Pediatric Dentistry -
              Click on the below links for more information

• Thumb, Finger, and Pacifier Habits
• Diet and Snacking
• Preventive Dentistry
• Sealants
• Fluoride
  
  

• Regular Dental Visits
• Early Orthodontic Care
• What is Malocclusion?
• Space Maintenance
• Tooth-colored Fillings

Q: Why do children suck on fingers, pacifiers or other objects?

A: This type of sucking is completely normal for babies and young children. It provides security. For young babies, it's a way to make contact with and learn about the world. In fact, babies begin to suck on their fingers or thumbs even before they are born.

Q: Are these habits bad for the teeth and jaws?

A: Most children stop sucking on thumbs, pacifiers or other objects on their own between two and four years of age. No harm is done to their teeth or jaws. However, some children repeatedly suck on a finger, pacifier or other object over long periods of time. In these children, the upper front teeth may tip toward the lip or not come in properly.

Q: When should I worry about a sucking habit?

A: Your pediatric dentist will carefully watch the way your child's teeth come in and jaws develop, keeping the sucking habit in mind at all times. For most children there is no reason to worry about a sucking habit until the permanent front teeth are ready to come in.

Q: What can I do to stop my child's habit?

A: Most children stop sucking habits on their own, but some children need the help of their parents and their pediatric dentist. When your child is old enough to understand the possible results of a sucking habit, your pediatric dentist can encourage your child to stop, as well as talk about what happens to the teeth if your child doesn't stop. This advice, coupled with support from parents, helps most children quit. If this approach doesn't work, your pediatric dentist may recommend a mouth appliance that blocks sucking habits.

Q: Are pacifiers a safer habit for the teeth than thumbs or fingers?

A: Thumb, finger and pacifier sucking all affect the teeth essentially the same way. However, a pacifier habit is often easier to break.

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Q: What is a healthy diet for my child?

A: A healthy diet is a balanced diet that naturally supplies all the nutrients your child needs to grow. And what's a balanced diet? One that includes the following major food groups every day: Fruits and Vegetables; Breads and Cereals; Milk and Dairy Products; Meat, Fish and Eggs.

Q: How does my child's diet affect her dental health?

A: She must have a balanced diet for her teeth to develop properly. She also needs a balanced diet for healthy gum tissue around the teeth. Equally important, a diet high in certain kinds of carbohydrates, such as sugar and starches, may place your child at extra risk of tooth decay.

Q: How do I make my child's diet safe for his teeth?

A: First, be sure he has a balanced diet. Then, check how frequently he eats foods with sugar or starch in them. Foods with starch include breads, crackers, pasta and such snacks as pretzels and potato chips. When checking for sugar, look beyond the sugar bowl and candy dish. A variety of foods contain one or more types of sugar, and all types of sugars can promote dental decay. Fruits, a few vegetables and most milk products have at least one type of sugar.

Sugar can be found in many processed foods, even some that do not taste sweet. For example, a peanut butter and jelly sandwich not only has sugar in the jelly, but may have sugar added to the peanut butter. Sugar is also added to such condiments as catsup and salad dressings.

Q: Should my child give up all foods with sugar or starch?

A: Certainly not! Many provide nutrients your child needs. You simply need to select and serve them wisely. A food with sugar or starch is safer for teeth if it's eaten with a meal, not as a snack. Sticky foods, such as dried fruit or toffee, are not easily washed away from the teeth by saliva, water or milk. So, they have more cavity-causing potential than foods more rapidly cleared from the teeth. Talk to your pediatric dentist about selecting and serving foods that protect your child's dental health.

Q: Does a balanced diet assure that my child is getting enough fluoride?

A: No. A balanced diet does not guarantee the proper amount of fluoride for the development and maintenance of your child's teeth. If you do not live in a fluoridated community or have an ideal amount of naturally occurring fluoride in your well water, your child needs a fluoride supplement during the years of tooth development. Your pediatric dentist can help assess how much supplemental fluoride your child needs, based upon the amount of fluoride in your drinking water and your child's age and weight.

Q: My youngest isn't on solid foods yet. Do you have suggestions for her?

A: Don't nurse your daughter to sleep or put her to bed with a bottle of milk, formula, juice, or sweetened liquid. While she sleeps, any unswallowed liquid in the mouth supports bacteria that produce acids and attack the teeth. Protect your child from severe tooth decay by putting her to bed with nothing more than a pacifier or bottle of water.

