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A pediatric dentist has an extra two to three years of specialized training after dental school, and is dedicated to the oral health of children from infancy through the teenage years. This specialized training allows the doctor to provide thorough treatment for a wide variety of children’s dental concerns.
Why Are The Primary Teeth So Important?
Primary teeth play an essential role in the development of a child’s smile. They allow a child to chew food properly as well as allow for correct pronunciation and speech. Primary teeth hold space for the permanent teeth to erupt into and aid in the correct development of the jaws. While the front 4 teeth last until 6-7 years of age, the back teeth (cuspids and molars) aren’t replaced until age 10-12.
Eruption Of Your Child’s Teeth
Children’s
teeth begin forming before birth. As early as 4 months, the first primary
(or baby) teeth begin to erupt through the gums. All 20 primary teeth
usually appear by age 3, but the pace and order of their eruption may vary
for each child. Permanent teeth begin appearing around age 6, starting with
the first molars and lower central incisors. This process ends with the
eruption of the third molars between the ages of 17 to 21. Adults have 28
permanent teeth, or up to 32 including the third molars (or wisdom teeth).
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. 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. 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. Approximately every 3 years it is a good idea to obtain a complete set of radiographs. Pediatric dentists are particularly careful to minimize the exposure of their patients to radiation. With contemporary safeguards, the amount of radiation received in a dental X-ray examination is very minimal. The risk is negligible. In fact, the dental radiographs represent a far smaller risk than an undetected and untreated dental problem. Lead body aprons and shields will always be used to protect your child.
What’s 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 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 fluoride-free toothpaste, using no toothpaste, or using only a "pea size" amount of toothpaste.
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.
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. 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.
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 dentist.
A few suggestions to help your child get through thumb sucking:
- Instead of scolding children for thumb sucking, praise them when they are not.
- 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.
- Your pediatric dentist can encourage children to stop sucking and explain what could happen if they continue.
- If these approaches don’t 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.
A sealant is a clear or shaded 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 sealant acts as a barrier to food, plaque and acid, thus protecting the decay-prone areas of the teeth.
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 not lost). 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", "pulpectomy" 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). A pulpectomy is required when the entire pulp is involved (into the root canal(s) of the tooth). During this treatment, the diseased pulp tissue is completely removed from both the crown and root. The canals are cleansed, disinfected and in the case of primary teeth, filled with a resorbable material. Then a final restoration is placed. A permanent tooth would be filled with a non-resorbing material.
What is the Best Time for Orthodontic Treatment?
Developing malocclusions, or bad bites, can be recognized as early as 2-3 years of age. The American Association for Orthodontists recommends that every child have an orthodontic evaluation by the age of 7. 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.
Fluoride is an element, which has been shown to be beneficial to teeth. 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. Many times, children get more fluoride than their parents realize. Being aware of a child’s potential source of fluoride can help parents prevent the possibility of dental fluorosis. Some of these sources are:
- Too much fluoridated toothpaste at an early age.
- The inappropriate use of fluoride supplements.
- Hidden sources of fluoride in the child’s diet.
- Tap and Bottle Water
Parents can take the following steps to decrease the risk of fluorosis in their children’s teeth:
- Use baby tooth cleanser on the toothbrush of the very young child.
- Place only a pea sized drop of children’s toothpaste on the brush when brushing.
- Account for all of the sources of ingested fluoride before requesting fluoride supplements from your child’s physician or pediatric dentist.
- Avoid giving any fluoride-containing supplements to infants until they are at least 6 months old.
- Obtain fluoride level test results for your drinking water before giving fluoride supplements to your child (check with local water utilities).
For more information on sedations please refer to: www.pediatricsedation.com.
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Knocked Out Baby Tooth: Contact your pediatric dentist during business hours. This is not usually an emergency and in most cases no treatment is necessary. Cut or Bitten Tongue, Lip or Cheek: Apply ice to injured areas to help control swelling. If there is bleeding apply firm but gentle pressure with a gauze or cloth. If bleeding cannot be controlled by simple pressure, call a doctor or visit the hospital emergency room. Chipped or Fractured Baby Tooth: Contact your pediatric dentist. |
Knocked Out Permanent Tooth: If possible, find the tooth. Handle it by the crown, not by the root. You may rinse the tooth with water only. DO NOT clean with soap, scrub 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 (beside the cheek). The patient must see a dentist IMMEDIATELY! Time is a critical factor in saving the tooth. |
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Chipped or Fractured Permanent Tooth: Contact your pediatric dentist immediately. Quick action can save the tooth, prevent infection and reduce the need for extensive dental treatment. Rinse the mouth with water and apply cold compresses to reduce swelling. If possible, locate and save any broken tooth fragments and bring them with you to the dentist. |
Toothache: Clean the area of the affected tooth. Rinse the mouth thoroughly with warm water or use dental floss to dislodge any food that may be impacted. If the pain still exists, contact your child's dentist. Do not place aspirin or heat on the gum or on the aching tooth. If the face is swollen apply cold compresses and contact your dentist immediately. |
Do's & Don'ts For Good Oral Health
- DO hold your baby while bottle-feeding. DO NOT prop the bottle.
- DO feed your baby before putting to bed. DO NOT put baby to sleep with a bottle.
- DO wipe the inside of your baby’s mouth daily.
- DO begin brushing your baby’s teeth as soon as they begin erupting.
- DO check for white or brown spots on teeth. If you see any, call your dentist.
- DO ensure proper brushing of inner, outer and chewing surfaces. DO NOT forget about back teeth!
- DO floss your baby’s teeth as soon as two teeth touch. DO NOT forget to brush tongue!
- DO take your child to the dentist before his/her first birthday!
- DO have dental work recommended by dentist to prevent or treat cavities!
- DO get your child a mouth guard if he/she is active in recreational activities or organized sports.
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