Frequently Asked Questions

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.

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.

When Should My Child First See A Dentist?

“First visit by first birthday” sums it up. Your child should visit a pediatric dentist when the first tooth comes in, usually between 6 and 12 months of age. This visit will establish a dental home for your child. Early examination and preventive care will protect your child’s smile now and in the future.

Why So Early? What Dental Problems Could A Baby Have?

The most important reason is to begin a thorough prevention program. Dental problems can begin early. A big concern is Early Childhood Caries (formerly known as baby bottle tooth decay or nursing caries). Once a child’s diet includes anything besides breast-milk, erupted teeth are at risk for decay. The earlier the dental visit, the better the chance of preventing dental problems. Children with healthy teeth chew food easily and smile with confidence. Start your child now on a lifetime of good dental habits.

How Can I Prevent Tooth Decay From Nursing Or Using A Bottle?

At-will breast-feeding should be avoided after the first primary (baby) teeth begin to erupt and other sources of nutrition have been introduced. Children should not fall asleep with a bottle containing anything other than water. Drinking juice from a bottle should be avoided. Fruit juice should only be offered in a cup with meals or at snack time.

When Should Bottle-Feeding be Stopped?

Children should be weaned from the bottle at 12-14 months of age.

Should I Worry About Thumb And Finger Sucking?

Thumb sucking is perfectly normal for infants; many stop by age 2. Prolonged thumb sucking can create crooked teeth or bite problems. If the habit continues beyond age 3, a professional evaluation is recommended. Your pediatric dentist will be glad to suggest ways to address a prolonged thumb sucking habit.

When Should I Start Cleaning My Baby’s Teeth?

The sooner the better! Starting at birth, clean your child’s gums with a soft infant toothbrush or cloth and water. As soon as the teeth begin to appear, start brushing twice daily using fluoridated toothpaste and a soft, age-appropriate sized toothbrush. Use a “smear” of toothpaste to brush the teeth of a child less than 2 years of age. For the 2-5 year old, dispense a “pea-size” amount of toothpaste and perform or assist your child’s toothbrushing. Remember that young children do not have the ability to brush their teeth effectively.

Any Advice On Teething?

From six months to age 3, your child may have tender gums when teeth erupt. Many children like a clean teething ring, cool spoon or cold wet washcloth. Some parents swear by a chilled ring; others simply rub the baby’s gums with a clean finger.

What Is A Healthy Diet For My Child?

A healthy diet is a balanced diet that naturally supplies all the nutrients your child needs to grow. A balanced diet is one that includes the following major food groups: Fruits Vegetables Grains Meat & Beans Milk.

How Does My Children’s Diet Affect Their Dental Health?

They must have a balanced diet for their teeth to develop properly. They also need a balanced diet for healthy gum tissue around the teeth. Equally important, a diet high in certain kinds of carbohydrates, such as sugar and starches, may place your child at extra risk for tooth decay.

How Do I Make My Children’s Diet Safe For Their Teeth?

First, be sure they have a balanced diet. Then, check how frequently they eat foods with sugar or starch in them. Foods with starch include breads, crackers, pasta and snacks, such as pretzels and potato chips. When checking for sugar, look beyond the sugar bowl and candy dish. A variety of foods contain one or more types of sugar, and all types of sugars can promote dental decay. Fruits, a few vegetables, and most milk products have at least one type of sugar.

Sugar can be found in many processed foods, even some that do not taste sweet. For example, a peanut butter and jelly sandwich not only has sugar in the jelly, but may have sugar added to the peanut butter. Sugar is also added to such condiments as ketchup and salad dressings.

Should My Child Give Up All Foods With Sugar Or Starch?

Certainly not! Many of these foods provide nutrients your child needs. You simply need to select and serve them wisely. A food with sugar or starch is safer for teeth if it is eaten with a meal, not as a snack. Sticky foods, such as dried fruit or toffee, are not easily washed away from the teeth by saliva, water or milk. Therefore, they have more cavity-causing potential than foods more rapidly cleared from the teeth. Talk to your pediatric dentist about selecting and serving foods that protect your child’s dental health.

Does A Balanced Diet Assure That My Child Is Getting Enough Fluoride?

