Click on a topic of interest for more
What is a Pediatric Dentist?
Your Child's First Dental Visit
Why are the Primary Teeth
Dental Radiographs (X-rays)
Care of your Child's Teeth
Good Diet = Healthy Teeth
How Do I Prevent Cavities
Baby Bottle Tooth Decay (Early Childhood
When will my Baby Start
Eruption of your Child's Teeth
What is Pulp Therapy?
What's the Best Toothpaste for
Does your Child Grind his Teeth at Night? (Bruxism)
Tongue Piercing - Is
it Really Cool?
Tobacco - Bad News in Any Form
What is the Best
Time for Orthodontic Treatment?
For more information on
oral health care needs, please visit the website for the
American Academy of Pediatric Dentistry.
What Is A
The pediatric dentist is a dental professional who has
an additional two to three years of specialized training after dental school
and is dedicated to the oral health of children ranging in age 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 trained in the psychology of children and is best
qualified to meet children’s needs. Pediatric dentists are taught to
recognize diseases that are typically diagnosed in childhood years.
Additionally, pediatric dentists are further trained in sedation techniques,
and if need be, can practice advanced procedures in an operating room
setting. Pediatric dentistry is a recognized specialty of the American
Dental Association (ADA).
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Your Childs First Dental Visit
According to the American
Academy of Pediatric Dentistry (AAPD), your child should visit the dentist
by his/her 1st birthday. You can make the first visit to the
dentist enjoyable and positive. It is helpful to let the child interact
with the pediatric dentist and staff. The pediatric dentist and staff will
try to engage the child in conversation. The parent’s role should be one of
a silent observer and allow the child to build a rapport with the dental
specialist. Empowering the child to have a dominant role in his/her own
dental health will foster good oral hygiene practices into adulthood.
Many parents may be fearful
or apprehensive of their own dental visits, however, it is imperative that
the parent’s feelings are NOT passed on or communicated to your child
regarding their visit. We are fully aware that a child’s tears are a
natural response to the unknown. We are trained and experienced in
comforting a nervous or fearful child, and in many cases, can turn their
anxiety around and continue to have a positive experience. Through use of
positive reinforcement, even the most tentative of children can successfully
complete an exam or treatment and in doing so, feel a strong sense of
Your child should be
informed of the visit and told that the dentist and their staff will explain
all procedures and answer any questions. The less “to-do” concerning the
visit, the better.
It is best if you
refrain from using words around your child that might cause unnecessary
fear, such as “needle,” “shot,” “pull,” “drill,” or “hurt,”. Pediatric
dental offices make a practice of using words that convey the same message,
but are pleasant and non-frightening for the child. [Back to Top]
Why Are The Primary Teeth So
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.
NITROUS OXIDE [Back to Top]
“The American Academy of Pediatric Dentistry (AAPD) recognizes nitrous
oxide/oxide inhalation as a safe and effective technique to reduce anxiety,
produce analgesia, and enhance effective communication between a patient and
health care provider. The need to diagnose and treat, as well as the safety
of the patient and practitioner, should be considered before using nitrous
oxide.” Pediatric Dentistry, Vol. 27, No. 7, Reference Manual 2005-2006, p
107-109. Also see American Dental Association: http://ada.org/prof/resources/positions/statements/useof.asp.
Nitrous oxide (N2O) is a quick acting and safe analgesic agent when
administered by a trained, knowledgeable professional. N2O is also referred
to as “laughing gas,” “sweet air,” or, “the gas.” The nitrous oxide system
in our office has safeguards installed whereby the amount of nitrous oxide
is regulated and is always accompanied by a continuous flow of oxygen. The
use of nitrous oxide is not mandatory in every dental procedure, but is
considered “standard of care” for certain procedures and/or for certain
children. The disadvantages of nitrous oxide use are few, however cost could
be the biggest as some insurance companies do not reimburse for its use
during some dental procedures. The risks of nitrous oxide are minimal but
sometimes patients experience lightheadedness or feelings of nausea. The
effects of nitrous oxide are short-lived as nitrous oxide leaves the body
within two minutes of cessation. The alternative measure to nitrous oxide,
is to simply decline its use during treatment. Remember the use of nitrous
oxide is not mandatory, however, is recommended for your child’s comfort
Radiographs (X-Rays) are a
vital and necessary part of your child’s dental diagnostic process. Without
them, certain dental conditions can and will be missed. In our office, we
use digital X-Rays which expose children to 90% less radiation than
traditional X-Ray modalities. Digital X-Rays are instantaneous, so children
and parents can see images immediately upon taking them. Digital X-Rays
also have the ability to be enlarged, so areas of interest can be closely
examined by the doctor. Finally, digital X-Rays can be sent electronically
(emailed) to other specialists such as orthodontists, oral surgeons,
endodontists, or to another dentist for a second opinion.
