- What is a Pediatric Dentist?
- Why are the Primary Teeth so Important?
- Eruption of Your Child's Teeth
- DENTAL EMERGENCIES
- Dental Radiographs (X-rays)
- What's the Best Toothpaste for my Child?
- Does Your Child Grind His Teeth at Night? (Bruxism)
- Thumb Sucking
- What is Pulp Therapy?
- What is the Best Time for Orthodontic Treatment?
- Adult Teeth Coming in Behind Baby Teeth
- Behavioral Management Techniques
- Refusal of Dental Treatment
- Perinatal & Infant Oral Health
- Your Child's First Dental Visit
- Examination - Diagnostic Process
- When Will My Baby Start Getting Teeth?
- Baby Bottle Tooth Decay (Early Childhood Caries)
- Sippy Cups
- Care of Your Child's Teeth
- Good Diet = Healthy Teeth
- How Do I Prevent Cavities?
- Seal Out Decay
- Mouth Guards
- Xylitol - Reducing Cavities
- Beware of Sports Drinks
- Tooth Restoration Procedure
- Interceptive Orthodontics
- Stage I – Primary Dentition Treatment
- Stage II - Mixed Dentition Treatment
- Stage III - Adolescent Dentition Treatment
- Dental Devices or Appliances used in Interceptive Orthodontics
- Space Maintainer
For more information concerning pediatric dentistry, please visit the website for the American Academy of Pediatric Dentistry.
What Is A Pediatric Dentist?
The pediatric dentist has an extra two to three years of specialized training after dental school, and is dedicated to the oral health of children from infancy through the teenage years. The very young, pre-teens, and teenagers all need different approaches in dealing with their behavior, guiding their dental growth and development, and helping them avoid future dental problems. The pediatric dentist is best qualified to meet these needs.
Why Are The Primary Teeth Important?
It is very important to maintain the health of the primary teeth. Neglected cavities can and frequently do lead to problems which affect developing permanent teeth. Primary teeth, or baby teeth are important for (1) proper chewing and eating, (2) providing space for the permanent teeth and guiding them into the correct position, and (3) permitting normal development of the jaw bones and muscles. Primary teeth also affect the development of speech and add to an attractive appearance. While the front 4 teeth last until 6-7 years of age, the back teeth (cuspids and molars) aren't replaced until age 10-13.
Eruption Of Your Child's Teeth
Children’s teeth begin forming before birth. As early as 4 months, the first primary (or baby) teeth to erupt through the gums are the lower central incisors, followed closely by the upper central incisors. Although all 20 primary teeth usually appear by age 3, the pace and order of their eruption varies.
Permanent teeth begin appearing around age 6, starting with the first molars and lower central incisors. At the age of 8, you can generally expect the bottom 4 primary teeth (lower central and lateral incisors) and the top 4 primary teeth (upper central and lateral incisors) to be gone and permanent teeth to have taken their place. There is about a one to two year break from ages 8-10 and then the rest of the permanent teeth will start to come in. This process continues until approximately age 21.
Adults have 28 permanent teeth, or up to 32 including the third molars (or wisdom teeth).
Toothache: Clean the area of the affected tooth. Rinse the mouth thoroughly with warm water or use dental floss to dislodge any food that may be impacted. If the pain still exists, contact your child's dentist. Do not place aspirin or heat on the gum or on the aching tooth. If the face is swollen, apply cold compresses and contact your dentist immediately.
Cut or Bitten Tongue, Lip or Cheek: Apply ice to injured areas to help control swelling. If there is bleeding, apply firm but gentle pressure with a gauze or cloth. If bleeding cannot be controlled by simple pressure, call a doctor or visit the hospital emergency room.
Knocked Out Permanent Tooth: If possible, find the tooth. Handle it by the crown, not by the root. You may rinse the tooth with water only. DO NOT clean with soap, scrub or handle the tooth unnecessarily. Inspect the tooth for fractures. If it is sound, try to reinsert it in the socket. Have the patient hold the tooth in place by biting on a gauze. If you cannot reinsert the tooth, transport the tooth in a cup containing the patient's saliva or milk. If the patient is old enough, the tooth may also be carried in the patient's mouth (beside the cheek). The patient must see a dentist IMMEDIATELY! Time is a critical factor in saving the tooth.
