Questions and Answers about Children’s Dentistry
Q: Why choose a pediatric dentist for your children?
Pediatric dentists have years of additional training after dental school to learn specialized procedures in children's oral care. These dentists are dedicated to patients as young as one or as old as their late teens. Any parent knows that children of all ages need a unique approach to deal behavior, dental anxiety, and oral development. Pediatric dentists are the most equipped to meet these needs and allay any concerns parents or children might have about their next dental appointment.
Q: Why are primary teeth (baby teeth) important to children's oral health?
Primary teeth are the building blocks of a healthy smile later in life. These teeth can often be very sensitive though, so untreated cavities can actually affect the development of adult teeth. Primary teeth are an important part of eating and digestion, speech and communication, and providing space and alignment for future teeth. It's also important to note that caring for primary teeth builds daily habits for a lifetime of good hygiene.
Q: At what age will my child's teeth begin erupting?
In the dental field, dental eruption is the term we use to refer to teeth breaking through the gums and becoming visible. While dental formation below the gums starts even before birth, the lower front teeth (or incisors) usually erupt by 4-6 months of age. By age 3, the toddler mouth typically has about 20 primary teeth, even though the order of eruption varies drastically from one child to another. By age 6, permanent teeth begin to grow in, a process that can sometimes last another decade.
What should I do in the event of a dental emergency?
A: Parents can surely have their hands full if their child is complaining about sore teeth or dental pain. For anyone that's experienced a cavity or dental emergency, these problems can be painful and often require medical attention. Here is a list of frequent dental emergencies in children and what you should do if you encounter them:
- Toothache: Clean the area of the affected tooth with mouthwash and dental floss to remove any food or residue that may be causing irritation. A warm, salt water rinse may clean the affected and over-the-counter pain relievers can cut down on discomfort. If any signs of swelling or pain persist for 12-24 hours, call your pediatric dentist.
- Cut or Bite on Inside of Mouth: Apply an ice pack to the exterior of the mouth to reduce swelling. In the event of bleeding, apply gentle pressure with gauze or cloth. If bleeding continues, visit the emergency room at your nearest hospital.
- Permanent Tooth Loss: If a permanent tooth is ever knocked out, it is important that you react quickly and contact your dentist immediately. Recover the tooth (if possible) and handle it only by the crown. You can rinse the tooth under water only to remove dirt or other materials; do not use household cleaners like soap to scrub the tooth. Once clean, try reinserting the tooth into the socket and hold it in place by biting down on gauze. If the tooth cannot be reinserted, place the tooth in a cup of whole milk or hold it between the gum and cheek to prevent it from drying out.
- Knocked-Out Baby Tooth: Contact your pediatric dentist and schedule the soonest appointment available. While this usually is not a huge emergency, the dentist may opt to use a dental spacer until a permanent tooth replaces it.
- Chipped Permanent Tooth: Locate and save any tooth fragments and call your dentist immediately. Rinse the mouth with water and apply cold packs to reduce any swelling.
- Possible Broken or Fractured Jaw: Immediately take your child to the nearest emergency room and try to reduce jaw movement as much as possible by wrapping a bandage around the top of the head and jaw.
Q: What are dental radiographs?
Dental radiographs (or x-rays) are an important part of dental diagnoses and treatment. This simple procedure usually lasts only a few minutes and can catch dental problems before they come to fruition. A routine dental exam can only check problems on the surface of the teeth, while an x-ray can give your pediatric dentist tons of information about health conditions within the gums.
Q: Why are dental x-rays important?
Radiographs can first be used to pinpoint hard-to-detect cavities in your child's teeth. More importantly though, dental x-rays can provide a roadmap for orthodontic treatment, checking the alignment of erupting teeth and the shape of the jaw. Radiographs can also evaluate the extent of dental trauma or even diagnose early bone disease.
Q: How often does my child need dental x-rays?
The American Academy of Pediatric Dentistry advises that children should have routine radiographs at least once a year. Your dentist may even recommend them more frequently if your child is especially susceptible to tooth decay or dental problems.
