Dental FAQ

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What is a pediatric dentist?

Pediatric dentists are dedicated to the oral health of children from infancy through early adulthood. After four years of dental school, pediatric dentists attend 2 years of advanced, specialized training. They have the experience and qualification to care for a child’s teeth, gums and mouth throughout the various stages of childhood. Pediatric dentists provide comprehensive oral health care that includes the following:

• Infant oral health exams, which include risk assessment for cavities in mother and child
• Preventive dental care including cleaning and fluoride treatments, as well as nutrition and diet recommendations
• Habit counseling (for example, pacifier use and digit sucking)
• Early assessment and treatment for straightening teeth and correcting an improper bite
• Treatment of cavities
• Management of gum diseases and conditions including ulcers, short frenules, mucoceles, and pediatric periodontal disease.
• Care for dental injuries (for example, fractured, displaced, or knocked-out teeth)

Children are not just small adults. They are not always able to be patient and cooperative during a dental exam. Pediatric dentists know how to examine and treat children in ways that make them comfortable.  A pediatric dentist office is also especially designed for children and the goal is to provide a positive experience for each and every child.

At what age should my child first see a dentist?

The first dental visit should be at or around your child’s first birthday or upon the eruption of their first tooth. You can make the first visit to the dentist enjoyable and positive. To learn about your toddler’s first visit click here.

Do not surprise your child with a trip to the dentist. Our goal is to make sure they feel comfortable and have fun during their appointment. Your child’s reaction to their first visit to the dentist may surprise you.

It is best if you refrain from using words around your child that might cause unnecessary fear such as “needle”, “pull”, “drill” or “hurt”. The office makes a practice of using words which convey the same message but are pleasant and non-frightening to the child. 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. Please be aware it is very difficult to hide your anxiety from your child.

Parents are always welcome to accompany their child for their first visit. We are all highly experienced in helping children overcome anxiety. During future visits we suggest you allow your child to come into treatment alone. We can usually establish a closer rapport with your child when a parent is not present. Our purpose is to gain your child’s trust and overcome any apprehension. We ask children not being treated remain in the reception area with a supervising adult.

What happens at a “regular” dental visit?

A thorough risk assessment will be done where any risk factors which could leave your child prone to dental disease or improper bite (malocclusion) will be identified. Developing tooth decay, gum disease, or adverse habits like thumb sucking are just some of the factors which can have adverse effects on the oral health of your child.  X-rays may be taken to identify any decay in-between teeth or the position of any unerupted permanent teeth. We will clean your child’s teeth and may apply topical fluoride to help protect the teeth against tooth decay. Although brushing and flossing are extremely important the most important factor in children’s dental decay is their diet. We will review with you how to clean and care for your child’s teeth and make any dietary and treatment recommendation if necessary.

What is baby bottle decay?

Baby bottle tooth decay is an advanced form of early childhood caries which can be prevented. It is caused by a prolonged exposure of sugary liquids during the day or in the evening while child is being put to bed or is sleeping. Parenting does not come with a manual. As a parent it is your responsibility to enforce some hard rules your child will not always understand. This is one of those times giving into your child will not produce results you or your child will be happy with.

Tips for avoiding Baby bottle decay:

• If your child insists on going to bed with a bottle use only water. Do not put your child to bed with milk or juice. Many parents think watered down juice is acceptable, it is NOT. Watered down juice still promotes tooth decay by feeding decay promoting bacteria.
• Stop nursing your child when they are asleep.
• DO NOT allow your child to have unlimited access to a sippy cup with juice or milk. Do not allow them to use the sippy 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 12-14 months

Why are baby teeth so important?

Primary teeth are important for several major reasons. First they help with proper chewing, eating and in the development of speech. A child who can chew easily, speak clearly and smile confidently is a happier child. Healthy primary teeth allow for normal development on 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 are not treated.

What is the appropriate timing for tooth eruption?

