Pediatric Dentistry FAQs
Pediatric dentists complete two or three years of additional specialized training after dental school, which includes study in child psychology, behavior, growth, and development. Pediatric dentistry training also includes sedation and monitoring and hospital dentistry.
To become credentialed with the American Board of Pediatric Dentistry, specialists have to pass a rigorous voluntary written and oral examination and can then call themselves “Board Certified” or Diplomate of American Board of Pediatric Dentistry.
Perinatal Oral Health Care
Perinatal oral health care is more commonly known as dental care during pregnancy. This type of dental care focuses on the prevention of Early Childhood Caries before the baby is born.
Expectant mothers with poor oral health and high level of Cariogenic bacteria can pass those bacteria to their infants. Research shows a link between gum disease in pregnant mothers and preterm and low birthweight babies. It is very important for all expecttant mothers to establish a dental home as early as possible in pregnancy.
Preventing Early Childhood Tooth Decay
Breast-feeding on demand (ad lib) should be avoided. A washcloth can be used to clean the mouth after nursing. After the first tooth begins to erupt, a soft toothbrush can be used. Children should be weaned from the bottle at 12-14 months of age. “Sippy cups” should only be used for water. Fruit juices should be limited and offered in a cup with meals.
A child should visit the dentist within six months of the first tooth eruption (usually between 6 to 12 months of age) or latest by the first birthday. Early preventive care and establishing a dental home will maintain a child’s oral health and smile and also help establish trust and positive attitude towards dental visits.
The biggest risk is Early Childhood Caries (earlier known as baby bottle tooth decay or nursing caries). Once teeth erupt in the child’s mouth they are at risk for decay. The earlier the dental visit, the better the chance of preventing dental problems.
Prevention is always better than treatment. Caries is preventable with proper diet and nutrition, maintaining oral hygiene and regular dental visits. To prevent orofacial trauma care, special attention should be given to play toys, pacifiers, car seats, and electric wires.
Between six months to age 3, children may have tender gums when teeth erupt. It is very common for children to drool and chew on fingers and toys when teeth are erupting. Children can be cranky and can also have mild fever due to excessive drooling, dehydration, and putting unclean toys and fingers in their mouth. Clean teething toys, frozen/cold rings or washcloths are usually soothing for their sore gums. Simply massaging baby’s gums with a clean finger can also help.
At birth, a child’s gums should be cleaned with a soft wash cloth. When the first tooth erupts, one can start brushing twice daily using nonfluoridated toothpaste and a soft bristled, age-appropriate sized toothbrush.
For ages under 2 years just a “SMEAR” of toothpaste on a toothbrush should be used. For children ages 2-5 years, a pea-size amount of toothpaste can be used. Children should be assisted by an adult to brush their teeth until they are able to independently clean their teeth properly. Flossing should be introduced as soon as adjacent teeth make contact to clean the surfaces between teeth, especially primary (baby) teeth!
There are two different mechanisms how fluoride helps teeth. First is dietary fluoride, which is fluoride in your drinking water, fluoride in various foods or fluoride supplements. Optimal exposure to dietary fluoride is important for children during tooth formation, which is usually until age 16. It is given in very low doses and is intended for regular daily consumption. Use of dietary fluoride for prevention and control of caries is documented to be safe and effective.
Second is local/topical fluoride which is in your toothpaste, mouthwash or given as Fluoride Varnish at a dental office. This has a higher concentration of fluoride and acts on the teeth already present in your mouth.
When the first tooth erupts, one can start brushing twice daily using fluoridated toothpaste and a soft, age-appropriate sized toothbrush. For ages under 2 years, just a “SMEAR” of toothpaste to brush should be used. For children ages 2-5 years, a pea-size amount of toothpaste can be used. Excessive and cumulative use of Fluoride can cause fluorosis (discoloration) of teeth depending upon dose, duration and time of exposure.
