directly underneath the baby tooth, therefore allowing the permanent tooth to erupt out of its natural alignment. It is wise to have your child evaluated by a dentist to determine whether or not the baby tooth needs to be removed to allow the permanent tooth to erupt in the best possible position. If a baby tooth is over-retained on the upper front area, it must be evaluated for possible removal as soon as possible.
The American Academy of Orthodontics recommends that children receive an orthodontic evaluation by age 7 because enough permanent teeth have come in and enough jaw growth has occurred that the dentist or orthodontist can identify current problems, anticipate future problems, and alleviate parents' concerns if all seems normal. The first permanent molars and incisors have usually come in by age 7, and crossbites, crowding, and developing injury-prone dental protrusions can be evaluated. Any ongoing finger sucking or other oral habits can be assessed at this time also.
Fluoride supplementation is determined by the history of each child's fluoride intake. A child who drinks plenty of water in an optimally "Fluoridated Community" or Fluoridated bottled water, may not need a fluoride supplement. If you use a water filtration system or are considering the purchase of one, check to see if it filters out fluoride (i.e., reverse osmosis). If it does filter out fluoride, your child may need a fluoride supplement. Fluoride assessments can be done by your child's pediatrician or pediatric dentist.
Is your child active in sports? If your child is involved in athletic activities such as football, baseball, basketball, soccer, hockey, skateboarding, gymnastics, or any other activity where there is a risk of falls or head contact with other team players or equipment, you should consider having your dentist make your child a custom mouthguard. Mouth guards are the number one priority when it comes to sports equipment. You can get preformed mouth guards at your local sports store. However, customized mouth guards made by your pediatric dentist are more effective in preventing injuries and are more comfortable for your child. It does cost a bit more, but the protection it offers to their permanent teeth is priceless.
A sealant is a clear or opaque resin coating that is applied to the chewing
surfaces of teeth. More commonly used on permanent teeth, they can be applied
to baby teeth as needed. They have been shown to prevent cavities on the
chewing surfaces of teeth.
This procedure only takes a few minutes without any local anesthetic. In order to maintain the sealants, it is best to have your child avoid hard and sticky candies, such as jawbreakers or caramels, as well as chewing on ice. The longevity of a sealant depends on diet, hygiene, and oral habits.
Is my child’s pacifier or thumbsucking habit harmful? At what age should I begin to worry if he/she does not stop?
Sucking is normal for babies and young children. Thumbsucking habits are usually established by three months of age. Some children have the need to "suckle" more than others. Frequent use of a pacifier or thumb can create a number of problems, such as an anterior open bite (front teeth do not meet), palatal changes, and tongue protrusive posturing (tongue thrusting). Although these conditions can be corrected through orthodontics and/or surgical procedures in the future, early intervention is recommended. Pacifiers should be discontinued by 2-3 years of age. If your child has a thumbsucking habit, begin to encourage discontinuation at 4-6 years of age. Your pediatric dentist will work with you and your child to develop a positive reinforcement reward system to help them quit. If this approach isn't successful, a thumbsucking or orthodontic habit appliance may be recommended. These appliances block the thumb or fingers from being inserted into the mouth. Periodical visits are performed to check progress. Treatment may last anywhere from 6 to 9 months.
Bruxism is the action of involuntarily grinding your teeth. Usually "grinding" occurs during the night while sleeping. If your child does this and there is a lot of wear on his/her teeth, your dentist may recommend a night guard. A night guard is a customized splint made out of hard or soft plastic. It is to be worn during the night to help protect the enamel from being damaged. The wearing of a night guard induces relaxation of the muscles used during grinding. Instead of the teeth making contact with the opposing teeth, they come in contact with the splint.
A fluoride varnish is a concentrated fluoride substance that is “painted” on a tooth to re-mineralize (repair) enamel on baby or permanent teeth.