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Related Links
- Pediatric Dentistry
- Brushing & Flossing
- Sedation
- Digit Sucking
- Children's Oral Health Issues
- Early Childhood Caries
- Fluoride
- Cavity Prevention
- Dental Trauma
- Orthodontics
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Pediatric Dentistry
What Is A Pediatric Dentist (Pedodontist)?
In the same way that pediatricians are trained to meet a child's medical needs, pediatric dental specialists are uniquely qualified to protect your child's oral health. Pediatric dentists have an additional two years of specialty training at university and hospital pediatric facilities, in addition to four years of dental school and four years of college study. They learn how to deal with the behavioral aspects of children, how to make them feel comfortable, and to make the experience pleasant. Pediatric dentists receive extensive training in behavior management, dentistry for children with special needs, sedation dentistry, and use advanced techniques. They are trained to recognize and manage dental problems unique to children.
What Dental Problems Could My Child Have?
Some dental problems begin very early in life. One concern is early childhood caries (erroneously known as baby bottle tooth decay), a serious condition caused by staying on the bottle, breastfeeding, or sippy cup for too long. Cavities between the teeth are very common. They are not visible without dental x-rays in their early stages of decay. Early intervention may prevent extensive treatment needs in the future. By the time a child has pain associated with these types of cavities, the teeth require major treatment such as root canals or extraction. Another problem is gum disease. About 40 percent of children two to three years old have at least mild inflammation of gum tissues. Oral habits (such as digit sucking or tongue thrust) should also be checked. The earlier the dental visit, the better the chances of preventing problems. Strong, healthy teeth help your child chew food easily, speak clearly, and feel good about his or her appearance.
Why Are Baby Teeth So Important?
Primary teeth are important because they help with proper chewing and eating, help in speech development, and add to an attractive appearance. A child who can chew easily, speak clearly, and smile confidently is a happier child. Healthy primary teeth allow normal development of the jaw bones and muscles, save space for the permanent teeth, and guide them into place. If a baby tooth is lost too soon, permanent teeth may come in crooked or may be completely blocked from coming in at all. Decayed baby teeth can cause pain, abscesses, infections, and can spread to the permanent teeth. Also, your child's general health can be affected if diseased baby teeth aren't treated. Remember, some primary molars are not replaced until age 10-14, so they must last for years.
What Should I Tell My Child About Their First Dental Visit?
We are asked this question many times. This will not be the frightening experience you may remember from your youth. We suggest that you try to make it an exciting first experience. If you are nervous about the trip, then the less you say the better. You cannot hide your anxiety from a child (they can easily sense your anxiety and will react to it). Have fun reading books about dentistry with your child and encourage play behaviors that mimic a dental visit with your child being the dentist and then the patient. Talk about how the dentist or assistant will help keep your child’s teeth healthy and how they are specially trained to care about and be gentle with children. Your child's reaction to his dental visit may surprise you.
Brushing & Flossing Instructions
Children’s hands and mouths are different than adults. They need to use toothbrushes designed for children. Both adults and children should use brushes with soft, rounded bristles for gentle cleaning. Change to a new brush about every three months.
Wipe infant’s teeth gently with a moist, soft cloth. As babies grow, use a child’s toothbrush with a small, pea-sized dab of toothpaste. By age two or three begin to teach your child to brush. You will still need to brush where they miss. Dentists and hygienists often advise children to use a gentle, short, circular motion to remove plaque. When children are older, they can switch to this method. Flossing daily is also recommended. It can also be a good idea to create a "tooth brushing routine". And stick to the same routine each day. A staff member would be happy to demonstrate proper brushing and flossing techniques to you and your child during the checkup and cleaning appointment.
Sedation
Children who are very young or who have a high level of anxiety that interferes with the cooperation necessary for the dentist to perform treatment may require some level of sedation. Sedation is also helpful for children with special needs or children who require extensive treatment. There are many safe and effective drugs available today that can help relax the child and promote a good environment for optimal and safe dental treatment.
