What is a pediatric dentist?

A pediatric dentist is a dentist that specializes in treating children, adolescents and patients with special health care needs. In order to become a pediatric dentist, an additional two-year residency must be completed after dental school. During this residency, the dentist receives additional training in many areas including: dental growth and development, pediatric restorative dentistry and pharmacologic and non-pharmacologic behavior management techniques. Pediatric dentists are trained to be experts in dental care for children.

What are primary teeth and why are they important?

Primary teeth, commonly referred to as baby teeth, are the first set of teeth that erupt into the mouth. These 20 teeth come into the mouth between the age of 6 months and 3 years. Front baby teeth will be lost between the ages of 6 and 9 years as the permanent teeth begin to erupt. Back baby teeth will be lost between age 9 and 12. These are just averages. Some children lose teeth sooner and some will lose them later.

Baby teeth are important because they hold the space for the permanent teeth forming beneath them. If baby teeth are lost early, shifting of the permanent teeth may occur which can cause crooked permanent teeth and other spacing issues. Orthodontic treatment or braces is often the only way to correct these preventable problems. If a baby tooth is lost early, the dentist may recommend a space maintainer to help prevent this shifting. Preventing and treating dental decay in baby teeth is also important to avoid unnecessary pain and potential infection for your child.

When should my child first see a dentist?

The American Academy of Pediatric Dentistry (AAPD) recommends that children see a dentist by age 1. These early visits are important for setting your child’s dental health in a positive direction. At these first visits, important individualized oral health information is given to parents to help prevent dental problems in the future. A dental home is also established so the child has a dentist available in the event of dental trauma or other dental concerns.

What can I expect for my child’s first dental visit?

For children 2 years old and younger, parents will accompany their child for the dental appointment. The dental hygienist or dentist will clean your child’s teeth with a toothbrush often in a knee-to-knee position that allows your child to remain in your lap during the appointment. Young children often fuss and cry during these early visits; this is normal and expected. The dental hygienist or dentist will work quickly to make the appointment a positive experience. Once the teeth are clean, the dentist will examine the teeth, gums and other oral soft tissues. Fluoride will be placed on your child’s teeth and individualized recommendations will be given regarding your child’s oral health.

For children age 3 years and up, we recommend that parents allow their child to experience his/her dental appointment with our dental professionals. We find that children this age often thrive and become independent when we are given the opportunity to walk them through the appointment. During this first appointment, the dental hygienist will clean your child’s teeth, complete a fluoride treatment and discuss oral hygiene with your child. The dentist will examine your child’s teeth, gums and oral soft tissues and dental x-rays will be taken if appropriate. After the appointment, individualized recommendations will be given regarding your child’s oral health.

How often should my child see a dentist?

For most children, we will recommend a dental exam and cleaning every 6 months. Some children will require more frequent visits such as every 3 months and other children may only need to be seen every year. This will be determined on an individual basis by the dentist at every visit.

When should I start brushing my child’s teeth?

It is best to begin brushing your child’s teeth as soon as they come into his/her mouth around age 6-9 months. The best times to brush are in the morning after breakfast and right before bed. It is not uncommon for children to resist toothbrushing at this young age. The bathroom may not be the ideal location to brush your child’s teeth because of the many hard surfaces. Laying your child into your lap on a couch or soft floor may help make brushing easier. If a second caregiver can help, the knee-to-knee position used during the dental appointment can be helpful as well. Even if your child resists, it is important to clean your child’s teeth daily with a soft toothbrush. Gentle brushing along the gum-line will remove the plaque and food that causes cavities. When brushing, lift your child’s upper lip and examine the front teeth for any bright white or brown spots. This could be an indication that a cavity is beginning to form. Call and set up an appointment with the dentist if you see any sign of this. Flossing should be done anywhere teeth are in contact with one another. This is very important because cavities commonly start between the teeth because these are difficult areas to clean with only a toothbrush.

Children will need adult assistance with toothbrushing and flossing at least until age seven. Children this age and younger may want to be independent and brush on their own, but they do not have the manual dexterity to remove all of the plaque that forms daily on their teeth. It is important to help your children with their brushing to prevent dental decay. Older children may still need supervision of their brushing to be sure they are thoroughly cleaning their teeth. They should brush for 2 times per day. Brushing before bed is the most important. After brushing at bedtime, children should have nothing to eat or drink except water. This gives the teeth an opportunity to clean for many hours.

Is thumb sucking and pacifier use bad for my child’s teeth?

Thumb sucking and/or pacifier use is normal for very young children and most children will stop on their own by age 2. It provides comfort to children at this stage. Prolonged thumb sucking and/or pacifier use may cause permanent changes in your child’s bite and growth of his/her jaw. If you have concerns about this, speak to your pediatric dentist.

