1. What do I need to know about my baby's teeth?
2. At what age should I bring my child to the dentist?
3. How often should I bring my child to the dentist?
4. What will my child's first visit to the dentist be like?
5. What do I need to know about fluoride?
6. What causes cavities and why should we fix them on baby teeth if these teeth will
be lost anyway?
7. Will my child have problems with her permanent teeth if her baby teeth have had
a history of cavities?
8. What should I do if my child has tooth pain or an injury to the mouth?
9. What toothpaste is best for my child and how much should be used?
10. Are dental x-rays safe for my child?
11. What is a "tooth healthy" diet?
12. Is thumb sucking or use of a pacifier harmful to my child's teeth?
13. Why are my child's permanent teeth yellow?
14. My 8-year-old has a large space between his two front teeth. Should I be
concerned?
15. What if a permanent tooth is coming in and the baby tooth has not fallen out?
16. Why does my child need sealants?
17. What is the best time for orthodontic treatment?
What do I need to know about my baby's teeth?
Babies begin to get their first teeth at about six months of age. The two lower front teeth typically erupt first, followed shortly by the upper front teeth. During the next 18 to 24 months the remaining baby teeth appear, although not necessarily in order from front to back. All 20 baby teeth should be present by 36 months. Some babies do not get their first teeth until close to their first birthday. To help soothe your baby during teething, offer her a teething biscuit, a cold teething ring, frozen bagels, or a piece of toast. Over the counter teething medications can offer temporary relief by numbing the gums, although they should be used sparingly. A baby can benefit from occasional use of infant pain relievers.
Home dental care should start early, even before the baby has teeth in her mouth. A soft washcloth can be used at bath time to wipe the gums. As the teeth appear in the mouth, a small, soft-bristled toothbrush should be used at least once per day, preferably before bedtime. Toothpaste is not necessary for children under 2 years old. The main goal of these brushings is to remove food residue from your child's teeth.
It is often tempting to nurse an infant to sleep or let the child take a bottle of milk or juice to bed. These habits can lead to massive tooth decay (commonly known as baby bottle tooth decay) as the sugars in the milk, formula, or juice are left on the teeth during the night. We recommend brushing your child's teeth before bedtime and providing only water at night.
At what age should I bring my child to the dentist?
The American Academy of Pediatric Dentistry recommends that children visit the dentist within 6 months of the first tooth eruption or by one year of age. Regular visits help a child get comfortable with his dentist and the dental staff. These visits also allow us to consistently evaluate your child's dental health and take early corrective measures if needed. Also, regular exams, cleanings, and fluoride treatments help prevent decay and avoid costly problems. Regular dental visits are part of leading a healthy and normal life for your child. Our goal is to create a sense of comfort and responsibility when it comes to routine dental care, so that our patients grow up to take their oral health seriously.
How often should I bring my child to the dentist?
Both children and teenagers should visit our office every six months in order to prevent cavities and other dental problems. Baby teeth have thinner enamel and often have large nerve chambers. A cavity on a baby tooth tends to grow at a fast pace. When discovered early, we can often stop the cavity, thereby preventing the need to place a large filling.
What will my child's first visit to the dentist be like?
The first visit includes a thorough discussion of medical history, fluoride use, prior dental history, habits (pacifier or thumb sucking), and any concerns with the child's teeth. A comprehensive exam is completed addressing not only the teeth, but also growth and development of the jaws and the soft tissues of the mouth. If the child is ready, a professional cleaning and fluoride treatment are completed. The dentist will assess the need for x-rays. Oral hygiene instructions as well as diet history are reviewed. If there is need for further treatment, a future appointment will be made after the treatment plan is explained in detail. Our patients are praised and rewarded with prizes and balloons in order to emphasize a positive experience at the office.
What do I need to know about fluoride?
Fluoride is an element that, when incorporated in the tooth structure, can greatly strengthen the tooth and help prevent cavities. Overwhelming evidence by the American Dental Association (ADA), the Centers for Disease Control (CDC), and the World Health Organization (WHO) has demonstrated that fluoride dramatically decreases the chance of getting cavities. Many adults who grew up with regular dental care and fluoride supplementation have few or no dental problems. Most communities have fluoridated water. When the appropriate amount of water is ingested, the developing teeth that have not erupted are strengthened. Fluoride in toothpaste and rinses strengthens teeth that are already in the mouth.
At your child's first visit we assess the amount of fluoride your child is getting on a regular basis. Each child's intake can vary greatly. If your child's fluoride intake is insufficient, we will often prescribe fluoride supplementation.
Unfortunately, there is also a large amount of conjecture and opinion on the Internet that has claimed that fluoride is dangerous. At therapeutic levels, there has never been a published study that has been able show reliable, repeatable results that demonstrate even a possibility of any harm. Many people find all of the negative opinions very confusing, and we look forward to answering any questions you may have so that you can feel comfortable and make an informed decision about your child's health.
What causes cavities and why should we fix them on baby teeth if these teeth will be lost anyway?
A cavity is essentially a bacterial infection. Decay is caused when plaque -- a thin, sticky, colorless deposit of bacteria that constantly forms on everyone's teeth - is allowed to stay on the teeth. When sugar is eaten, the bacteria in plaque produce acids that attack the tooth enamel. After repeated acid attacks, the enamel breaks down and a cavity or hole is formed in the tooth. The process happens especially quickly with sugar in liquid form. The most common culprits are 100% fruit juice, sports drinks, and chocolate milk. Regular milk, water, or Crystal Light are all great alternatives that kids love and that will not cause cavities.
