Q. When should my child first see a dentist?

A: "First visit by first birthday" sums it up. Your child should visit a pediatric dentist when the first tooth comes in, usually between six and twelve months of age. Early examination and preventive care will protect your child’s smile now and in the future.

Q: What is the difference between a pediatric dentist and a family dentist?

A: Pediatric dentists are the pediatricians of dentistry. A pediatric dentist has two to three years specialty training following dental school and limits his/her practice to treating children only. Pediatric dentists are primary and specialty oral care providers for infants and children through adolescence, including those with special health needs.

Q: Are baby teeth really that important to my child?

A: Primary, or "baby," teeth are important for many reasons. Not only do they help children speak clearly and chew naturally, they also aid in forming a path that permanent teeth can follow when they are ready to erupt.

Q. Why so early? What dental problems could a baby have?

A: The most important reason is to begin a thorough prevention program. Dental problems can begin early. A big concern is Early Childhood Caries (also know as baby bottle tooth decay or nursing caries). Your child risks severe decay from using a bottle during naps or at night or when they nurse continuously from the breast.

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.

Q. How can I prevent tooth decay from a bottle or nursing?

A: Encourage your child to drink from a cup as they approach their first birthday. Children should not fall asleep with a bottle. At-will nighttime breast-feeding should be avoided after the first primary (baby) teeth begins to erupt. Drinking juice from a bottle should be avoided. When juice is offered, it should be in a cup.

Q. When should bottle-feeding be stopped?

A: Children should be weaned from the bottle at 12-14 months of age.

Q. Should I worry about thumb and finger sucking?

A: Thumb sucking is perfectly normal for infants; most stop by age 2. If your child does not, discourage it after age 4. Prolonged thumb sucking can create crowded, crooked teeth, or bite problems. Your pediatric dentist will be glad to suggest ways to address a prolonged thumb sucking habit.

Q. When should I start cleaning my baby’s teeth?

A: The sooner the better! Starting at birth, clean your child’s gums with a soft infant toothbrush and water. Remember that most small children do not have the dexterity to brush their teeth effectively. Unless it is advised by your child’s pediatric dentist, do not use fluoridated toothpaste until age 2-3.

Q. Any advice on teething?

A: From six months to age 3, your child may have sore gums when teeth erupt. Many children like a clean teething ring, cool spoon, or cold wet washcloth. Some parents swear by a chilled ring; others simply rub the baby’s gums with a clean finger.

Q: What should I do if my child's baby tooth is knocked out?

A: Contact your pediatric dentist as soon as possible.

Q: What should I do if my child's permanent tooth is knocked out?

A: Find the tooth and rinse it gently in cool water. (Do not scrub it or clean it with soap -- use just water!) If possible, replace the tooth in the socket and hold it there with clean gauze or a wash cloth. If you can't put the tooth back in the socket, place the tooth in a clean container with milk, saliva, or water. Get to the pediatric dental office immediately. (Call the emergency number if it's after hours.) The faster you act, the better your chances of saving the tooth.

Q: What if a tooth is chipped or fractured?

A: Contact your pediatric dentist immediately. Quick action can save the tooth, prevent infection and reduce the need for extensive dental treatment. Rinse the mouth with water and apply cold compresses to reduce swelling. If you can find the broken tooth fragment, bring it with you to the dentist.

Q: What about a severe blow to the head or jaw fracture?

A: Go immediately to the emergency room of your local hospital. A blow to the head can be life threatening.

Q: What if my child has a toothache?

A: Call your pediatric dentist and visit the office promptly. To comfort your child, rinse their mouth with water. Apply a cold compress or ice wrapped in a cloth. Do not put heat or aspirin on the sore area.

Q: Can dental injuries be prevented?

A: Absolutely! First, reduce oral injury in sports by wearing mouth guards. Second, always use a car seat for young children and require seat belts for everyone else in the car. Third, child-proof your home to prevent falls, electrical injuries, and choking on small objects. Fourth, protect your child from unnecessary toothaches with regular dental visits and preventive care.

Q: Why do children suck on fingers, pacifiers or other objects?

A: This type of sucking is completely normal for babies and young children. It provides security. For young babies, it's a way to make contact with and learn about the world. In fact, babies begin to suck on their fingers or thumbs even before they are born.

Q: Are these habits bad for the teeth and jaws?

A: Most children stop sucking on thumbs, pacifiers or other objects on their own between two and four years of age. No harm is done to their teeth or jaws. However, some children repeatedly suck on a finger, pacifier or other object over long periods of time. In these children, the upper front teeth may tip toward the lip or not come in properly.

Q: When should I worry about a sucking habit?

