Q. Why should I choose a pediatric dentist?
A. Pediatric dentists are specialists who have gone beyond the training of a general dentist and received education in the treatment of kids. They have had instruction in treatment of special needs, medically compromised patients, as well as training in the art and science of providing excellent care to kids of all ages.
Kids’ bodies react to things differently than adult bodies and pediatric dentists are trained to know how to treat these differences. Just as you send your child to a pediatrian, you can bring your child to be treated by a pedodontist (that’s the fancy word for a pediatric dentist).
Q. When can I expect to see my baby’s first tooth?
...OR Why hasn’t my third grader lost a tooth yet?
A. Each child is different in how soon or late they will gain or loose teeth. Some kids get their first baby tooth as early as 3 months or as late as 13 months. Or maybe you have a 3rd grader who has yet to put anything under his pillow. Not to worry. It takes a while to do all that tooth moving. If you are still concerned, or if a family member still has baby teeth, even though they are now adults, consult your dentist. He or she will be able to take an X-ray called a panorex. It will show if the permanent teeth are present or not.
Q. What are those brown spots on my baby’s teeth?
A. They could be decay, but your dentist will have to examine your child to tell for sure. Very often when babies go to sleep with a bottle they can develop cavities in their baby teeth. We call this Early Childhood Decay or Baby Bottle Syndrome.
It’s really very easy to prevent this. Simply do not allow your child to sleep with a bottle. Or once he’s done nursing, remove him from the breast.
If she takes a bottle before bed, remove it before putting her in the crib. We know some kids are used to this, and may, very vocally, complain about it, but be firm.
If it’s just the sucking he craves, try one of the orthodontic pacifiers on the market, like MAM. Or if you want to give her a bottle, only put water in it. Just fresh, clean, PLAIN water. Not even weak juice and water mixtures, and no sugar added. Hang in there. Some of these little guys will complain mightily for a few nights. Just know for certain that you are doing what’s best for him. Explain to the neighbors what you are doing if you are concerned about your child disturbing them. Most of them will support your good parenting and will be patient. Children are wonderfully resilient and after a few days will come around and adapt to the change.
Q. At what age should my child begin coming to the dentist?
A. The American Academy of Pediatric Dentistry recommends after the first tooth appears, but definitely by 12-24 months. This introduces your child to our office early, gets her used to having strangers in her mouth, and we can intercept any harmful habits that may be forming and prevent them.
Q. How often should my child brush her teeth?
A. The same as you, twice a day, after breakfast and before he goes to bed. We realize that mornings can be hectic with many moms working outside the home, but figure out a way to make this work. If your child has to leave early and spend the morning at the sitters, perhaps you could leave a toothbrush and toothpaste at the sitter or at the daycare. Don’t allow cartoons or video games in the morning until all necessary chores-including morning tooth brushing-are completed. Kids zone out and the time files away!
Q. How can I keep my child’s teeth cavity free?
A. While there are no guarantees, there are things you as parents can do to maximize the chances of your child having healthy teeth for a lifetime.
- Be sure to remove plaque twice a day.
- Limit sweets to after meals--not between!
- Limit sweet drinks- a biggie!
- Visit the dentist twice a year.
- Include fluoride at checkups and at home-as prescribed by your pediatrician or dentist.
- Consider having sealants applied to your child’s teeth if recommended by the dentist.
Q. If baby teeth are going to fall out anyway, why fill them? Is it worth it?
A. Absolutely!! Baby teeth work like little bookmarks for the adult teeth. They hold a place open so that the adult teeth can come up in proper alignment. We don’t realize it, but our teeth move around in our mouths all the time. And generally that motion is toward the front of the mouth. If a baby tooth is lost the teeth behind it slowly shift forward and sometimes tip over and this can make it difficult or even impossible for the adult teeth to erupt.
A decayed tooth is often uncomfortable for your child, and even if it’s not, if the decay gets big enough, the tooth has to be wiggled out to avoid causing, or sometimes to remove, an infection. In that case, a space maintainer (Link to Health Library-Space Maintenance) must be put in to hold the space open for the adult tooth.
If teeth shift and do not allow the adult teeth to erupt, then they must be removed in the case of baby teeth, or orthodontic treatment may be needed to return the teeth to proper position. Your child could be spared these extra steps with a little preventive care.