Knocked Out Baby Tooth: Contact your pediatric dentist during business hours. This is not usually an emergency, and in most cases, no treatment is necessary.
Chipped or Fractured Permanent Tooth: Contact your pediatric dentist immediately. Quick action can save the tooth, prevent infection and reduce the need for extensive dental treatment. Rinse the mouth with water and apply cold compresses to reduce swelling. If possible, locate and save any broken tooth fragments and bring them with you to the dentist.
Chipped or Fractured Baby Tooth: Contact your pediatric dentist.
Severe Blow to the Head: Take your child to the nearest hospital emergency room immediately.
Possible Broken or Fractured Jaw: Keep the jaw from moving and take your child to the nearest hospital emergency room.
Dental Radiographs (X-Rays)
Radiographs (X-Rays) are a vital and necessary part of your child's dental diagnostic process. Without them, certain dental conditions can and will be missed.
Radiographs detect much more than cavities. For example, radiographs may be needed to survey erupting teeth, diagnose bone diseases, evaluate the results of an injury, or plan orthodontic treatment. Radiographs allow dentists to diagnose and treat health conditions that cannot be detected during a clinical examination. If dental problems are found and treated early, dental care is more comfortable for your child and more affordable for you.
The American Academy of Pediatric Dentistry recommends radiographs and examinations every six months for children with a high risk of tooth decay. On average, most pediatric dentists request radiographs approximately once a year. Approximately every 3 years, it is a good idea to obtain a complete set of radiographs, either a panoramic and bitewings or periapicals and bitewings.
Pediatric dentists are particularly careful to minimize the exposure of their patients to radiation. With contemporary safeguards, the amount of radiation received in a dental X-ray examination is extremely small. The risk is negligible. In fact, the dental radiographs represent a far smaller risk than an undetected and untreated dental problem. Lead body aprons and shields will protect your child. Today's equipment filters out unnecessary x-rays and restricts the x-ray beam to the area of interest. High-speed film and proper shielding assure that your child receives a minimal amount of radiation exposure.
What's The Best Toothpaste For My Child?
Tooth brushing is one of the most important tasks for good oral health. Many toothpastes, and/or tooth polishes, however, can damage young smiles. They contain harsh abrasives, which can wear away young tooth enamel. When looking for a toothpaste for your child, make sure to pick one that is recommended by the American Dental Association as shown on the box and tube. These toothpastes have undergone testing to insure they are safe to use.
Remember, children should spit out toothpaste after brushing to avoid getting too much fluoride. If too much fluoride is ingested, a condition known as fluorosis can occur. If your child is too young or unable to spit out toothpaste, consider providing them with a fluoride free toothpaste, using no toothpaste, or using only a "pea size" amount of toothpaste.
Does Your Child Grind His Teeth At Night? (Bruxism)
Parents are often concerned about the nocturnal grinding of teeth (bruxism). Often, the first indication is the noise created by the child grinding on their teeth during sleep. Or, the parent may notice wear (teeth getting shorter) to the dentition. One theory as to the cause involves a psychological component. Stress due to a new environment, divorce, changes at school; etc. can influence a child to grind their teeth. Another theory relates to pressure in the inner ear at night. If there are pressure changes (like in an airplane during take-off and landing, when people are chewing gum, etc. to equalize pressure) the child will grind by moving his jaw to relieve this pressure.
The majority of cases of pediatric bruxism do not require any treatment. If excessive wear of the teeth (attrition) is present, then a mouth guard (night guard) may be indicated. The negatives to a mouth guard are the possibility of choking if the appliance becomes dislodged during sleep and it may interfere with growth of the jaws. The positive is obvious by preventing wear to the primary dentition.
The good news is most children outgrow bruxism. The grinding decreases between the ages 6-9 and children tend to stop grinding between ages 9-12. If you suspect bruxism, discuss this with your pediatrician or pediatric dentist.
Sucking is a natural reflex and infants and young children may use thumbs, fingers, pacifiers and other objects on which to suck. It may make them feel secure and happy, or provide a sense of security at difficult periods. Since thumb sucking is relaxing, it may induce sleep.
Thumb sucking that persists beyond the eruption of the permanent teeth can cause problems with the proper growth of the mouth and tooth alignment. How intensely a child sucks on fingers or thumbs will determine whether or not dental problems may result. Children who rest their thumbs passively in their mouths are less likely to have difficulty than those who vigorously suck their thumbs.
