Pediatric Dentistry

A child’s first visit to the dentist should be enjoyable. Children are not born with a natural fear of the dentist, but they can fear the unknown. Our office makes a special effort to use pleasant, non-frightening, simple words to describe each treatment. We want you and your child to feel at ease from the moment your family arrives at our office. The more you and your child know about the first visit, the better you will feel.

The American Academy of Pediatric Dentistry recommends …

Children should visit the dentist by their first birthday. It is important that your child’s newly-erupted teeth (erupting at six and 12 months of age) receive proper dental care and benefit from proper oral hygiene habits right from the beginning.

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When New Teeth Arrive

Your child’s first primary or baby teeth will begin to erupt between the ages of six and 12 months, and will continue to erupt until about age three. During this time, your child’s gums may feel tender and sore. To help alleviate this discomfort, we recommend that you soothe the gums by rubbing a clean finger or a cool, wet cloth across them. You may also choose to make use of a teething ring. When your child has finished teething, you can expect a total of 20 primary teeth.

Your child’s primary teeth are shed at various times throughout childhood. Permanent teeth begin erupting at age six, and continue until age 21. Adults have 28 permanent teeth (32, including wisdom teeth).

Adopting Healthy Oral Hygiene Habits

As your child’s teeth erupt, be sure to examine them every two weeks, looking for lines and discoloration that may be caused by decay. Remember that sugary foods and liquids can attack a new tooth, so take care that your child brushes after feeding or eating. We recommend brushing four times a day for optimal oral hygiene: after breakfast, after lunch, after dinner, and at bedtime.

Brushing can be fun, and your child should brush as soon as the first tooth arrives. When a baby’s tooth erupts, parents should brush the tooth with a soft-bristled toothbrush and a pea-sized amount of toothpaste. For children younger than two, do not use fluoride toothpaste unless advised to do so by your dentist or other healthcare professional. We suggest reviewing proper tooth brushing procedures with your child.

Flossing is also a part of good oral hygiene habits, and your doctor will discuss with you the right time to start flossing. If you notice signs of decay, contact your dentist immediately.

Preventing Tooth Decay with Regular Checkups

Tooth decay is caused by sugars left in your mouth that turn into an acid, which can break down your teeth. Children are at high risk for tooth decay for a simple reason: many children and adolescents do not practice regular, good oral hygiene habits. Proper brushing and flossing routines combined with regular dental visits help keep tooth decay away.

Your child should visit the dentist every six months for regular dental cleanings and checkups. We recommend fluoride treatments twice a year along with cleanings to keep teeth their strongest. Tooth sealants are also recommended because they “seal” the deep grooves in your child’s teeth, preventing decay from forming in these hard-to-reach areas. Sealants last for several years, but will be monitored at your child’s regular checkups.

Dental Care for Your Baby

Congratulations on the arrival of your baby! Are you prepared for the arrival of your baby’s first tooth? Follow these guidelines and your son or daughter will be on the way to a lifetime of healthy smiles!

Caring for Gums

Even before your baby’s first tooth appears, the gums can benefit from your careful attention. After breast- or bottle-feeding, wrap one finger with a clean, damp washcloth or piece of gauze and gently rub it across your baby’s gum tissue. This practice both clears your little one’s mouth of any fragments of food and begins the process for building good daily oral care habits.

Baby’s First Tooth

When that first tooth makes an entrance, it’s time to upgrade to a baby toothbrush. There are usually two options: a long-handled toothbrush that you and your baby can hold at the same time, and a finger-puppet-like brush that fits over the tip of your pointer finger. In each case, the bristles are soft and few.

At this stage, toothpaste isn’t necessary; just dip the brush in water before brushing. If your little one doesn’t react well to the introduction of a toothbrush, don’t give up. Switch back to a damp washcloth for a few months and try the toothbrush again. During the teething process, your child will want to chew on just about anything, and a baby toothbrush with a teether can become a favorite toy during this period.

Brushing with Toothpaste

When a few more teeth appear, you can start using toothpaste with your child’s brush. However, for the first two years, be sure to choose toothpaste that does not contain fluoride, unless advised to do so by your dentist, because too much fluoride can be dangerous for youngsters. At this stage, use only a tiny amount of toothpaste. From the beginning, have your little one practice spitting the toothpaste out after brushing to prepare for fluoride toothpaste, which should not be swallowed at any age.

Avoiding Cavities

Don’t give your baby any sort of sweetened liquids such as flavored drinks or soda. Even the sugars present in fruit juice, formula, and milk (this goes for breast milk as well) can cause decay, so regular teeth and gum cleaning is vital. Also, make sure your baby never goes to bed with a bottle; sugary liquids in prolonged contact with teeth are a guarantee for early-childhood decay, also called baby-bottle caries.

