GENERAL PEDIATRIC DENTISTRY FAQs.

Broken Tooth

Rinse the area with warm water. Put a cold compress over the facial area of the injury. Recover any broken tooth fragments. Get immediate dental attention.

Knocked Out Permanent Teeth

Recover the tooth, making sure to hold it by the crown (top) and not the root end. Rinse, but do not clean or handle the tooth more than necessary. Reinsert the tooth in the socket and hold it in place using a clean piece of gauze or cloth. If the tooth cannot be reinserted, carry it in a cup containing milk or water. Because time is essential, see a dentist immediately.

Possible Broken Jaw

In the event of jaw injury, tie the mouth closed with a towel, tie or handkerchief. Go immediately to an emergency room.

Cut or Bitten Tongue, Lip or Cheek

Ice can be applied to any bruised areas. For bleeding, apply firm (but gentle) pressure with sterile gauze or a clean cloth. If the bleeding does not stop with pressure or continues after 15 minutes, go to an emergency room.

Toothache

Begin by cleaning around the sore tooth meticulously. Using warm salt water, rinse the mouth to displace any food trapped between teeth. UNDER NO CIRCUMSTANCES should you use aspirin on the aching tooth or on the gum. In the event of facial swelling, apply a cold compress to the area. For temporary pain relief, acetaminophen is recommended. See a dentist as soon as possible.

Bleeding after baby tooth falls out

Fold a piece of gauze and place it (tightly) over the bleeding area. Bite down on the gauze for 15 minutes; if bleeding continues, see a dentist.

Cold or Canker sores

Over-the-counter medications will usually provide temporary relief. If sores persist, visit your dentist.

The pediatric dentist is the only medical specialist who is committed to the comprehensive oral health care of children from infancy through the teen-age years.

In addition to a general dentistry degree, pediatric dentists complete two additional years of post-doctoral training that includes special education in pediatric growth and development, child psychology and behavior management and the treatment of the medically, developmentally, and physically compromised children.

Because of this specialized training, the pediatric dentist is best qualified to meet the needs of infants, children and teenagers by providing different approaches in dealing with their behavior, guiding their dental growth and development, managing their dental treatment needs, and helping them avoid future dental problems.

Just as parents choose a pediatrician for their child’s medical needs, many parents wisely choose a pediatric dentist for their child’s dental needs. Think of us as the pediatricians of dentistry.

Your baby’s teeth begin developing before your baby is even born: The first tooth begins to mineralize in the fourth month of pregnancy. Even before the first tooh appears oral care is essential: After breastfeeding or bottle feeding, we recommend using a soft cloth to clean your baby’s gums. This way you’re removing bacteria from the gums (while giving you baby a nice gum massage too). From the sixth month to approximately 2.5 years of age, your child will get 20 teeth. Usually the two bottom teeth erupt first and the molars erupt last. We recommends finding cool, BPA free things for your child to chew on that can massage the teeth (feel free to place these in the fridge but NOT in the freezer). There are also many natural and OTC remedies that help soothe your baby’s teething discomfort.

The most common question we hear is “If my child barely has any teeth, why am I here?” The American Academy of Pediatric Dentistry recommends that an initial oral evaluation visit should occur within six months after the eruption of the first primary tooth and no later than twelve months of age. During this important visit we will complete a thorough medical and dental history, complete a thorough oral examination, assess your child’s risk of developing oral and dental disease, review habits such as grinding, thumb sucking, etc, discuss oral hygiene instructions, perform a nutritional consult, and determine an appropriate interval for periodic reevaluation.

Occasionally, a child’s facial and dental growth becomes disrupted as a result of genetics or early dental habits such as thumb sucking or mouth breathing (commonly caused by allergies/asthma/etc). Pediatric dentists are specialists in the area of growth and development of the face and teeth, and are ideally suited to intervene in these situations. Many times extensive orthodontic treatment may be averted through timely pediatric orthodontic care as the face, jaws, and teeth are developing.