Conscious sedation is an option for children who are mildly apprehensive yet able to reason and follow direction (usually older children, above 4 years of age). The mildest form is administered as an inhalation agent, known as nitrous oxide (“laughing gas”). Oral conscious sedation is used for children who are apprehensive and who may lack the coping skills to undergo dental treatment. Conscious sedation is never a guarantee of cooperation, but can allow the patient to have a more comfortable experience.
Deep sedation is sometimes necessary for children that are unable, by either age or maturity level, to cooperate during dental treatment. Our practice utilizes a certified anesthesiologist for cases where the patient may pose a threat to their own safety during treatment. This will be discussed with the parent(s)/guardian(s) of the patient before treatment to ensure the optimum beneficial outcome. We want to make sure that you are comfortable with the recommendations being made for your child, and welcome any questions or concerns you may have about the treatment options available.
Sedation dentistry is most helpful for:
- Infants and babies
- Children who require major treatment
- A very anxious child
- Children that have had traumatic dental experiences (sound and smell aversion)
- Children with a strong gag reflex
- Children who are medically compromised or have special needs
Digit Sucking
Digit sucking is a habit that occurs in infants. Children usually give up digit sucking by the age of four. If the child continues past the age when their permanent teeth start to erupt, they may develop crooked teeth and a malformed palate (roof of mouth). This results from the frequency, duration, intensity, and position of the digit in the child’s mouth. This can also affect the position of the upper and lower jaw and can also affect speech.
Suggestions to break the habit:
- Wait till the time is right (low stress).
- Motivate your child (show examples of what could happen to their teeth and fingers/thumbs).
- Use a reward system (small incentives will encourage your child to stick with it).
Children’s Oral Health Issues
Gum Disease
While many people believe periodontal disease is an adult problem, studies indicate that gingivitis (the first stage of periodontal disease) is nearly a universal problem among children and adolescents. Advanced forms of periodontal disease are more rare in children than adults, but can occur.
Chronic gingivitis is common in children. It can cause gum tissue to swell, turn red, and bleed easily. Gingivitis is preventable and treatable with a regular routine of brushing, flossing, and professional dental care. If left untreated, it can eventually advance to more serious forms of periodontal disease.
What Causes Tooth Decay?
Tooth decay is a bacterial infection. Several specific types of bacteria that live on the teeth cause decay. When sugar is consumed, the bacteria use the sugar and then manufacture acids that dissolve the teeth and cause an infection (decay) in the tooth.
Adolescence & Oral Care
There is evidence that demonstrates how periodontal disease may increase during adolescence due to lack of motivation to practice oral hygiene. Children who maintain good oral health habits up until the teen years are more likely to continue brushing and flossing than children who were not taught proper oral care.
Advice For Parents
Early diagnosis is important for successful treatment of periodontal diseases. Therefore, it is important that children receive a periodontal examination as part of their routine dental visits. Be aware that if your child has an advanced form of periodontal disease, this may be an early sign of systemic disease. A general medical evaluation should be considered for children who exhibit severe periodontitis, especially if it appears resistant to therapy.
An important step in the fight against periodontal disease is to establish good oral health habits with your child early. Serve as a good role model by practicing good oral health care habits yourself and schedule regular dental visits for family check-ups, periodontal evaluations, and cleanings. Check your child's mouth for the signs of periodontal disease, such as bleeding gums, swollen and bright red gums, gums that are receding away from the teeth, and bad breath.
If your child currently has poor oral health habits, work with your child to change these now. It's much easier to modify these habits in a child than in an adult. Since your child models behavior after you, it follows that you should serve as a positive role model in your oral hygiene habits. A healthy smile, good breath, and strong teeth all contribute to a young person's sense of personal appearance, as well as confidence and self-esteem.
What Is Early Childhood Caries (ECC)?
ECC was previously known as baby bottle tooth decay, because extensive decay was seen commonly in babies who had been put to bed with a bottle of formula, milk or juice. However, it is now known that ECC can also occur with prolonged breastfeeding past one year of age or sippy cup use. Because the sugar in formula, milk, or juice stays in contact with the teeth for a long time during the night, the teeth can decay quickly.
Some Tips To Avoid ECC
- Put your child to bed with a bottle of plain water, not milk or juice.
- Stop nursing when your child is asleep or has stopped sucking on the bottle.