It is unwise to leave any amount of decay on baby teeth. Decay can easily move to other baby teeth or even to permanent teeth. It can also cause pain, lead to facial infections, and cause expensive orthodontic problems that could have been avoided. We recommend carefully restoring all decayed teeth to optimal health. Our office can determine if the tooth will fall out soon by taking an x-ray to verify the permanent tooth's expected time of eruption. Some baby teeth may not fall out until the child is 12 years old.
Will my child have problems with her permanent teeth if her baby teeth have had a history of cavities?
Generally, the health of your child's permanent teeth will be affected by the same conditions that affected the baby teeth. Unfortunately, a child with a history of multiple cavities has a higher bacterial count in her mouth and will always be more susceptible to decay. The bacteria can spread to healthy teeth and cause more decay. This is another reason why it is important for your child to visit our office on a regular basis. If your child has had multiple cavities in the past, we may want to consider a more frequent check-up schedule.
What should I do if my child has tooth pain or an injury to the mouth?
Please refer to our Dental Emergencies section under Services.
What toothpaste is best for my child and how much should be used?
We recommend using any fluoridated toothpaste that is recognized by the American Dental Association. However, children under the age of three generally should not use a fluoridated toothpaste -- they should use a non-fluoridated infant toothpaste or water if they are not able to rinse and spit effectively. Children's toothpaste is usually milder in flavor, and thus more pleasing to younger children. If a child does not like the sweeter flavors of children's toothpaste, regular fluoridated toothpaste is fine. Do not use tartar control, peroxide, whitening, or baking soda toothpaste on a young child, as these are more abrasive toothpastes and may irritate your child's gums.
Most children under the age of five will swallow some amount of toothpaste. We recommend that the parent place an amount of toothpaste roughly one half the size of a pea on the brush or simply a small smear across the toothbrush head.
Are dental x-rays safe for my child?
There is very little risk associated with receiving dental X-rays. Our state-of-the-art digital x-ray machines utilize a fraction of the radiation used in the older models. X-rays are highly valuable in finding hidden decay, tumors, and missing or extra teeth as well as for determining growth patterns.
What is a "tooth healthy" diet?
A balanced diet of fruits, vegetables, grains, dairy products, meat, fish, and eggs will go a long way toward developing overall health. The most common risk factor for children's tooth decay is the amount of liquid sugar they drink. The most common drinks that cause decay include juice (both 100% fruit juice, sports drinks (Gatorade), chocolate milk, 'kids drinks' (Sunny Delight and Capri Sun), and soda. Some healthy alternatives to these drinks that most children will like include sugar-free Kool-Aid, milk, and unsweetened soy and rice milk.
Sticky sweets (including dried fruits, chewy granola bars, peanut butter and jelly) should be kept to a minimum. (Even Dr. Niloo has a sweet tooth, but she brushes after eating sugary foods.) Be wary of gummy vitamins, as they are loaded with sugar and have been a more recent culprit in causing cavities because they stick to teeth and take a long time to dissolve as do sticky candies.
Is thumb sucking or use of a pacifier harmful to my child's teeth?
Generally, children will outgrow these habits before they become harmful. Children vary in the way they carry out their habits. The extent of damage depends on the duration of the habit, the length of time the child sucks the thumb or pacifier, and the severity of the sucking. Some children who continue these habits as their permanent teeth are erupting may benefit from a corrective appliance that allows for a more normal growth pattern. These "habit breakers" are meant as a reminder and not as a punishment. Therefore, the child has to be ready and want to stop the habit on his own in order for the treatment to be successful. If your child uses a pacifier or sucks his finger or thumb, please mention these habits during your child's regular exams so we can properly monitor your child's growth.
What if a permanent tooth is coming in and the baby tooth has not fallen out yet?
This is a very common problem, especially in the front lower incisors. If the tooth is loose, it may come out on its own within a few weeks. If the baby tooth is not loose, the dentist may need to extract the baby tooth. In either case, it is best to make an appointment so that the situation can be assessed and the best course of action taken for your child.
My 8-year-old has a large space between his two front teeth. Should I be concerned?
Usually there is no need for concern, and the space will close during the next few years as the other front teeth erupt. We will monitor progress during exams and help you determine if orthodontics may be recommended.
Why are my child's permanent teeth yellow?
Permanent teeth are normally more yellow than baby teeth. This becomes very apparent when the child is between the ages of seven and ten, which is when the adult teeth are next to the very white baby teeth. Once the child has lost several more baby teeth, most children appear to have white smiles when compared to adults.
Why does my child need sealants?
The most common type of cavity is on the chewing surface of the teeth, where there are deep pits and grooves. Sealants are protective tooth-colored coatings that are placed on the deep pits and grooves of molars to help prevent decay. Sealants are most commonly recommended for permanent molars. In some cases where the cavity risk of a child is high and the deep grooves are stained, sealants may be placed on the baby molars.
What is the best time for orthodontic treatment?
The American Academy of Orthodontics recommends an orthodontic evaluation by age seven. However, pediatric dentists are trained to examine growth and development as well as the child's bite at every exam and to respond early if there is a concern. Certain problems, such as crossbites, are corrected early while most other cases can be treated when the child has lost all the baby teeth, typically between the ages of 11 and 13. Our office will refer you to an orthodontist at the appropriate time.