Q: Should I be concerned about radiation?
While radiation is a large concern for many parents, Dr. John's office uses only the most sophisticated dental x-ray technology to isolate radiation exposure and reduce it as much as possible. With high-speed film and protective body aprons, any radiation exposure is negligible and our team always works hard to make children and parents feel comfortable with the procedure.
Choosing the Right Kids' Toothpaste
Q: What kind of toothpaste does Dr. John recommend?
Our office recommends using only children's toothpaste that is approved by the American Dental Association (ADA). All toothpastes that meet this requirement have the organization's emblem printed on the side of the box, informing parents that the toothpaste has undergone strict testing. Avoid adult toothpastes, as these can be overly abrasive on a young mouth and reduce children's enamel.
Q: What if my child forgets to spit out toothpaste after use?
Toothpaste should always be spit out after use. If ingested in large amounts, fluoride in the toothpaste can lead to a condition called fluorosis, which leaves spotted discolorations on the teeth. If your child is too young to spit out toothpaste, try using a fluoride-free variety.
Parents might notice a grinding noise from the inside of their child's mouth while sleeping. Grinding between the top and bottom teeth is called bruxism and can sometimes lead to serious problems like chipped teeth or misalignment.
Why does it happen? There are two primary hypotheses for children's bruxism. The first is that the problem is stress-related. In other words, environmental factors like school changes may be causing psychological stress that manifests itself in nighttime teeth grinding. Other researchers suggest that the problem is the result of inner-ear pressure and children grind their teeth to alleviate the discomfort associated with this pressure.
Treating Bruxism: The good news is that most children outgrow teeth grinding by age 12, but if the problem persists, talk to your pediatric dentists about possible treatment options. One option in particular is to use a nighttime mouth guard, protecting the teeth from unnecessary grinding.
Thumb sucking is a natural reflex that occurs in many young children. The behavior typically begins as an early habit to reduce anxiety and provide relaxation. Most thumb sucking stops between ages two and four, but the continuation of this habit may lead to some dental problems.
Q: Are there any problems associated with thumb sucking?
If your child is still thumb sucking by the time permanent teeth begin erupting, then constant sucking pressure can actually affect tooth alignment. In fact, frequent high-pressure thumb sucking can lead to alveolar prognathism, causing the top teeth to project outwards and lower teeth to bend inwards. Not to mention, constant thumb sucking can introduce harmful bacteria to the mouth, leading to illness or more frequent cavities.
Getting your child to grow out of thumb sucking can be a difficult journey, but one that is extremely important. Talk with your pediatric dentist about ways that you can encourage your child to stop thumb sucking.
Q: What is pulp therapy?
Pulp refers to the inner core of a tooth, which is lined with nerve endings, blood vessels, and connective tissue. This inner component of a tooth is essential to gum and oral health, so your dentist may recommend pulp therapy or treatment for certain procedures.
Q: What are some different types of pulp therapy treatment?
Dental caries (or cavities) as well as dental trauma are the two biggest reasons why dentists use pulp therapy. What is often referred to as a "children's root canal," pulp therapy includes two main procedures:
- Pulpotomy: This procedure removes diseased pulp tissue from the crown of the tooth and uses specialized dental agents to reduce further bacterial growth. The tooth is then restored with a protective crown.
- Pulpectomy: When the infection has spread beyond the crown and into the tooth's root, a dentist will use a pulpectomy to remove the diseased pulp within the gum. The root canal is cleansed and disinfected of bacteria and replaced with a final restoration.
Seeking Orthodontic Treatment
Q: How important is orthodontic care like braces and retainers?
Orthodontic care is an essential part of having a healthy, radiant smile with straight teeth and a properly aligned jaw. Bite problems and alignment issues can be pinpointed as young as age 3 with the help of dental radiographs, but actual orthodontic procedures may not start until years later. Treatment is usually broken up into three distinct parts:
Stage I: Early treatment from ages 2 to 6 can address underdeveloped dental arches, premature loss of teeth, or harmful habits like thumb sucking. Preventative treatment at a young age can cut back on orthodontic costs later in life.
