What Is A Pediatric Dentist ?
A pediatric dentist focuses on the oral health of infants, children and teens, including those with special health care needs. After completing 4 years of dental school, 2 to 3 additional years of training are required to become a pediatric dentist.
The very young, pre-teens and teenagers all need different approaches in dealing with their behavior, guiding their dental growth and developments and helping them avoid future dental problems. A pediatric dentist is best qualified to meet these needs.
When Should My Child First See A Dentist?
Your child should visit the dentist by his or her first birthday, or when the first tooth erupts, which is usually between 6 and 12 months of age. Your child’s first visit will establish a dental home for your child where early examination and preventive care will protect your child’s smile now and in the future.
Dental problems can develop at an early age. A big concern is early childhood caries (formerly known as baby bottle tooth decay.) The earlier the dental visit, the better the chance of preventing dental problems.
Why Are Primary Teeth So Important?
It is very important to maintain the health of your child’s primary teeth. Neglected cavities can and frequently do lead to problems which affect developing permanent teeth. Primary teeth, or baby teeth, are important for (1) proper chewing and eating, (2) providing space for the permanent teeth and guiding them into the correct position, and (3) permitting normal development of the jaw bones and muscles. Primary teeth also affect the development of speech and add to an attractive appearance. While the front 4 teeth last until 6-7 years of age, the back teeth (cuspids and molars) aren’t replaced until age 10-13.
Why Does My Child Need X-rays?
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. X-rays detect much more than cavities. For example, X-rays may be needed to survey erupting teeth, diagnose bone diseases, evaluate the results of an injury, or plan orthodontic treatment. X-rays allow dentists to diagnose and treat health conditions that cannot be detected during a clinical examination. 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 X-rays and examinations every six months for children with a high risk of tooth decay.
A panoramic X-ray is recommended when your child is 7 years old for evaluation and monitoring of dental and facial growth and development. 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 extremely small. The risk is negligible. In fact, the dental X-rays represent a far smaller risk than an undetected and untreated dental problem. Lead body aprons and shields will protect your child. At Sweetpea Smiles, we use new low-dose digital X-rays which filter out unnecessary radiation and restrict the X-ray beam to the area of interest. High speed film and proper shielding ensure the minimal amount of radiation exposure.
How Do I Prevent Cavities?
Good oral hygiene removes bacteria and the left over food particles that combine to create cavities. For infants, use a wet gauze or clean washcloth to wipe the plaque from teeth and gums. Avoid putting your child to bed with a bottle filled with anything other than water. For older children, brush their teeth at least twice a day. Also, watch the number of snacks containing sugar that you give your children. The American Academy of Pediatric Dentistry recommends 6 month visits to the pediatric dentist beginning at your child’s first birthday. Routine visits will start your child on a lifetime of good dental health. During your child’s visit, Dr. Hunter may also recommend protective sealants or home fluoride treatments for your child. Sealants can be applied to your child’s molars to prevent decay on hard to clean surfaces.
Good Diet = Healthy Teeth
Healthy eating habits lead to healthy teeth. Like the rest of the body, the teeth, bones, and the soft tissues of the mouth need a well-balanced diet. Children should eat a variety of foods from the five major food groups (which are fruits, vegetables, grains, meats and dairy.) Most snacks that children eat can lead to cavity formation. The more frequently a child snacks, the greater the chance for tooth decay. How long food remains in the mouth also plays a role. For example, hard candy, sticky foods and breath mints stay in the mouth a long time, which cause longer acid attacks on tooth enamel. A diet high in sugar and starches may place your child at higher risk for tooth decay. If your child snacks, choose nutritious foods such as vegetables, low-fat yogurt, and low-fat cheese which are healthier and better for children’s teeth.
Baby Bottle Tooth Decay
One serious form of decay among young children is baby bottle tooth decay (currently called early childhood caries.) This condition is caused by frequent and long exposures of an infant’s teeth to liquids that contain sugar. Among these liquids are milk (including breast milk), formula, fruit juice, and other sweetened drinks.
Putting a baby to bed for a nap or at night with a bottle containing a liquid other than water can cause serious and rapid tooth decay. Sweet liquid pools around the child’s teeth giving plaque bacteria an opportunity to produce acids that attack tooth enamel. If you must give your baby a bottle as a comforter at bedtime, it should contain only water. If your child won’t fall asleep with a bottle containing only water, gradually dilute the bottle’s contents with water over a period of 2 to 3 weeks.
After each feeding, wipe the baby’s gums and teeth with a damp washcloth or gauze pad to remove plaque. The easiest way to do this is to sit down, place the child’s head in your lap or lay the child on a dressing table or the floor. Whatever position you use, be sure you can see into the child’s mouth easily.
When Will My Baby Start Getting Teeth?
Teething, the process of baby (primary) teeth coming through the gums into the mouth, varies among individual babies. Some babies get their teeth early and some get them late. In general, the first baby teeth are usually the lower front (anterior) teeth and usually begin erupting between the age of 6-8 months.
Eruption Of Your Child's Teeth
Children’s teeth begin forming before birth. As early as 4 months, the first primary (or baby) teeth to erupt through the gums are the lower central incisors, followed closely by the upper central incisors. Although all 20 primary teeth usually appear by age 3, the pace and order of their eruption varies.
Permanent teeth begin appearing around age 6, starting with the first molars and lower central incisors. This process continues until approximately age 21.
Adults have 28 permanent teeth, or up to 32 including the third molars (or wisdom teeth).