Radiographs detect much
more than cavities. For example, radiographs may be needed to survey
erupting teeth, diagnose bone diseases, evaluate the results of an injury,
or plan orthodontic treatment. Radiographs allow dentists to diagnose and
treat health conditions that cannot be detected during a clinical
examination. If dental problems are found and treated early, dental care is
more comfortable for your child and more affordable for you.
The American Academy of
Pediatric Dentistry recommends radiographs and examinations every six months
for children with a high risk of tooth decay. On average, most pediatric
dentists request radiographs approximately once a year. Approximately every
3 years it is a good idea to obtain a complete set of radiographs, either a
panoramic and bitewings or periapicals and bitewings.
A panoramic radiograph is a
growth and development X-Ray and is taken every 3 to 4 years. It shows the
development of the permanent teeth, their position in relation to the
primary (baby) teeth, missing teeth, or any extra teeth that may be
present. The X-Ray will also show any anomalies in the bone such as a cyst
or a tumor.
Bitewing X-Rays are taken
to detect decay between the teeth. When teeth touch, it is
impossible to see between them. Bitewing X-Rays let us visualize between
these teeth and are essential in the diagnosis of early decay between the
Periapical X-Rays allow the
dentist to visualize the entire tooth, including the root structure. These
X-Rays are used to visualize the structures/bone that hold the teeth in
place. These types of films are especially important in cases, such as
trauma, where roots or bone may be damaged. Periapical X-Rays can also help
visualize the development of permanent teeth and can help diagnose extra or
Pediatric dentists are
particularly careful to minimize the exposure of their young patients to
radiation. With contemporary safeguards, the amount of radiation received in
a dental X-Ray examination is extremely small and the risk is negligible. In
fact, the dental radiographs represent a far smaller risk than an undetected
and untreated dental problem. Lead body aprons with thyroid collars when
appropriate, will protect your child. Today’s equipment filters out
unnecessary X-Rays and restricts the X-Rays beam to the area of interest.
High-speed film and proper shielding assure that your child receives a
minimal amount of radiation exposure.
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Care of Your Childs Teeth
Begin daily brushing
as soon as the child’s first tooth erupts. Initially, just a wet toothbrush
or a toothbrush with non-fluoridated toothpaste can be used until the child
learns to spit. A pea-size amount of fluoride toothpaste can be used after
the child is old enough not to swallow it. By age 4 or 5, children should be
able to brush their own teeth twice a day with supervision. At about age
seven, children do not need to be directly supervised while they brush,
however parents should still make sure they are doing a thorough job. Each
child is different; your dentist or hygienist can help you determine whether
the child has the skill level to brush properly.
Proper brushing removes
plaque from the inner, outer and chewing surfaces. When teaching children to
brush, place toothbrush at a 45 degree angle; start along gum line with a
soft bristle brush in a gentle circular motion. Brush the outer surfaces of
each tooth, upper and lower. Repeat the same method on the inside surfaces
and chewing surfaces of all the teeth. Finish by brushing the tongue to help
freshen breath and remove bacteria. Be sure to thoroughly rinse the
toothbrush to remove all bacteria and avoid reintroducing bacteria into the
mouth during the next brushing. A tongue scraper can be used instead of a
toothbrush to remove bacteria from the tongue.
Flossing removes plaque
between the teeth where a toothbrush can’t reach. Flossing should begin when
any two teeth touch. You should floss the child’s teeth until he or she can
do it alone, approximately at 9 or 10 years old depending upon your child’s
dexterity. For children, flossers with handles are a great, and fun, way to
floss, especially for small children with developing dexterity. For
traditional string flossing, use about 18 inches of floss, winding most of
it around the middle fingers of both hands. Hold the floss lightly between
the thumbs and forefingers. Use a gentle, back-and-forth motion to guide the
floss between the teeth. Curve the floss into a C-shape and slide it into
the space between the gum and tooth until you feel resistance. Gently scrape
the floss against the side of the tooth. Repeat this procedure on each
tooth. Don’t forget the backs of the last four teeth.
