Dental FAQ For Pediatric Dentistry

Why should my child see a Pediatric dentist?

Pediatric dentists are specialists just for kids. They have two to three years of training beyond dental school which is focused on child psychology, growth and development and treating people with special health care needs.

When should my child see the dentist?

The American Academy of Pediatric Dentistry recommends that a child should be seen by a dentist by 12 months of age. This is important because it establishes a dental home for the child and encourages an ongoing relationship between the dentist, patient and family. As soon as there is a tooth, there is potential for tooth decay. Many parents who wait until the child is older to see the dentist are diagnosed with cavities at their first appointment.

What if my child has special needs?

Special health care needs can include physical, developmental, sensory, behavioral, cognitive, or emotional impairment that require extra care or additional medical management. Dr. Parhar has extensive training and experience working with children with special needs and at Growing Smiles Children’s Dentistry we are committed at providing the best care possible for your child.

When will my baby start growing baby teeth?

The average age for the eruption of the first baby tooth is 6 months old and it is usually the lower central incisor.

When will my child start loosing baby teeth and growing permanent teeth?

The average age for the exfoliation of the first baby tooth (lower central incisor) and the eruption of the permanent tooth (lower central incisor) is 6 years old.

What causes cavities?

Cavities are caused by a combination of factors which can all be controlled and thus prevent the caries process from starting.

Four things are necessary for cavities to form:

  1. Tooth surface
  2. Bacteria
  3. Sugars or other carbohydrates
  4. Time

Some teeth are more susceptible to tooth decay due to the shape, number and depth of grooves and tight contacts between teeth. Proper oral hygiene including flossing and the placement of dental sealants are important in reducing the risk factors. Since cavity causing bacteria is passed through saliva parents should try and eliminate the sharing of objects going into their children’s mouth such as eating utensils and pacifiers. Foods high in sugar and carbohydrates (cookies, pretzels, crackers, chips and juice) are metabolized to acid by specific oral bacteria leading to cavities. The longer these foods stay in our mouths, the more damage is done.

What is baby bottle decay?

Baby bottle decays is a severe form of early childhood caries caused by prolonged exposure to milk, formula or other sugar containing liquids such as juice. Baby bottle decay leads to pain and often extractions of several baby teeth. To prevent baby bottle decay avoid putting your child to sleep with a bottle that contain any sugar containing liquids. Make sure to wipe your child’s teeth with a washcloth/tooth brush after every feeding or give a bottle with water to clear the mouth. Start transitioning your baby to a "sippy" cup soon after the first birthday. If you see white spots starting to develop on your babies teeth, visit a Pediatric dentist ASAP. White spots could be the start of the carious process and can be reversed.

How common is tooth decay?

Tooth decay is the number one chronic infectious disease among kids in America, according to the Centers for Disease Control and Prevention. By age 5, about 60 percent of children will have had tooth decay at some point, including the 40 percent of children who have it when they enter kindergarten.

How can you prevent cavities?

Parents should help their children brush their teeth twice daily – after breakfast and before bedtime are ideal. It is recommended that parents assist their children with brushing until the child can tie their own shoe laces. It’s recommended that parents/caregivers supervise the brushing for school-age children until they are 7 to 8 years of age.

Parents can begin flossing for their children when any two teeth are touching.

Avoid giving carbonated beverages to your kids, which can erode enamel on teeth and be sure to limit juice to less than four ounces per day.

Keep an eye on snacking- ideally children should have no more than three snacks times a day. Cheeses are great as a snack or to eat after a meal because they clear the mouth of food and neutralize the acids that attack teeth.

Also, regular check-ups with the dentist every six months are the most important steps to prevent childhood tooth decay. If your child has braces, special needs or poor oral health the dentist may recommend more frequent office visits.

Why do you need to fix baby teeth?

Baby teeth serve as the blueprint and pathway for permanent teeth. So even though they eventually fall out, preventing tooth decay in baby teeth is one way to avoid future problems in permanent teeth.

What can happen if tooth decay is left untreated?

Along with pain, children with untreated tooth decay also experience difficulty chewing, problems speaking, insufficient sleep and resulting self-esteem problems.

If there is significant swelling in the face or mouth and high fever due to an infection associated with an untreated cavity, the infection will cause significant pain and can result in death in rare cases.

What do I expect at the first visit?

You and your child will be introduced to the dental environment in a positive and friendly way. The first dental visit should be an opportunity for the doctor and parents to discuss the current and future oral health of the child and focus on prevention of oral health problems. The dentist will perform an extra oral and intra oral exam which may or many not include a dental cleaning, professionally applied fluoride treatment or dental x- rays. Risk factors for future cavities will be identified and discussed and an appropriate diagnosis, treatment and follow up will be determined.