First Visit to the Dentist

Providing you are practicing good oral health practices for your child at home, it is recommended that you bring your child in for a happy visit between three and four years old. At this age your child will be more receptive to their first dental visit. Often it is good to have them watch a sibling or parent visit for a short time to get aquainted with the office and staff. We’ll look for any signs of early problems with your baby’s oral heath, and check in with you about the best way to care for your little one’s teeth. Remember that preparing for each dental visit with a positive attitude goes a long way toward making your child comfortable with regular checkups.

Setting a Good Example

As part of the natural learning process, little ones are expert mimics, and you can take advantage of this talent. Brush and floss daily while your child is watching, and he or she will intuit at an early age the importance of your good habits. As soon as your child shows interest, offer a toothbrush of his or her own and encourage your toddler to “brush” with you. (You’ll find toothbrushes with chunky, short handles that are easy to grip.) Most children don’t have the dexterity necessary to thoroughly clean their own teeth until they’re about six or seven, so you’ll have to do that part of the job. Try different tactics to make brushing fun: flavored toothpaste, a toothbrush with a favorite character on it, or singing songs about brushing. The primary goal is to instill healthy oral habits at an early age to set your child up for a lifetime of healthy, cavity-free teeth!

Pediatric Dental Emergencies

If your child faces a dental emergency, give us a call immediately. If you need urgent treatment after hours, you can call our emergency number. We are always here to assist when your child’s dental health is at risk. Below are tips on dealing with urgent dental situations. You may want to display this list on your refrigerator or store it near your emergency phone numbers for easy reference.

Bitten Lip or Tongue

If your child has a bitten lip or tongue severe enough to cause bleeding, clean the bite gently with water and use a cold compress (a cold, wet towel or washcloth pressed firmly against the area) to reduce or avoid swelling. Give us a call to help determine how serious the bite is.

Object Caught In Teeth

If your child has something caught between his or her teeth, use dental floss to gently remove it. Never use a metal, plastic, or sharp tool to remove a stuck object. If you are unable to remove the item with dental floss, call to schedule an appointment during office hours.

Broken, Chipped, or Fractured Tooth

If your child has chipped or broken a piece off of a tooth, rinse his or her mouth with warm water, then use a cold compress to reduce swelling. Try to locate and save the tooth fragment that broke off. Call us immediately.

Knocked-Out Tooth

If your child’s tooth has been knocked out, find the tooth and rinse it with water (no soap), taking care to only touch the crown of the tooth (the part you can see when it’s in place). Place the tooth in a clean container with milk. Call us immediately and/or head to the hospital. If you act quickly it’s possible to save the tooth.

Loose Tooth

If your child has a very loose tooth, it should be removed to avoid being swallowed or inhaled.

Toothache

If your child complains of a toothache, rinse his or her mouth with warm water and inspect the teeth to be sure there is nothing caught between them. If pain continues, use a cold compress to ease the pain. Do not apply heat or any kind of aspirin or topical pain reliever directly to the affected area, as this can cause damage to the gums. Children’s pain relievers may be taken orally. Schedule an appointment immediately.

Broken Jaw

If you know or suspect your child has sustained a broken jaw, use a cold compress to reduce swelling. Call 911 or head to the hospital immediately. In many cases a broken jaw is the result of a blow to the head. Severe blows to the head can be dangerous and even life-threatening.

Avoiding Injury

You can help your child avoid dental emergencies. Child-proof your house to avoid falls. Don’t let your child chew on ice, popcorn kernels, or other hard foods. Always use car seats for young children and require seatbelts for older children. And if your child plays contact sports, have him or her wear a mouthguard. Ask us about creating a custom-fitted mouthguard for your child. Finally, prevent toothaches with regular brushing, flossing, and visits to our office.

Pediatric Dental FAQs

Below are common questions and our answers about the best way to care for children’s teeth.

When should I schedule my child's first visit to the dentist?

The American Academy of Pediatric Dentistry recommends that children be seen by six months after their first tooth erupts, or at one year of age, whichever comes first. Most of the time your pediatrician will look in the child’s mouth as part of their general exam. We often have parents bring their child with them to their cleaning appointments. This will familiarize the child with the dental office, they can read a children’s book about dentistry, get a prize (bribe) and many times we’ll take a quick look in the child’s mouth to screen for any obvious problems. We call this a “Happy Visit!” We don’t usually do any x-rays at an appointment like this.

How is a pediatric dentist different from other dentists?

All dental specialists (pediatric dentists, orthodontists, oral surgeons, and others) begin by completing dental school, then continue their education with several years of additional specialized training. Dr. Ness is highly comfortable working with children of all ages, however, there are times where behavioral or serious medical or dental issues exist. Utilizing the unique services of a pediatric dentist is sometimes necessary. As a general rule, we do not sedate children under the age of 14. If a child requires this level of care, we typically would refer your child to a pediatric dentist who has additional training in Pediatric Advanced Life Support and sedation techniques that create a safe and efficient environment.

