Dental FAQ

General Dental Questions

Why should children see a pediatric dentist?

A pediatric dentist has two extra years of specialized training after the four years in dental school. Pediatric dentists are dedicated to the oral health of children from birth through the adolescent years. Newborn babies, infants, children, & teenagers all have different needs and require different approaches in dealing with their behavior, guiding their dental development, and helping them avoid future problems. A pediatric dentist is best qualified to meet these needs including those of special needs patients. We love to see children with special needs and we talk to them and treat them as a human being whether or not they can comprehend what we are saying or doing. Each child regardless their mental or physical state is treated with compassion and special care yet allowing them to feel important and as “normal” as possible during their dental visit.

Why do you have to take x-rays?

For children that are new to our office, it is necessary to obtain radiographs of the back teeth that show the doctor the surfaces in between the teeth to check for decay. It is important to also obtain radiographs that show the roots and the bone surrounding both the back and front teeth to check for presence or absence of pathology such as soft or hard tissue tumors, extra teeth, and proper development of both the baby and adult teeth. Other potential problems areas that would be missed include but are not limited to cysts, supernumerary or congenitally missing teeth, pathology such as odontomas, etc…The earlier an abnormality is detected, the sooner it can be treated limiting the amount of damage it can cause your child’s mouth. For children who are established patients, sometimes radiographs are not necessary depending on their caries risk and/or what radiographs were taken at the previous visit.

What are dental sealants and how do they work?

Sealants are a clear or white coating applied to the chewing surfaces of the teeth that have grooves to help keep them cavity-free. Sealants fill in the grooved and pitted surfaces of the teeth, which are hard to clean even by the smallest toothbrush bristle. Relatively fast and comfortable to apply, sealants can effectively protect the chewing surfaces of the teeth for many years. It is recommended that your child not chew on sticky foods/candy or crush hard foods or chew on ice when sealants are applied to extend their longevity. It is important to note that sealants may not be feasible to place on a child that is uncooperative and/or has a hypersensitive gag reflex. Our sealants are fluoride-free.

What causes tooth decay?

There are four main things that contribute to tooth decay—a tooth, bacteria, sugars or other carbohydrates and time. Dental plaque is a thin, sticky, colorless (or white) deposit of bacteria that constantly forms on everyone’s teeth. When you eat, the sugars in your food cause the bacteria in plaque to produce acids that attach the tooth enamel. With time and repeated acid attacks, the enamel breaks down and a cavity forms.

How should I clean my baby’s teeth?

For babies and infants: use a soft toothbrush with a small head, especially one designed for infants. Brush the teeth twice a day, especially at bedtime to remove plaque and bacteria which can lead to tooth decay. Start using a toothpaste that contains xylitol beginning with the eruption of the first baby teeth using a small smear for children under 3 years old.

Should I use toothpaste to brush my baby’s teeth? Which toothpaste do you recommend?

Yes. Toothpaste can be used for babies but limit the amount to a very small smear on toothbrush. We recommend to use a toothpaste that contains xylitol such as Spry Kid’s toothpaste or any other brand that contains xylitol. For children 3 years old and older a pea size amount of toothpaste can be used. There are a variety of appropriate toothpaste brands and flavors to choose from at your local health food store.

My child plays sports. How should I protect my child’s teeth?

A mouth guard should be a top priority on your child’s list of sports equipment. Athletic mouth protectors, or mouth guards, are made of soft plastic and fit comfortably to the shape of the upper teeth. They protect a child’s teeth, lips, cheeks, and gums from sports-related injuries. Any mouth guard works better than no mouth guard, but a custom-fitted mouth guard fitted by our doctor is your child’s best protection against sports-related injuries.

Does my child truly need to come in for check-ups every six months?

Yes, in addition to detection of cavities, children need their dental development checked for exfoliation and eruption of teeth, habits that may alter function, skeletal discrepancies, ankylosis, fusion and gemination, and any pathology. In regards to cavities, we have seen cavities form in less than a year, sometimes even as fast as 6-9 months! It is important to detect them early to treat them with white fillings rather than when they are very large in size and the teeth may require crowns.

My young child goes to school can his appointment be after school?

For children younger than 8 years of age that need treatment, we prefer they are seen early in the morning. Children are better able to cope in the morning when they are well rested. For children older than 8 years and teens treatment can be scheduled later in the morning or in the early afternoon.

Is it possible to treat my child without use of sedation, nitrous oxide gas, restraint, or verbal behavior management?

This will depend on the child and the situation. For very young, anxious children with extensive treatment needed, it is not possible to treat without sedation, some sort of passive restraint or verbal guidance. For older children and/or small treatment plans it may be possible to treat without any of the above.

For children that are younger than 3 years of age or those with complicated medical histories, who require immediate or extensive treatment, it is usually necessary to use general anesthesia since they are usually not candidates for in-office IV sedation due to age and weight.

For babies and infants, it is necessary that they are restrained by you the parent or legal guardian so that the doctor can conduct the dental examination. It is normal for children this age to cry and be guarded. It is important that you remain calm and are supportive following the doctor’s recommendations so that the visit can be a short as possible and your child’s apprehension is short lived.

Baby or Infant-Related Dental Questions

How should I clean my baby’s teeth?