Children should cease thumb sucking by the time their permanent front teeth are ready to erupt. Usually, children stop between the ages of two and four. Peer pressure causes many school-aged children to stop.
Pacifiers are no substitute for thumb sucking. They can affect the teeth essentially the same way as sucking fingers and thumbs. However, use of the pacifier can be controlled and modified more easily than the thumb or finger habit. If you have concerns about thumb sucking or use of a pacifier, consult your pediatric dentist.
A few suggestions to help your child get through thumb sucking:
- Children often suck their thumbs when feeling insecure. Focus on correcting the cause of anxiety, instead of the thumb sucking.
- Children who are sucking for comfort will feel less of a need when their parents provide comfort.
- Reward children when they refrain from sucking during difficult periods, such as when being separated from their parents.
- Your pediatric dentist can encourage children to stop sucking and explain what could happen if they continue.
- If these approaches don't work, remind the children of their habit by bandaging the thumb or putting a sock on the hand at night. Your pediatric dentist may recommend the use of a mouth appliance.
What Is Pulp Therapy?
The pulp of a tooth is the inner, central core of the tooth. The pulp contains nerves, blood vessels, connective tissue and reparative cells. The purpose of pulp therapy in Pediatric Dentistry is to maintain the vitality of the affected tooth (so the tooth is not lost).
Dental caries (cavities) and traumatic injury are the main reasons for a tooth to require pulp therapy. Pulp therapy is often referred to as a "nerve treatment", "children's root canal", "pulpectomy" or "pulpotomy". The two common forms of pulp therapy in children's teeth are the pulpotomy and pulpectomy.
A pulpotomy removes the diseased pulp tissue within the crown portion of the tooth. Next, an agent is placed to prevent bacterial growth and to calm the remaining nerve tissue. This is followed by a final restoration (usually a stainless steel crown).
A pulpectomy is required when the entire pulp is involved (into the root canal(s) of the tooth). During this treatment, the diseased pulp tissue is completely removed from both the crown and root. The canals are cleansed, disinfected and, in the case of primary teeth, filled with a resorbable material. Then, a final restoration is placed. A permanent tooth would be filled with a non-resorbing material.
What Is The Best Time For Orthodontic Treatment?
Developing malocclusions, or bad bites, can be recognized as early as 2-3 years of age. Often, early steps can be taken to reduce the need for major orthodontic treatment at a later age.
Stage I - Early Treatment: This period of treatment encompasses ages 2 to 6 years. At this young age, we are concerned with underdeveloped dental arches, the premature loss of primary teeth, and harmful habits such as finger or thumb sucking. Treatment initiated in this stage of development is often very successful and many times, though not always, can eliminate the need for future orthodontic/orthopedic treatment.
Stage II - Mixed Dentition: This period covers the ages of 6 to 12 years, with the eruption of the permanent incisor (front) teeth and 6 year molars. Treatment concerns deal with jaw malrelationships and dental realignment problems. This is an excellent stage to start treatment, when indicated, as your child's hard and soft tissues are usually very responsive to orthodontic or orthopedic forces.
Stage III - Adolescent Dentition: This stage deals with the permanent teeth and the development of the final bite relationship.
Adult Teeth Coming in Behind Baby Teeth
This is a very common occurrence with children, usually the result of a lower, primary (baby) tooth not falling out when the permanent tooth is coming in. In most cases if the child starts wiggling the baby tooth, it will usually fall out on its own within two months. If it doesn't, then contact your pediatric dentist, where they can easily remove the tooth. The permanent tooth should then slide into the proper place.
Behavioral Management Techniques
Our Pediatric Dentist has received advance training in the following behavior management techniques recommended and accepted by the American Academy of Pediatric Dentistry (AAPD):
- Tell-Show-Do: Tell or explain to the child what is to be done, show an example then do the procedure on the child's tooth.
- Positive Reinforcement: Rewards for cooperative behavior include complements, praises, stickers and prizes.
- Voice Control: Voice changes to a firmer tone or higher volume to gain the attention of an uncooperative child.
- Parent in the Dental Op: Sometimes having the parent with the child during the procedure helps to reassure the child.