A: Your pediatric dentist will carefully watch the way your child's teeth come in and jaws develop, keeping the sucking habit in mind at all times. For most children there is no reason to worry about a sucking habit until the permanent front teeth are ready to come in.

Q: What can I do to stop my child's habit?

A: Most children stop sucking habits on their own, but some children need the help of their parents and their pediatric dentist. When your child is old enough to understand the possible results of a sucking habit, your pediatric dentist can encourage your child to stop, as well as talk about what happens to the teeth if your child doesn't stop. This advice, coupled with support from parents, helps most children quit. If this approach doesn't work, your pediatric dentist may recommend a mouth appliance that blocks sucking habits.

Q: Are pacifiers a safer habit for the teeth than thumbs or fingers?

A: Thumb, finger and pacifier sucking all affect the teeth essentially the same way. However, a pacifier habit is often easier to break.

Q: How often should a child see the dentist?

A: The American Academy of Pediatric Dentistry recommends a dental check-up at least twice a year for most children. Some children need more frequent dental visits because of increased risk of tooth decay, unusual growth patterns or poor oral hygiene. Your pediatric dentist will let you know the best appointment schedule for your child.

Q: Why visit the dentist twice a year when my child has never had a cavity?

A: Regular dental visits help your child stay cavity-free. Teeth cleanings remove debris that build up on the teeth, irritate the gums and cause decay. Fluoride treatments renew the fluoride content in the enamel, strengthening teeth and preventing cavities. Hygiene instructions improve your child's brushing and flossing, leading to cleaner teeth and healthier gums.

Tooth decay isn't the only reason for a dental visit. Your pediatric dentist provides an ongoing assessment of changes in your child's oral health. For example, your child may need additional fluoride, dietary changes, or sealants for ideal dental health. The pediatric dentist may identify orthodontic problems and suggest treatment to guide the teeth as they emerge in the mouth.

Q: What happens in a dental check-up?

A: The pediatric dentist will review your child's medical and dental history. He or she will gently examine your child's teeth, oral tissues, and jaws. The teeth will be cleaned and polished, followed by the application of a fluoride solution.

Your pediatric dentist won't talk just to you about dental health, he or she will talk to your child with easily understandable words, pictures, and ideas. Your child will be motivated to take responsibility for healthy smile.

Q: Will X-rays be taken at every appointment?

A: No. Pediatric dentists, acting in accord with guidelines from the American Academy of Pediatric Dentistry, recommend X-rays only when necessary to protect your child's dental health.For example, X-rays maybe needed to diagnose tooth decay or abnormalities. Or, they may be required for orthodontic treatment. Your pediatric dentist will discuss the need for X-rays with you before any are taken.

Q: How can I help my child enjoy good dental health?

A: The following steps will help your child be part of the cavity-free generation:

  1. Beware of frequent snacking
  2. Brush effectively twice a day with a fluoride toothpaste
  3. Floss once a day
  4. Have sealants applied when appropriate
  5. Seek regular dental check-ups
  6. Assure proper fluoride through drinking water, fluoride products or fluoride supplements

Q: What is enamel fluorosis?

A: 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.

Q: Why is enamel fluorosis a concern?

A: Most cases of fluorosis are mild and will appear as tiny white specks or streaks that are often unnoticeable. However, 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.

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, then swallow it instead of spitting it out.

Q: How can enamel fluorosis be prevented?

A: Talk to your pediatric dentist as the first step. He or she can tell you how much fluoride is in your drinking water. (Your local water treatment plant is another source of this information.) If you drink well water or bottled water, your pediatric dentist can assist you in getting an analysis of its fluoride content. After you know how much fluoride your child receives, you and your pediatric dentist can decide together whether your child needs a fluoride supplement.

Watch your child's use of fluoridated toothpaste as the second step. A pea-sized amount on the brush is plenty for fluoride protection. Teach your child to spit out the toothpaste, not swallow it, after brushing.

Q: Should I just avoid fluorides for my child altogether?

A: No! Fluoride prevents tooth decay. It is an important part of helping your child keep a healthy smile for a lifetime. Getting enough -- but not too much -- fluoride can be easily accomplished with the help of your pediatric dentist.

Q: Can enamel fluorosis be treated?

A: Once fluoride is part of the tooth enamel, it can't be taken out. But the appearance of teeth affected by fluorosis can be greatly improved by a variety of treatments in esthetic dentistry. If your child suffers from severe enamel fluorosis, your pediatric dentist can tell you about dental techniques that enhance your child's smile and self-confidence.

Q: What is a healthy diet for my child?

A: A healthy diet is a balanced diet that naturally supplies all the nutrients your child needs to grow. And what's a balanced diet? One that includes the following major food groups every day: Fruits and Vegetables; Breads and Cereals; Milk and Dairy Products; Meat, Fish and Eggs.