Q. My child has a new tooth, but it’s not as white as the baby teeth. Is this stain, and how can I get it off?
A. No it’s not stain. Adult teeth are normally darker than baby teeth. Remember we ourselves come in different shades and so do our teeth. Your child’s teeth are the right color for him or her. They match his or her skin tone, and hair and eye color.
Q. My child chews on the toothbrush, and swallows the toothpaste. Is this dangerous?
A. Not if it only happens once in a while. Use just a little 'schmear' to thinly cover the bristles. They don’t even have to use toothpaste. Just water on a brush is all that is needed to remove plaque. Toothpaste is useful for the fluoride in it, and the rest is just cosmetic to make your mouth feel nice.
Orajel“ makes a “Tooth and Gum” cleansing paste that doesn’t contain fluoride, and is another option for kids who swallow a lot.
If your kids are taking fluoride supplements or there is fluoride in your drinking water, they’re probably getting enough to protect their forming adult teeth. The fluoride in the toothpaste is for the teeth that are in the mouth.
Another option is to dip a toothbrush in a little ACT fluoride rinse, and use that to brush.
Children who consistently swallow toothpaste run the risk of creating white spots on the permanent teeth. (Enamel Fluorosis)
Q. At what age can my child begin brushing on his own?
A. Generally, we recommend that you help your child until the 3rd grade. Most kids don’t develop good fine motor coordination until about age 8. That’s why they don’t begin learning cursive handwriting in earnest until the 3rd grade. Now, your kid may be good at it at a younger age and that’s fine. Each child develops at their own rate.
Take turns at night. Let your child brush first on her own and then you take a turn. Pay particular attention to the upper teeth in the back next to the cheek, and the tongue side of all the bottom teeth. These are areas where kids, and even grownups, usually collect calculus, or tartar. The hygienist can help you and your child learn how to use the toothbrush effectively and correctly.
In the mornings, let them do it by themselves. Our teeth really only need to have plaque broken up once every 24 hours, so if you do a good job at night, that should be sufficient. But twice doesn’t hurt!! This helps your kid feel independent, helps to establish an important habit, and begins to make them responsible for taking care of themselves.
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Q. Should my child wear a mouthguard for sports?
A. Absolutely!! We don’t care how cool you think you are, we don’t want to hear any excuses for not wearing one! And we don’t want to hear any complaining about it if you don’t! Particularly while we’re putting that knocked out tooth back in your head!!
Q. Should I floss my child’s teeth?
A. Yes. Some baby teeth have enough space in between that the toothbrush works pretty well, but if the teeth touch it’s a great idea. The places in between the molars are broad and flat and plaque gets trapped there.
There are disposable floss holders that can be reused a few times. They allow you to floss one handed so it’s easy for older kids. For the younger ones, you can tuck their head under your arm to stabilize it, and with their head tipped back, it makes it easier for you to reach all their teeth. I want to put a photo or graphic here that demos this position
Just rinse them out and let them dry like a toothbrush. If the floss becomes wavy or fuzzy, toss it and use a new one. Toss it anyway after a few days. A bag of 20 should last a while.
Q. What kind of toothbrush is best for my child?
A. For little tiny kids, you can just a wet baby washcloth wrapped around your finger. Even a baby needs their gums wiped off, once they begin the oooey-gooey cereals. Just wipe off the teeth on both sides. This also helps get them used to having you near and in their mouths.
Generally, smaller is better when it comes to kids’ brushes. And we recommend a soft one. Medium and hard toothbrushes are only on the market due to consumer demand from a time when we thought our teeth were actually ceramic tile that needed a good scrubbing! Don’t even use them. You, too, parents! Save them for your tile grout or your car tires. Don’t put them in your mouth!
A smaller brush head makes it easier for kids to get to all areas of their mouths and is better for those kids with a sensitive gag reflex.
Other specialized brushes are available for kids who have braces or other special needs, but your hygienist can tell you if you need those.
Q. My kid has bad breath! What can be done?
A. There can be several reasons for this, so take inventory.
Most bad breath comes from the tongue. The tongue is very bumpy and food sticks to it easily, which then starts to smell bad after a few hours and especially after sleeping. Clean your tongue morning and night to keep odors away. There are quite a few tongue cleaners--brushes and scrapers- at the store. These are designed to clean the surface of your tongue with out bothering your gag reflex too much. Check for them in the store near where you buy floss.