What if my child has a cavity?

Parents are always welcome during all examinations and procedures but we suggest that parents allow the doctors and dental staff to explain all dental treatments. At Growing Smiles Children’s Dentistry we take great care in explaining and using behavior modification strategies to ensure that the child feels safe and non-threatened. For the safety and privacy of all patients, other children who are not being treated should not be present in the treatment room.

All the steps involved are explained to the child in non-threatening terms he or she can understand. We try and avoid using terms such as "needle", "shot", "drill", "pain", "pull- out tooth", "hurt", since they can add to anxiety. The office uses terms that convey the same message in non-frightening language.

All procedures are done in the office using distraction techniques and if needed, mild sedation such as nitrous oxide. If a child has a lot of dental work to be done and cannot tolerate treatment in the chair due to anxiety, fear, age, and or special needs then dentistry under general anesthesia is an available alternative.

Does the office use amalgam filling?

Growing Smiles Children's Dentistry recommends and only uses composite (white fillings) for primary and permanent teeth.

What is a baby root canal?

A baby root canal (also known as a pulpotomy/pulpectomy) is indicated when a large cavity is present that involves the nerve of the tooth. The nerve of the primary tooth needs to be removed in order to prevent infection of the tooth. Unlike a permanent tooth root canal, it is a simple procedure and will take only one visit to complete and restore.

Why does my child need to have a tooth extracted?

A primary tooth may need to be extracted for the following reasons:

  1. To allow eruption of permanent tooth
  2. Due to a large cavity the tooth may not be able to be restored and an extraction may be recommended;
  3. An orthodontist may recommend a primary or permanent tooth extraction to enable proper teeth alignment.

Why does my child need a space maintainer?

A space maintainer is recommended when a primary tooth is extracted or falls out early and the space of the arch needs to be maintained to allow the permanent tooth to erupt in the correct position.

Why does my child need a crown?

A crown is recommended for a tooth when the structure of the tooth is compromised due to decay, root canal treatment, developmental defect or trauma and a "full coverage" restoration is the best choice to maintain the integrity of the tooth.

Are dental sealants important?

Dental sealants are a safe and effective way to prevent cavities. They may be recommended for primary and permanent teeth with pits and fissures (grooves on the teeth) that trap plaque and bacteria thereby putting the teeth at risk for cavities. The tooth colored sealant material is applied in a quick and easy appointment to the pits and fissures of the teeth and acts as a barrier to food, plaque and acid thereby protecting cavity prone areas of a tooth. Sealants are continually monitored and repaired or replaced as needed.

When should my child stop thumb-sucking, pacifier use?

The sucking reflex is completely normal and many children will stop sucking on thumbs, pacifiers or other objects on their own between 2 and 4 years of age. Intervention may be recommended for children beyond 3 years of age when changes in teeth alignment start to occur. The earlier a child can stop a sucking habit, the less chance there is that it will lead to orthodontic problems down the road. Discuss appropriate strategies with your Pediatric Dentist in helping to decrease or eliminate thumb-sucking, finger-sucking or pacifier use in your child.

What is the office fluoride policy?

Growing Smiles Children’s Dentistry supports the American Academy of Pediatric Dentistry’s policy that fluoride is a safe and effective adjunct in reducing the risk of caries and reversing enamel demineralization.

It is important to discuss when to start fluoridated tooth paste with your Pediatric Dentist. A general recommendation by the American Academy of Pediatric Dentistry is using no more than a "smear" or "rice-size" amount of fluoridated toothpaste for children less than three years of age and using no more than a "pea-size’ amount of fluoridated toothpaste for children aged three to six.

When does my child need x-rays?

At Growing Smiles Children’s Dentistry we believe in the importance of taking dental radiographs to aid in the diagnosis of oral disease and to monitor dental facial development. In accordance to the American Academy of Pediatric Dentist guidelines, necessary precautions to minimize the patients exposure and employ good radiological practices are in place, such as the use of lead aprons, thyroid collars and the use of digital radiographs.

When does my child need braces?

An important role of the Pediatric Dentist is to monitor and guide the eruption and development of the primary and permanent teeth. The best time to see an orthodontist is different for every child and the Pediatric Dentist is trained to diagnose problems in occlusion and will make the appropriate referrals to orthodontists and/or oral surgeons when the child requires it.

Does my child need to wear a mouth guard for sports?

Children are most susceptible to sports-related oral injury between the ages of seven and 17 years. Helmets, facemasks and mouth guards have been shown to reduce the frequency and severity of dental and facial trauma.

Discuss the fabrication of a custom fitted mouth guard with the dentist to ensure maximum protection, cushioning and retention.