Frequently Asked Questions
A pediatric dentist is a dentist who provides dental care to children, from infancy through the teenage years, as well as to patients with special needs. In order to specialize in pediatric dentistry, the dentist attends an additional two years of training dedicated to the oral health of pediatric patients. A pediatric dentist is best qualified to meet the needs of children of all ages, in different stages of dental growth and development, with varying temperaments and dental needs. The training and experience of a pediatric dentist enables them to treat patients that are medically compromised, such as those with hemophilia, leukemia, congenital syndromes, and other special needs.
Maintaining the health of primary teeth, also known as baby teeth, is essential for normal growth and development. Primary teeth are important for chewing, speaking, and appearance. They also affect jaw bone and muscle development, and provide space in the jaw for the permanent teeth. Poor oral hygiene and unhealthy eating habits often lead to tooth decay, which left untreated can affect the development of permanent teeth.
Baby teeth begin forming before birth, and typically erupt around six to eight months of age. The four front teeth are usually the first to erupt, with all 20 primary teeth erupting by three years of age. As your child grows, the jaw also grows, making room for the permanent teeth that will begin to erupt around six years of age. Most children have the majority of their permanent teeth by 12 to 14 years of age, with the remaining 4 permanent molars (wisdom teeth) erupting between 17 to 21 years of age.
Begin cleaning an infant’s mouth during the first few days after birth. You may sit with the infant’s head in your lap, or lay the infant on a changing table or the floor. Wipe the infant’s gums with a clean, wet gauze pad or baby washcloth daily. This removes residual food that can harm erupting teeth, and helps your infant become accustomed to having his/her mouth checked. Once your child’s teeth begin to erupt, clean them in the same manner twice daily. You can transition to the use of a soft infant toothbrush and water once multiple teeth are present. Brush the teeth of children over the age of two years with a pea size amount of fluoride toothpaste. Place the toothbrush at a 45 degree angle and brush in a gentle circular motion, starting along the gum line. Brush the outer surface of each tooth, upper and lower. Repeat the same method on the inside surfaces and chewing surfaces of the teeth. Finish by brushing the tongue to help freshen breath and to remove bacteria. Most children are able to brush their own teeth by seven years of age, however, adult supervision is needed to ensure that they are doing a thorough job of removing plaque from the inner, outer, and chewing surfaces of the teeth.
Flossing removes the plaque between teeth where a toothbrush cannot reach. Begin flossing when your child’s teeth are touching together, usually about three or four years of age. Your dentist and hygienist will alert you as to when to begin flossing, and also demonstrate the use of floss. Most children are able to start flossing their own teeth around 10-11 years of age. Start with about 18 inches of floss, winding most of it around the middle fingers of both hands. Holding the floss lightly between the thumbs and forefingers, use a gentle, back-and-forth motion to guide the floss between the teeth. Curve the floss into a C-shape and slide it into the space between the gum and tooth until you feel resistance. Gently scrape the floss against the side of the tooth. Repeat this process on each tooth. Don’t forget the backs of the last four teeth.
Practicing good oral hygiene, healthy eating habits, and attending routine dental check-ups are imperative to cavity prevention. The American Academy of Pediatrics and the American Academy of Pediatric Dentistry recommend visiting the dentist every six months, beginning six months after the first tooth erupts or by your child’s first birthday. At these bi-yearly visits the dentist or hygienist will perform a thorough cleaning and examination, along with the application of a topical fluoride treatment. Sealants can be applied to the chewing surface of molars, to prevent cavities where decay most often occurs.
Baby bottle tooth decay (early childhood caries) is a serious form of tooth decay caused by frequent and prolonged exposure of a babies teeth to liquids that contain sugar, such as milk, formula, and juices. Baby bottle tooth decay can occur when a baby is routinely put to bed with a bottle and also when a toddler is routinely given juice out of a non-spill cup, such as a sippie cup, throughout the day. The sugar-containing liquids surround the teeth giving bacterial plaque an opportunity to produce acids that attack tooth enamel. If you must give your baby a bottle while in bed, it should contain only water. If you are currently giving your baby a bottle in bed with a fluid other than water and he/she refuses the water bottle, you may need to transition more slowly. You may do this by gradually diluting the contents with water over a two to three week period.