- Mouth Props A padded device is placed in the child's mouth to keep their mouth open so as not to bite the dentist’s fingers or dental equipment.
- Hand and/or Head Holding by the Parent, Dentist and/or Dental Assistant: Gentle physical restraint to keep the child’s body still so the child cannot grab the dentist’s hand or dental tools.
- Happy Gas (Also known as laughing gas): A gas mixture of Nitrous Oxide / Oxygen gases breathed through a mask that is placed over the child’s nose, allowing them to breathe normal. This helps to relax them without putting them to sleep, your child remains fully conscious and keeps all natural reflexes. It is a safe and effective sedative agent that used to calm a child’s fear of the dental visit and to enhance effective communication. Additionally, it works well for children who have a strong gag reflex. The gas is mild, and easily taken up through the lungs with normal breathing. Once treatment is completed, it is quickly eliminated from the body after a short period of breathing 100% Oxygen with no lingering effects. Sometimes if a child starts to cry or is crying, the Happy Gas will not help them as much. Children with sensitive stomachs or have eaten heavy meals may become nauseated when breathing happy gas.
- Passive Physical Restraint (Papoose Stabilizer/Board or Pedi-Wrap): Very young children and some special needs patients are not able to understand why they need dental treatment. Partial or complete stabilization of the patient is used to protect them from harming themselves as well as to protect the safety of the practitioner, staff, and parent while providing dental care. A stabilization body wrap made of fabric mesh and Velcro that is placed around the child to limit their movement. It is used as a last resort to control movement and protect the child and staff during dental procedures. Additional Consent required.
- Oral Sedation and Happy Gas: This works best for healthy children who have a very high level of fear or anxiety and for whom basic behavior guidance techniques are not very successful. This is also used for children who do not have good coping skills or are very young and do not understand how to cope cooperatively for the delivery of dental care. This management technique uses medication(s) that reduces anxiety and/or discomfort associated with dental treatments. Your child may be quite drowsy, and may even fall asleep, but they will not become unconscious.
- Intravenous (IV) Sedation: Intravenous Sedation or IV Sedation is not the same as the general anesthesia used in a hospital. IV Sedation is when anti-anxiety medications are administered into the blood stream by an IV. It produces a deep sleep or a deep level of relaxation that insulates your child from the stress and discomfort associated with long dental procedures. The medications help to produce either partial or full memory loss (amnesia) that starts from when it is injected until it wears off. This level of sedation is done in the office by a Dental Anesthesiologist who administers carefully measured doses of anti-anxiety medications by IV. All medications and their dosage are determined on a patient-by-patient basis. Additionally, IV sedation can be particularly useful for children with special needs, who may face extra difficulty in tolerating the experience of dental treatment.
- Special Health or Medical Conditions: Children with health or medical conditions such as congenital abnormalities, diabetes, seizures, severe asthma or severe behavioral disturbances may not be able to have IV sedation in the office. We recommend that children with Medical conditions have their dental care done at the hospital or surgery center under general anesthesia. Most medical insurance companies are now required to cover hospitalization or outpatient surgery services for pediatric dental patients.
- Hospital Dentistry: General Anesthesia in a Hospital setting is a controlled state of unconsciousness that eliminates awareness, movement and discomfort during dental treatment. This is conducted on an outpatient basis at a surgery center or hospital which is a facility that has the appropriate anesthesia staff and physicians who are trained to deliver anesthesia and monitor your unconscious child and manage complications. Precautions are taken to protect your child during general anesthesia for their dental care. This type of anesthesia is the same as if he/she was having their tonsils removed, ear tubes, or hernia repaired. The risks here are greater than that of other treatment options, but if this option is recommended for your child, then the benefits of treatment with general anesthesia outweigh the risks. This type of behavioral management is recommended only for a child who is in need of extensive dental treatment and is a very uncooperative and apprehensive, or is a very young child, or is a child with special needs.
Refusal of Dental Treatment
They are not just baby teeth. The risks of No dental treatment include having your child suffer from toothache pain, tooth infection, cellulitis or swelling in surrounding oral structures, the spread of decay to other teeth, damage to their developing adult teeth and possible life threatening hospitalization from a severe dental infection. Your pediatric dentist will discuss the Risks vs Benefits and alternatives of dental treatment to no treatment.BACK TO TOP
Early Infant Oral Care
Perinatal & Infant Oral Health
The American Academy of Pediatric Dentistry (AAPD) recommends that all pregnant women receive oral healthcare and counseling during pregnancy. Research has shown evidence that periodontal disease can increase the risk of preterm birth and low birth weight. Talk to your doctor or dentist about ways you can prevent periodontal disease during pregnancy.