What is fluoride?

Fluoride is a natural mineral that helps prevent tooth decay by strengthening the outer layer of your teeth (enamel). Teeth can be strengthened as they are developing by drinking fluoridated water and also strengthened once they are in the mouth by using fluoride toothpaste and fluoride rinses. Fluoride also helps protect your child’s teeth from cavities by inhibiting growth of the bacteria that cause cavities. It is important to control the amount of fluoride that your child receives to maximize its benefits and prevent adverse side effects. At your dental appointment we will discuss your child’s fluoride exposure and make recommendations for the proper dosage of fluoride.

What are sealants?

Sealants are a plastic material that is applied to the back teeth to help prevent decay of the chewing surface. Many teeth have deep grooves on the chewing surface that are impossible to clean completely with a toothbrush. The food and bacteria that become stuck in this area can cause tooth decay. When sealants are placed, the grooves are first cleaned and then the sealant material is flowed into these grooves and hardened. This creates a surface that is smooth and easy to clean daily. Sealants can become worn or dislodge over time. The dentist will evaluate your child’s teeth at each visit to see if the sealants require replacement.

What is a cavity and what causes it?

A cavity is simply a hole in a tooth. Sometimes these holes cannot be seen immediately by just looking in the mouth because they are small or they are beginning in between the teeth. The dentist is specially trained to identify cavities that are small and first forming. Dental X-rays will aid the dentist in diagnosing cavities between the teeth when they are first forming and easier to treat.

Cavities are caused by certain types of bacteria that are found in the plaque that grows on teeth. These bacteria are fed by sugars that we eat and produce acid that breaks down tooth structure.

How can I prevent cavities in my child’s teeth?

The bacteria that cause cavities are often passed from parent to child through saliva. Keeping your own mouth healthy and free of tooth decay and not sharing toothbrushes or utensils with your child may help prevent the spread of cavity-causing bacteria to your child.

Toothbrushing with the proper amount of fluoride toothpaste and flossing helps prevent cavities by removing the plaque that forms on your teeth every day. This plaque holds the cavity-causing bacteria close to your child’s tooth allowing it to form cavities.

Modifying your child’s diet is one of the most effective ways to prevent cavities. Sugary drinks such as juice, soda pop, and chocolate milk should limited and should not be placed in bottles or sippy cups because they allow the sugar to be in contact with the teeth for a long period of time. Water is the best choice for you child to drink between meals/snacks and at bedtime. White milk is the best choice for mealtimes. Children should drink no more than 4-6 oz of juice per day and it should be given in an open cup and with a meal. Feeding your child a healthy diet and limiting sweets and sticky foods will also help to prevent cavities. It is best to have specified meal and snack times during the day and avoid grazing. Teeth need a break from food and drink between meals and snacks. This is a great time for children to drink water. At snack times, focus on meat, dairy, whole fruits and vegetables. These foods are lower in sugar and clear quickly from the mouth, making them less likely to cause dental cavities.

What procedures are required when my child has a cavity?

When your child has a cavity, the treatment required will depend on the size of the cavity and the health of the tooth. For very small cavities, usually only a filling will be required. If the cavity is large or involves a significant surface area of the tooth, a crown may be required to restore the tooth. If the cavity is large enough that it has reached the nerve inside of the tooth, a procedure called a pulpotomy will be necessary prior to the placement of the crown. A pulpotomy is a procedure performed on a baby tooth or young permanent tooth that is similar to a root canal. In a pulpotomy, the top portion of the nerves and blood vessels inside of the tooth are cleaned out and sanitized. A filling is then placed to soothe the remaining nerve tissue and a crown is placed to restore the tooth. In some cases, a deep cavity will cause infection of a tooth. If this occurs in a permanent tooth, it will need a full root canal treatment to be saved. If this occurs in a baby tooth, the only option may be to extract the tooth. If a baby tooth is lost early, a space maintainer may need to be placed to prevent shifting of the other teeth.

What is nitrous oxide?

Nitrous oxide is a gas that when inhaled can help reduce anxiety and the sensation of pain. Your pediatric dentist may recommend using this agent to help your child through his/her dental procedures. Nitrous oxide is very effective for many children; however, it is only effective if the child is able to breathe the gas through his/her nose continuously.

When is general anesthesia needed for a dental procedure?

General anesthesia may be recommended if your child is young, anxious in the dental setting and has extensive dental needs. This may also be the best option for children and adults with special needs who are unable to cooperate in the traditional dental setting. If general anesthesia is indicated for your child’s dental treatment, your pediatric dentist will discuss this option with you. Our team completes these dental procedures at a local hospital in