Thumb And Finger Sucking
Thumb sucking is considered normal for infants until the age of 2-3 years. Prolonged and frequent thumb sucking can create crooked teeth or bite problems. Positive reinforcement can be used to wean children off the habit. Professional advice is recommended if the habit persists beyond that age.
Are baby teeth really that important to my child?
Primary, or “baby,” teeth are important to help children speak clearly and chew naturally. They also aid in forming a path that permanent teeth can follow when they are ready to erupt. Some “baby” teeth are lost starting at age 6 years but the last “baby” tooth might not be lost till the child is his/her teens.
A check-up every six months is recommended in order to prevent cavities and other dental problems. However, a pediatric dentist can tell you when and how often your child should visit based on their personal oral health and needs.
Children with any medical or developmental disabilities are more susceptible to tooth decay, gum disease or oral trauma. This could be due to their special health concerns, medications, special diet or inability to maintain the oral health without any help. Establishing a dental home at an early age can help maintain a child’s oral health and develop a specific preventive care regime. Children with special needs may require to visit a dentist more frequently than twice a year.
Make sure your child has a balanced diet, including one serving each of fruits and vegetables, breads and cereals, milk and dairy products, and meat, fish and eggs.
Limiting the frequency of servings of sugars and starches will also aid in protecting child’s teeth from decay. Avoid frequent sipping on drinks that are high in sugar, including juice, energy drinks, soda, and chocolate milk in a baby bottle, “sippy” cup, or re-sealable bottle
Special customized diet instructions may be recommended for children with special health care needs.
- Set a good example for your child.
- Make good oral health a family effort and use positive reinforcements.
- Show children that daily brushing and flossing, limited snacking and regular dental checkups are necessary for good oral health.
- Brush your child’s teeth with a fluoride toothpaste twice a day.
- Floss once daily with your children.
- When children are able to brush by themselves, supervise and spot check.
- Visit your pediatric dentist regularly beginning with the eruption of first tooth.
- Eat a balanced diet.
- Limit the frequency of snacks and avoid sticky, sugary snacks and drinks.
- Appropriate use of Fluoride.
- Get teeth sealants on deep groves of permanent molars.
- Use a good electric/battery powered toothbrush.
Wearing a soft plastic mouth guard can protect children from injury to teeth, lips, cheeks, gums, face and even provide protection from severe injuries to head and jaw fractures.
Wearing a mouth guard is recommended to be worn for any sports or activity with a risk of fall or trauma due to contact with other players.
Many pre-formed mouth guards are available at sport stores. For a more effective prevention and a less bulky fit, a customized mouth guard can be fabricated in our dental office.
There is very little risk in dental X-rays. Pediatric dentists are especially careful to limit the amount of radiation to which children are exposed. Lead aprons and high-speed digital sensors are used to ensure safety and minimize the amount of radiation.
Frequency of radiographs is determined according to the child’s needs and American Academy of Pediatric Dentistry recommendations.
Sealants are the tooth-colored adhesive resin coatings that are applied to the fissures on the chewing surfaces of teeth and can be very effective in preventing plaque and food from accumulating in the pits and fissures of the molars, thus preventing cavities. The application is fast and comfortable and can effectively provide additional protection to teeth for many years.
Amalgam or silver fillings are used to restore or fill decayed teeth. The dentists at Must Love Kids Pediatric Dentistry prefer non-mercury composite fillings instead of amalgam fillings.
Composites or resins are tooth colored fillings used to restore carious or fractured teeth without taking too much of a healthy tooth while preparing the tooth for a filling. They are preferred on anterior (front teeth) due to esthetic reasons.
Stainless steel crowns are silver-colored “caps” used to restore back molars that have multi-surface cavities or are too badly fractured to hold a filling, teeth in need of nerve treatment (pulpotomy, root canal treatment), or when durability is a concern.
Pulpotromy is also known as the baby root canal, a nerve treatment in which the sick portion of the tooth nerve is removed and medicine is placed in order to avoid extracting the tooth. The tooth is then covered with a stainless steel cap.
