Pediatric Dentistry
   Dental specialty focusing on treatment of children and young adults

Common Questions Asked
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When should I take my child to the dentist for the first check-up?
     In order to prevent dental problems, your child should see a pediatric dentist when the first tooth appears, or no later than his/her first birthday.

What is the difference between a pediatric dentist and a family dentist?
    Pediatric dentists are the pediatricians of dentistry. A pediatric dentist has two to three years specialty training following dental school and limits his/her practice to treating children only. Pediatric dentists are primary and specialty oral care providers for infants and children through adolescence, including those with special health needs.

Are baby teeth really that important to my child?
    Primary, or "baby," teeth are important for many reasons. Not only do they help children speak clearly and chew naturally, they also aid in forming a path that permanent teeth can follow when they are ready to erupt.

How can I best care for my child's teeth?
    Good dental hygiene habits should begin before your child's first tooth comes in. Wiping your baby's gums with a soft damp cloth after feedings helps to prevent the buildup of bacteria. When teeth appear, start using a soft children's toothbrush twice a day. Once your child is preschool-age, start using fluoride toothpaste. Don't cover the brush with toothpaste; a pea-sized amount is just right (see picture above). Young children tend to swallow most of the toothpaste, and swallowing too much fluoride toothpaste can cause permanent stains on their teeth.

Are thumb sucking and pacifier habits harmful for a child's teeth?
    Thumb and pacifier sucking habits will generally only become a problem if they go on for a very long period of time. Most children stop these habits on their own, but if they are still sucking their thumbs or fingers when the permanent teeth arrive, a mouth appliance may be recommended by your pediatric dentist.

How can I prevent decay caused by nursing?
    Avoid nursing children to sleep or putting anything other than water in their bed-time bottle. Also, learn the proper way to brush and floss your child's teeth. Take your child to a pediatric dentist regularly to have his/her teeth and gums checked. The first dental visit should be scheduled by your child's first birthday.

How often does my child need to see the pediatric dentist?
    A check-up every six months is recommended in order prevent cavities and other dental problems. However, your pediatric dentist can tell you when and how often your child should visit based on their personal oral health.

How does a pediatric dentist help with dental anxiety?
    Pediatric dentists have special training in helping anxious children feel secure during dental treatment. And, pediatric dental offices are designed for children. Staff members choose to work in a pediatric dental practice because they like kids. So, most children are calm, comfortable and confident in a pediatric dental office.

What if a child misbehaves during treatment ?
    Occasionally a child's behavior during treatment requires assertive management to protect him or her from possible injury. Voice control (speaking calmly but firmly) usually takes care of it. Some children need gentle restraint of the arms or legs as well. Mild sedation, such as nitrous oxide/oxygen or a sedative, may benefit an anxious child. If a child is especially fearful or requires extensive treatment, other sedative techniques or general anesthesia may be recommended. Infants and some young children may feel more confident when parents stay close during treatment. With older children, doctor-child communication is often enhanced if parents remain in the reception room.

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Toothpaste:

When should we begin using it and how much should we use?
    Fluoridated toothpaste should be introduced when a child is 2-3 years of age. Prior to that, parents should clean the child's teeth with water and a soft-bristled toothbrush. When toothpaste is used after age 2-3, parents should supervise brushing and make sure the child uses no more than a pea-sized amount on the brush. Children should spit out and not swallow excess toothpaste after brushing.

How do I make my child's diet safe for his teeth?
    Make sure your child has a balanced diet, including one serving each of: fruits and vegetables, breads and cereals, milk and dairy products, and meat fish and eggs. Limiting the servings of sugars and starches will also aid in protecting your child's teeth from decay. You can also ask your pediatric dentist to help you select foods that protect your children's teeth.

How do dental sealants work?
    Sealants work by filling in the crevasses on the chewing surfaces of the teeth. This shuts out food particles that could get caught in the teeth, causing cavities. The application is fast and comfortable and can effectively protect teeth for many years.

How do I know if my child is getting enough fluoride?
    Have your pediatric dentist evaluate the fluoride level of your child's primary source of drinking water. If your child is not getting enough fluoride internally through water (especially if the fluoride level is deficient or if your child drinks bottled water without fluoride), then your pediatric dentist may prescribe fluoride supplements.

