Frequently Asked Questions About Pediatric Dentistry
The American Academy of Pediatric Dentistry, the American Academy of Pediatrics, and the American Dental Association recommend that your child’s first pediatric dental visit should be scheduled once the first tooth erupts or by one year of age. At your child’s first dental visit, we’ll perform a comprehensive exam to ensure your little one’s teeth are erupting properly. We’ll also review important oral health and dietary practices that will minimize cavities. After this initial visit, your little one should continue to see us every six months.
We should see your child once every six months to prevent the formation of cavities and other dental problems. We may recommend more frequent visits if your child’s oral health needs more attention.
The single most important thing you can do as a parent to prepare your child for their first visit is to have a positive attitude. Children are remarkably adept at picking up attitudes from those around them, and will tune in if you are nervous. Don’t make negative comments about dentists or dental visits in general in the child’s presence, as your child will anticipate a negative experience.
To help prepare your little one for the visit, show them a picture of the office and the dentist on the website. Tell them how important it is to have healthy teeth, and that the dentist will help them achieve this goal. Consider getting some children’s books on teeth, dentists and good dental care. You can always call us for more suggestions.
Teething occurs when the baby teeth begin to grow in. While this is relatively problem-free for most children, others may experience some discomfort. We recommend frozen washcloths, frozen teething rings and if needed some Tylenol or Motrin to provide comfort through this process. You may notice a drop in appetite, fever, diarrhea, and earaches. It’s important to ensure that your little one is well hydrated. Avoid using products containing benzocaine (ORAJEL) for teething as they are very dangerous and can cause a life threatening blood condition, known as methemoglobinemia. We’ll be very happy to answer any questions you might have about this topic.
There are 20 baby teeth. As a rule of thumb, they begin to erupt at about 6 months of age and appear in pairs. By the age of 3, your baby should have all their 20 baby teeth. At approximately 6 years of age, adult molars start to make their appearance, and the front two lower teeth are replaced with adult incisors. By the age of 8, your child will loose 8 front baby teeth (4 top and 4 bottom). By the age of 12, the remaining 12 baby teeth will be gone, and almost all adult teeth will be present (excluding wisdom teeth).
Since all children are unique, the timing of eruption may vary from child to child. These variations are very common. We’ll be very happy to address any concerns you might have.
One of the most common questions we get is, “Why are baby teeth important? They are going to fall out anyway.” Primary teeth are vital for your child’s overall health. Baby teeth serve multiple important functions. They help children chew their food well and maintain a balanced, healthy diet. Children with multiple cavities may be in pain and become unable to eat a healthy diet. Baby teeth help to protect children’ self-esteem. A gift of a beautiful smile is important to everyone, especially our children. Also, baby teeth serve as placeholders for permanent teeth. Children who lose baby teeth prematurely are at risk of having their adult teeth come in misplaced.
Early Childhood Caries was formerly known as baby bottle tooth decay or nursing caries. The condition occurs when a child is overexposed to sugary liquids. Severe early childhood caries usually occurs when the child is routinely put to bed with a bottle containing juice, soda or milk. It can also occur from allowing toddlers to “graze” with a sippy cup. Early childhood caries often destroys teeth and leads to the need for major dental treatment. The condition can be very painful to your little one, and can cause irreversible damage to your child’s adult teeth if left untreated.
By following the guidelines listed below, you can prevent Early Childhood Caries from occurring.
- Help your child start learning to drink from a regular cup by their first birthday.
- Only allow water in any bottles or sippy cups used.
- Clean your baby’s gums and teeth with a fresh gauze pad after each feeding.
- Begin brushing as soon as the first tooth erupts
- Never give your child a pacifier coated in sugar or dipped in honey.
- The bacteria that cause caries are transmissible; avoid sharing drinks or kissing your baby close to the mouth, especially if you have not seen your dentist for regular appointments.
Before your child gets their first tooth, clean the gums after each feeding with a soft, damp washcloth. As soon as the first tooth erupts, you can begin using a toothbrush. Be sure to use a brush with soft bristles. You can purchase toothbrushes specifically designed for infants. Regular tooth brushing will remove plaque and bacteria that can lead to decay. The current ADA and AAPD guidelines recommend that a smear amount of fluoridated toothpaste should be used. Parents should supervise/brush their children’s teeth to ensure the correct amount of toothpaste is used and teeth are properly cleaned. You should brush twice a day, at least once before bed.
