Please feel free to read the most Frequently Asked Questions that we hear asked about Pediatric Dentistry. Always know that you are welcome to ask us anything you want to know about your child's dental health or other related questions. We're here to help!
Questions:- When should my child first visit the pediatric dentist?
- My child has "gaps" between his baby teeth, is that ok?
- Which is the best toothpaste for my child?
- Why is enamel fluorosis a concern?
- How does a child get enamel fluorosis?
- Why do you need to place "silver caps" on my child's teeth?
- My child has to have his/her front baby teeth "pulled".
How is that going to affect him/her? - What is a General Anesthesia appointment and how safe is it?
- Can you do all the work at once on my child?
- Will you need to give my child a "shot" to do the dental work?
- My child's teeth have stains on them, are these cavities?
- My child is getting "shark teeth" on the bottom, what can I do?
- My child has crooked teeth, will he/she need braces?
- Is my child's dental appointment an excused absence from school?
Answers:
Q: When should my child first visit the pediatric dentist?
A: 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. Our office goes one step further since we advocate that the infant exam occur at six months of age. At this age, certain simple strategies can be initiated by parents that can allow a lifetime free of dental disease. This visit mainly will involve counseling on oral hygiene, habits, and on the effects that diet can have on his/her teeth. It also will provide information regarding bacterial transmission as a risk factor for dental disease. In addition, the doctor will provide a careful oral exam to determine if your infant is developing normally relative to teeth, jaws, and gums. 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.
Q: My child has "gaps" between his baby teeth, is that ok?
A: It is normal and highly desirable for baby teeth to have spacing between each other. Keep in mind that when permanent teeth erupt, their size will be considerably larger (at least in the front) than that of baby teeth. As the baby teeth are lost, the erupting permanent tooth will quickly take advantage of excess space. Children who do not have spacing in their primary dentition have a far higher incidence of crowding (crooked teeth) in the permanent dentition.
Q: Which is the best toothpaste for my child?
A: There is not such a thing as the best toothpaste. We recommend ONLY products that have been ADA (American Dental Association) accepted or approved. The most important preventative ingredient in the toothpaste is fluoride. However, very young children should be closely monitored. Only a very small amount of paste, barely a smudge, is sufficient to provide adequate fluoride levels. Too much fluoride can result in defects in tooth enamel. So, be sure that the toothpaste is kept safely away from young children between supervised brushings.
Q: Why is enamel fluorosis a concern?
A: In severe cases of enamel fluorosis, the appearance of the teeth is marred by discoloration or brown markings. The enamel may be pitted, rough, and hard to clean. In mild cases of fluorosis, the tiny white specks or streaks are often unnoticeable.
Q: How does a child get enamel fluorosis?
A: By swallowing too much fluoride for the child's size and weight during the years of tooth development. This can happen in several different ways. First, a child may take more of a fluoride supplement than the amount prescribed. Second, the child may take a fluoride supplement when there is already an optimal amount of fluoride in the drinking water. Third, some children simply like the taste of fluoridated toothpaste. They may use too much toothpaste, and then swallow it instead of spitting it out.
Q: Why do you need to place "silver caps" on my child's teeth?
A: Stainless Steel Crowns (SSCs) have been used successfully in dentistry for many years for primary and permanent tooth repair. For primary teeth, SSCs are usually placed on teeth that have extensive caries (where two or more surfaces are involved), or teeth that have pulp treatment (such as pulpotomy or pulpectomy). We also use them in teeth that will remain in the mouth for a considerably long period of time, where other materials will not last long enough. Teeth covered by SSCs become loose and come out of the mouth just like normal primary teeth. They function just like normal teeth do, and require the same care. Alternatives to Stainless Steel Crowns do exist, particularly for front teeth. Usually these can be one of the following:
- A prefabricated SSC that has a white facing bonded to it on the front and sides. Several brands exist and four types are available in our office.
- A normal SSC that we modify by creating a window in the front of it, which we later fill with tooth colored filling material. We call these facings. This results in a durable, well-fitting crown with highly desirable esthetics.
Q: My child has to have his/her front baby teeth "pulled".
How is that going to affect him/her?
A: Children require extraction of one or more primary teeth in certain situations. These situations may include overwhelming decay of their front teeth, and/or localized infection (for example an abscess or a gum boil). Extractions might also be necessary in cases of trauma, where the baby teeth have been pushed back, pushed forward, or broken. Parents are obviously concerned about the esthetic and functional effects (on speech, feeding, and breathing) of removing one or more front baby teeth. There is good evidence that has shown long-term speech impediments in these cases are a rarity. We also know from our professional experience that once the gums heal, children will be able to eat most foods as long as some supervision by parents assures no choking hazards exist. However, in our practice, we make every effort to preserve the front teeth, even following extensive decay or trauma. As far as esthetics is concerned, we can offer you information on appliances that can replace the missing tooth/teeth, assuming your child meets the right criteria.