What can I do to protect my child's teeth during sporting events?
    Soft plastic mouthguards can be used to protect a child's teeth, lips, cheeks and gums from sport related injuries. A custom-fitted mouthguard developed by a pediatric dentist will protect your child from injuries to the teeth, face and even provide protection from severe injuries to the head.

What should I do if my child falls and knocks out a permanent tooth?
    The most important thing to do is to remain calm. Then find the tooth. Hold it by the crown rather than the root and try to reinsert it in the socket. If that is not possible, put the tooth in a glass of milk and take your child and the glass immediately to the pediatric dentist.

How safe are dental X-rays?
    There is very little risk in dental X-rays. Pediatric dentists are especially careful to limit the amount of radiation to which children are exposed. Lead aprons and high-speed film are used to ensure safety and minimize the amount of radiation.

How can parents help prevent tooth decay?
    Parents should take their children to the dentist regularly, beginning with the eruption of the first tooth. Then, the dentist can recommend a specific program of brushing, flossing, and other treatments for parents to supervise and teach to their children. These home treatments, when added to regular dental visits and a balanced diet, will help give your child a lifetime of health habits.

How will a pediatric dentist help my child feel comfortable?
    Pediatric dentists are trained in many methods to help children feel comfortable with dental treatment. For example, in the "Tell-Show-Do" technique, a pediatric dentist might name a dental instrument, demonstrate the instrument by using it to count your child's fingers, and then apply the instrument in treatment.
The modeling technique pairs a timid child in dental treatment with a cooperative child of similar age. Coaching, distraction, and parent participation are other possibilities to give your child confidence in dentistry. But by far the most preferred technique is praise. Every child something right during a dental visit, and pediatric dentists let children know that.

Should I accompany my child into treatment?
    Infants and some young children may feel more confident when parents stay close during treatment. With older children, doctor-child communication is often enhanced if parents remain in the reception room.

What if a child misbehaves during treatment?
    Occasionally a child's behavior during treatment requires assertive management to protect him or her from possible injury. Voice control (speaking calmly but firmly) usually takes care of it. Some children need gentle restraint of the arms or legs as well. Mild sedation, such as nitrous oxide/oxygen or a sedative, may benefit an anxious child. If a child is especially fearful or requires extensive treatment, other sedative techniques or general anesthesia may be recommended

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Thumb, Finger and Pacifier Habits

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's 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 two and four years of age. No harm is done to their teeth or jaws. However, some children repeatedly suck on a finger, pacifier or other object over long periods of time. In these children, the upper front teeth may tip toward the lip or not come in properly.

When should I worry about a sucking habit?
    Your pediatric dentist will carefully watch the way your child's teeth come in and jaws develop, keeping the sucking habit in mind at all times. For most children there is no reason to worry about a sucking habit until the permanent front teeth are ready to come in.

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 if your child doesn't stop. This advice, coupled with support from parents, helps most children quit. If this approach doesn't work, your pediatric dentist may recommend a mouth appliance that blocks sucking habits.

Are pacifiers a safer habit for the teeth than thumbs or fingers?
    Thumb, finger and pacifier sucking all affect the teeth essentially the same way. However, a pacifier habit is often easier to break.

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Space Maintenance

Why do children lose their baby teeth?
     A baby tooth usually stays in 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. So, permanent teeth are crowded and come in crooked. If left untreated, the condition may require extensive orthodontic treatment.

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.

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's 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, don't 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.

	1. Healthy Tooth Enamel is the hard outer crystal-like layer.
	2. White Spots       Dentin is the softer layer beneath the enamel. The pulp chamber contains nerves and blood vessels and is considered the living part of the tooth. Bacteria that are exposed to sugars or carbohydrates can make acid, which attacks the crystal-like substance in the tooth's outer surface. This process is known as demineralization. The first sign of this is a chalky white spot. At this stage, the decay process can be reversed. Using fluorides at home and in the dental office can help the tooth repair itself.
	3. Enamel Decay Demineralization continues. Enamel starts to break down. Once the enamel surface is broken, the tooth can no longer repair itself. The cavity has to be cleaned and restored by a dentist.
	4. Dentin Decay The decay reaches into the dentin where it can spread and undermine the enamel.
	5. Pulp Involvement       If decay is left untreated, it will reach the tooth's pulp, which contains nerves and blood vessels. The pulp becomes infected. An abscess (swelling) or a fistula (opening to the surface of the gum) can form in the soft tissues.

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