Q: Any final advice?

A: Yes. Here are tips for your child's diet and dental health.

1. Ask your pediatric dentist to help you assess your child's diet.
2. Shop smart! Do not routinely stock your pantry with sugary or starchy snacks. Buy "fun foods" just for special times.
3. Limit the number of snack times; choose nutritious snacks.
4. Provide a balanced diet, and save foods with sugar or starch for mealtimes.
5. Don't put your young child to bed with a bottle of milk, formula, or juice.
6. If your child chews gum or sips soda, choose those without sugar.

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Q: What is preventive dentistry?

A: Preventive dentistry for children includes:

• brushing
• dental development
• flossing
• fluorides
• oral habits
• orthodontics
• parent involvement
• proper diet
• sealants
• sports safety

Your pediatric dentist practices preventive dentistry.

Q: Why is preventive dentistry important?

A: Preventive dentistry means a healthy smile for your child. Children with healthy mouths chew more easily and gain more nutrients from the foods they eat. They learn to speak more quickly and clearly. They have a better chance of general health, because disease in the mouth can endanger the rest of the body. A healthy mouth is more attractive, giving children confidence in their appearance. Finally, preventive dentistry means less extensive, and less expensive, treatment for your child.

Q: When should preventive dentistry start?

A: Preventive dentistry begins with the first tooth. Visit your pediatric dentist when the first tooth comes in. You will learn how to protect your infant's dental health. The earlier the dental visit, the better the chance of preventing dental disease and helping your child belong to the cavity-free generation.

Q: What role do parents play in prevention?

A: After evaluating your child's dental health, your pediatric dentist will design a personalized program of home care for your child. This program will include brushing and flossing instructions, diet counseling, and if necessary, fluoride recommendations. By following these directions, you can help give your child a lifetime of healthy habits.

Q: How do pediatric dentists help prevent dental problems?

A: Tooth cleaning and polishing and fluoride treatments are all part of your child's prevention program. But there's much more. For example, your pediatric dentist can apply sealants to protect your child from tooth decay, help you select a mouth guard to prevent sports injuries to the face and teeth, and provide early diagnosis and care of orthodontic problems. Your pediatric dentist is uniquely trained to develop a combination of office and home preventive care to insure your child a happy smile.

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Q: What are sealants?

A: Sealants protect the grooved and pitted surfaces of the teeth, especially the chewing surfaces of back teeth where most cavities in children are found. Made of clear or shaded plastic, sealants are applied to the teeth to help keep them cavity-free.

Q: How do sealants work?

A: Even if your child brushes and flosses carefully, it is difficult - sometimes impossible -to clean the tiny grooves and pits on certain teeth. Food and bacteria build up in these crevices, placing your child in danger of tooth decay. Sealants "seal out" food and plaque, thus reducing the risk of decay.

Q: How long do sealants last?

A: Research shows that sealants can last for many years if properly cared for. So, your child will be protected throughout the most cavity-prone years. If your child has good oral hygiene and avoids biting hard objects, sealants will last longer. Your pediatric dentist will check the sealants during routine dental visits and can recommend reapplication or repair when necessary.

Q: What is the treatment like?

A: The application of a sealant is quick and comfortable. It takes only one visit. The tooth is first cleaned. It is then conditioned and dried. The sealant is then flowed onto the grooves of the tooth and allowed to harden or hardened with a special light. Your child will be able to eat right after the appointment.

Q: How much does it cost?

A: The treatment is very affordable, especially in view of the valuable decay protection it offers your child. Most dental insurance companies cover sealants. Some companies, however, have age and specific tooth limitations. Check with your benefits provider about your child’s coverage and talk to your pediatric dentist about the exact cost of sealants for your child.

Q: Which teeth should be sealed?

A: The natural flow of saliva usually keeps the smooth surfaces of teeth clean but does not wash out the grooves and fissures. So, the teeth most at risk of decay—and therefore most in need of sealants - are the six-year and twelve-year molars. Many times the permanent premolars and primary molars will also benefit from sealant coverage. Any tooth, however, with grooves or pits may benefit from the protection of sealants. Talk to your pediatric dentist, as each child’s situation is unique.