No. A balanced diet does not guarantee the proper amount of fluoride for the development and maintenance of your child’s teeth. If you do not live in a fluoridated community or have an ideal amount of naturally occurring fluoride in your well water, your child may need a fluoride supplement during the years of tooth development. Your pediatric dentist can help assess how much supplemental fluoride your child needs, based upon the amount of fluoride in your drinking water and other potential sources of fluoride.

My Youngest Is Not On Solid Foods Yet. Do You Have Any Suggestions For Him?

Do not nurse a young child to sleep or put him to bed with a bottle of milk, formula, juice or sweetened liquid. While a child sleeps, any unswallowed liquid in the mouth feeds bacteria that produce acids and attack the teeth. Protect your child from severe tooth decay by putting him to bed with nothing more than a pacifier or bottle of water.

What Is Fluroide?

Fluoride is a compound that contains fluorine, a natural element. Using small amounts of fluoride on a routine basis can help prevent tooth decay. In areas where fluoride does not occur naturally, it may be added to community water supplies. Research shows that community water fluoridation has lowered decay rates by over 50 percent, which means that fewer children grow up with cavities. Fluoride can be found as an active ingredient in many dental products such as toothpaste, mouth rinses, gels and varnish.

How Does Fluoride Prevent Cavities?

Fluoride inhibits loss of minerals from tooth enamel and encourages remineralization (strengthening areas that are weakened and beginning to develop cavities). Fluoride also affects bacteria that cause cavities, discouraging acid attacks that break down the tooth. Risk for decay is reduced even more when fluoride is combined with a healthy diet and good oral hygiene.

May Child Need Fluoride Supplements?

The pediatric dentist considers many factors before recommending a fluoride supplement. Your child’s age, risk of developing dental decay and dietary sources of fluoride are important considerations. Infant formulas contain different amounts of fluoride. Bottled, filtered and well waters also vary in the amount of fluoride they contain. Your pediatric dentist can help determine if your child is receiving – and not exceeding – the recommended amount.

How Safe Is Fluoride?

Using fluoride for the prevention and control of decay is proven to be both safe and effective. Nevertheless, products containing fluoride should be stored out of the reach of young children. Too much fluoride could cause fluorosis of developing permanent teeth. Fluorosis usually is mild, with tiny white specks or streaks that often are unnoticeable. In severe cases of fluorosis, the enamel may be pitted with brown discoloration. Development of fluorosis depends on the amount, duration and timing of excessive fluoride intake. The appearance of teeth affected by fluorosis can be greatly improved by a variety of treatments in esthetic dentistry.

What Type Of Toothpaste Should My Child Use?

Your child should use toothpaste with fluoride and the American Dental Association Seal of Acceptance. Brushing twice a day (after breakfast and before bedtime) provides greater benefits than brushing once daily. Parents should dispense toothpaste to prevent their young children from swallowing too much.

How Much Toothpaste Should My Child Use?

For children under two-years-old, use a smear of fluoridated toothpaste. For those aged 2 to 5 years, a pea-sized amount is recommended.

How Does Fluoride Prevent Cavities?

Fluoride inhibits loss of minerals from tooth enamel and encourages remineralization (strengthening areas that are weakened and beginning to develop cavities). Fluoride also affects bacteria that cause cavities, discouraging acid attacks that break down the tooth. Risk for decay is reduced even more when fluoride is combined with a healthy diet and good oral hygiene.

What Is Topical Fluoride?

Topical fluoride is a preventive agent applied to tooth enamel. It comes in a number of different forms. A dental professional places gels or foams in trays that are held against the teeth for up to 4 minutes. Fluoride varnish is brushed or “painted” on the enamel. Varnish is especially useful for young patients and those with special needs who may not tolerate fluoride trays. Children who benefit the most from fluoride are those at highest risk for decay. Risk factors include a history of previous cavities, a diet high in sugar or carbohydrates, orthodontic appliances, and certain medical conditions such as dry mouth.