When the baby’s first tooth erupts, you can use a smear (size of a grain of rice) of fluoridated toothpaste. When the child reaches the age of three, you can increase this amount to a pea-sized drop. Be sure to supervise the brushing process to make sure your child is using the correct amount of toothpaste and cleaning all their teeth.
We can evaluate the fluoride levels in your child’s drinking water and food. We will also look at the status of your child’s oral health. After careful evaluation of all factors, we’ll make a recommendation on whether supplemental fluoride is needed.
If your child has a toothache, clean the affected area with a toothbrush and toothpaste. Rinse the mouth vigorously with warm water and use dental floss. If your child needs a pain reliever, you can give them Tylenol or Motrin, but follow package directions. Do not place aspirin on the tooth itself or on the gums. If your child’s face is swollen, apply cold compresses and contact our office immediately. A swollen face indicates a serious problem and requires immediate attention.
Pediatric dentists are especially trained in helping children feel at ease in the dentist’s chair. We’ll evaluate your child and come up with the best solution to overcome their anxiety and fear.
Although many children suck their thumbs or fingers as infants, most grow out of the habit by the age of three without causing permanent damage. Prolonged habits past the age of 3 can cause dental as well as orthodontic changes which can include but not limited to speech problems, flared teeth, front teeth that don’t close on biting, crowded teeth, cross bites of the back teeth and narrowing of the arches.
Pacifiers should be discontinued by the age of two. A pacifier habit is easier to discontinue than a thumb-sucking habit.
If we notice any damage occurring to your child’s teeth and oral structures, we’ll make sure that every effort is made to help your child stop the harmful habit as soon as possible.
Sealants fill in the deep crevices on the chewing surfaces of molars. They block food residue from staying inside the grooves and causing cavities. Sealants are easy to apply and are very effective in cavity prevention. We recommend placing sealants on all permanent molars, as well as, some baby molars that are at a higher risk. Sealants are recommended for children of all ages, especially those at high risk for getting cavities.
The frequency of dental x-rays depends on each individual child. Once the baby teeth in the back are touching one another, we recommend a series of x-rays to detect any cavities. We generally recommend taking dental x-rays yearly. However, we may recommend a more frequent set, depending your child’s dental history and current dental health.
Dental x-rays pose very little risk for children. We are extremely careful about the amount of radiation to which our patients are exposed. We use lead aprons and digital x-rays to make sure that the amount of radiation is absolutely minimal.
We highly recommend mouth guards for all kids that play any type of contact sports including football, hockey and soccer. Mouth guards do more than prevent just tooth injuries. They are also effective in reducing concussions and more severe brain injuries. You can purchase them over the counter or we can make a custom one. Also, make sure your child always wears a helmet when riding a bicycle.
If your child has lost (avulsed/knocked out) a permanent tooth, it’s very important that you seek treatment immediately to keep the tooth alive. Please follow the steps below until you are able to contact us.
1. Hold the tooth by the crown. Avoid touching the root.
- Rinse the tooth with salt water or cold milk. NOTE: Do not use regular water to rinse/store the tooth.
- If the root is intact, try to reinsert the tooth into the socket and have the child bite down normally. If unable to do so, place the tooth in a glass of cold milk and head to our office/ER immediately
If your child has knocked out a baby tooth, do not reinsert it. Come see us at first availability.
In the mixed dentition phase, problems with the jaw and teeth can become apparent. During this time period, we’ll check to see if the teeth and jaws are aligned properly. We recommend that children receive a comprehensive orthodontic evaluation around the age of seven. If we notice any orthodontic problems at this time, we will refer your child for an early evaluation.
During an orthodontic evaluation, when the first set of adult molars have erupted, we will take a panoramic x-ray. This radiograph allows us to do an overall evaluation of the joints and position of the adult teeth that are still developing.
Bad breath is a concern for most teenagers. Good oral hygiene practices which including regular brushing and flossing will help with this. Remind your teenager to brush their tongue as well. Plaque can coat the surface of the tongue and contribute to bad breath. After trying the above, if bad breath still persists, let us know and we will help rule out any underlying issues. Asthma, sinus and throat infections can also contribute to bad breath and are known as secondary halitosis.
Teeth grinding is a serious issue, especially in teenagers and young adults. You should definitely let us know as grinding can lead to problems with the TMJ later on. The stress on the joint can cause pain and soreness. We’ll evaluate your child and may prescribe a special mouth/night guard.
Yes. Sugar free gum is actually helpful because it helps stimulate a constant salivary flow, which naturally cleans teeth. Just make sure it’s sugar free, and has Xylitol!