Does your kid have bad breath in the morning? Or all day? What we call hunger breath occurs most often in the morning and it can be nasty! It’s due to a lack of anything in your child’s stomach. See if it goes away after he eats. Picky or light eaters may have this problem before all meal times. Try to determine a pattern.
If it is more often, does your child have allergies, enlarged tonsils or chronic sinus problems? The problem may be from the nose or throat, not the mouth. See your child’s physician to be sure they are not harboring a sinus infection. A post-nasal drip can cause bad odors.
Some odors can be from underlying medical or systemic conditions. Be sure your child is in good health and speak to your pediatrician if you have any concerns.
Q. So, like, what's the big deal with tongue piercing? Like, who cares? It's my body.
A. Yeah, only except you can cause, like, problems for yourself?
The mouth has, like, a gi-normous amount of bacteria, and stuff? And so, like, all the food you eat and junk? It gets into the stud hole, and sticks to the stud, and gets, like rilly gross, and it stinks, and you can get, like, an infection? And your tongue could, like, totally swell up? Eeeuuuuw!
And the stud, the one in your mouth, not, like, Orlando Bloom, that could, like, totally break your teeth, cause it's, like, hard, ya know? And it, like whacks your front teeth, like when you play with it? So it chips your front teeth, so you have to, like, get 'em all fixed, and stuff? If you whack 'em too much, they could, like, die inside and you'd need something called a, um a...a.. root canal, or something like that, which my parentals say is like......bleaah!
Plus, if, like, the person who pierced you, didn't like, clean everything right? You could totally get a serious infection, man. Like hepatitis! Whoa!
And if you have, like a, a heart problem or something? Like one you were born with, you could, like get an infection in your heart. Like, really whoa!
Plus, you could, like totally choke on it if it comes loose.
And! And, like they make you have more spit, so like *snort, giggle* you could look like a total doofus 'cause you're drooling all the time!! *snigger*!!
Q. What can my child expect on her first visit?
A. She can expect to walk into a friendly comfortable reception area with toys and books available to divert her and put her at ease. She will be greeted by the assistant or hygienist and led into the treatment area to pick a new toothbrush and a fluoride flavor. The brush will be used to apply the fluoride if your child is young, and may be used to remove plaque during the cleaning.
He or she will be led to the room in which we take radiographs (or x-rays). Depending on the child's age we will take radiographs that are appropriate for them. We explain what we are doing for the child as we go.
After the pictures are taken we will lead the child to the treatment chair. Each step is explained and shown and we do our best to put the child at ease and to praise the child for co-operation and the accomplishment of each step.
If the child is very young we may do what is termed a "lap-prohy". The parent or the assistant will hold the child on her lap in the chair with the child facing the parent/assistant. The head of the child is then placed in the hygienist's lap. This allows the parent to maintain contact with the child, the child's hands can be held by the parent, so that they do not try to grab instruments. This ensures the child's safety. We are better able to stabilize the child's head and are able to look in the mouth and perform the cleaning.
Sometimes with a very young child we will do a toothbrush prophy (prophylaxis- a cleaning). We will scale the teeth, and use the toothbrush to remove plaque and apply fluoride. This is more familiar to a toddler and puts them at ease.
After the hygienist is done, the dentist will come and do the exam and then it's PRIZE time!!!! Time to go to the box and pick prizes for a job well done.
Q. You mentioned scaling the teeth. Is that the same thing the hygienist does to me when I go to the dentist? Do kids really need to have their teeth scaled?
A. Ya sure, ya betcha! Calculus (or tartar) is not a product of age.
Everyone has their own specific pH in their mouth. Some people are more acidic, some more basic, most people fall somewhere in between. People with more acidic pH may be more prone to decay, may get more cavities. Those with a more basic pH will build up more calculus (tartar).
If your child has a pH that leans basic and the plaque is not thoroughly removed daily, he or she will tend to build up calculus that should be removed at each cleaning appointment. Kids actually tolerate this procedure very well. It tickles a lot less than the polishing!
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