Additionally, mothers with poor oral health may be at a greater risk of passing the bacteria which causes cavities to their young children. Mother's should follow these simple steps to decrease the risk of spreading cavity-causing bacteria:
- Visit your dentist regularly.
- Brush and floss on a daily basis to reduce bacterial plaque.
- Proper diet, with the reduction of beverages and foods high in sugar & starch.
- Use a fluoridated toothpaste recommended by the ADA and rinse every night with an alocohol-free, over-the-counter mouth rinse with .05 % sodium fluoride in order to reduce plaque levels.
- Don't share utensils, cups or food which can cause the transmission of cavity-causing bacteria to your children.
- Use of xylitol chewing gum (4 pieces per day by the mother) can decrease a child's caries rate.
Your Child's First Dental Visit-Establishing A "Dental Home"
The American Academy of Pediatrics (AAP), the American Dental Association (ADA), and the American Academy of Pediatric Dentistry (AAPD) all recommend establishing a "Dental Home" for your child by one year of age. Children who have a dental home are more likely to receive appropriate preventive and routine oral health care.
The Dental Home is intended to provide a place other than the Emergency Room for parents.
You can make the first visit to the dentist enjoyable and positive. If old enough, your child should be informed of the visit and told that the dentist and their staff will explain all procedures and answer any questions. The less to-do concerning the visit, the better.
It is best if you refrain from using words around your child that might cause unnecessary fear, such as needle, pull, drill or hurt. Pediatric dental offices make a practice of using words that convey the same message, but are pleasant and non-frightening to the child.
Early visits help us provide care and education that p
romote good dental health, as well as, help us identify and reduce any risk factors that could lead to unhealthy teeth or habits. At every dental visit, we provide you, the parent, with the information needed to help take care of your child's smile. You can prevent fearful dental experiences and costly dental work in the future by knowing what to do with your child's diet and hygiene as well as your own.
Examination - Diagnostic Process:
During the examination, your child's medical and dental history will be reviewed. Vitals: Blood pressure, Temperature, Height and Weight are taken. A visual screening will determine if any radiographs are necessary. A thorough examination of your child's teeth, oral tissues, and jaws will be performed. If warranted Digital Diagnostic Radiographs will be taken. An oral growth and development assessment will be done along with a dental bite and tooth spacing evaluation. Oral habits such as thumb or finger sucking, mouth breathing, etc., and their impact will also be assessed. After the examination, a prophy or tooth cleaning and fluoride treatment will be performed followed by a review of radiographs and treatment plan, oral hygiene instructions, dietary and nutritional counseling, and patient/parent education.
When Will My Baby Start Getting Teeth?
Teething, the process of baby (primary) teeth
coming through the gums into the mouth, is variable
among individual babies. Some babies get their teeth
early and some get them late. In general, the first
baby teeth to appear are usually the lower front
(anterior) teeth and they usually begin erupting
between the age of 6-8 months.
See "Eruption of Your Child's Teeth" for more details.
Baby Bottle Tooth Decay (Early Childhood Caries)
One serious form of decay among young children is baby bottle tooth decay. This condition is caused by frequent and long exposures of an infant's teeth to liquids that contain sugar. Among these liquids are milk (including breast milk), formula, fruit juice and other sweetened drinks.
Putting a baby to bed for a nap or at night with a bottle other than water can cause serious and rapid tooth decay. Sweet liquid pools around the child's teeth giving plaque bacteria an opportunity to produce acids that attack tooth enamel. If you must give the baby a bottle as a comforter at bedtime, it should contain only water. If your child won't fall asleep without the bottle and its usual beverage, gradually dilute the bottle's contents with water over a period of two to three weeks.
After each feeding, wipe the baby's gums and teeth with a damp washcloth or gauze pad to remove plaque. The easiest way to do this is to sit down, place the child's head in your lap or lay the child on a dressing table or the floor. Whatever position you use, be sure you can see into the child's mouth easily.