- Try not to let your child walk around using a bottle of milk or juice as a pacifier.
- Start to teach your child to drink from a cup at about six months of age. Plan to stop breastfeeding or bottle-feeding by 12 to 14 months at the latest.
- Don't dip your child's pacifier in honey or sugar.
What Is Fluoride?
Fluoride helps make teeth strong and prevents tooth decay. If the water where you live does not have enough fluoride, your doctor may prescribe fluoride supplements. We can help you determine how much (if any) of a supplement your child needs based upon their weight, age, current water fluoride level, and brand of toothpaste you are using. Fluoride works via two methods: systemically or topically. Systemic fluoride, such as drops or pills, is most effective when it is taken while the teeth are still developing in the jaws, while topical fluoride (toothpaste, gels, rinses) is effective on teeth already in eruption in the mouth.
Cavity Prevention
Most of the time cavities are due to a diet high in sugary foods, frequent snacking, and a lack of brushing. A cup of juice or milk at one sitting is far better for your child’s teeth than allowing him/her to take sips at a time, whenever he/she wishes to. Limiting sugar intake and brushing regularly, of course, can help. The longer it takes your child to chew their food, the longer the residue stays on their teeth and the greater the chances of getting cavities.
Consistency of a person's saliva also makes a difference as thinner saliva breaks up and washes away food more quickly. When a person eats diets high in carbohydrates and sugars, they tend to have thicker saliva, which in turn produces more of the acid-producing bacteria that causes cavities.
Some tips for cavity prevention:
- Limit frequency of meals and snacks.
- Encourage brushing, flossing, and rinsing.
- Watch what you drink.
- Avoid sticky foods and candies.
- Make treats part of meals.
- Choose nutritious snacks.
Dental Trauma
What should I do if my child’s tooth is knocked out?
Contact our office as soon as possible. The doctor will examine your child and take the necessary x-rays to determine the course of treatment. Baby teeth are not put back into the socket if they are knocked out. If your child’s permanent tooth is knocked out, rinse the knocked out tooth in cool water. Do not scrub the tooth. If possible, replace the tooth in the socket and hold it there with clean gauze or tissue. If you can’t put the tooth back into the socket, place the tooth in a container of vitamin D milk (or water if milk is not available.) Come to our office immediately. Feel free to call our emergency number if it is after hours. The tooth has a better chance of being saved if you act immediately.
What should I do if my child’s tooth is fractured or chipped?
Contact our office as soon as possible. If the fracture does not involve the nerve of the tooth, we will most likely place a temporary filling on that day, and schedule your child for follow-up. If there has been no sensitivity, we can place a permanent restoration. If the nerve has been exposed, we may have to refer you to a root canal specialist for further examination. Our goal is to save the tooth and prevent infection.
What do I do if my child has a toothache?
Call our office to schedule an appointment. To help comfort your child, rinse out the mouth with cold water and apply a compress. Giving children’s Motrin or Tylenol may also help to ease your child’s discomfort.
How can we prevent dental injuries?
Sports-related dental injuries can be reduced or prevented by wearing custom or store-bought mouth guards. Mouth guards not only protect the teeth, but the lips, cheeks, tongue, and jaw bone as well. They contribute to the protection of the child from head and neck injuries such as concussions. Child proofing your home can help reduce injuries at home. In addition, regular dental check ups will contribute to preventative care.
ORTHODONTICS
Orthodontics is the branch of dentistry that specializes in the diagnosis, prevention, and treatment of dental and facial irregularities. The technical term for these problems is "malocclusion," which means bad bite. Orthodontic problems must be diagnosed before treatment begins. Pediatric dentists and orthodontists share a close relationship in this process to determine the necessary treatment for your child.
What’s the right age for orthodontic treatment?
All children should receive their first orthodontic evaluation by the age of seven. This allows early identification of potential problems. There are some situations where we may even refer your child to the orthodontist before age 7. Orthodontic treatment at this age is known as Phase I treatment, and usually involves a combination of appliances, retainers, and/or partial braces. Phase II, full braces, are placed after most of the permanent teeth erupt, generally from age ten to twelve.
The timing of treatment is very important. The doctor will be able to monitor your child’s development and refer you at the proper time.
