Frequently Asked Questions

Why choose a pediatric dentist instead of a general or family dentist?

Pediatric dentists are the pediatricians of dentistry with two to three additional years of specialty training following dental school. Pediatric dentists limit their practice to treating children only. Pediatric dentists are primary and specialty oral care providers for infants and children through adolescence, including those with special healthcare and behavioral needs. Infants, toddlers, preschoolers, adolescents, and teenagers all require 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.

When should my child see a pediatric dentist?

The American Academy of Pediatric Dentistry recommends the first dental visit when the first tooth appears, no later than age one. The goal is to establish an ongoing relationship between the pediatric dentist, the child and family, inclusive of all aspects of oral health care as the child grows and develops.

When will my child's teeth come in?

Each child’s development varies, but in general the first primary or “baby” teeth are the two lower front teeth which erupt between six to eight months of age. These teeth are followed by the two upper front teeth and four more front side teeth. Children usually have a total of eight front teeth until one year of age.  Around age one, the first primary molars erupt. After that, the primary canines erupt around 18 months followed by the second primary molars between two and three years old. By three years old, most children have twenty primary teeth and this remains the same until around age five to six. The baby teeth start to change at that time and the permanent molars erupt, usually around six years of age. This “teething” process continues until age 18 for a total of 28 to 32 teeth.

When should I start brushing my child’s teeth?

You should start cleaning your child’s mouth even before teeth erupt. You can begin wiping your infant’s gums with a wash cloth or using an infant brush prior to any teeth erupting. Once the first tooth erupts, use a soft bristled toothbrush with a small head made specifically for infants or toddlers. Cleaning the teeth and brushing the gums removes plaque and bacteria which may lead to tooth decay.

What is fluoride and why is it important?

Fluoride is a naturally occurring ion found in the earth’s crust. Water becomes fluoridated in nature when water passes over the rocks and soil, releasing the fluoride ions. Fluoride is known as nature’s cavity fighter and has been proven to protect the teeth from decay when introduced both systemically and topically. In growing children, fluorides are incorporated into the developing adult teeth to strengthen them before they erupt into the mouth. Teeth protected during this period enjoy longer lasting protection against decay. In older children and adults, fluoride can remineralize weakened areas in teeth and reduce sensitivity.

When does my child need fluoride?

Infant or training toothpaste without fluoride should be used until two to three years of age. Children’s or kids’ fluoride toothpaste can be used at the discretion of the pediatric dentist after a child is two to three years old depending on the child’s risk for decay. It is critical avoid excess fluoride exposure between 22 and 26 months of age and to keep toothpaste out of reach of children. It is important to use a grain of rice size amount of fluoride toothpaste for children under age four or five. Once a child has learned how to spit, a pea size amount of toothpaste can be used.  Adult toothpaste is very abrasive and should not be used for children under age eight. It is also recommended for children to drink tap water instead of bottled or spring water from infancy (mixing baby formulas) onwards.

What is the best toothpaste for my child?

New teeth are different from existing teeth and a gentle toothpaste is important. Adult toothpastes often contain harsh abrasives which wear away young enamel. Make sure your child’s toothpaste is recommended by the American Dental Association for that age group.

What is “baby bottle” or “nursing” tooth decay?

Frequent and long exposure of an infant’s teeth to liquids containing sugar can cause “baby bottle” tooth decay. Milk (including breast milk), formula, fruit juice, and other sweetened drinks like soda and sports drinks can all contribute. Putting a baby down for a nap or for the night with a bottle other than water can cause serious and rapid tooth decay. Sweet liquid pools around the baby’s teeth, promoting acids that attack tooth enamel. If you have already begun giving sweetened beverages and the child won’t fall asleep without them, begin diluting the bottle’s contents with water over two or three weeks.

How does my child's diet affect his or her teeth?

Almost every snack contains at least one type of sugar. Most often, parents are tempted to throw away candy and chocolate but do not realize that fruit snacks for example contain several types of sugar or carbohydrate. When sugar-rich snacks are eaten, the sugar content attracts oral bacteria. The bacteria feast on food remnants left on or around the teeth. Eventually, feasting bacteria produce enamel-attacking acids. When tooth enamel is constantly exposed to acid, it begins to erode – the result is childhood tooth decay. Regular checkups and cleanings at our office are an important line of defense against tooth decay. However, implementing good dietary habits and minimizing sugary food and drink intake as part of the “home care routine” are equally important.