The first baby teeth come into the mouth around 6 to 8 months. They will be the front bottom teeth. Next to follow will be the 4 upper front teeth and the remainder of your child’s teeth will appear periodically. Baby or deciduous teeth usually appear in pairs until the child reaches 2 ½ years old.

At or around 2 ½ your child should have 20 teeth. Between the ages of 5 and 6 the first permanent teeth appear. From 7-12 years your child will start to replace their baby teeth with permanent teeth. Your child’s teeth may not follow the chart of tooth eruption. We are not generally concerned unless a tooth has not erupted a year past it’s observed eruption cycle.

Remember one of the main function of baby teeth is to hold the space for permanent teeth.

For this reason it is important to maintain a healthy diet and daily hygiene. Click here to view the American Dental Association Tooth Eruption Chart.

How is tooth brushing different with children?

Children’s hands and mouth are different than adults. There is no easy way to brush most children’s teeth. The most successful families are diligent, and brush every day. The children will usually learn to like the routine. Children will often demand to do it themselves. Fine! But Mom and Dad need to take a minute and “check” to make sure the child did a good job and finish the brushing the areas your child missed. There are many different approaches to help your child brush their teeth. Some find it easier to have their child lay on the floor, others stand behind them. Whichever option you choose we recommend a thorough cleaning of the teeth every day. Although it is different for every child we see children are usually ready to brush their teeth alone around the time they learn to tie their shoes. However many children get lazy and still need a parents check to see it was done properly

Many parents are surprised to find out how important flossing is between baby teeth. If your child’s teeth are touching we recommend flossing every day. We find most parents find flossing with a flossing stick much easier than with floss held between their fingers.

Click here for a video on proper brushing. 

What is flouride?

Fluoride is a naturally occurring element found naturally in many foods and water. Everyday minerals are added to and lost from a tooth’s enamel layer through two processes, demineralization and remineralization. Minerals are lost (demineralization) from a tooth’s enamel layer when acids formed from plaque bacteria and sugars in the mouth attack the enamel. Mineral such as fluoride, calcium and phosphate (found in toothpaste) are redeposited (remineralization) to the enamel layer. Too much demineralization without enough remineralization to repair the enamel layer leads to cavities.

It has shown to be very beneficial to teeth in appropriate doses. Fluoride makes the tooth more resistant to cavities by reducing the bacteria’s ability to produce acid, regenerate and strengthens the outer enamel by remineralization. If a little is good, too much fluoride is NOT better. It has been found excessive fluoride use in our children can lead to dental fluorosis, which is a frosty white to brown discoloration of permanent teeth.

It has been shown children who are unable to spit out fluoride containing toothpaste will swallow the majority of this toothpaste. This is why the American Academy of Pediatric Dentists recommends having a child who cannot spit apply a smear of fluoride containing toothpaste on their brush two times a day. If your child can spit it is recommended your child place a “pea” size amount on their brush. This is a secret the toothpaste company’s do not want us to know as our toothpaste consumption is greatly reduced. Following this recommendation will help your child avoid excessive and inappropriate fluoride intake.

As fluoride has been incorporated in many consumables it is important to be aware of fluoride levels in your area before requesting for fluoride supplements.

Despite the risks of fluoride it remains one the most effective agents in preventing cavities and remineralizing teeth.

What is thumb or finger sucking?

Thumb or digit sucking can be a very difficult habit to break. If a child does not stop early enough, they may cause permanent damage to the growth and development of their teeth and jaws. If your child is  happy with a pacifier and does not require a digit to self soothe a pacifier habit is easier to break then a thumb or digit habit. We recommend the following ways to break the habit:

• Wait until the time is right to explain the damaging effects of the habit. Ultimately it will be the child’s choice to stop the habit. Timing is everything
• Motivate your child with what works (calendar with stickers, special prize, etc). Realize every child is different in what motivate them.
• Be patient and understanding. Thumb sucking is a form of comfort and many patients may not be ready to lose this comfort.
• There are aids we can recommend once all resources have been exhausted by parent and child.

