Pediatric Dentistry

Child's First Pediatric Dental Visit

According to guidelines from the American Academy of Pediatric Dentistry (AAPD), your child should be seen by his/her pediatric dentist no later than six months after the eruption of the first tooth.

This visit mainly will involve counseling on oral hygiene, habits, and on the effects that diet can have on his/her teeth. It is NOT recommended to wait until age 3 to visit your dentist and as a general rule, the earlier the dental visit, the better the chance of preventing dental problems.

Children with healthy teeth chew food easily, learn to speak clearly, and smile with confidence. Start your child now on a lifetime of good dental habits.

The AAPD also recommends a dental check-up at least twice a year; however some children that may be at a higher-than-average caries risk may need to be seen more often.

Children's Tooth Development

Children continually get new teeth from age 3 months to the age 6 years. Most children have a full set of 20 primary teeth by the time they are 3 years old. As a child nears the age 6, the jaw grows making room for the permanent teeth. At the same time, the roots of the baby teeth begin to be resorbed by the tissues around them and the permanent teeth under them begin to erupt.

Primary teeth are just as important as permanent teeth for chewing, speaking and appearance. They also serve as placement holders for the permanent teeth. Primary teeth also provide structure to help shape the child's face.

Baby Bottle Tooth Decay

Baby bottle tooth decay or syndrome is a form of tooth decay that can destroy the teeth of an infant. This decay may even enter the underlying bone structure, which can hamper development of the permanent teeth. The teeth most likely to be damaged are the upper teeth.

Baby bottle decay is caused by frequent and long exposure of a child's teeth to liquids containing sugar such as milk, formula, fruit juices, pop and other sweetened liquids. These liquids fuel the bacteria in a child's mouth, which produces acids that attack enamel.

Baby Tooth Care

Healthy teeth are important to your baby's overall health. Teeth help your baby chew food and form words and sounds when speaking. They also affect the way your baby's jaw grows.

Every baby is different. Generally, the 2 front teeth start to appear between 4 and 7 months of age. Teething is usually painless, but it can make some babies uncomfortable and fussy. Giving your baby a cold teething ring or a cold washcloth to chew or suck on may help. Teething does not cause a fever. If your baby has a fever, you should talk to your doctor.

Start cleaning your baby's teeth twice a day as soon as the first tooth appears. Until your child is 1 year old, you can use a wet wash cloth or gauze to clean your baby's teeth and gums. At about 1 year to 18 months of age, you should start using a soft baby toothbrush and a small dab of toothpaste that does not have fluoride in it. This type of toothpaste is safe for your baby to swallow.

Be sure to take your baby to a dentist by his or her first birthday, especially if there is a high risk for cavities or any other problems with his or her teeth. It is better for your child to meet the dentist and see the office before he or she has a tooth problem.

Early Childhood Caries

Childhood cavities, also now known as "Early Childhood Caries" is an aggressive form of caries that occurs in infants and very young children. It is typically associated with prolonged consumption of liquids containing sugar and affects initially the top front teeth, later spreading to other "baby teeth." Because of the aggressive nature of this disease, early intervention is necessary.

The American Academy of Pediatric Dentistry (AAPD) and the American Academy of Pediatrics (AAP) recommend that ALL children should see a dentist before age one.

There are gaps between my child's teeth, is this normal?

It is normal and even "ideal" for baby teeth to have spacing between each other.

Keep in mind that when permanent teeth erupt, their size will be considerably larger than that of baby teeth. As the baby teeth are lost, the erupting permanent tooth will quickly take advantage of this excess space.

Children who do not have spacing in their primary dentition can have a higher incidence of crowding (crooked teeth) in the permanent dentition.

Having Baby Teeth Pulled

How is that going to affect him or her?

Children require extraction of one or more primary teeth in certain situations. These situations may include extensive decay on their front teeth, and/or localized infection (for example an abscess or a gum boil).

Extractions are also necessary in cases of trauma, where the baby teeth have been pushed back, pushed forward, broken or simply knocked out.

Parents are obviously concerned of the aesthetic and functional effects (on speech, feeding, and breathing) of removing one or more front baby teeth.

There is good evidence that has shown NO long-term speech impediments on these cases. We also know from our professional experience that once the gums heal, children will be able to eat almost anything, since they can still bite-and-cut with the remaining teeth.

As far as aesthetics is concerned, your pediatric dentist can offer you information on fixed appliances that can replace the missing tooth/teeth, assuming your child meets the right criteria.

Missing Permanent Teeth

Hypodontia (the common dental term) describes a situation when fewer than 6 permanent teeth are missing, the term Oligodontia is used when more than 6 permanent teeth are missing (they were never formed). The most common missing teeth are the third molars (otherwise known as the Wisdom Teeth), followed by the premolars and the lateral incisors. Although it is not uncommon to have one missing tooth, patients with multiple missing teeth generally have a strong genetic component and it has been linked to conditions such as Ectodermal Dysplasia and several syndromes. Because early recognition aids in proper treatment, your dentist will refer you to specialists (orthodontist, oral surgeons, etc) that will determine which options suit you best to replace the missing teeth.

Pediatric Dental X-Rays

In general, children need x-rays more often than adults. Their mouths grow and change rapidly. They are more susceptible to tooth decay than adults. The American Academy of Pediatric Dentistry recommends x-ray examinations every six months for children with a high risk of tooth decay. Children with a low risk of tooth decay require x-rays less frequently.

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 and affordable.

X-ray films detect:

  • Cavities
  • Erupting teeth
  • Diagnose bone diseases
  • Evaluate the results of an injury
  • Plan orthodontic treatment

Particular care is applied to minimize the exposure of young 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, dental x-rays represent a far smaller risk than an undetected and untreated dental problem.

Toothpaste for my child

There is no such thing as the best toothpaste. We recommend ONLY products that have been ADA (American Dental Association) accepted or approved.

The selection is usually made on a case-by-case basis, however the main consideration when selecting toothpaste is your child's age.

This is due to the risk of fluorosis in younger children that swallow toothpaste during regular brushing. A child may face the condition called enamel fluorosis if he or she gets too much fluoride during the years of tooth development. Too much fluoride can result in defects in tooth enamel.