Sippy cups should be used as a training tool from the bottle to a cup and should be discontinued by the first birthday. If your child uses a sippy cup throughout the day, fill the sippy cup with water only (except at mealtimes). By filling the sippy cup with liquids that contain sugar (including milk, fruit juice, sports drinks, etc.) and allowing a child to drink from it throughout the day, it soaks the child's teeth in cavity causing bacteria.
Care Of Your Child's Teeth
- Starting at birth, clean your child's gums with a soft cloth and water.
- As soon as your child's teeth erupt, brush them with a soft-bristled toothbrush.
- If they are under the age of 2, use a small "smear" of toothpaste.
- If they're 2-5 years old, use a "pea-size" amount of toothpaste.
- Be sure and use an ADA-accepted fluoride toothpaste and make sure your child does not swallow it.
- When brushing, the parent should brush the child's teeth until they are old enough to do a good job on their own.
- Flossing removes plaque between teeth and under the gumline where a toothbrush can't reach.
- Flossing should begin when any two teeth touch.
- Be sure and floss your child's teeth daily until he or she can do it alone.
Good Diet = Healthy Teeth
Healthy eating habits lead to healthy teeth. Like the rest of the body, the teeth, bones and the soft tissues of the mouth need a well-balanced diet. Children should eat a variety of foods from the five major food groups. Most snacks that children eat can lead to cavity formation. The more frequently a child snacks, the greater the chance for tooth decay. How long food remains in the mouth also plays a role. For example, hard candy and breath mints stay in the mouth a long time, which cause longer acid attacks on tooth enamel. If your child must snack, choose nutritious foods such as vegetables, low-fat yogurt, and low-fat cheese, which are healthier and better for children's teeth.
How Do I Prevent Cavities?
Good oral hygiene removes bacteria and the left over food particles that combine to create cavities. For infants, use a wet gauze or clean washcloth to wipe the plaque from teeth and gums. Avoid putting your child to bed with a bottle filled with anything other than water. See "Baby Bottle Tooth Decay" for more information.
For older children, brush their teeth at least twice a day. Also, watch the number of snacks containing sugar that you give your children.
The American Academy of Pediatric Dentistry recommends visits every six months to the pediatric dentist, beginning at your child's first birthday. Routine visits will start your child on a lifetime of good dental health.
Your pediatric dentist may also recommend protective sealants or home fluoride treatments for your child. Sealants can be applied to your child's molars to prevent decay on hard to clean surfaces.
Seal Out Decay
A sealant is a protective coating that is applied to the chewing surfaces (grooves) of the back teeth (premolars and molars), where four out of five cavities in children are found. This sealant acts as a barrier to food, plaque and acid, thus protecting the decay-prone areas of the teeth.
Fluoride is an element, which has been shown to be beneficial to teeth. However, too little or too much fluoride can be detrimental to the teeth. Little or no fluoride will not strengthen the teeth to help them resist cavities. Excessive fluoride ingestion by preschool-aged children can lead to dental fluorosis, which is a chalky white to even brown discoloration of the permanent teeth. Many children often get more fluoride than their parents realize. Being aware of a child's potential sources of fluoride can help parents prevent the possibility of dental fluorosis.
Some of these sources are:
- Too much fluoridated toothpaste at an early age.
- The inappropriate use of fluoride supplements.
- Hidden sources of fluoride in the child's diet.
Two and three year olds may not be able to expectorate (spit out) fluoride-containing toothpaste when brushing. As a result, these youngsters may ingest an excessive amount of fluoride during tooth brushing. Toothpaste ingestion during this critical period of permanent tooth development is the greatest risk factor in the development of fluorosis.
Excessive and inappropriate intake of fluoride supplements may also contribute to fluorosis. Fluoride drops and tablets, as well as fluoride fortified vitamins should not be given to infants younger than six months of age. After that time, fluoride supplements should only be given to children after all of the sources of ingested fluoride have been accounted for and upon the recommendation of your pediatrician or pediatric dentist.
Certain foods contain high levels of fluoride, especially powdered concentrate infant formula, soy-based infant formula, infant dry cereals, creamed spinach, and infant chicken products. Please read the label or contact the manufacturer. Some beverages also contain high levels of fluoride, especially decaffeinated teas, white grape juices, and juice drinks manufactured in fluoridated cities.