It is very unlikely for your child to break the habit unless they have a desire or are properly motivated to quit.

What is an appropriate diet for my child?

It is important your child receives a naturally balanced diet which includes the important nutrients your child needs to grow appropriately. A daily diet includes the major food groups of meat, fish and eggs, vegetables and fruits, breads and cereals as well as milk and other dairy products.  Please visit www.choosemyplate.gov for additional information about appropriate food choices.

Can my child’s diet affect their dental health?

Absolutely. A balanced diet will help your child grow appropriately as well as provide the proper foundation for their teeth to develop. A diet either high in sugar or with sources of sugar or carbohydrates given frequently will increase the probability of tooth decay.

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

As stated earlier, create a balanced diet. The bacteria which cause cavities feeds on simple sugars, and the frequency of those sugars eaten depend on how active the bacteria are in the mouth. Sugar is found in more than just candy. All types of sugars can promote tooth decay. For example the sugar found in milk can lead to baby bottle tooth decay. Raisins are a favorite snack of children but they can stick to the teeth given the bacteria on the teeth hours of exposure even after snack time is over. The highest risk factor for cavities is how frequently the child eats or drinks sugary substances. Children should not be allowed to graze, but should be allowed to eat 3 times a day with a 15-20 minute snack appropriately placed between meal times.

Foods contain sticky sugars:

Candy, granola bars, dried fruit (raisins, craisins, etc), fruit roll ups, fruit snacks, gummy candy, breads, marshmallows, brownies, hard candy, caramel, suckers, toffee, cough drops.

Liquids with sugar:

Juices (apple, fruit), soda pop, Kool-Aid, Gatorade, milk, popsicles, flavored medicine.

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

No. Many of these foods are incredibly important for proper development and some are just plain fun. Moderation and frequency is the secret. Foods which stick to the teeth as listed above will placed your child at greater risks for developing cavities because they are harder to wash away with water or saliva. It is important for use to discuss with you a proper diet in maintaining a healthy oral environment.

What is a pulpotomy?

Pulpotomies are caused by the decay present on the tooth reaching the nerve or pulp of the tooth. A pulpotomy is similar to a root canal treatment for a permanent tooth. If a specific tooth is symptomatic (hurts) it will most likely require a pulpotomy. Pulpotomies are much quicker then root canal treatments and usually add only 10 or so minutes to the procedure time. A pulpotomy is not always anticipated at the start of treatment but may need to occur if the decay from the tooth reaches the pulp. A pulpotomy is performed as the infected pulp is removed from the chamber of a tooth. The remaining pulpal tissue is treated and in some cases an antibiotic material is placed, followed by a filler material and a crown.

What’s the difference between composite vs silver fillings?

Many people have worried about the safety of silver fillings. They worry that the mercury in the restoration will lead to health problems. As a result, the silver fillings have been heavily studied, and their safety evaluated. You are actually much more likely to be exposed to mercury when eating seafood harvested from the ocean.

The mercury in the silver filling becomes volatile, or turned into particles that can be absorbed into your body when the filling is being placed or when it is being removed. Once a silver filling has been placed in your mouth, it is often safer to leave it there than expose the patient to the aerosol of the filling when it is being removed. When silver fillings are placed or removed, care must be taken to suction as much of the dust and debris as possible.

White restorations are more complex. They are a mixture of plastic, or resin, components and small glass particles. The most asked about ingredient in plastic is probably BPA. BPA, or Bisphenol A, is an estrogen analog, or a material that mimics estrogen in your body when consumed in large quantities. BPA is often found in commercial plastics.

There is no BPA in composite restorations, but there a BPA derivative called Bis-GMA is used. Bis-GMA has not been shown to cause any adverse health problems, but is still being studied.