Pediatric Dentistry General Topics & FAQ
What Is A Pediatric Dentist?
The pediatric dentist has an additional two to three years of specialized training after dental school, and is dedicated to the oral health of children from infancy through the teenage years including those with special needs. The very young, pre-teens, and teenagers all need different approaches in dealing with their behavior, guiding their dental growth and development, and helping them avoid future dental problems. The pediatric dentist is best qualified to meet these needs.
We aim to make all our patients comfortable and looking forward to their next visit.
Why Are The Primary Teeth So Important?
It is very important to maintain the health of the primary teeth. Neglected cavities can and frequently do lead to problems which affect developing permanent teeth. Primary teeth or baby teeth are important for (1) proper chewing and eating, (2) providing space for the permanent teeth and guiding them into the correct position, and (3) permitting normal development of the jaw bones and muscles. Primary teeth also affect the development of speech and add to an attractive appearance. While the front 8 teeth last until 6-7 years of age, the back teeth (cuspids and molars) arent replaced until age 10-13.
Eruption Of Your Childs Teeth
Childrens teeth begin forming before birth. As early as 4 months, the first primary (or baby) teeth to erupt through the gums are the lower central incisors, followed closely by the upper central incisors. Although all 20 primary teeth usually appear by age 3, the pace and order of their eruption varies.
Permanent teeth begin appearing around age 6, starting with the first molars and lower central incisors. This process continues until approximately age 21.
Adults have 28 permanent teeth, or up to 32 including the third molars (or wisdom teeth).
Tooth Development
Tooth Eruption Chart of Primary Teeth
Tooth Eruption Chart of Permanent Teeth
Dental Radiographs (X-Rays)
Radiographs (X-Rays) are a vital and necessary part of your childs dental diagnostic process. Without them, certain dental conditions can and will be missed.
Putting on the lead blanket
Panorex X-ray
Radiographs detect much more than cavities. For example, radiographs may be needed to survey erupting teeth, diagnose bone diseases, evaluate the results of an injury, or plan orthodontic treatment. Radiographs 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 for your child and more affordable for you.
The American Academy of Pediatric Dentistry recommends radiographs and examinations every six months for children with a high risk of tooth decay. On average, most pediatric dentists request bitewing radiographs approximately once a year starting at approximately age 8. Panoramic x-rays are taken approximately at the age ranges of 8-9, 13-14, and 17.
Bitewing X-raysWhats the Best Toothpaste for my Child?
Tooth brushing is one of the most important tasks for good oral health. Many toothpastes, and/or tooth polishes, however, can damage young smiles. They contain harsh abrasives which can wear away young tooth enamel. When looking for toothpaste for your child make sure to pick one that is recommended by the American Dental Association. These toothpastes have undergone testing to insure they are safe to use.
Remember, children should spit out toothpaste after brushing to avoid getting too much fluoride. If too much fluoride is ingested, a condition known as fluorosis can occur. If your child is too young or unable to spit out toothpaste, consider providing them with a fluoride free toothpaste, using no toothpaste, or using only a “pea size” amount of toothpaste.
Does Your Child Grind His Teeth At Night? (Bruxism)
Parents are often concerned about the nocturnal grinding of teeth (bruxism). Often, the first indication is the noise created by the child grinding on their teeth during sleep. Or, the parent may notice wear (teeth getting shorter) to the dentition. Grinding of the teeth
in children is a fairly common occurrence that begins at around age 4 or 5. Because the childs jaw is growing and the teeth are starting to erupt, the child starts to compensate for this by grinding to find a comfortable position for the bite.
Sometimes stress can cause a child to grind his/her teeth. A new environment, divorce, or changes at school can cause stress in a child. Another theory relates to pressure in the inner ear while sleeping at night. If there are pressure changes (like in an airplane during take-off and landing) the child will grind by moving his jaw to relieve this pressure.
The majority of cases of pediatric bruxism do not require any treatment. If excessive wear of the teeth (attrition) is present, then a mouth guard (night guard) may be indicated at around age 13. Wearing a mouth guard at night can prevent damaging wear to the permanent teeth.
The good news is that most children outgrow bruxism. The grinding decreases between the ages 6-9 and children tend to stop grinding between ages 9-12. If you suspect bruxism, discuss this with your pediatrician or pediatric dentist.
Thumb Sucking
Sucking is a natural reflex and infants and young children may use thumbs, fingers, pacifiers, blankets, or other objects on which to suck. It may provide them with a sense of security at difficult periods. Since thumb sucking is relaxing, it may induce sleep.
Thumb sucking that persists beyond the eruption of the permanent teeth can cause problems with the growth, development, and alignment of the teeth and jaws. How intensely a child sucks on fingers or thumbs will determine whether or not dental problems may result. Children who rest their thumbs passively in their mouths are less likely to have difficulty than those who vigorously suck their thumbs.
Ideally, children should cease thumb sucking by the time their permanent front teeth are ready to erupt. Realistically, children usually stop between the ages of six and eight. Peer pressure causes many school-aged children to stop.
Pacifiers are no substitute for thumb sucking. They can affect the teeth essentially the same way as sucking fingers and thumbs. However, use of the pacifier can be controlled and modified more easily than the thumb or finger habit. If you have concerns about thumb sucking or use of a pacifier, consult your pediatric dentist.
If your child is pre-school age and happy, dont be concerned about thumb sucking. As your child reaches age 5, you may want to try to help your child discontinue thumb sucking using the following suggestions.
Suggestions for Breaking the Habit
- Instead of scolding children for thumb sucking, praise them when they don’t do it.
- Children often suck their thumbs when feeling insecure. Focus on correcting the cause of anxiety, instead of the thumb sucking. Examples: Children who are sucking for comfort will feel less need to do so when their parents provide comfort.
- Limit the sucking to a particular place (such as the child’s room) and time (nap or bedtime).
- Agree on a code word to be used as a no thumb sucking reminder and say the word when your child begins to suck.
- Keep the childs hands busy with projects such as puzzles, coloring, or playing
with clay. - Your pediatric dentist can encourage children to stop sucking and explain the consequences if they continue.
- If these approaches dont work, remind the children of their habit by using gentle reminders such as bandaging the thumb or putting a sock or glove on the hand at night. Your pediatric dentist may recommend the use of an intra-oral appliance.
What is Pulp Therapy?
The pulp of a tooth is the inner central core of the tooth. The pulp contains nerves, blood vessels, connective tissue and reparative cells. The purpose of pulp therapy in Pediatric Dentistry is to maintain the vitality of the affected tooth (so the tooth is not lost).
Dental caries (cavities) and traumatic injury are the main reasons for a tooth to require pulp therapy. Pulp therapy is often referred to as a “nerve treatment”, “children’s root canal”, “pulpectomy” or “pulpotomy”. The two common forms of pulp therapy in children’s teeth are the pulpotomy and pulpectomy.
A pulpotomy removes the diseased pulp tissue within the crown portion of the tooth. Next, an agent is placed to prevent bacterial growth and to calm the remaining nerve tissue. This is followed by a final restoration.
A pulpectomy is required when the entire pulp is involved (into the root canal(s) of the tooth). During this treatment, the diseased pulp tissue is completely removed from both the crown and root. The canals are cleansed, disinfected and in the case of primary teeth, filled with a resorbable material. Then a final restoration is placed. A permanent tooth would be filled with a non-resorbing material.