For babies and infants: use a soft toothbrush with a small head, especially one designed for infants. Brush the teeth twice a day, especially at bedtime to remove plaque and bacteria which can lead to tooth decay. Start using a toothpaste that contains xylitol beginning with the eruption of the first baby teeth using a small smear for children under 3 years old.

At what age should my baby/child have his/her first visit?

As a general rule, every baby should see a pediatric dentist by the first birthday. However, your child can have the first visit when the first tooth erupts, between 6 and 12 months of age, usually.

What is baby bottle decay and how can I prevent it?

Baby bottle decay is a pattern of rapid decay associated with frequent and long exposures of an infant’s teeth to liquids that contain sugar. Among these liquids are milk (including breastmilk), formula, juice, and other sweetened drinks. It happens when a child goes to sleep (day or night) while breastfeeding or bottle feeding. Sweet liquid pools around the child’s teeth giving plaque bacteria an opportunity to produce acid which causes decay. Breastmilk alone does not cause tooth decay, however, you should brush or wipe your baby’s teeth with a wet soft cloth or xylitol wipes after feedings (including at night). Another factor associated with this decay may be an upper lip tie which can create a reservoir for liquids to remain in contact with the teeth for longer periods of time. In addition, during sleep, the flow of saliva is reduced and the natural self-cleansing action of the mouth is diminished. If you must give your baby a bottle for comfort when going to sleep, it should only contain water. If unable to do this, dilute liquids gradually until it’s mostly water to decrease sugars on the surfaces of the teeth.

How soon should I start flossing my child’s teeth? How often?

As soon as your child’s teeth are in contact with each other and the toothbrush cannot clean the surfaces in between the teeth start flossing. It should be done at least once a day, especially before bedtime to remove all food trapped between the teeth throughout the day. You can use regular floss or use floss holders which may be easier for you and your child to hold.

How does thumb sucking harm my child’s teeth?

Prolonged thumb sucking can cause crowded crooked teeth or bite problems. Thumb sucking changes not only the position of the teeth but also affects the growth and shape of the bone holding the teeth in place. The thumb places pressure on the upper arch causing narrow arches and the upper front teeth to incline forward resulting in an open bite. At times, if a child is still sucking the thumb or fingers when the permanent teeth arrive, a mouth appliance (palatal crib) may be recommended to help stop the habit. These appliances are recommended only as a reminder for a child that is ready to stop the habit to help him/her remember not to place the thumb or finger in the mouth. It is not recommended for a child that does not yet understand the purpose and benefits of it. Some children will stop this habit on their own.

How can I help my child through the teething stage?

Sore gums when teeth erupt are part of the normal eruption process. The discomforts is eased for some children by use of a teething toy, a piece of toast, a cold (refrigerated not frozen) teething ring, or by your child sucking on an ice cold moist clean washcloth. You can also use Hyland’s teething gel which has all natural ingredients to help soothe your child’s teeth.

I notice a space between my child’s two upper front teeth. Is this a concern? Does something need to be done?

It is normal for baby teeth to have gaps/spaces between them. In fact, gaps between baby teeth mean there is more space available for permanent teeth when they erupt. Since permanent teeth are usually larger in size, sometimes even twice the size of baby teeth, it is a good sign to see gaps between baby teeth.

When a gap is larger than average, it may be caused by a lip-tie and it may need to be evaluated. If the lip-tie is a class IV and wraps into the palatal papilla, there is a higher chance that it needs to be revised to prevent a large gap between the permanent upper front teeth. The lip revision doesn’t always prevent your child from having braces if there are other crowding or malocclusion problems that need to be addressed.

If my child gets a cavity in a baby tooth, should it still be filled—aren’t they just baby teeth?

They’re not just baby teeth. They are important for many reasons. They provide function of chewing during the years of greatest body growth; esthetically, they provide an attractive appearance and smile; they play a role in speech development; and they aid in forming path that permanent teeth can follow when they are ready to erupt. Some children have their baby teeth until they are 12 years old or older. Pain, infection of the gums and jaws, impairment of general health, and premature loss of teeth are just a few of the problems that can happen when baby teeth are neglected. Also, because tooth decay is really an infection and will spread, decay on baby teeth can cause decay on permanent teeth. Proper care of baby teeth is instrumental in enhancing the health of your child.

In my years of experience, I’ve seen several children end up in the hospital for a severe tooth infection that spread through the neck area compromising the airway or the upper face area with risk for infection traveling to the brain, due to neglect or refusal to treat and follow recommendations. In some cases the infection spread quickly and unexpectedly.

School-Aged Children Dental Questions

My child has a new tooth coming in behind the front ones—is this a problem?

Probably not, but it can be a sign of teeth crowding. When this happens, it is usually due to a narrow mandible that lacks enough space to allow teeth to erupt into proper position. If the baby teeth have no mobility and child is not able to wiggle them on his/her own, we may have to remove them to allow the permanent teeth into better position, especially when the permanent teeth have fully erupted. When baby teeth are very mobile, we highly encourage children to remove them on their own.

If my child has trauma to the mouth, can we be seen immediately?

If it is during office hours, yes. If it is after office hours or during the weekend, we encourage you to contact our emergency line which is provided to you when you call our office phone number. The doctor will advise you if your child needs to be seen immediately or be seen when the office is open.

More FAQs coming soon! Please feel free to submit any questions you’d like added to this section.