Generally speaking, wax
floss is typically easier to use, especially when the teeth are close
together. When flossing a child, it is sometimes easier to lay them down.
This will make it easier to visualize what you are doing and the child will
be unable to back away.
[Back to Top]
Good Diet = Healthy Teeth
eating habits lead to healthy teeth. Like the rest of the body, the teeth,
bones and the soft tissues of the mouth need a well-balanced diet. Children
should eat a variety of foods from the five major food groups. Most snacks
that children eat contain carbohydrates and can lead to cavity formation.
Carbohydrates break down into simple sugars in the mouth and start the
cavity process. These simple sugars feed the bacteria in the mouth thereby
creating acids that lower the pH. The acids attack the dental enamel and
weaken it, allowing for the formation of cavities. The more frequently a
child snacks, the more acidic their mouth will become and the greater the
risk for tooth decay. The time between meals or snacks allows for the mouth
to reach a neutral pH level where the risk of tooth decay drastically
decreases. The length of time food remains in the mouth also plays a role
in tooth health. For example, hard candy and breath mints stay in the mouth
a long time, which cause longer acid attacks on tooth enamel. If your child
must snack, choose nutritious foods such as vegetables, low-fat yogurt, and
low-fat cheese which are healthier and better for children’s teeth.
Remember, even if your child is snacking on healthy foods, the more
frequently a child eats, or continually grazes during the day, the greater
the risk for tooth decay. It is best to have planned snacks between meals
and consume nothing but water after toothbrushing before bed.
[Back to Top]
Do I Prevent Cavities?
Cavities are caused by
of the mouth (see
Diet = Healthy Teeth" for more information),
Anatomy of teeth can
affect the formation of cavities. If the chewing surfaces of molars and
premolars have numerous and/or deep grooves, bacteria and plaque lodge in
these grooves increasing the risk of decay.
Genetics play a role in
not only how the teeth are shaped but how much bacteria a person inherently
has in their mouth. The more bacteria a person harbors in their mouth, the
more acidic their mouth will become after carbohydrates are ingested.
Additionally, the more bacteria a person has, the longer it will take for
the acid to clear from the mouth and for the pH to neutralize.
Good oral hygiene
removes bacteria and the left over food particles that combine to create
cavities. For infants, use a wet gauze or clean washcloth to wipe the plaque
from teeth and gums. Avoid putting your child to bed with a bottle filled
with anything other than water. See "Baby
Bottle Tooth Decay" for more information.
Cavities are preventable
through good oral hygiene, regular dental check-ups, and proper nutrition.
For older children, parents should brush their teeth at least twice a
day. Also, watch the number of snacks containing carbohydrates and sugar
that you give your children. Drinking water, or for older children, chewing
sugar-free gum that contains xylitol (like Trident) following a meal can
help in washing away acid causing bacteria.
The American Academy of
Pediatric Dentistry recommends six month visits to the pediatric dentist
beginning at your child’s first birthday. Routine visits will start your
child on a lifetime of good dental health.
Your pediatric dentist
may also recommend preventive resins or home fluoride treatments for your
child. Preventive resins can be applied to your child’s molars and premolars
to prevent decay on hard to clean surfaces.
[Back to Top]
At our office, we use preventive resins to prevent decay on the chewing
surfaces (grooves) of molars and premolars (back teeth). Preventive resins
are different than traditional sealants in that preventive resins are made
of a more durable material that adhere better to the enamel of the tooth.
These resins have been found to last longer than traditional sealants. Once
applied, it is rare that a preventive resin would have to be replaced or
repaired, unlike traditional sealants. Therefore, by using preventive
resins, children are awarded the long term benefit of less overall treatment
time and parents benefit too from the cost effectiveness of a single
procedure. A preventive resin is a white plastic material that is applied to
the chewing surfaces (grooves) of the back teeth (premolars and molars),
where four out of five cavities in children are found. This resin acts as a
barrier to food, plaque and acid, thus protecting the decay-prone areas of
Before Resin Applied After Resin Applied
Before Resin Applied
After Resin Applied
Most cavities form on the chewing
surfaces of teeth; therefore preventive resins greatly decrease the
chances of cavity formation in a child’s mouth. However, since preventive
resins are applied only to the chewing surfaces of back teeth, it is
important to floss between these teeth where the enamel is not protected
and cavities have the potential to form.