What happens during my child's first visit to the dentist?

The first visit is usually short and simple. In most cases, we focus on getting to know your child and giving you some basic information about dental care. The doctor will check your child’s teeth for placement and health, and will look for any potential problems with the gums and jaw. If necessary, we may do a bit of cleaning. We will also answer any questions you have about how to care for your child’s teeth as they develop, and provide you with materials containing helpful tips that you can refer to at home. We’ve found that most kids are 2-3 years old before they can really sit in the chair on their own for a comprehensive cleaning and exam with x-rays should it even be necessary. Prior to your child possessing the ability to sit in the chair we might only be able to perform a very quick, general exam to screen for serious issues.

How can I prepare my child for his first dental appointment?

The best preparation for your child’s first visit to our office is maintaining a positive attitude. Children pick up on adults’ apprehensions, and if you make negative comments about trips to the dentist you can be sure that your child will fear an unpleasant experience and act accordingly. Show your child the pictures of the office and staff on the website. Let your child know that it’s important to keep his teeth and gums healthy, and that the doctor will help him do that. Remember that your dentist is specially trained to handle fears and anxiety, and our staff excels at putting children at ease during treatment.

How often should my child visit the dentist?

We generally recommend scheduling checkups every six months. Depending on the circumstances of your child’s oral health, we may recommend more frequent visits, like if they are in braces making perfect oral hygiene rather challenging, for instance.

Baby teeth aren't permanent. Why do they need special care?

Although they don’t last as long as permanent teeth, your child’s first teeth play an important role in his development. While they’re in place, these primary teeth help your little one speak, smile, and chew properly. They also hold space in the jaw for permanent teeth. If a child loses a tooth too early (due to damage or decay) nearby teeth may encroach on that space, which can result in crooked or misplaced permanent teeth. Also, your child’s general health is affected by the oral health of the teeth and gums.

What's the best way to clean my baby's teeth?

Even before your baby’s first tooth appears, we recommend you clean his gums after feedings with a damp, soft washcloth. As soon as his first tooth appears, you can start using a toothbrush. Choose a toothbrush with soft bristles and a small head. You most likely can find a toothbrush designed for infants at your local drugstore.

At what age is it appropriate to use toothpaste to clean my child's teeth?

Once your child has a few teeth, you can start using toothpaste on the brush. Use only a tiny amount for each cleaning, and be sure to choose toothpaste without fluoride for children under two, because too much fluoride can be dangerous for very young children. Always have your child rinse and spit out toothpaste after brushing, to begin a lifelong habit he’ll need when he graduates to fluoride toothpaste. Children naturally want to swallow toothpaste after brushing, and swallowing too much fluoride toothpaste can cause teeth to stain. You should brush your child’s teeth for him until he is ready to take on that responsibility himself, which usually happens by age six or seven.

What causes cavities?

Certain types of bacteria live in our mouths. When these bacteria come into contact with sugary foods left behind on our teeth after eating, acids are produced. These acids attack the enamel on the exterior of the teeth, eventually eating through the enamel and creating holes in the teeth, which we call cavities.

How can I help my child avoid cavities?

Be sure that your child brushes his teeth at least twice a day with fluoride toothpaste. Flossing daily is also important, because flossing can reach spots between the teeth that brushing can’t. Check with your pediatric dentist about a fluoride supplement which helps tooth enamel become harder and more resistant to decay. Avoid sugary foods and drinks, limit snacking, and maintain a healthy diet. And finally, make regular appointments so that we can check the health of your child’s teeth and provide professional cleanings.

Does my child need dental sealants?

Sealants cover the pits and fissures in teeth that are difficult to brush and therefore susceptible to decay. We recommend sealants as a safe, simple way to help your child avoid cavities, especially for molars, which are hardest to reach.

My child plays sports. How can I protect his teeth?

Even children’s sports involve contact, and we recommend mouthguards for children active in sports. If your little one plays baseball, soccer, or other sports, ask us about having a custom-fitted mouthguard made to protect his teeth, lips, cheeks, and gums.

What should I do if my child sucks his thumb?

The large majority of children suck their thumbs or fingers as infants, and most grow out of it by the age of four, without causing any permanent damage to their teeth. If your child continues sucking after permanent teeth erupt, or if he sucks aggressively, let us know and we can check to see if any problems may arise from the habit.

When should my child have dental X-rays taken?