Q: If my child has sealants are brushing and flossing still important?

A: Absolutely! Sealants are only one step in the plan to keep your child cavity-free for a lifetime. Brushing, flossing, balanced nutrition, limited snacking, and regular dental visits are still essential to a bright, healthy smile.

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How does fluoride work?

When the element fluoride is used in small amounts on a routine basis it helps to prevent tooth decay. It encourages "remineralization," a strengthening of weak areas on the teeth. These spots are the beginning of cavity formation. Fluoride occurs naturally in water and in many different foods, as well as in dental products such as toothpaste, mouth rinses, gels, varnish and supplements. Fluoride is effective when combined with a healthy diet and good oral hygiene.

Will my child need fluoride supplements?

Children between the ages of six months and 16 years may require fluoride supplements. The pediatric dentist considers many different factors before recommending a fluoride supplement. Your child's age, risk of developing dental decay and the different liquids your child drinks are important considerations. Bottled, filtered and well waters vary in their fluoride amount, so a water analysis may be necessary to ensure your child is receiving the proper amount.

What type of toothpaste should my child use?

Your child should use toothpaste with fluoride and the American Dental Association Seal of Acceptance. Young children, especially pre-school aged children, should not swallow any toothpaste. Careful supervision and only a small pea-sized amount on the brush are recommended. If not monitored, children may easily swallow over four times the recommended daily amount of fluoride in toothpaste.

How safe is fluoride?

Fluoride is documented to be safe and highly effective. Research indicates water fluoridation, the most cost effective method, has decreased the decay rate by over 50 percent. Only small amounts of fluoride are necessary for the maximum benefit. Proper toothpaste amount must be supervised, and other forms of fluoride supplementations must be carefully monitored in order to prevent a potential overdose and unsightly spots on the developing permanent teeth. Do not leave toothpaste tubes where young children can reach them. The flavors that help encourage them to brush may also encourage them to eat toothpaste.

What is topical fluoride?

Topical fluoride comes in a number of different forms. Gels and foams are placed in fluoride trays and applied at the dental office after your child's teeth have been thoroughly cleaned. Fluoride varnish is one of the newer forms of topical fluoride applied at the dentist office. It has been documented to be safe and effective to fight dental decay through a long history of use in Europe.

The advantages of varnish are:

• Easily and quickly applied to the teeth.
• Decreases the potential amount of fluoride digested.
• Continues to "soak" fluoride into the enamel for approximately 24 hours after the original application.

This method is especially useful in young patients and those with special needs that may not toleratefluoride trays comfortably.

Children who benefit the most from fluoride are those at highest risk for dental decay. Riskfactors include a history of decay, high sucrose carbohydrate diet, orthodontic appliances andcertain medical conditions such as dry mouth.

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Q: How often should a child see the dentist?

A: The American Academy of Pediatric Dentistry recommends a dental check-up at least twice a year for most children. Some children need more frequent dental visits because of increased risk of tooth decay, unusual growth patterns or poor oral hygiene. Your pediatric dentist will let you know the best appointment schedule for your child.

Q: Why visit the dentist twice a year when my child has never had a cavity?

A: Regular dental visits help your child stay cavity-free. Teeth cleanings remove debris that build up on the teeth, irritate the gums and cause decay. Fluoride treatments renew the fluoride content in the enamel, strengthening teeth and preventing cavities. Hygiene instructions improve your child's brushing and flossing, leading to cleaner teeth and healthier gums.

Tooth decay isn't the only reason for a dental visit. Your pediatric dentist provides an ongoing assessment of changes in your child's oral health. For example, your child may need additional fluoride, dietary changes, or sealants for ideal dental health. The pediatric dentist may identify orthodontic problems and suggest treatment to guide the teeth as they emerge in the mouth.

Q: What happens in a dental check-up?

A: The pediatric dentist will review your child's medical and dental history. He or she will gently examine your child's teeth, oral tissues, and jaws. The teeth will be cleaned and polished, followed by the application of a fluoride solution.

Your pediatric dentist won't talk just to you about dental health, he or she will talk to your child with easily understandable words, pictures, and ideas. Your child will be motivated to take responsibility for healthy smile.

Q: Will X-rays be taken at every appointment?