What Is Nitrous Oxide/Oxygen?
Most children are calm, comfortable and confident in a pediatric dental office. The office is designed for young people, and pediatric dentists have additional training in caring for infants, children and adolescents. Staff members choose to work in a pediatric dental office because they like children and want to cater to their special needs. These elements combine to make your child feel relaxed and special. Sometimes, however, a child may feel anxious before or during treatment. Your child may need more support than a gentle, caring manner to feel comfortable. Nitrous oxide/oxygen is a safe, effective sedative agent used to calm a child’s fear of the dental visit and enhance effective communication. Additionally, it works well for children whose gag reflex interferes with dental treatment. Nitrous oxide/oxygen (N2O-O2) is a blend of two gases—oxygen and nitrous oxide. A fitted mask is placed over the nose and, as the patient breathes normally, uptake occurs through the lungs. At the end of treatment, it is eliminated after a short period of breathing oxygen and has no lingering effects.

How Will My Child Feel When Breathing Nitrous Oxide/Oxygen?
Very safe. Nitrous oxide/oxygen is perhaps the safest sedative in dentistry. It is well tolerated. It has a rapid onset, is reversible, can be adjusted in various concentrations and is non-allergenic. Your child remains fully conscious—keeps all natural reflexes— when breathing nitrous oxide/oxygen. He/she will be capable of responding to a question or request. Nitrous oxide/oxygen may also be used in combination with other sedative agents.

How Safe Is Nitrous Oxide/Oxygen?
Your child will smell a faint sweet aroma and experience a sense of well-being and relaxation. Since it may produce a feeling of giddiness or euphoria, it is often called “laughing gas.” Children sometimes report dreaming and their arms and legs may feel “tingly.” It raises the pain threshold and may even make the time appear to pass quickly. If your child is worried by the sights, sounds or sensations of dental treatment, he or she may respond more positively with the use of nitrous oxide/oxygen.

Are There Any Special Instructions For Nitrous Oxide/Oxygen?
First, give your child little or no food in the two hours preceding the dental visit (occasionally, nausea or vomiting occurs when a child has a full stomach). Second, tell your pediatric dentist about any respiratory condition that makes breathing through the nose difficult for your child, as it may limit the effectiveness of nitrous oxide/oxygen. Third, tell your pediatric dentist if your child is taking any medication on the day of the appointment.

Will Nitrous Oxide/Oxygen Work For All Children?
Pediatric dentists know that all children are not alike. Every service is tailored to your child as an individual. Nitrous oxide/oxygen may not be effective for some children, especially those who have severe anxiety, nasal congestion, or discomfort wearing a nasal mask. Your pediatric dentist will review your child’s medical history, level of anxiety, and dental treatment needs and inform you if nitrous oxide/ oxygen is recommended for your child. Pediatric dentists have comprehensive specialty training and can offer other sedation methods that are right for your child.

What Is Oral Sedation?
Sedation is a technique to guide a child’s behavior during dental treatment. Medications are used to help increase cooperation and to reduce anxiety or discomfort associated with dental procedures. Sedative medications cause most children to become relaxed and drowsy. Unlike general anesthesia, sedation is not intended to make a patient unconscious or unresponsive.

Who Should Be Sedated For Dental Treatment?
Sedation may be indicated for children who have a level of anxiety that prevents good coping skills, those who are very young and do not understand how to cope in a cooperative fashion, or those requiring extensive dental treatment. Sedation can also be helpful for some patients who have special needs.

Why Utilize Sedation?
Sedation is used for a child’s safety and comfort during dental procedures. It allows the child to cope better with dental treatment and helps prevent injury to the child from uncontrolled or undesirable movements. Sedation promotes a better environment for providing dental care.

What Medications Are Used?
Various medications can be used to sedate a child. Medicines will be selected based upon your child’s overall health, level of anxiety and dental treatment recommendations.

Is Sedation Safe?
Sedation can be used safely and effectively when administered by a pediatric dentist who follows the sedation guidelines of the American Academy of Pediatric Dentistry. Your pediatric dentist will discuss sedation options and patient monitoring for the safety and comfort of your child.

What Special Instructions Should I Follow Before The Sedation Appointment?
Children often perceive a parent’s anxiety which makes them more fearful. They tolerate procedures best when their parents understand what to expect and prepare them for the experience. If you have any questions about the sedation process, please ask. As you become more confident, so will your child. Should your child become ill, contact your pediatric dentist to see if it is necessary to postpone the appointment. Tell your pediatric dentist about any prescribed, over-the-counter or herbal medications your child is taking. Check with your pediatric dentist to see if routine medications should be taken the day of the sedation. Your pediatric dentist will provide you with additional detailed instructions before your sedation visit. It is very important to follow the directions regarding fasting from fluids and foods prior to the sedation appointment.