What causes tooth decay (cavities)?

Dental plaque is a collection of sticky bacteria that constantly live on all teeth. When we eat, sugars in our food interact with the bacteria in plaque to produce acid. With time and repeated acid production, the tooth begins to break down and a cavity or hole forms.

Why are primary or “baby” teeth so important?

It is important to maintain the health of primary teeth for several reasons. They play an important role everyday in chewing and eating, speaking, smiling and overall appearance and self image. Primary teeth also help developmentally to hold space for and guide permanent teeth into the correct position in the mouth for the jaw bones and muscles to grow properly. Neglected cavities lead to pain, infection, tooth loss and space problems which affect the developing permanent teeth. While the front four teeth fall out between six and seven years of age, the primary molars are not replaced until ten to thirteen years old.

Are checkups necessary if my child has healthy teeth?

The condition of a child’s teeth can change fairly rapidly. Even if the child’s teeth were evaluated as healthy just six months prior, changes in diet or oral habits (for example, thumb sucking) can quickly render them vulnerable to decay or misalignment.
In addition to visual examinations, the pediatric dentist provides thorough dental cleanings during each visit. These cleanings eradicate the plaque and debris that can build up between teeth and in other hard to reach places. Though a good homecare routine is especially important, these professional cleanings provide an additional tool to keep smiles healthy. The pediatric dentist is also able to monitor the child’s fluoride levels during routine visits. Oftentimes, a topical fluoride gel or varnish is applied to teeth after the cleaning. Topical fluoride remineralizes the teeth and staunches mineral loss, protecting tooth enamel from oral acid attacks. Some children are also given take-home fluoride supplements (especially those residing in areas where fluoride is not routinely added to the community water supply). Finally, the pediatric dentist may recommend dental sealants to the child’s back teeth.

What are dental sealants?

Sealants are tooth colored resin materials that are applied to the chewing surface of the molars. The sealant material fills in the pits and fissures of the teeth to block sticky, chewy foods from getting caught in the grooves of the teeth. The sealant creates a barrier between the tooth and food to help seal out and prevent decay. Sealants have been proven to be very successful in preventing cavities on the chewing surfaces of teeth over the course of many years.

When do you recommend sealants?

If a child can tolerate it, we sometimes recommend sealing primary molars to prevent decay if the grooves are deep and susceptible to cavities. We also recommend sealing all of the permanent molars when they erupt around six and twelve years old, especially since these teeth are not fully calcified and strong when they erupt. Sometimes we recommend sealing front teeth if there are deep pits that are susceptible to getting cavities.

What do sealants involve?

Sealants are easily applied to the chewing surface of the molars by your pediatric dentist or dental hygienist. The teeth to be sealed are thoroughly cleaned and then surrounded with cotton to keep the area dry. The teeth are then rinsed with water and dried with air. Sealant material is carefully painted onto the enamel surface to cover the grooves. The sealant is hardened on the tooth with a special curing light. After sealants are placed, we recommend avoiding really sticky snacks like caramels and taffy and avoiding chewing on ice or hard candies to prevent the sealants from breaking down. Proper home care, a balanced diet and regular dental visits will help your new sealants last a lifetime.

How can I protect my child’s teeth during sports?

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. Mouthguards are required in sports such as lacrosse, football, field hockey and ice hockey. They are highly recommended in other sports such as basketball, soccer and wrestling.

What if my child is grinding their teeth?

Bruxism, or nighttime teeth grinding, is a concern because it can damage teeth and jaw. On the other hand, it is usually outgrown before such damage occurs. Among the possible causes are stress, such as a move to a new area, divorce, or problems at school. Another theory is that pressure in the inner ear is being relieved by clenching and unclenching the jaw. Parents might notice the noise caused by grinding while the child is asleep, or in more extreme cases, wear on the teeth. In older children, if wear is excessive, a mouth guard for use at night might be indicated although there is a risk of choking if the device becomes dislodged or improper growth of the jaw.

What are dental x-rays?