We believe that regular oral health maintenance is a sound investment in your child’s overall health. To maintain optimum oral health, we recommend that your child be seen every six months for a continuing care appointment that includes an oral examination, a cleaning, the application of fluoride, and any necessary radiographs (x-rays). Preventive care will help prevent tooth decay and gum disease. At continuing care time you will be asked to update your child’s dental, medical, and social history which may have changed since the last visit. We will examine and treat your child as we did at the first visit and discuss the findings with you.

We’ve designed our office to treat infants, children, teenagers, and children with special needs. Home-care recommendations and instructions will be provided based on your child’s individual needs. If your child requires special care due to a specific concern, please let us know prior to their appointment so that we can be sure to accommodate them.

In addition to the oral hygiene instructions, preventative care tips, and nutritional consult you will receive for your child, feel free to ask the doctor or assistants about the materials used in the practice. Our office utilizes the latest pediatric dental technology such as high-speed digital x-rays and digital photographs, quiet electric hand pieces and dental instruments, and modern diagnosing techniques. Dr. Michelle uses bio-compatible, non-metal, BPA-free materials for all sealants and fillings.

Before being attached to our dental delivery units BPA-free water container, all of the water used in the practice is distilled twice a day through a patented water distiller that removes all harmful minerals, chemicals, bacteria and viruses; we do not use public plumbing for our patient’s water supply. Additionally, our office uses digital x-rays; digital x-rays reduces radiation 80-90% compared to the already low exposure of traditional dental x-rays.

To reduce our carbon footprint, we use state-of-the-art dental technology to minimize toxic pollution and water waste. Biodegradable sterilization solutions are used to clean examination areas and our play areas. Please feel free to call or or email us with any questions/concerns you may have.

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.

Tooth decay is not 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.

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.

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 will not just talk 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 a healthy smile.

No. Pediatric dentist, acting in accordance with the guidelines from the American Academy of Pediatric Dentistry, recommended x-rays only when necessary to protect your child’s dental health. For example, x-rays may be 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.

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 fluoride toothpaste
3. Floss once a day
4. Have sealants applied with appropriate
5. Seek regular dental check-ups
6. Assure proper fluoride intake through drinking water, fluoride products or fluoride supplements
7. Talk to your child about his/her teeth and the importance of keeping them healthy

INFANT PEDIATRIC DENTISTRY FAQs.

If there is anything you would like us to know (in private) before we see you child, please make sure to let our front desk know so that we may notify the doctor. We try very hard to make your child’s treatment physically comfortable and enjoyable. All of our care is based on the behavior management technique Tell-Show-Do. What is Tell-Show-Do? This technique prepares your child for dental treatment by telling and showing your child what we are going to do before we do it. During all visits, we believe in giving your child lots of praise. We begin the first visit by introducing the office environment and the staff.

For children two and above, we recommend an oral examination, a cleaning, the application of fluoride, and any necessary radiographs (x-rays). After a thorough study of our findings, we will prepare and discuss a treatment plan for your child’s dental needs. This plan will provide guidance on dental and oral development, fluoride status, oral habits, injury prevention, oral hygiene, and the effects of diet on the dentition.

Dr. Michelle prefers that parents/caretakers be present with the children for the first visit. However, please do not be upset if your child cries. We are trained to help fearful children through their dental experience. As your child matures, it is our goal to encourage your child’s independence in the dental setting and work to prevent any future mouth problems. Please permit us the time to develop a rapport with your child.

We encourage you to prepare your child for a visit to the pediatric dentist before the first appointment. For young children, many excellent books and videos can be found that describe a visit to the dentist (we do recommend however that you read through these before you read them to your child, some are friendlier than others). Convey good feelings about the dental visit as being a part of growing up. Let your child know they are going to learn lots of new ways to make their teeth sparkle and enjoy a healthy smile. We make the experience fun!

Morning appointments are recommended for little ones when they are refreshed and more accepting of new experiences. If you expect your child to react well, chances are very good your child will enjoy the first visit to our office. In addition to preparing your child for the important first visit, please provide all information pertinent to your child’s dental, medical and social situation on the health forms you will be given by our office. This will enable us to provide the best possible care for your child.