Q: How does my child's diet affect her dental health?

A: She must have a balanced diet for her teeth to develop properly. She also needs a balanced diet for healthy gum tissue around the teeth. Equally important, a diet high in certain kinds of carbohydrates, such as sugar and starches, may place your child at extra risk of tooth decay.

Q: How do I make my child's diet safe for his teeth?

A: First, be sure he has a balanced diet. Then, check how frequently he eats foods with sugar or starch in them. Foods with starch include breads, crackers, pasta and such snacks as pretzels and potato chips. When checking for sugar, look beyond the sugar bowl and candy dish. A variety of foods contain one or more types of sugar, and all types of sugars can promote dental decay. Fruits, a few vegetables and most milk products have at least one type of sugar.

Sugar can be found in many processed foods, even some that do not taste sweet. For example, a peanut butter and jelly sandwich not only has sugar in the jelly, but may have sugar added to the peanut butter. Sugar is also added to such condiments as catsup and salad dressings.

Q: Should my child give up all foods with sugar or starch?

A: Certainly not! Many provide nutrients your child needs. You simply need to select and serve them wisely. A food with sugar or starch is safer for teeth if it's eaten with a meal, not as a snack. Sticky foods, such as dried fruit or toffee, are not easily washed away from the teeth by saliva, water or milk. So, they have more cavity-causing potential than foods more rapidly cleared from the teeth. Talk to your pediatric dentist about selecting and serving foods that protect your child's dental health.

Q: Does a balanced diet assure that my child is getting enough fluoride?

A: No. A balanced diet does not guarantee the proper amount of fluoride for the development and maintenance of your child's teeth. If you do not live in a fluoridated community or have an ideal amount of naturally occurring fluoride in your well water, your child needs a fluoride supplement during the years of tooth development. Your pediatric dentist can help assess how much supplemental fluoride your child needs, based upon the amount of fluoride in your drinking water and your child's age and weight.

Q: My youngest isn't on solid foods yet. Do you have suggestions for her?

A: Don't nurse your daughter to sleep or put her to bed with a bottle of milk, formula, juice, or sweetened liquid. While she sleeps, any unswallowed liquid in the mouth supports bacteria that produce acids and attack the teeth. Protect your child from severe tooth decay by putting her to bed with nothing more than a pacifier or bottle of water.

Q: Any final advice?

A: Yes. Here are tips for your child's diet and dental health.

  1. Ask your pediatric dentist to help you assess your child's diet.
  2. Shop smart! Do not routinely stock your pantry with sugary or starchy snacks. Buy "fun foods" just for special times.
  3. Limit the number of snack times; choose nutritious snacks.
  4. Provide a balanced diet, and save foods with sugar or starch for mealtimes.
  5. Don't put your young child to bed with a bottle of milk, formula, or juice.
  6. If your child chews gum or sips soda, choose those without sugar.

Q: What are sealants?

A: Sealants protect the grooved and pitted surfaces of the teeth, especially the chewing surfaces of back teeth where most cavities in children are found. Made of clear or shaded plastic, sealants are applied to the teeth to help keep them cavity-free.

Q: How do sealants work?

A: Even if your child brushes and flosses carefully, it is difficult - sometimes impossible -to clean the tiny grooves and pits on certain teeth. Food and bacteria build up in these crevices, placing your child in danger of tooth decay. Sealants "seal out" food and plaque, thus reducing the risk of decay.

Q: How long do sealants last?

A: Research shows that sealants can last for many years if properly cared for. So, your child will be protected throughout the most cavity-prone years. If your child has good oral hygiene and avoids biting hard objects, sealants will last longer. Your pediatric dentist will check the sealants during routine dental visits and can recommend reapplication or repair when necessary.

Q: What is the treatment like?

A: The application of a sealant is quick and comfortable. It takes only one visit. The tooth is first cleaned. It is then conditioned and dried. The sealant is then flowed onto the grooves of the tooth and allowed to harden or hardened with a special light. Your child will be able to eat right after the appointment.

Q: How much does it cost?

A: The treatment is very affordable, especially because of the valuable decay protection it offers your child. Most dental insurance companies cover sealants. Some companies, however, have age and specific tooth limitations. Check with your benefits provider about your child’s coverage and talk to your pediatric dentist about the exact cost of sealants for your child.

Q: Which teeth should be sealed?

A: The natural flow of saliva usually keeps the smooth surfaces of teeth clean but does not wash out the grooves and fissures. So, the teeth most at risk of decay—and therefore most in need of sealants - are the six-year and twelve-year molars. Many times the permanent premolars and primary molars will also benefit from sealant coverage. Any tooth, however, with grooves or pits may benefit from the protection of sealants. Talk to your pediatric dentist, as each child’s situation is unique.