A: No. Pediatric dentists, acting in accord with guidelines from the American Academy of Pediatric Dentistry, recommend X-rays only when necessary to protect your child's dental health.For example, X-rays maybe needed to diagnose tooth decay or abnormalities. Or, they may be required for orthodontic treatment. Your pediatric dentist will discuss the need for X-rays with you before any are taken.

Q: How can I help my child enjoy good dental health?

A: The following steps will help your child be part of the cavity-free generation:

1. Beware of frequent snacking
2. Brush effectively twice a day with a fluoride toothpaste
3. Floss once a day
4. Have sealants applied when appropriate
5. Seek regular dental check-ups
6. Assure proper fluoride through drinking water, fluoride products or fluoride supplements

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It's never too early to keep an eye on your child's oral development. Your pediatric dentist can identify malocclusion -- crowded or crooked teeth or bite problems -- and actively intervene to guide the teeth as they emerge in the mouth. Orthodontic treatment early can prevent more extensive treatment later.

Q: What causes crowded teeth and other orthodontic problems?

A: Malocclusion is often inherited. Orthodontic problems also are caused by dental injuries, the early loss of primary teeth or such habits a thumb sucking, fingernail biting, or lip biting. Your pediatric dentist can help your child avoid oral habits that may create orthodontic problems.

Q: Why is early orthodontic care important?

A: Early orthodontics can enhance your child's smile, but the benefits far surpass appearance. Pediatric orthodontics can straighten crooked teeth, guide erupting teeth into position, correct bite problems, even prevent the need for tooth extractions. Straight teeth are easier to keep clean and less susceptible to tooth decay and gum disease.

Q: What is early orthodontic treatment like?

A: Different orthodontic appliances work in different ways to benefit your child's dental health. Some are fixed; others are removable. Your pediatric dentist will explain which appliance is best for your child, what the treatment can do, and how long it will take.

Q: What care is recommended during orthodontic treatment?

A: As with any dental treatment, the more a child cooperates, the better the results. First, careful brushing and flossing keep the appliance and your child's health in top shape. (Removable appliances should be brushed each time the teeth are brushed.) Second, regular dental check-ups -- besides orthodontic appointments -- protect your child from tooth decay and gum disease. Third, prompt contact with your pediatric dentist when an appliance breaks will keep orthodontic treatment on-time and on-track.

Q: Can my child speak, eat, and play normally?

A: Your child can eat a normal diet except sticky foods (gum, caramels) and large, hard foods (peanuts, ice chips, popcorn). Some appliances alter speech, but most children adapt quickly and speak clearly within a day or two. Generally, children can safely run, jump, swim, and play with an orthodontic appliance. Check with your pediatric dentist for specific advise on your child's activities.

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Q: What is malocclusion?

Malocclusion is the improper positioning of the teeth and jaws. It is a variation of normal growth and development which can affect the bite, the ability to clean teeth properly, gum tissue health, jaw growth, speech development and appearance.

Q: What causes malocclusion?

Both heredity and environmental factors can play a role in developing malocclusions. The shape and size of the face, jaws and teeth are determined mostly by inheritance. Environmental factors can also have a large impact and these are the types of problems which the pediatric dentist is well trained to manage.

Q: How long does it take to treat a malocclusion?

Every child is unique and must be treated individually. The pediatric dentist will provide an estimate of the length of time required prior to initiating treatment. In complex malocclusions the treatment may be divided into several phases which are scheduled to coincide with the child's particular pattern of growth and development.

Q: Is it necessary to remove healthy teeth to correct a malocclusion?

Carefully controlled removal of selected primary teeth may be necessary to guide the permanent teeth into proper position. This procedure requires frequent monitoring over a period of time and usually in combination with the use of some type of appliance. The removal of permanent teeth depends specifically upon the circumstances for that particular child. There are some malocclusions which cannot be treated successfully without removing permanent teeth and there are other situations where permanent teeth should definitely not be removed. This is a decision which must be made very carefully after thoroughly evaluating all of the diagnostic materials available for that patient.

Q: What information does the pediatric dentist need to evaluate a developing malocclusion?