[Back to Top]
Baby Bottle Tooth Decay (Early
One serious form of decay
among young children is baby bottle tooth decay. This condition is caused by
frequent and long exposures of an infant’s teeth to liquids that contain
sugar. Among these liquids are milk (including breast milk), formula, fruit
juice and other sweetened drinks.
Putting a baby to bed for a
nap or at night with a bottle other than water can cause serious and rapid
tooth decay. Sweet liquids pool around the child’s teeth giving plaque
bacteria an opportunity to produce acids that attack tooth enamel. If you
must give the baby a bottle as a comforter at bedtime, it should contain
only water. If your child won't fall asleep without the bottle and its
usual beverage, gradually dilute the bottle's contents with water over a
period of two to three weeks.
After each feeding, wipe
the baby’s gums and teeth with a damp washcloth or gauze pad to remove
plaque. The easiest way to do this is to sit down, place the child’s head in
your lap or lay the child on a dressing table or the floor. Whatever
position you use, be sure you can see easily into the child’s mouth.
[Back to Top]
Will My Baby Start Getting Teeth?
Teething, the process of baby (primary) teeth coming through the gums
into the mouth, is variable among individual babies. Some babies get their
teeth early and some get them late. In general the first baby teeth are
usually the lower front (anterior) teeth and usually begin erupting between
the age of 6-8 months. See "Eruption
of Your Child’s Teeth" for
[Back to Top]
Eruption Of Your Childs
Childrens teeth begin forming before birth. As early as 4
months, the first primary (or baby) teeth to erupt through the gums are the lower central
incisors, followed closely by the upper central incisors. Although all 20 primary teeth
usually appear by age 3, the pace and order of their eruption varies.
Permanent teeth begin appearing around age 6, starting with the
first molars and lower central incisors. This process continues until approximately age
Adults have 28 permanent teeth, or up to 32 including the third
molars (or wisdom teeth).
[Back to Top]
Clean the area of the affected tooth thoroughly. Rinse the mouth vigorously
with warm water or use dental floss to dislodge impacted food or debris. If
the pain still exists, contact your child's dentist. DO NOT place aspirin
on the gum or on the aching tooth. If the face is swollen, apply cold
compresses and contact your dentist immediately.
Cut or Bitten Tongue,
Lip or Cheek:
Apply ice to bruised areas. If there is bleeding, apply firm but gentle
pressure with sterile gauze or cloth. If bleeding does not stop after 15
minutes or it cannot be controlled by simple pressure, take the child to
hospital emergency room.
Knocked Out Primary (Baby)Tooth: Find the tooth. Inspect the tooth for fractures. Call your pediatric
dentist. Under NO circumstances should you try to reinsert the tooth, as
this could damage the tooth bud of the permanent adult tooth that will
eventually develop. The pediatric dentist may want to see the child and the
tooth, if it could be found, to see if there may be a tooth fragment still
left inside the bone socket.
If there is any question
whether the tooth is a baby or adult tooth, place the tooth in a cup
containing the patient’s saliva or milk and call a pediatric dentist
IMMEDIATELY! Time is a critical factor in saving an adult tooth. DO NOT
attempt to reinsert the tooth.
Permanent (Adult)Tooth: Find the tooth. Handle the tooth by the crown, not the root portion.
You may rinse the tooth gently but DO NOT clean or handle the tooth
unnecessarily. Inspect the tooth for fractures. If it is sound, try to
reinsert it in the socket. Have the patient hold the tooth in place by
biting on a gauze. If you cannot reinsert the tooth, transport the tooth in
a cup containing the patient’s saliva or milk. If the patient is old enough,
the tooth may also be carried in the patient’s mouth under the tongue. The
patient must see a dentist IMMEDIATELY! Time is a critical factor in saving
Following a Fall:
In some instances, a child may fall in such a way that the tooth gets forced
up into the bone and will appear as a missing or partially erupted tooth.