Stage II: In the Mixed Dentition phase, children of 6 to 12 years old are beginning to have a full set of adult teeth and rear molars. Jaw and tooth alignment problems can be successfully treated because the child's soft tissue is especially responsive to orthodontic procedures.
Stage III: Adolescent Dentition is usually the last step in orthodontic care in which we are dealing only with permanent adult teeth. Addressing your child's bite (i.e. overbites, underbites, and crossbites) is usually the final step in orthodontic treatment.
Perinatal and Early Infant Oral Care
Q: Are there any steps I can take during pregnancy to promote dental health?
Adequate dental care during pregnancy is an important part of ensuring the health of your child. Research shows that only about one-third of women visit the dentist during pregnancy, even though this is an important component to overall prenatal health. Undiagnosed periodontal disease can actually increase the risk of low birth weights and preterm births. It is important that you seek routine dental visits during pregnancy.
Q: Is there anything I can do with my child before his/her teeth grow in?
When it comes to early infant oral care, teeth haven't erupted yet, but you should use a soft washcloth or gauze to clean food or drink residue from the gums. Simply wrap your finger in soft material and lightly wipe your child's gums to reduce the presence of bacteria in the mouth.
Scheduling Your First Visit
Q: When should I schedule my first dentist appointment?
A: Leading organizations in pediatric dentistry suggest that you should schedule your child's first visit to the dentist by one year of age. By the time teeth begin erupting, it's a good idea to visit a pediatric dentist, who can give you important information about brushing and teething.
Q: Why do some dentists call their office a “dental home?”
Instead of calling it a dentist office, practitioners often refer to a child's “dental home.” At All Star Pediatric Dentistry, we believe that your dentist is more than someone that provides diagnoses and dental procedures. Instead, your dentist should foster a relationship between the family, child, and staff to address all aspects of oral care.
Q: When do my child's primary teeth begin coming in?
Primary dental eruption is certainly not a concrete standard from one child to the next and we find that young child can vary drastically at the age they begin sprouting their first teeth. As a rule of thumb, a toddler's first baby teeth (the lower central incisors) usually erupt between 6-10 months. The next teeth that usually erupt are the upper central incisors, usually around 8-12 months. By 33 months, your child's second molars will probably have grown in for a full set of baby teeth.
Q: Is constant use of a baby bottle bad for my child's oral health?
There tends to be a large coincidence of dental caries in young children that frequently sip on bottles with sugary drinks. Milk (including breast milk), formula, and other sweetened drinks like fruit juices can lead to a mouthful of cavities if not properly cared for. Sugary buildups can lead to bacteria growth that slowly breaks down the enamel of your baby's primary teeth - this is called "baby bottle tooth decay."
- Instead of putting your baby to sleep with a bottle full of milk or juice, substitute it for water. This sudden change may make your child uncomfortable at first, so you can slowly dilute the bottle with water over the course of a few weeks.
Q: How much does diet influence cavity formation?
Diet, hygiene habits, and genetics are the three biggest factors that influence children's cavities. As we all know, candy and sugary snacks are bad news for a developing mouth. While it might be hard to keep your child away from junk food, a healthy diet is one of the best defenses against cavities. Naturally sweet foods like raisins are a great substitute for gummy snacks and crunchy, fibrous vegetables like carrots and apples can actually strengthen your teeth. Check out our blog post for some healthy snacking ideas!
Q: What kind of daily steps can my child take to prevent cavities?
Oral hygiene should occur on a twice-daily basis to ensure that food residues are being properly scrubbed from the enamel surface of your child's teeth. Generally, children should brush early in the morning and before bedtime, using an ADA-approved toothpaste and a soft-bristled brush. Flossing should also occur on a daily basis to remove hard-to-reach bacteria from between the teeth. Fluoride mouthwashes are also a good idea to cut down on plaque and the chances of developing gingivitis later in life.
Q: What are dental sealants?