What Special Instructions Should I Follow After The Sedation Appointment?
Your pediatric dentist will evaluate your child’s health status and discharge your child when she is responsive, stable and ready to go. Children recover from effects of sedatives at different rates so be prepared to remain at the office until the after-effects are minimal. Once home, your child must remain under adult supervision until fully recovered from the effects of the sedation. Your pediatric dentist will discuss specific post-sedation instructions with you, including appropriate diet and physical activity.

What Are Space Maintainers?
Space maintainers are appliances made of metal or plastic that are custom fit to your child’s mouth. They are small and unobtrusive in appearance. Most children easily adjust to them after the first few days.

Why Do Children Lose Their Baby Teeth?
A baby tooth usually stays in place until a permanent tooth underneath pushes it out and takes its place. Unfortunately, some children lose a baby tooth too soon. A tooth might be knocked out accidentally or removed because of dental disease. When a tooth is lost too early, your pediatric dentist may recommend a space maintainer to prevent future space loss and dental problems.

Why All The Fuss? Baby Teeth Fall Out Eventually On Their Own!
Baby teeth are important to your child’s present and future dental health. They encourage normal development of the jaw bones and muscles. They save space for the permanent teeth and guide them into position. Remember: Some baby teeth are not replaced until a child is 12 or 14 years old.

How Does A Lost Baby Tooth Cause Problems For Permanent Teeth?
If a baby tooth is lost too soon, the teeth beside it may tilt or drift into the empty space. Teeth in the other jaw may move up or down to fill the gap. When adjacent teeth shift into the empty space, they create a lack of space in the jaw for the permanent teeth. Therefore, permanent teeth are crowded and come in crooked. If left untreated, the condition may require extensive orthodontic treatment.

How Does A Space Maintainer Help?
Space maintainers hold open the empty space left by a lost tooth. They steady the remaining teeth, preventing movement until the permanent tooth takes its natural position in the jaw. It is more affordable – and easier on your child – to keep teeth in normal positions with a space maintainer than to move them back in place with orthodontic treatment.

What Special Care Do Space Maintainers Need?
Pediatric dentists have four rules for space maintainer care. First, avoid sticky sweets or chewing gum. Second, do not tug or push on the space maintainer with your fingers or tongue. Third, keep it clean with conscientious brushing and flossing. Fourth, continue regular dental visits.

Why Do Children Suck On Fingers, Pacifiers Or Other Objects?
This type of sucking is completely normal for babies and young children. It provides security. For young babies, it is a way to make contact with and learn about the world. In fact, babies begin to suck on their fingers or thumbs even before they are born.

Are These Habits Bad For The Teeth And Jaws?
Most children stop sucking on thumbs, pacifiers or other objects on their own between 2 and 4 years of age. However, some children continue these habits over long periods of time. In these children, the upper front teeth may tip toward the lip or not come in properly. Frequent or intense habits over a prolonged period of time can affect the way the child’s teeth bite together, as well as the growth of the jaws and bones that support the teeth.

When Should I Worry About A Sucking Habit?
Your pediatric dentist will carefully watch the way your child’s teeth erupt and jaws develop, keeping the sucking habit in mind at all times. Because persistent habits may cause long term problems, intervention may be recommended for children beyond 3 years of age.

What Can I Do To Stop My Child’s Habit?
Most children stop sucking habits on their own, but some children need the help of their parents and their pediatric dentist. When your child is old enough to understand the possible results of a sucking habit, your pediatric dentist can encourage your child to stop, as well as talk about what happens to the teeth and jaws if your child does not stop. This advice, coupled with support from parents, helps most children quit. If this approach does not work, your pediatric dentist may recommend ways to change the behavior, including a mouth appliance that interferes with sucking habits.

Are Pacifiers A Safer Habit For The Teeth Than Thumbs Or Fingers?
Thumb, finger and pacifier sucking affect the teeth and jaws in essentially the same way. However, a pacifier habit often is easier to break.