A pulpectomy is root canal treatment necessary when the nerve of the tooth is dead or has irreversible inflammation. The entire infected pulp is removed and medication is placed in the root canals.
A space maintainer is a fixed metal retainer used to hold space for the un-erupted permanent tooth when a baby tooth has been prematurely lost. If space is not maintained, teeth on either side of the missing tooth can drift into the space and prevent the permanent tooth from erupting. When the permanent tooth erupts in the spot of the missing baby tooth. The space maintainer is removed by the dentist.
All children have unique dental and psychological needs. Dental treatment plans are determined by a child’s age, the extent of work needed, and a child’s ability to safely cooperate. Most children require various levels of behavior management techniques which include tell-show-do, distraction, or mild sedation.
For more extensive treatment, it might be recommended to provide care with general anesthesia in our office or in the hospital. All the benefits and risks will be discussed before the day of treatment.
Parents are welcomed back to observe during the initial exam and checkups. We have a designated parent seating from which parents can observe during treatment. This arrangement allows the doctor and staff to communicate with your child directly without distractions or safety concerns.
Over time, we hope to bring your child back by themselves to better establish your child’s trust and independence. During sedation and general anesthesia treatment, no parents are allowed to observe due to safety concerns and restriction of space.
The most important thing to remember is to stay calm. If there is loss of consciousness, trauma to the head, uncontrolled bleeding or several other injuries, please call 911.
If trauma is localized to the mouth, have all the facts about the incident and medical history handy. Use a sterile gauze/cotton to stop bleeding and call the office as soon as possible.
If a baby tooth is knocked out, do notdo not attempt to put it back in the socket.
If a permanent tooth is knocked out, gently rinse with clean water without scrubbing the tooth. Hold the tooth from the crown part and if possible, safely replace the tooth in the socket. Otherwise, place the tooth in milk, patient’s saliva or clean water and bring it along to the office immediately. If the tooth is fractured, then also bring in any pieces you can find.
Any injured child will be seen before other children regardless of appointment time. If your appointment gets delayed due to an emergency during your child’s appointment, your patience will be appreciated. Do accept our apologies in advance.
At every visit, evaluation will also be done to determine the growth and eruption of teeth and their relationship. Not every child needs braces. Any time after age 7, as recommended by the American Academy of Orthodontics, it might be suggested to get an Orthodontic consult.
Sometimes, phase I treatment is recommended. Interceptive orthodontic treatment (Phase I) allows minor tooth movement during an early developmental time in child’s life. This may include fixed or removable appliances, spacer-maintainers or braces. Early treatment can eliminate or minimize the need for additional treatment later in life. Whether or not your child needs braces will be determined after the evaluation.
Oral conscious sedation with protective stabilization can safely and effectively be used with patients who are unable to receive dental care for reasons of age or mental, physical, or medical condition.
Sedation is used to help increase cooperation and reduce anxiety and/or discomfort associated with dental treatment in a child. Various medications can be used along with nitrous oxide to sedate a child. Medicines are selected based upon child’s overall health, level of anxiety, and dental treatment needed. Most children become relaxed and/or drowsy from which they can be roused easily.
General anesthesia is a controlled state of unconsciousness that eliminates the awareness, movement and discomfort during dental procedures. The use of general anesthesia is sometimes necessary to provide quality dental care for children who are extremely uncooperative, fearful, anxious or need extensive dental treatment.
It is also recommended for very young children who do not understand how to cope with dental procedures and for children with complex medical and special health care needs. Depending upon the patient’s medical and dental needs, general anesthesia can be provided in the hospital or in our office by a trained anesthesiologist.
Primary, or “baby,” teeth are important to help children speak clearly and chew naturally. They also aid in forming a path that permanent teeth can follow when they are ready to erupt. Some “baby” teeth are lost starting at age 6 years but the last “baby” tooth might not be lost till the child in his/her teens.