We recommend taking X-rays around the age of two or three. The first set consists of simple pictures of the front upper and lower teeth, which familiarizes your child with the process. Once the baby teeth in back are touching one another, then regular (at least yearly) X-rays are recommended. Permanent teeth start coming in around age six, and X-rays help us make sure your child’s teeth and jaw are healthy and properly aligned. If your child is at a high risk of dental problems, we may suggest having X-rays taken at an earlier age.

Sports Dentistry

Sports dentistry is the prevention and treatment of dental injuries and related oral diseases, as well as the sharing of information and equipment designed to help protect the teeth, mouth, jaw, and face of athletes of all ages. Injuries to the teeth and mouth are common among athletes. It’s important to protect your child’s smile if he or she plays sports, for aesthetics as well as health reasons.

Common Dental Injuries in Sports

Tooth knocked out:

  • Time is the most important factor when trying to save a tooth, so get to your dentist as soon as possible. In general, there is a 30-minute window of opportunity to re-implant the tooth in the socket.
  • Do not try to re-implant the tooth yourself.
  • The best liquid to transport a tooth in is cold milk. If milk is not available, use saliva (if possible), saline, or if nothing else is available, water.
  • Don’t let the tooth dry out and don’t wrap it in anything.
  • Don’t touch the tooth root if you can avoid it.

Tooth chipped/cracked:

  • Your dentist will likely use an X-ray of the tooth to determine the treatment necessary.
  • For a serious chip that exposes the pulp of the tooth, get to your dentist as soon as possible.
  • If a tooth is chipped or cracked, sometimes the tooth can be fixed with a filling or bonding alone.
  • Sometimes a tooth is cracked or chipped in a way affecting the nerve of the tooth, and a more complicated treatment may be needed.

Tooth displaced:

  • If a tooth is moved due to trauma, see your dentist as soon as possible.
  • Do not try to move the tooth back on your own.
  • For any mouth discomfort before you get to the dentist, apply ice.

Preventing Injury

One of the best ways to prevent injury to your child’s teeth and mouth is to have him or her to wear a mouthguard while playing sports. There are several types of mouthguards to choose from, and your doctor can help you choose the best one for your child’s particular needs.

Thumb Sucking

Along with favorite blankets, teddy bears, and nap time, thumb sucking can be one of the most comforting aspects of childhood. According to a recent report, between 75% and 95% of infants suck their thumbs, so chances are there’s a thumb sucker (or a former thumb sucker) in your family. Is this cause for worry?

In most cases, the answer is no. However, it’s important to pay attention to your child’s habits in case his or her behavior has the potential to affect overall oral health.

What is normal thumb-sucking behavior?

Most children begin sucking their thumbs or fingers from a very young age; many even start inside the womb. Sucking is a natural reflex for an infant and it serves an important purpose. Sucking often provides a sense of security and contentment for a young one. It can also be relaxing, which is why many children suck their thumbs as they fall asleep.

According to the American Dental Association, most children stop thumb sucking on their own between the ages of two and four. They simply grow out of a habit that is no longer useful to them. However, some children continue sucking beyond the preschool years (although studies show that the older a child gets, the lower the chances are of continuing the habit). If your child is still sucking when his or her permanent teeth start to erupt, it may be time to take action to break the habit.

What signs should I watch for?

First, take note of how your child sucks his or her thumb. If the sucking is passive, with the thumb gently resting inside the mouth, it is less likely to cause damage. If, on the other hand, the thumb sucking is aggressive, placing pressure on the mouth or teeth, the habit may cause problems with tooth alignment and proper mouth growth. Extended sucking affects both the teeth and the shape of the face and may lead to a need for orthodontic treatment in the future.

If at any time you suspect your child’s thumb sucking may be affecting his or her oral health, please give us a call and schedule a visit. We can help you assess the situation.

How can I help my child quit thumb sucking?

Should you need to help your child end the habit, follow these guidelines:

  1. Always be supportive and positive. Instead of punishing your child for thumb sucking, give praise when he or she doesn’t.
  2. Put a band-aid on your child’s thumb or a sock over the hand at night. Let your little one know that this is not a punishment, but rather a way to help remember to avoid sucking.
  3. Start a progress chart and let your child put a sticker up every day that he or she doesn’t suck. If your child makes it through a week without sucking, he or she gets to choose a prize. When the whole month is full, reward your child with something great (a toy or new video game); by then the habit should be over. Making your child an active participant in his or her treatment will increase the willingness to break the habit.
  4. If you notice your child sucking when he or she is anxious, work on alleviating the anxiety rather than focusing on the thumb sucking.
  5. Take note of the times your child tends to suck (long car rides, while watching movies) and create diversions during these occasions.
  6. Explain clearly what might happen to the teeth if he or she keeps thumb sucking.

Whatever your method, always remember that your child needs your support and understanding during the process of breaking the habit of thumb sucking.

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