It is important that the pediatric dentist is contacted immediately to
evaluate the trauma to the tooth. In many cases, a primary tooth will be
left alone to re-erupt. An adult tooth can be pulled back down into normal
position and splinted to aid in healing. X-Rays will need to be taken to
evaluate the teeth, bony anatomy, and to exclude the possibility of any
additional trauma that may have occurred.
[Back to Top]
Fluoride is a
naturally occurring element, which has been shown to be beneficial to teeth
by maintaining the strength of dental enamel. However, too little or too
much fluoride can be detrimental to the teeth. Little or no fluoride will
not strengthen the teeth to help them resist cavities. Excessive fluoride
ingestion by preschool-aged children can lead to dental fluorosis, which is
a chalky white to even brown discoloration of the permanent teeth (see
fluorosis). Many children often get more fluoride than their parents
realize. Being aware of a child’s potential sources of fluoride can help
parents prevent the possibility of dental fluorosis.[Back to Top]
is Pulp Therapy?
The pulp of a tooth is the inner central core
of the tooth. The pulp contains nerves, blood vessels, connective
tissue and reparative cells. The purpose of pulp therapy in Pediatric
Dentistry is to maintain the vitality of the affected tooth (so the tooth is
Dental caries (cavities) and traumatic injury
are the main reasons for a tooth to require pulp therapy. Pulp therapy
is often referred to as a "nerve treatment", "children's root canal", or "pulpotomy".
A pulpotomy removes the diseased pulp tissue
within the crown portion of the tooth. Next, an agent is placed to
prevent bacterial growth and to calm the remaining nerve tissue. This
is followed by a final restoration (usually a stainless steel crown).
the Best Toothpaste for my Child?
Tooth brushing is one of the most important tasks for good oral health.
Many toothpastes, and/or tooth polishes, however, can damage young smiles.
They contain harsh abrasives which can wear away young tooth enamel. When
looking for a toothpaste for your child make sure to pick one that is
recommended by the American Dental Association. These toothpastes have
undergone testing to insure they are safe to use.
Remember, children should spit out toothpaste after brushing to avoid
getting too much fluoride. If too much fluoride is ingested, a condition
known as fluorosis can occur. If your child is too young or unable to spit
out toothpaste, consider providing them with a fluoride free toothpaste,
using no toothpaste, or using only a "pea size" amount of
[Back to Top]
Does Your Child Grind His Teeth
At Night? (Bruxism)
Parents are often concerned about the nocturnal grinding of teeth
(bruxism). Often, the first indication is the noise created by the child grinding on their
teeth during sleep. Or, the parent may notice wear (teeth getting shorter) to the
dentition. One theory as to the cause involves a psychological component. Stress due to a
new environment, divorce, changes at school; etc. can influence a child to grind their
teeth. Another theory relates to pressure in the inner ear at night. If there are pressure
changes (like in an airplane during take-off and landing when people are chewing gum, etc.
to equalize pressure) the child will grind by moving his jaw to relieve this pressure.
The majority of cases of pediatric bruxism do not require any
treatment. If excessive wear of the teeth (attrition) is present, then a mouth guard
(night guard) may be indicated. The negatives to a mouth guard are the possibility of
choking if the appliance becomes dislodged during sleep and it may interfere with growth
of the jaws. The positive is obvious by preventing wear to the primary dentition.
The good news is most children outgrow bruxism. The grinding gets
less between the ages 6-9 and children tend to stop grinding between ages 9-12. If you
suspect bruxism, discuss this with your pediatrician or pediatric dentist.
[Back to Top]
Sucking is a natural reflex and infants and young children may use
thumbs, fingers, pacifiers and other objects on which to suck. It may make them feel
secure and happy or provide a sense of security at difficult periods. Since
is relaxing, it may induce sleep.
Thumb sucking that persists beyond the eruption of the permanent
teeth can cause problems with the proper growth of the mouth and tooth alignment. How
intensely a child sucks on fingers or thumbs will determine whether or not dental problems
may result. Children who rest their thumbs passively in their mouths are less likely to
have difficulty than those who vigorously suck their thumbs.
Children should cease thumb sucking by the time their permanent front
teeth are ready to erupt. Usually, children stop between the ages of two and four. Peer
pressure causes many school-aged children to stop.