“First visit by first birthday” sums it up. Your child should visit a pediatric dentist when the first tooth comes in, usually between 6 and 12 months of age. This visit will establish a dental home for your child. Early examination and preventative care will protect your child’s smile now and in the future.

The most important reason is to begin a thorough prevention program. Dental problems can begin early. A big concern is Early Childhood Caries (formerly known as baby bottle tooth decay or nursing caries). Once a child’s diet includes anything besides breast=-milk, erupted teeth are at risk for decay. The earlier the dental visit, the better the chance of preventing dental problems. Children with healthy teeth chew food easily and smile with confidence. Start your child now on a lifetime of good dental habits.

At-will breast-feeding should be avoided after the first primary (baby) teeth begin to erupt and other sources of nutrition have been introduced. Children should not fall asleep with a bottle containing anything other than water. Drinking juice from a bottle should be avoided. Fruit juice should only be offered in a cup with meals or at snack time.

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

Thumb sucking is perfectly normal for infants; many stop by age 2.  Prolonged thumb sucking can create crooked teeth or bite problems. If the habit continues beyond age 3, a professional evaluation is recommended. Your pediatric dentist will be glad to suggest ways to address a prolonged thumb sucking habit.

The sooner the better! Starting at birth, clean your child’s gums with a soft infant toothbrush or cloth and water. As soon as the teeth begin to appear, start brushing twice daily using fluoridated toothpaste and a soft, age-appropriate sized toothbrush. Use a “smear” of toothpaste to brush the teeth of a child less than 2 years of age. For the 2-5 year old, dispense a “pea-size” amount of toothpaste and perform or assist your child’s tooth brushing. Remember that young children do not have the ability to brush their teeth effectively.

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

This type of sucking is completely normal for babies and young children. It provides security. For young babies, it is 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.

Most children stop sucking on thumbs, pacifiers, or other objects on their own between 2 and 4 years of age. However, some children continue these habits over long periods of time. In these children, the upper front teeth may tip toward the lip or not come in properly. Frequent or intense habits over a prolonged period of time can affect the way the child’s teeth bite together, as well as the growth of the jaws and bones that support the teeth.

Your pediatric dentist will carefully watch the way your child’s teeth erupt and jaws develop, keeping the sucking habit in mind at all times. Because persistent habits may cause long term problems intervention may be recommended for children beyond 3 years of age.

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 and jaws if your child down not stop. This advice, coupled with support from parents, helps most children quit. If this approach does not work, your pediatric dentist may recommend ways to change the behavior, including a mouth appliance that interferes with sucking habits.

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

SEALANT FAQs.

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.

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.

Research shows that sealants can last for many years if properly cared for. Therefore, your child will be prote3cted 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 recommend re-application or repair when necessary.

The application of sealants 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 ear right after the appointment.

The treatment is very affordable, especially in view 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.

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.

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.

SPACE MAINTAINENCE FAQs.

Space maintainers are appliances made of metal or plastic that are custom fit to your child’s mouth. They are small and unobtrusive in appearance. Most children easily adjust to them after the first few days.

A baby tooth usually stays in place until a permanent tooth underneath pushes it out and takes its place. Unfortunately, some children lose a baby tooth too soon. A tooth might be knocked out accidentally or removed because of dental disease. When a tooth is lost too early, your pediatric dentist may recommend a space maintainer to prevent future space loss and dental problems.

Baby teeth are important to your child’s present and future dental health. They encourage normal development of the jaw bones and muscles. They save space for the permanent teeth and guide them into position. Remember: Some baby teeth are to replaced until a child is 12-14 years old.

If a baby tooth is lost too soon, the teeth beside it may tilt or drift into the empty space. Teeth in the other jaw may move up or down to fill the gap. When adjacent teeth shift into the empty space, they create a lack of space I the jaw for the permanent teeth. Therefore, permanent teeth are crowded and come in crooked. If left untreated, the condition may require extensive orthodontic treatment.

Space maintainers hold open the empty space left by a lost tooth. They steady the remaining teeth, preventing movement until the permanent tooth takes its natural position in the jaw. It is more affordable – and easier on your child – to keep teeth in normal positions with a space maintainer than to move them back in place with orthodontic treatment.

