Pediatric FAQs
Child's First Dental Visit
Child's First Dental Visit

According to guidelines from the American Academy of Pediatric Dentistry (AAPD), your child should be seen by your child's 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.

Gaps Between Child's Teeth
Gaps between childs teeth

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.

Toothpaste For My Child
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.

Enamel Fluorosis
Enamel Fluorosis

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.

Silver Caps For Children
Silver Caps for children

Recent controversy regarding the use of Stainless Steel Crowns (SSCs) in some states have led some parents to question dental care providers more thoroughly on their use and on other alternatives. SSCs have been used in dentistry for over 50 years for primary and permanent dentition.

For primary teeth, SSCs are usually placed on teeth that have extensive caries (where two or more surfaces are extensively 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.

SSCs become loose and come out of the mouth just like normal primary teeth. They work 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 (Commonly we use the Nu-Smile brand: www.nusmilecrowns.com)
- A white cap fabricated with a white filling material (Usually we call these strip crowns).
- A normal SSC that we modify by building a window in the front of it, which we later fill with a white filling material called a composite.

Having Baby Teeth Pulled
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.

After extraction instructions
Dental Anesthesia For Children
Dental Anesthesia for Children

Trips to the dentist’s office can be a much more simple affair for some patients than others; for many of our patients, help from us to ensure a comfortable and successful treatment is a necessary part of their treatment. General Anesthesia is a great option to be considered by those who may struggle with age, behavior, medical history, or any other variables that makes the dentist office a challenge.

Dr. Pivnik is experienced and willing to help all patients achieve their happy and healthy smile – when you schedule your appointment, ask us about anesthesia and how it may solve your child’s dental difficulties.

Can You Do All The Work At Once With Sedation?
Can you do all the work at once with a Sedation?

In cases with extensive decay, we are limited by the maximum dosage of local anesthetic that we can use. As a rule, we also consider your child's comfort after he/she leaves the clinic in order to determine how much local anesthetic we can use. Very young children are at high risk of biting their lips 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. For these and other reasons, it is unlikely that we could work on all of your child's teeth at once. An exception to this rule would be a child that is taken to the operating room.

Will You Need To Give My Child A Shot To Do The Dental Work?
Will you need to give my child a shot to do the dental work?

This is the 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 were the injection will be administered. Profound local anesthesia is usually obtained five to ten minutes after the injection, depending on the area of the mouth where the anesthetic was placed. We always check to confirm that the area is numb before we begin to work. In cases of localized infection or trauma (like broken teeth) it is very difficult to obtain profound anesthesia, however we do have other means of supplementing the anesthetic (like cojoined use of nitrous-oxide gas, medications, or conscious sedation). Younger children, particularly pre-schoolers may interpret the feeling of numbness as pain, and therefore cry. Please follow the post-operative instructions that we give you, in order to minimize complications such as lip biting.

Are The Stains On My Child's Teeth Cavities?
My child's teeth have stains on them, are these cavities?

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. Caries is an infectious disease; it progresses if left untreated, and usually 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. Other less common causes of changes in color may be: fluorosis, food staining (particularly tea or colas), systemic disease (hepatitis), etc.

My Child Is Getting "Shark Teeth", What Can I Do?
My child is getting shark teeth; what can i do?

One of our most common consults occurs when children around the age of seven begin to lose their lower front teeth. Many of our parents become overly worried 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 to pull it.

Are Braces Necessary If My Child Has Crooked Teeth?
My child has crooked teeth; will he or she need braces?

Crooked or crowded teeth are very common in the growing patient. Even patients that get braces may develop a minor degree of crooked (crowded) teeth, particularly in the front teeth of the jaws, as they grow old. The first step in determining the need for treatment is what we call an orthodontic consult. During this appointment we may obtain special records and special x-rays of your child's jaw. This information will allow us to make a decision based on predicted growth patterns that your child may show later. In orthodontic terms we refer to this as Early Treatment. Early Treatment refers to ANY orthodontic (braces) or orthopedic appliances (like Headgear) treatment that begins when the child is in primary dentition, or in early mixed dentition (when the first permanent teeth begin to erupt). Early Treatment has been proven to be effective despite objections by some people in the orthodontic community. The AAPD 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.

Dental Appointment Excuse

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.

Schedule your appointment TODAY

Gold River Pediatric Dentisty would love to meet you and your family
and provide your children with the dental care they need and give them all smiles they deserve!