Parents can take the following steps to decrease the risk of fluorosis in their children's teeth:
- Use baby tooth cleanser on the toothbrush of the very young child.
- Place only a pea sized drop of children's toothpaste on the brush when brushing.
- Account for all of the sources of ingested fluoride before requesting fluoride supplements from your child's physician or pediatric dentist.
- Avoid giving any fluoride-containing supplements to infants until they are at least 6 months old.
- Obtain fluoride level test results for your drinking water before giving fluoride supplements to your child (check with local water utilities).
When a child begins to participate in recreational activities and organized sports, injuries can occur. A properly fitted mouth guard, or mouth protector, is an important piece of athletic gear that can help protect your child's smile, and should be used during any activity that could result in a blow to the face or mouth.
Mouth guards help prevent broken teeth, and injuries to the lips, tongue, face or jaw. A properly fitted mouth guard will stay in place while your child is wearing it, making it easy for them to talk and breathe.
Ask your pediatric dentist about custom and store-bought mouth protectors.
Xylitol - Reducing Cavities
The American Academy of Pediatric Dentistry (AAPD) recognizes the benefits of xylitol on the oral health of infants, children, adolescents, and persons with special health care needs.
The use of XYLITOL GUM by mothers (2-3 times per day) starting 3 months after delivery and until the child was 2 years old, has proven to reduce cavities up to 70% by the time the child was 5 years old.
Studies using xylitol as either a sugar substitute or a small dietary addition have demonstrated a dramatic reduction in new tooth decay, along with some reversal of existing dental caries. Xylitol provides additional protection that enhances all existing prevention methods. This xylitol effect is long-lasting and possibly permanent. Low decay rates persist even years after the trials have been completed.
Xylitol is widely distributed throughout nature in small amounts. Some of the best sources are fruits, berries, mushrooms, lettuce, hardwoods, and corn cobs. One cup of raspberries contains less than one gram of xylitol.
Studies suggest xylitol intake that consistently produces positive results ranged from 4-20 grams per day, divided into 3-7 consumption periods. Higher results did not result in greater reduction and may lead to diminishing results. Similarly, consumption frequency of less than 3 times per day showed no effect.
To find gum or other products containing xylitol, try visiting your local health food store or search the Internet to find products containing 100% xylitol.
Beware of Sports Drinks
Due to the high sugar content and acids in sports drinks, they have erosive potential and the ability to dissolve even fluoride-rich enamel, which can lead to cavities.
To minimize dental problems, children should avoid sports drinks and hydrate with water before, during and after sports. Be sure to talk to your pediatric dentist before using sports drinks.
If sports drinks are consumed:
- reduce the frequency and contact time
- swallow immediately and do not swish them around the mouth
- neutralize the effect of sports drinks by alternating sips of water with the drink
- rinse mouthguards only in water
- seek out dentally friendly sports drinks
Tooth Restoration Procedures
When a child's teeth have been damaged by trauma, dental decay, or congenital defects, we consider several factors before making a decision about the treatment for those teeth. These factors include the age of your child, how severely the tooth is damaged, and in the case of primary teeth, how long that tooth must continue to function before the permanent teeth come in. Our decisions for your child's care are never based on finances or insurance, especially when it compromises the quality of treatment provided.
Tongue Piercing - Is It Really Cool?
You might not be surprised anymore to see people with pierced tongues, lips or cheeks, but you might be surprised to know just how dangerous these piercings can be.
There are many risks involved with oral piercings, including chipped or cracked teeth, blood clots, blood poisoning, heart infections, brain abscess, nerve disorders (trigeminal neuralgia), receding gums or scar tissue. Your mouth contains millions of bacteria, and infection is a common complication of oral piercing. Your tongue could swell large enough to close off your airway!
Common symptoms after piercing include pain, swelling, infection, an increased flow of saliva and injuries to gum tissue. Difficult-to-control bleeding or nerve damage can result if a blood vessel or nerve bundle is in the path of the needle.
So follow the advice of the American Dental Association and give your mouth a break - skip the mouth jewelry.
Tobacco - Bad News In Any Form
Tobacco in any form can jeopardize your child's health and cause incurable damage. Teach your child about the dangers of tobacco.