Space maintainers hold open the empty space left by a lost tooth. They steady the remaining teeth, preventing movement until the permanent tooth takes its natural position in the jaw. It is more affordable – and easier on your child – to keep teeth in normal positions with a space maintainer than to move them back in place with orthodontic treatment..

Pediatric dentists have four rules for space maintainer care. First, avoid sticky sweets or chewing gum. Second, do not tug or push on the space maintainer with yoru fingers or tongue. Third, keep it clean with conscientious brushing and flossing. Fourth, continue regular dental visits.

DIET AND SNACKING FAQs.

A healthy diet is a balanced diet that naturally supplies all the nutrients your child needs to grow. A balanced diet is one that includes the following major food groups:

– Fruits, Vegetables, Grains, Meat and Beans, Milk

They must have a balanced diet for their teeth to develop properly. They also need 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 for tooth decay.

First, be sure they have a balanced diet. Then, check how frequently they eat foods with sugar or starch in them. Foods with starch include breads, crackers, pasta and snacks, such 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 ketchup and salad dressing.

Certainly not! Many of these foods 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 is 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. Therefore, 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.

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 will water, your child may need 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 other potential sources of fluoride.

Do not nurse a young child to sleep or put him to bed with a bottle of milk, formula, juice, or sweetened liquid. While a child sleeps, any unswallowed liquid in the mouth feeds bacteria that produce acids and attack the teeth. Protect your child from severe tooth decay by putting him to bed with nothing more than a pacifier or bottle of water.

Yes, here are some 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 meal times.
5. Do not 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.

NITROUS OXIDE FAQs.

Most children are calm, comfortable and confident in a pediatric dental office. The office is designed for young people, and pediatric dentist have additional training in caring for infants, children, and adolescents. Staff members choose to work in a pediatric dental office because they like children and want to caster to their special needs. These elements combine to make your child feel relaxed and special.

Sometimes, however, a child may feel anxious before or during treatment. Your child may need more support than a gentle, caring manner to feel comfortable. Nitrous oxide/oxygen is a safe, effective sedative agent used to calm a child’s fear of the dental visit and enhance effective communication. Additionally, it works well for children whose gag reflex interferes with dental treatment.

Nitrous oxide/oxygen (N2O-O2) is a blend of two gases – oxygen and nitrous oxide. A fitted mask is placed over the nose and, as the patient breathes normally, uptake occurs through the lungs. At the end of treatment it is eliminated after a short period of breathing oxygen and has no lingering effects.

Your child will smell a faint sweet aroma and experience a sense of well-being and relaxation. Since it may produce a feeling of giddiness or euphoria, it is often called “laughing gas.” Children sometimes report dreaming and their arms and legs may feel “tingly.” It raises the pain threshold and may even make the time appear to pass quickly. If your child is worried by the sights, sounds, or sensations of dental treatment, he or she may respond more positively with the use of nitrous oxide/oxygen.

Very safe. Nitrous oxide/oxygen is perhaps the safest sedative in dentistry. It is well tolerated. It has a rapid onset, is reversible, can be adjusted in various concentrations and is non-allergenic. Your child remains fully conscious – keeps all natural reflexes – when breathing nitrous oxide/oxygen. He/she will be capable of responding to a question or request. Nitrous oxide/oxygen may also be used in combination with other sedative agents.

First, give your child little or no food in the tow hours preceding the dental visit (occasionally, nausea or vomiting occurs when a child has a full stomach). Second, tell your pediatric dentist about any respiratory condition that makes breathing through the nose difficult for your child, as it may limit the effectiveness of nitrous oxide/oxygen. Third, tell your pediatric dentist if your child is taking any medication on the day of the appointment.

Pediatric dentist know that all children are not alike. Every service is tailored to your child as an individual. Nitrous oxide/oxygen may not be effective for some children, especially those who have severe anxiety, nasal congestion, or discomfort wearing a nasal mask. Your pediatric dentist will review your child’s medical history, level of anxiety, and dental treatment needs and inform you if nitrous oxide/oxygen is recommended for your child. Pediatric dentists have comprehensive specialty training and can offer other sedation methods that are right for your child.

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