Pacifiers are no substitute for thumb sucking. They can affect the
teeth essentially the same way as sucking fingers and thumbs. However, use
of the pacifier can be controlled and modified more easily than the thumb or finger habit.
If you have concerns about thumb sucking or use of a pacifier, consult your pediatric
A few suggestions to help your child get through thumb
[Back to Top]
- Instead of scolding children for thumb sucking, praise them when they
- Children often suck their thumbs when feeling insecure. Focus on
correcting the cause of anxiety, instead of the thumb sucking.
- Children who are sucking for comfort will feel less of a need when
their parents provide comfort.
- Reward children when they refrain from sucking during difficult
periods, such as when being separated from their parents.
- Your pediatric dentist can encourage children to stop sucking and
explain what could happen if they continue.
- If these approaches dont work, remind the children of their
habit by bandaging the thumb or putting a sock on the hand at night. Your pediatric
dentist may recommend the use of a mouth appliance.
Piercing – Is it Really Cool?
You might not be surprised anymore to see people with
pierced tongues, lips or cheeks, but you might be surprised to know just how
dangerous these piercings can be.
There are many risks involved with oral piercings
including chipped or cracked teeth, blood clots, or blood poisoning. Your
mouth contains millions of bacteria, and infection is a common complication
of oral piercing. Your tongue could swell large enough to close off your
Common symptoms after piercing include pain, swelling,
infection, an increased flow of saliva and injuries to gum tissue.
Difficult-to-control bleeding or nerve damage can result if a blood vessel
or nerve bundle is in the path of the needle.
So follow the advice of the American Dental
Association and give your mouth a break – skip the mouth jewelry.
[Back to Top]
– Bad News in Any Form
Tobacco in any form can jeopardize your child’s
health and cause incurable damage. Teach your child about the dangers of
Smokeless tobacco, also called spit, chew or snuff, is
often used by teens who believe that it is a safe alternative to smoking
cigarettes. This is an unfortunate misconception. Studies show that spit
tobacco may be more addictive than smoking cigarettes and may be more
difficult to quit. Teens who use it may be interested to know that one can
of snuff per day delivers as much nicotine as 60 cigarettes. In as little as
three to four months, smokeless tobacco use can cause periodontal disease
and produce pre-cancerous lesions called leukoplakias.
If your child is a tobacco user you should watch for
the following that could be early signs of oral cancer:
- A sore that won’t heal.
- White or red leathery patches on the lips, and on
or under the tongue.
- Pain, tenderness or numbness anywhere in the mouth
- Difficulty chewing, swallowing, speaking or moving
the jaw or tongue; or a change in the way the teeth fit together.
Because the early signs of oral cancer usually are not
painful, people often ignore them. If it’s not caught in the early stages,
oral cancer can require extensive, sometimes disfiguring, surgery. Even
worse, it can kill.
Help your child avoid tobacco in any form. By doing
so, they will avoid bringing cancer-causing chemicals in direct contact with
their tongue, gums and cheek.
[Back to Top]
is the Best Time for Orthodontic Treatment?
Developing malocclusions, or bad bites, can be
recognized as early as 2-3 years of age. Often, early steps can be taken to
reduce the need for major orthodontic treatment at a later age.
Stage I – Early Treatment: This period of treatment
encompasses ages 2 to 6 years. At this young age, we are concerned with
underdeveloped dental arches, the premature loss of primary teeth, and
harmful habits such as finger or thumb sucking. Treatment initiated in this
stage of development is often very successful and many times, though not
always, can eliminate the need for future orthodontic/orthopedic treatment.
Stage II – Mixed Dentition: This period covers the
ages of 6 to 12 years, with the eruption of the permanent incisor (front)
teeth and 6 year molars. Treatment concerns deal with jaw malrelationships
and dental realignment problems. This is an excellent stage to start
treatment, when indicated, as your child’s hard and soft tissues are usually
very responsive to orthodontic or orthopedic forces.
Stage III – Adolescent Dentition: This stage deals
with the permanent teeth and the development of the final bite relationship.
[Back to Top]
When a child begins to participate in recreational
activities and organized sports, injuries can occur. A properly fitted mouth
guard, or mouth protector, is an important piece of athletic gear that can
help protect your child’s smile, and should be used during any activity
that could result in a blow to the face or mouth.