Smokeless tobacco, also called spit, chew or snuff, is often used by teens who believe that it is a safe alternative to smoking cigarettes. This is an unfortunate misconception. Studies show that spit tobacco may be more addictive than smoking cigarettes and may be more difficult to quit. Teens who use it may be interested to know that one can of snuff per day delivers as much nicotine as 60 cigarettes. In as little as three to four months, smokeless tobacco use can cause periodontal disease and produce pre-cancerous lesions called leukoplakias.
If your child is a tobacco user you should watch for the following that could be early signs of oral cancer:
- A sore that won't heal.
- White or red leathery patches on the lips, and on or under the tongue.
- Pain, tenderness or numbness anywhere in the mouth or lips.
- Difficulty chewing, swallowing, speaking or moving the jaw or tongue; or a change in the way the teeth fit together.
Because the early signs of oral cancer usually are not painful, people often ignore them. If it's not caught in the early stages, oral cancer can require extensive, sometimes disfiguring, surgery. Even worse, it can kill.
Help your child avoid tobacco in any form. By doing so, they will avoid bringing cancer-causing chemicals in direct contact with their tongue, gums and cheek.
In most cases, interceptive orthodontics is more accurately considered orthopedics since it is the jaw that is changed rather than the teeth. As the child’s jaw grows several functional orthodontic appliances can be used to change the shape and size of the jaw. In most cases the jaw is expanded and lengthened to accommodate all of the teeth. This helps to prevent crowding and promotes the normal eruption of the teeth. Because the jaw is affected more than the teeth at this stage, the process is accurately called dentofacial orthopedics but is more commonly referred to as interceptive orthodontics.
For most kids, orthodontic treatment usually begins during their early teenage years when all the baby teeth have fallen out and the permanent teeth have come into their place. Braces are then put on your child's teeth and the teeth are moved into their right position. But sometimes, a bad bite develops during the primary dentition (Baby Teeth) stage or during the mixed dentition phase. Developing malocclusions, or bad bites, can be recognized as early as 2-3 years of age. It is recommended that once a developing, severe malocclusion (bad bite) is noticed that early orthodontics be considered for your child. Early intervention helps to reduce the need for major orthodontic treatment at a later age. Interceptive orthodontic treatment helps corrects problems such as severely crooked and crowded teeth, underbites, overbites, incorrect jaw position, and disorders of the jaw.
Stage I – Primary Dentition Treatment
This period covers the ages 2 to 6 years, where we are concerned with the developing dental arches, the early loss of baby teeth, and harmful habits such as finger or thumb sucking. Treatment initiated in this stage of development is often very successful and many times, though not always, can eliminate the need for future orthodontic treatment for your child.
Stage II - Mixed Dentition Treatment
This period covers the ages of 6-12 years, with the eruption of the permanent incisors (front) teeth and the 6 year molars. Treatment concerns are with bad jaw relationships and tooth realignment problems. This is an excellent stage to start treatment, when indicated, as your child's hard and soft tissues are usually very responsive to orthodontic forces.
Stage III - Adolescent Dentition Treatment
This stage deals with your child's permanent teeth and the development of the final bite relationship.
Dental Devices or Appliances used in Interceptive Orthodontics
There are a number of dental devices that are used to change the shape of the jaw and palate in young children. These devices can be removable, like retainers. They can also be fixed, like the Nance appliance which holds the molars in place until other permanent teeth have erupted. The dental devices can work primarily on the teeth, on the jaw, or both. For example, a rapid palatal expander (also known as a Hyrax appliance) is a device that may be anchored to the upper teeth, but it actually provides pressure to the palate to increase its size.
Sometimes if a child loses a tooth early, all they need is a space maintainer. A space maintainer is used to occupy the space left by the lost tooth so that the other teeth don’t move or invade that space inappropriately. Commons examples of a space maintainer have names like “unilateral,” “crown and loop,” “band and loop,” and “distal shoe.” These dental devices are chosen based on which teeth are missing. A space maintainer may be cemented in place until the permanent erupts in the place.
Retainers are custom-made devices that are made of wires or clear plastic. They are most often used before or after dental braces to keep teeth in position while assisting the adjustment of the surrounding gums to changes in the bone. Most patients are required to wear their retainer(s) every night at first, but many are also being required to wear them during the day to.