The complexity of each child's individual problem will dictate the extent of examination and diagnostic procedures. Following a thorough clinical examination with a review of past medical and dental history, impressions of the teeth are taken from which plaster models are made. These study models provide a baseline reference of the current relationship of the teeth and jaws and also provide a method to monitor the progress of any treatment. Photographs of the face and teeth also provide a record of the child's facial appearance prior to treatment. Several types of X-rays may be needed to properly diagnose a developing malocclusion. Most commonly used are a panoramic X-ray, which shows all the upper and lower teeth in biting position as well as any teeth still developing within the jaws, and a lateral X-ray of the entire head, known as a cephalometric X-ray which shows the relationship of the teeth and jaws to the face and skull.

Q: What types of appliances are used to correct malocclusion?

There are two basic types of tooth movement appliances, removable and fixed. Removable appliances are made of wires and plastic and can be removed from the mouth by the patient. Some fit the upper and lower teeth at the same time. Their success is totally dependent on the patient's compliance in wearing the appliance exactly as instructed by the pediatric dentist. An advantage of removable appliances is that they are easy to keep clean. Fixed appliances are what we know as "braces." Because this type of appliance is attached directly to the teeth, there is better control of tooth movement. However, cooperation from the patient in maintaining scrupulous oral hygiene while wearing fixed appliances is essential in preventing cavities in areas where food collects easily around these appliances.

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Q: Why do children lose their baby teeth?

A: A baby tooth usually stays in until a permanent tooth underneath pushes it out and takes its place. Unfortunately, some children lose a baby tooth too soon. A tooth might be knocked out accidentally or removed because of dental disease. When a tooth is lost too early, your pediatric dentist may recommend a space maintainer to prevent future space loss and dental problems.

Q: Why all the fuss? Baby teeth fall out eventually on their own!

A: Baby teeth are important to your child's present and future dental health. They encourage normal development of the jaw bones and muscles. They save space for the permanent teeth and guide them into position. Remember: Some baby teeth are not replaced until a child is 12 or 14 years old.

Q: How does a lost baby tooth cause problems for permanent teeth?

A: If a baby tooth is lost too soon, the teeth beside it may tilt or drift into the empty space. Teeth in the other jaw may move up or down to fill the gap. When adjacent teeth shift into the empty space, they create a lack of space in the jaw for the permanent teeth. So, permanent teeth are crowded and come in crooked. If left untreated, the condition may require extensive orthodontic treatment.

Q: What are space maintainers?

A: Space maintainers are appliances made of metal or plastic that are custom fit to your child's mouth. They are small and unobtrusive in appearance. Most children easily adjust to them after the first few days.

Q: How does a space maintainer help?

A: Space maintainers hold open the empty space left by a lost tooth. They steady the remaining teeth, preventing movement until the permanent tooth takes its natural position in the jaw. It's more affordable -- and easier on your child -- to keep teeth in normal positions with a space maintainer than to move them back in place with orthodontic treatment.

Q: What special care do space maintainers need?

A: Pediatric dentists have four rules for space maintainer care. First, avoid sticky sweets or chewing gum. Second, don't tug or push on the space maintainer with your fingers or tongue. Third, keep it clean with conscientious brushing and flossing. Fourth, continue regular dental visits.

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Q: What are tooth-colored fillings?

A: Tooth-colored fillings are made from durable plastics called composite resins. Similar in color and texture to natural teeth, the fillings are less noticeable, and much more attractive, than other types of fillings.

Q: What are the advantages of tooth-colored fillings?

A: Because composite resins are tooth-colored, they look more natural than other filling materials. Your child can smile, talk, and eat with confidence. In addition, tooth-colored fillings are compatible with dental sealants. A tooth can be filled and sealed at the same time to prevent further decay.

Q: What are disadvantages?

A: First, tooth-colored fillings are not for every tooth. They work best in small restorations and low-stress areas. For example, your pediatric dentist may not recommend a tooth-colored filling for a large cavity or for the chewing surface of a back tooth. Second, tooth-colored fillings may cost a bit more than silver fillings because they take longer to place.

Q: How do I decide if tooth-colored fillings are right for my child?

A: Talk to your pediatric dentist. Together you will decide what type of filling is best for your child.

Q: How do I care for a tooth-colored filling?

A: Take care of a tooth-colored filling the same way you take care of a silver filling: Brush, floss, and visit your dentist. Any filling will last longer with good oral hygiene. Your pediatric dentist will regularly check the fillings for color change, leakage, or unusual wear and inform you of the need for repair or replacement.

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