X-rays are invisible beams of energy that pass through the body to make black and white pictures of your child’s teeth and bones. X-rays are a form of radiation. When the x-ray picture is taken, your child has to sit still for a couple of seconds. Sometimes you may be asked to help your child sit still while the x-ray picture is taken. We use digital x-rays which are plastic sensors directly connected to a computer using a wire and you can instantly see the picture.

Why are x-rays important?

Dental x-rays are a useful diagnostic tool to help detect damage and disease not visible during a regular dental exam, for instance in between the teeth. X-rays are important to determine the present status of your child’s oral health and have a baseline to help identify changes that may occur later.

Are x-rays safe?

Dental x-rays are safe; however, they do require very low levels of radiation exposure, which makes the risk of potentially harmful effects very small. We all are exposed to small amounts of radiation daily from the sun, soil, rocks, buildings, air and water. This type of natural radiation is called background radiation. The radiation used in x-rays has been compared to the amount of background radiation a person gets daily. Dental x-ray tools and techniques are designed to limit the body’s exposure to radiation and every precaution is taken to ensure that radiation exposure is as low as possible. A leaded apron with a thyroid collar helps to minimize exposure. We also use digital x-rays which significantly decrease the amount of radiation used.

How and why are panoramic x-rays taken?

The panoramic x-ray machine rotates around the outside of the head to create a two-dimensional image. It provides an ear-to-ear view of both the upper and lower jaw and all the teeth. The most common uses for panoramic x-rays in pediatric dentistry are to determine when baby teeth will fall out, if adult teeth are present, if there is any crowding, if any teeth are misaligned and to determine if there are wisdom teeth. The panoramic is sometimes used in children who cannot tolerate regular dental x-rays.

What is type of sedation is used in the office?

Nitrous oxide sedation or “laughing gas” is used for children who exhibit particular signs of nervousness or anxiety. Nitrous oxide is delivered via a mask, which is placed over the child’s nose. Nitrous oxide is always combined with oxygen – meaning that the child can comfortably breathe in through the nose and out through the mouth. Laughing gas relaxes children extremely quickly, and can produce happy, euphoric behavior. It is also quick acting, painless to deliver, and wears off within a matter of minutes. Before removing the mask completely, regular oxygen is delivered for several minutes, to ensure the nitrous oxide is eliminated from the child’s body. On rare occasions, nitrous oxide may cause nausea. For this reason, it is recommended to minimize food intake to a few crackers and water for three hours prior to the appointment.

What if my child too scared to go through treatment in the office?

To keep your child safe and comfortable during a dental procedure, your child’s pediatric dentist might decide to use general anesthesia in the operating room of a hospital. General anesthesia also may be used if your child needs extensive or complicated procedures that will take a long time to complete, or needs several procedures done all at the same time. An anesthesiologist will give your child the medications that will make him or her sleep soundly during the procedure. General anesthesia makes your child’s whole body go to sleep. It is needed for certain dental procedures and treatments so that his or her reflexes will be completely relaxed. Your child will feel no pain during the procedure, nor have any memory of it, and wake up with all of their dental treatment completed.

What do I do if my child has a toothache?

Toothaches are common in children of all ages and rarely occur without cause. Impacted food can cause discomfort in young children, and can be dislodged using a toothbrush, a clean finger, or dental floss. If pain persists, call the office and we will schedule a visit for your child as soon as possible. Some common causes of toothache include: tooth decay, tooth fractures, tooth trauma, and tooth eruption.

How you can help:

  • Cleanse the area using warm water.
  • Do not medicate or warm the affected tooth or adjacent gum area.
  • Check for impacted food and remove it as necessary.
  • Keep the area clean with regular flossing and brushing.
  • Apply a cold compress to the affected area to reduce swelling.
  • Give an over the counter pain reliever as needed.
  • Call the office and we will schedule a visit for your child as soon as possible.
What do I do if my child’s adult tooth is knocked out?

Locate the tooth and gently rinse off any dirt or debris in milk or water. Do not scrub or scrape the tooth.  Avoid touching the root and handle by the crown only. Try to place the tooth back into the socket and hold in place with finger pressure or a wash cloth. If this is not possible, place the tooth in a cup of milk to keep the tooth moist. Call us immediately because time is of great importance when trying to save the natural tooth.


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