About 80% of all children's cavities are found on the chewing surfaces (or grooves) of the rear molars. This is the part of the mouth that comes in contact with the most food and is the hardest to scrub with a toothbrush, so it's no wonder that a majority of children's cavities are found here. Dental sealants are a protective and preventive measure to reduce the risk of cavities. Because of the deep fissures in these teeth, a sealant is placed along the surface of the tooth to act as a barrier against plaque and acid.
Q: What is fluoride? Is it safe to use?
Fluoride is an essential component of modern dental care. It is found in our toothpastes, our drinking water, and even some of our favorite foods. It is nearly impossible to avoid fluoride completely, and it poses no significant health risks. In fact, its effectiveness in preventing cavities is the biggest reason we find it in so many products and foods today. But, excessive fluoride ingestion can lead to a condition called fluorosis.
Q: What is fluorosis and how can I prevent it?
Fluorosis is a dental condition caused by the overconsumption of fluoride, causing discolorations on the surface of teeth. These discolorations may begin as white streaks, but can turn into large brown spots if left untreated. Early childhood exposure to too much fluoride is one of the biggest factors that contributes to fluorosis. If your child is too young to spit out toothpaste when they're finished, they may be ingesting unhealthy amounts of fluoride. Here are a few steps to limit unnecessary fluoride consumption:
Q: Should my child wear a mouth guard during sports?
- Use only a pea-size amount of toothpaste with your children's teeth.
- Ask your dentist about fluoride free toothpaste until your child is old enough to spit toothpaste on his or her own.
- Check with your local water utilities to see the level of fluoride presently in tap water and ask your dentist about using additional fluoride supplements.
- Keep fluoride-containing products like toothpaste and mouthwash out of the reach of young children.
If your child is old enough to begin participating in recreational sports, then you should certainly purchase a protective mouth guard. In sports like basketball, soccer, baseball, and football, physical contact can easily lead to a broken tooth or injuries to the tongue or lips. This small piece of equipment is essential to preventing sports injuries. Make sure that you purchase a mouth guard before your child steps onto the field.
Xylitol Food Products
Q: What is xylitol and can it help prevent cavities?
Xylitol is a sugar substitute primarily found in gum and other oral care products. As a sweetener, this compound can be found naturally in foods like berries and mushrooms. Gum companies have started using this compound as an alternative to sugary sweeteners and it can actually prove beneficial to oral health. Xylitol can drastically reduce the chances of cavity formation. If your child likes chewing gum, switch to a xylitol product that actually boosts their dental health!
Adolescent and Teenage Dentistry
Q: How often should my teenager visit the dentist? Is a pediatric dentist still the right choice?
Dentists recommend that even teenagers and adolescents should still see the dentist every 6 months. At this point, your teenager probably has a full set of adult teeth, but a pediatric dentist can still be the right option. With Dr. John, our office gives special attention to teenage dental problems and we understand that things like orthodontic treatment are a common part of teenage years. Our pediatric practice is perfectly catered to understanding how your child's mouth has developed and will continue to grow throughout their life.
Q: What's the deal with oral piercings?
Some teenagers may find lip or tongue piercings to be a cool new trend, but our office, along with the American Dental Association (ADA), strongly discourages patients from seeking oral piercings. While common problems include swelling, pain, and minor infections, these piercings can result in harmful health conditions. For example, blood clots, chipped teeth, sever gum conditions, and nerve damage can all be caused by oral piercings.
Q: What kind of effect can tobacco have on a teenage mouth?
We are surely taught about the dangers of tobacco in school and by parents, but dentists often have firsthand horror stories about the damage that smokeless tobacco and cigarettes can cause. Many teens will turn to smokeless tobacco as a “healthier” alternative to cigarettes, but this couldn't be any further from the truth. After only a few months of use, chewing or dipping tobacco can create open sores or abscesses in the mouth. If tobacco use isn't stopped, it can lead to pre-cancerous leukoplakia, which often needs extensive surgery to remove. Keep your teenager’s mouth healthy and explain the dangers of smokeless tobacco.