Mouth guards help prevent broken teeth, and injuries
to the lips, tongue, face or jaw. A properly fitted mouth guard will stay in
place while your child is wearing it, making it easy for them to talk and
Ask your pediatric dentist about custom and
store-bought mouth protectors.
[Back to Top]
retained baby teeth-
Sometimes an adult tooth can erupt, but the primary, or baby tooth, has not
yet fallen out. In these instances, the baby tooth needs to be extracted in
order to allow for the adult tooth to completely erupt and be in proper
alignment. In many cases, an emerging crooked adult tooth will fall into
proper alignment once the baby tooth is extracted.
An abscess is a small, localized infection that begins when a tooth’s nerve
is damaged by decay or trauma. This infection usually becomes visible on the
cheek-side of the gum tissue, near the affected tooth. It appears as a
small pimple or boil, or the gums can appear deep-red and swollen. If gone
untreated, the abscess can result in a more systemic infection that may
result in hospitalization.
malformation of enamel during tooth development caused by unknown origins.
A tooth with dysplasia may appear with white or brown spots depending on the
severity, or may even appear with frank holes in the tooth. A dysplastic
tooth can be sensitive, specifically to cold. A parent who believes that
their child has a dysplastic tooth should contact a pediatric dentist, for
this condition can be confused with dental caries, (cavities). Treatment
can range from small, traditional white fillings to stainless steel crowns,
in severe cases.
Loss of naturally present calcium in the tooth as a result of
demineralization. Demineralization occurs when plaque is allowed to sit on
the teeth and leach calcium from the tooth. It appears as white bands, or
halos, where plaque has accumulated. A decalcified area is a weakened area
and is more prone to developing into a cavity. A parent who believes that
their child has decalcification of a tooth should contact a pediatric
dentist, for this condition can develop into dental caries, (cavities).
is the chalky white to even brown discoloration of the permanent teeth due
to the ingestion of too much fluoride.
Some of the sources of
ingested fluoride are:
too much fluoridated toothpaste at an early age.
inappropriate use of fluoride supplements.
sources of fluoride in the child’s diet.
Two and three year olds may
not be able to expectorate (spit out) fluoride-containing toothpaste when
brushing. As a result, these youngsters may ingest an excessive amount of
fluoride during tooth brushing. Toothpaste ingestion during this critical
period of permanent tooth development is the greatest risk factor in the
development of fluorosis.
Excessive and inappropriate
intake of fluoride supplements may also contribute to fluorosis. Fluoride
drops and tablets, as well as fluoride fortified vitamins should not be
given to infants younger than six months of age. After that time, fluoride
supplements should only be given to children after all of the sources of
ingested fluoride have been accounted for and upon the recommendation of
your pediatrician or pediatric dentist.
Certain foods contain high
levels of fluoride, especially powdered concentrate infant formula,
soy-based infant formula, infant dry cereals, creamed spinach, and infant
chicken products. Please read the label or contact the manufacturer. Some
beverages also contain high levels of fluoride, especially decaffeinated
teas, white grape juices, and soda or juice drinks manufactured in
Parents can take the
following steps to decrease the risk of fluorosis in their children’s teeth:
tooth cleanser on the toothbrush of the very young child.
than a pea sized drop of children’s toothpaste on the brush when brushing.
all of the sources of ingested fluoride before requesting fluoride
supplements from your child’s physician or pediatric dentist.
any fluoride-containing supplements to infants until they are at least 6
fluoride level test results for your drinking water before giving fluoride
supplements to your child (check with local water utilities).
town’s water department and inquire if the water supply is fluoridated.
In some cases, an injured tooth may change color following a fall or blow to
the mouth. An injured tooth may appear off-white, to grey, or even brown
following trauma. This color change is a natural response to injury, but
could be indicative of varying types of injury. Color changes can occur in
days, weeks, or even months following the trauma. It is best to contact a
pediatric dentist as soon as discolorization is discovered to allow for the
widest possibility of treatment options for the child.
Many children’s medications contain flavoring and/or sweeteners that could
potentially increase the risk of cavities. Upon administering medications
to your child, it is important to brush their teeth or wipe out any of the
residue so staining or the risk of cavities will be minimized.
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