Q: If my child has sealants are brushing and flossing still important?

A: Absolutely! Sealants are only one step in the plan to keep your child cavity-free for a lifetime. Brushing, flossing, balanced nutrition, limited snacking, and regular dental visits are still essential to a bright, healthy smile.

Q: What are athletic mouth protectors?

A: Athletic mouth protectors, or mouth guards, are made of soft plastic. They are adapted to fit comfortably to the shape of the upper teeth.

Q: Why are mouth guards important?

A: Mouth guards hold top priority as sports equipment. They protect not just the teeth, but the lips, cheeks, and tongue. They help protect children from such head and neck injuries as concussions and jaw fractures. Increasingly, organized sports are requiring mouth guards to prevent injury to their athletes. Research shows that most oral injuries occur when athletes are not wearing mouth protection.

Q: When should my child wear a mouth guard?

A: Whenever he or she is in an activity with a risk of falls or of head contact with other players or equipment. This includes football, baseball, basketball, soccer, hockey, skateboarding, even gymnastics. We usually think of football and hockey as the most dangerous to the teeth, but nearly half of sports-related mouth injuries occur in basketball and baseball.

Q: How do I choose a mouth guard for my child?

A: Any mouth guard works better than no mouth guard. So, choose a mouth guard that your child can wear comfortably. If a mouth guard feels bulky or interferes with speech, it will be left in the locker room.

You can select from several options in mouth guards. First, preformed or "boil-to-fit" mouth guards are found in sports stores. Different types and brands vary in terms of comfort, protection, and cost. Second, customized mouth guards are provided through your pediatric dentist. They cost a bit more, but are more comfortable and more effective in preventing injuries. Your pediatric dentist can advise you on what type of mouth guard is best for your child.

Q: How often should a child have dental X-ray films?

A: Since every child is unique, the need for dental X-ray films varies from child to child. Films are taken only after a complete review of your child's health, and only when they are likely to yield information that a visual exam cannot.

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.

Q: Why should X-ray films be taken if my child has never had a cavity?

A: X-ray films detect much more than cavities. For example, X-rays may be needed to survey erupting teeth, diagnose bone diseases, evaluate the results of an injury, or plan orthodontic treatment. 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.

Q: Will X-ray films be taken routinely?

A: No. X-ray films are recommended only when necessary to protect your child's dental health. The frequency of X-ray films is determined by your child's individual needs.

Q: How safe are dental X-rays?

A: Pediatric dentists are particularly careful to minimize the exposure of child 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.

Q: How will my child be protected from X-ray exposure?

A: Lead body aprons and shields will protect your child. Today's equipment filters out unnecessary X-rays and restricts the X-ray beam to the area of interest. High-speed film and proper shielding assure that your child receives a minimal amount of radiation exposure.

Q: What is preventive dentistry?

A: Preventive dentistry for children includes:

  • brushing
  • dental development
  • flossing
  • fluorides
  • oral habits
  • orthodontics
  • parent involvement
  • proper diet
  • sealants
  • sports safety

Your pediatric dentist practices preventive dentistry.

Q: Why is preventive dentistry important?

A: Preventive dentistry means a healthy smile for your child. Children with healthy mouths chew more easily and gain more nutrients from the foods they eat. They learn to speak more quickly and clearly. They have a better chance of general health, because disease in the mouth can endanger the rest of the body. A healthy mouth is more attractive, giving children confidence in their appearance. Finally, preventive dentistry means less extensive, and less expensive, treatment for your child.

Q: When should preventive dentistry start?

A: Preventive dentistry begins with the first tooth. Visit your pediatric dentist when the first tooth comes in. You will learn how to protect your infant's dental health. The earlier the dental visit, the better the chance of preventing dental disease and helping your child belong to the cavity-free generation.

Q: What role do parents play in prevention?

A: After evaluating your child's dental health, your pediatric dentist will design a personalized program of home care for your child. This program will include brushing and flossing instructions, diet counseling, and if necessary, fluoride recommendations. By following these directions, you can help give your child a lifetime of healthy habits.

Q: How do pediatric dentists help prevent dental problems?

A: Tooth cleaning and polishing and fluoride treatments are all part of your child's prevention program. But there's much more. For example, your pediatric dentist can apply sealants to protect your child from tooth decay, help you select a mouth guard to prevent sports injuries to the face and teeth, and provide early diagnosis and care of orthodontic problems. Your pediatric dentist is uniquely trained to develop a combination of office and home preventive care to insure your child a happy smile.