Clean the area of the affected tooth thoroughly. Rinse the mouth vigorously with warm water or use dental floss to dislodge impacted food or debris. DO NOT place aspirin on the gum or on the aching tooth. If face is swollen apply cold compresses. Take your child to the dentist.
Cut of Bitten Tongue, Lip or Cheek:
Apply ice to bruised areas. If there is bleeding apply firm but gentle pressure with a gauze or cloth. If bleeding does not stop after 15 minutes or it cannot be controlled by simple pressure, take child to hospital emergency room.
Knocked Out Permanent Tooth:
Find the tooth. Handle the tooth by the crown, not the root portion. You may rinse the tooth but DO NOT clean or handle the tooth unnecessarily. Inspect the tooth for fractures. If it is sound, try to reinsert it in the socket. Have your child 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. The tooth may also be carried in the patient’s mouth. The patient must see a dentist IMMEDIATELY! Time is a critical factor in saving the tooth.
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. A lack of fluoride can leave teeth susceptible to cavities. Excessive fluoride ingestion by preschool-aged children can lead to dental fluorosis, which is a chalky white to even or brown discoloration of the permanent teeth. Many children often get more fluoride than their parents realize. Being aware of a child’s potential sources 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
2 and 3 year olds may not be able to expectorate (spit out) fluoride-containing toothpaste when brushing. As a result, these youngsters may ingest an excessive amount of fluoride during tooth brushing. Toothpaste ingestion during this critical period of permanent tooth development is the greatest risk factor in the development of fluorosis.
Excessive and inappropriate intake of fluoride supplements may also contribute to fluorosis. Fluoride drops and tablets, as well as fluoride fortified vitamins should not be given to infants younger than 6 months of age. After that time, fluoride supplements should only be given to children after all of the sources of ingested fluoride have been accounted for and upon the recommendation of your pediatrician or pediatric dentist.
Certain foods contain high levels of fluoride, especially: powdered concentrate infant formula, soy-based infant formula, infant dry cereals, creamed spinach and infant chicken products. Please read the label or contact the manufacturer. Some beverages also contain high levels of fluoride, especially: decaffeinated teas, white grape juices and juice drinks manufactured in fluoridated cities.
Parents can take the following steps to decrease the risk of fluorosis in their children’s teeth:
- Use a baby tooth cleanser on a young child’s toothbrush.
- 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 6 months old.
- Obtain fluoride level test results for your drinking water before giving fluoride supplements to your child (check with local water utilities).
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 a 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 a fluoride free toothpaste, using no toothpaste, or using only a “pea size” amount of toothpaste.
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. Since thumb sucking is relaxing, it may induce sleep.
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.
Children should cease thumb sucking by the time their permanent front teeth are ready to erupt. Usually, children stop between the ages of two and four. Peer pressure causes many school-aged children to stop.
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, talk with Dr. Hunter.
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.
- Reward children when they refrain from sucking during difficult periods, such as when being separated from their parents
- Dr. Hunter 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. Dr. Hunter may recommend the use of a mouth appliance.
Tongue Piercing - Is It Really Cool?
You might not be surprised anymore to see people with pierced tongues, lips or cheeks, but you might be surprised to know just how dangerous these piercings can be.
There are many risks involved with oral piercings including chipped or cracked teeth, blood clots, or blood poisoning. Your mouth contains millions of bacteria, and infection is a common complication of oral piercing. Your tongue could swell large enough to close off your airway!
Common symptoms after piercing include pain, swelling, infection, an increased flow of saliva, and injuries to gum tissue. Difficult-to-control bleeding or nerve damage can result if a blood vessel or nerve bundle is in the path of the needle.
So follow the advice of the American Dental Association and give your mouth a break – skip the mouth jewelry.
Tobacco - Bad News In Any Form
Tobacco in any form can jeopardize your child’s health and cause incurable damage. Teach your child about the dangers of tobacco.
Smokeless tobacco, also called spit, chew, or snuff, is often used by teens who believe that it is a safe alternative to smoking cigarettes. This is an unfortunate misconception. Studies show that spit tobacco may be more addictive than smoking cigarettes and may be more difficult to quit. Teens who use it may be interested to know that one can of snuff per day delivers as much nicotine as sixty cigarettes. In as little as three to four months, smokeless tobacco use can cause periodontal disease and produce pre-cancerous lesions called leukoplakias.
If your child is a tobacco user you should watch for the following that could be early signs of oral cancer:
- A sore that won’t heal
- White or red leathery patches on the lips, and on or under the tongue
- Pain, tenderness, or numbness anywhere in the mouth or lips
- Difficulty chewing, swallowing, speaking, moving the jaw or tongue or a change in the way the teeth fit together
Because the early signs of oral cancer usually are not painful, people often ignore them. If it’s not caught in the early stages, oral cancer can require extensive, sometimes disfiguring, surgery. Even worse, it can kill.
Help your child avoid tobacco in any form. By doing so, they will avoid bringing cancer-causing chemicals in direct contact with their tongue, gums, and cheeks.
What Is The Best Time For Orthodontic Treatment?
Developing malocclusions, or bad bites, can be recognized as early as 2 to 3 years of age. 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 two to six 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.
When a child begins to participate in recreational activities and organized sports, injuries can occur. A properly fitted mouthguard, or mouth protector, is an important piece of athletic gear that can help protect your child’s smile, and should be used during any activity that could result in a blow to the face or mouth.
Mouthguards help prevent broken teeth, and injuries to the lips, tongue, face or jaw. A properly fitted mouthguard will stay in place while your child is wearing it, making it easy for them to talk and breathe.
Ask Dr. Hunter about custom and store-bought mouthguards.