Q: What is a General Anesthesia appointment and how safe is it?
A: The use of general anesthesia for dental work in children is sometimes necessary in order to provide safe, efficient, and predictable care. The general anesthetic is given to your child by a specialist (anesthesiologist). Our academy (AAPD) recognizes the need for general anesthesia in certain situations where challenges relating to the child's age, behavior, medical conditions, developmental disabilities, intellectual limitations, or special treatment needs may warrant it. Pediatric dentists are, by virtue of training and experience, qualified to recognize the indications for such an approach and to render such care. Our staff will discuss all the necessary steps that must be taken in order to promptly and safely complete your child's dental treatment after this treatment option has been chosen.
Like any procedure in which a child's conscious state is altered, there are some risks involved. The main risks (serious complications) associated with sedation, needs to be thoroughly discussed with a dental anesthesiologist. www.BayAreaAnesthesia.com
Q: Can you do all the work at once on my child?
A: In cases with extensive decay, we are limited by the maximum dosage of local anesthetic that we can use. We also consider your child's comfort after he/she leaves the office, in order to determine how much local anesthetic we can use and the number of areas we can work in. Very young children are at high risk of biting their lips, tongue, or chewing on the inside part of their cheeks after they receive local anesthetic (a lidocaine shot). This usually happens because of their natural curiosity. They try to feel the area or areas that are numb. We take care to minimize this possibility by using special techniques to localize "numbness" and by other methods and instructions. Still it is unlikely that we could work on all of your child's teeth at one visit in cases of extensive decay or surgery. An exception to this rule would be for a child that is treated utilizing general anesthesia. For select cases, our anesthesiologist will monitor and assure safety as all the treatment is provided in a single treatment session.
Q: Will you need to give my child a "shot" to do the dental work?
A: This is one of the most commonly asked questions that we get from our patient's parents. We try to minimize the discomfort of the injection by placing a gel that works as a local anesthetic and numbs the tissue where the injection will be administered. We also use distraction, nitrous oxide, and other techniques to minimize your child's negative sensations during the injections. We may utilize a procedure that localizes the anesthetic and feels more like a pressure sensation than a sharp pinch. Younger children, particularly pre-schoolers, may interpret the feeling of numbness as pain, and therefore may cry. Please follow the postoperative instructions that we give you, in order to minimize complications such as lip biting.
Q: My child's teeth have stains on them, are these cavities?
A: When a baby-tooth changes color, it can mean many things. Baby teeth can and do normally change in color, particularly close to the time that they become loose. However, this change is minimal and should not be confused with a carious lesion (cavity). The best way to determine if your child has a stain or a true cavity is to take him or her to a pediatric dentist. Dental Caries (cavities) is an infectious disease; it progresses if left untreated, and often is associated with pain (especially when the "cavities" are large). Teeth with cavities typically assume a darker (brown) discoloration, and depending on the extent, may exhibit loss of tooth structure. Teeth that have been previously bumped may also change in color. Traumatized baby teeth can assume a yellow or a dark discoloration, which may or may-not be associated with pain. Occasionally, other common causes of changes in color may be: Fluorosis, food staining (particularly tea or colas), and systemic disease.
Q: My child is getting "shark teeth" on the bottom, what can I do?
A: One of our most common consults occurs when children around the age of 6 or 7 begin to lose their lower front teeth. Many of our parents become concerned about this phenomenon. It is VERY NORMAL for permanent lower incisors (front teeth) to erupt behind their predecessors (baby teeth). However if a baby tooth is not loose by the time half of the permanent incisor has erupted, it may be necessary for the dentist to remove it. Of more concern is a situation in which the replacement upper front teeth are found to be erupting behind the baby teeth. Removal of baby teeth is more urgent in this case to ensure avoidance of more extreme bite problems.
Q: My child has crooked teeth, will he/she need braces?
A: Crooked or crowded teeth are very common in the growing patient. Part of our routine at each examination involves an orthodontic assessment. Many times we can offer treatment modalities that can improve the positions of the jaws or erupting teeth. These techniques can be as simple as shaving down certain teeth to serialized early extractions of teeth to early phases of treatment utilizing braces or appliances. Early treatment begins when the child is in the primary dentition, or in early mixed dentition (when the first permanent teeth begin to erupt). The American Academy of Pediatric Dentistry recognizes that early diagnosis and successful treatment of developing malocclusions can have both short-term and long-term benefits, while achieving the goal of occlusal harmony, function, and facial esthetics. Gold River Pediatric Dentistry also may refer you to an orthodontist for evaluation or treatment when the complexity of the case requires, or if it is the correct timing for the final stage of orthodontic treatment.
Q: Is my child's dental appointment an excused absence from school?
A: Yes, dental appointments are an acceptable excused absence according to CA Educational Code (Sec. 1648A).
Your child cannot be penalized for attending a medical or dental appointment during school hours.
We have dental excuse slips available in our office for our patients.