Healthy eating habits lead to healthy teeth. A well-balanced diet is necessary to keep the teeth, bones, and soft tissues of the mouth healthy. Encourage your child to eat three meals a day, containing a variety of foods from the five major food groups. Discourage frequent snacking, as most snack foods contain sugars that along with bacterial plaque produce acids that attack tooth enamel, leading to decay. Foods that are kept in the mouth for a prolonged period of time, such as hard candy and breath mints, allow longer periods of acid attacks on tooth enamel. If your child does need a snack between meals, offer a nutritious snack from one of the major food groups.
Sucking is a natural reflex. Many infants and young children may suck on their thumbs, fingers, or a pacifier to console themselves. This sucking can be soothing to them, making them feel secure and content, often relaxing them to sleep. If you chose to use a pacifier, keep it clean as directed by the manufacturer, and never dip it into sugar, honey, or syrup before giving it to a baby. Thumb sucking and pacifier use that lasts beyond the eruption of the permanent teeth can cause problems with proper growth of the mouth and tooth alignment. How intensely a child sucks on his/her fingers or thumbs will determine whether or not dental problems, such as an abnormal bite, may develop. 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. Never scold your child for thumb sucking, rather praise and reward them when they are not.
Parents are often alerted of their child’s habit of teeth grinding (bruxism) when they hear the noise created by their grinding during sleep. You may also notice that teeth are wearing down or getting shorter. There are many theories as to the cause of bruxism. One theory relates to pressure in the inner ear at night, while another theory reports stress as the cause. Other studies suggest a genetic element, passed down from the parents. The frequency of grinding tends to lessen between 6 and 9 years of age, with most children stopping altogether between the ages of 9 and 12 years. If excessive wear of the teeth (attrition) is present, the dentist may suggest that the child wear a mouth guard at night.
A sealant is a plastic material that is applied to the chewing surfaces of the back teeth (molars and premolars), where decay is most often found. These back teeth are difficult to keep clean as the toothbrush bristles do not reach into the pits and fissures that form in the enamel of the chewing surfaces, trapping food and plaque. When a sealant is applied, the plastic resin bonds into the depressions and grooves of the chewing surfaces, becoming a barrier to protect the decay-prone areas of the teeth from plaque and acid. The risk of tooth decay is greatly reduced by the use of sealants. As long as the sealant remains intact, the tooth surface will be protected from decay. Sealants hold up well under the force of normal chewing, and usually last for several years before a reapplication is needed. Our office uses sealant material that is BPA-free.
X-rays are a vital and necessary part of your child’s dental diagnostic process. X-rays not only detect cavities, but are also used to survey erupting teeth, plan orthodontic treatment, evaluate injuries, and diagnose bone abnormalities and diseases. The use of x-rays allow dentists to diagnose conditions that may not be detected upon clinical examination and could otherwise go untreated. When dental problems are diagnosed and treated early, the dental care is often both more comfortable for the patient and more affordable for the parent. Most pediatric dentists suggest taking x-rays once every two years to check for cavities. The American Academy of Pediatric Dentistry recommends x-rays every six months for those with a high risk of tooth decay. Pediatric dentists take care to minimize the exposure of their patients to radiation. Precautions are taken, such as the use of lead body aprons and shields, to ensure that the amount of radiation exposure is very small. The risk of dental x-ray radiation exposure is negligible, and represents a far smaller risk than an undetected and untreated dental problem would represent.
Wisdom teeth (third molars) are the final teeth to form in the mouth. Most people develop wisdom teeth during their late teens or early twenties. The eruption of wisdom teeth can be uneventful in some teens, but frequently problems develop that require most teens to have them removed. Third molars often become impacted when the jaw isn’t large enough to accommodate them. They may grow sideways, emerge only partially from the gum, or remain trapped beneath the gum and bone. In most cases, it is recommended that impacted wisdom teeth be extracted.
There are many treatment options available to make teeth brighter and whiter. Whitening toothpaste, whitening strips, bleaching trays, and custom-fit bleaching trays are a few of the techniques currently used. Consult the dentist to decide which option is best both for the patient, and for your budget. The dental office may carry tooth whitening products that are not available for over-the counter sale. Certain whitening products available in the dental office, such as whitening strips, may be of higher strength, and therefore more effective, than those sold over the counter.
