Pediatric Dental FAQs

About the Dentist

What is a pediatric dentist?

The pediatric dentist has an extra two to three years of specialized training after dental school, and is dedicated to the oral health of children from infancy through teenage years. Very young, pre-teen, and teenage patients all need different approaches in dealing with their behavior, guiding their dental growth and development, and helping them avoid future dental problems. Pediatric dentists are best qualified to meet these needs.

What does “board certified” mean?

Dentists who graduate from an accredited pediatric specialty program have the option to become a board-certified pediatric dentist through the American Board of Pediatric Dentistry. The process involves a written qualifying examination and an oral clinical examination covering every aspect of pediatric dentistry. Dentists who pass the exams become diplomates of the American Board of Pediatric Dentistry, and certification is renewed annually.

Visiting the Dentist 

How can I prepare my child for their first visit?

As you prepare your child for their dentist appointment, it’s important to remember that parental anxiety about dental treatment can transfer to your child. So stay positive! In conversation, be mindful of the terms you use. Tell your child that the dentist keeps teeth happy and healthy, and that they’ll be gentle while “counting” and “tickling” their teeth. We use tons of different words and phrases in our office: “brush” instead of drill, “wiggle” instead of yank or pull, etc. And we don’t talk about needles or shots — we prefer to call it “sleepy juice.” Most children tolerate dental shots well, and usually don’t even know they received an injection, especially when they’re calm and relaxed.

When should I schedule my child’s first visit to the dentist?

The American Association of Pediatric Dentists recommends scheduling your first checkup as soon as the first tooth appears, or no later than your child’s first birthday.

How often should my child see a pediatric dentist?

We recommend checkups every six months. Visiting the pediatric dentist regularly is critical for the prevention and early detection of dental diseases, along with establishing a lifetime of healthy habits.

About Baby Teeth

When will my baby start getting teeth?

Children’s teeth begin forming before birth. By the time they’re 4 months old, the lower central incisors usually begin to erupt through the gums, followed closely by the upper central incisors. All 20 primary teeth should appear by age 3, but the pace and order of their eruption varies.

Permanent teeth begin appearing around age 6, starting with the first molars and lower central incisors. At age 8, you can generally expect the bottom 4 primary teeth (lower central and lateral incisors) and the top 4 primary teeth (upper central and lateral incisors) to have been replaced by permanent teeth. There’s about a one- to two-year break from ages 8-10, and then the rest of the permanent teeth will start to come in. This process continues until approximately age 21.

Why are baby teeth important?

Baby teeth (or primary teeth) are very important for your child’s health. Neglected cavities during this time frequently lead to problems in permanent teeth development. Primary teeth encourage proper chewing and eating, provide space for the permanent teeth, and promote natural jaw bone and muscle development. They also help your child speak clearly and add to a better overall appearance.

What should I use to clean my infant’s teeth?

The American Association of Pediatric Dentists recommends any soft-bristled toothbrush with a small head, preferably one designed specifically for infants. It should be used at least once a day before bedtime.

How can I prevent baby bottle tooth decay?

Baby bottle tooth decay is a serious problem among young children. The condition is caused by frequent and long exposures of an infant's teeth to liquids that contain sugar (like milk, formula, fruit juice, and other sweetened drinks).

To prevent baby bottle tooth decay, it’s important never to put your baby to bed with a bottle of anything other than water. Sweet liquids will pool around the child's teeth, giving plaque bacteria an opportunity to produce acids that attack tooth enamel. If your child won't fall asleep without a sweet beverage, gradually dilute it with water over a period of two to three 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 with the child's head in your lap or to lay the child on a dressing table. Whatever position you use, be sure you can see into the child's mouth easily.

Are sippy cups OK?

We recommend discontinuing the use of sippy cups after your child’s first birthday. While they’re in use, they should only be filled with water — sweet drinks will soak the child’s teeth in bacteria, causing cavities.

Is thumb sucking OK?

Sucking on thumbs, fingers, pacifiers, and other objects is a natural reflex in infants and young children. According to the American Association of Pediatric Dentists, it only becomes a problem after a very long period of time. Most children stop these habits on their own, but if they’re still sucking their thumbs or fingers past the age of three, it might be time to take action.

Here are a few suggestions to help your child get through thumb sucking:

  • Children often suck their thumbs when they feel 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, like when they’re away from their parents.
  • Band the thumb or put a sock over the entire hand at night.
  • Ask us to intervene. We can explain why it’s bad to your child, and tell them what could happen if they continue. We can also provide a mouth appliance in extreme cases.

What toothpaste is best for my child?

Maintaining a regular brushing schedule is one of the best things you can do for your teeth. However, some toothpastes and polishes can damage young smiles. A surprising amount contain harsh abrasives that erode juvenile tooth enamel. 

Make sure the toothpaste you pick for your child is recommended by the American Dental Association (the box and tube should say so). These toothpastes have undergone testing to make sure they’re safe for kids to use.

Keep in mind that children should spit out toothpaste after brushing to avoid getting too much fluoride, which can cause fluorosis. If your child is too young or unable to spit out toothpaste, consider giving them a fluoride-free toothpaste, using no toothpaste, or using only a pea-size amount of toothpaste.

General Dental Questions

Is fluoride OK for my child?

Fluoride is an element that’s been shown to help teeth. The proper amount will strengthen them and help prevent cavities. 

Problems arise when you deviate from that amount. Too little, and your child won’t see any of fluoride’s great benefits; too much, and they could develop fluorosis, a chalky white/brown discoloration of the permanent teeth. 

Most at-risk of fluorosis are two and three year olds, who may not be able to spit their toothpaste out after they brush. During this critical period of permanent tooth development, Toothpaste ingestion is the most common cause of fluorosis. Consider giving them a fluoride-free toothpaste, using no toothpaste, or using only a pea-size amount of toothpaste.

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 less than six months old. For infants six months and older, fluoride supplements should only be considered after all of the sources of ingested fluoride have been accounted for and upon the recommendation of your 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 baby tooth cleanser on the toothbrush of the very young child.
  • 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 at least 6 months old.
  • Obtain fluoride level test results for your drinking water before giving fluoride supplements to your child (check with local water utilities).

My child grinds their teeth at night — is that alright?

The nocturnal grinding of teeth, or bruxism, is common for kids. Very often, they’ll do it because they’re stressed — a new environment, changes at school, or a divorce can all contribute to the development of bruxism. Another cause has to do with inner-ear pressure at night: changes in pressure can cause children to grind their teeth in an attempt to relieve it.

Whatever the cause, the fact remains that the majority of bruxism cases don’t require any treatment, and most children outgrow it eventually. The grinding tends to decrease between ages 6-9, then stop altogether by age 12. If you suspect bruxism, bring it up during your next visit and we can talk about solutions. If excessive teeth wear is present, we might ask that your child wear a night guard.

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