Pediatric Frequently Asked Questions
Primary teeth or baby teeth are important for three reasons:
- They promote proper chewing and eating
- They provide space for the permanent teeth and guide them into the correct position
- They permit normal development of speech and add to an attractive appearance
Primary front teeth are replaced at an early age 6-8 years. The back teeth cuspids and molars aren’t replaced until age 10-13. 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.
Begin brushing your child’s first teeth as soon as they erupt. Avoid fluoride toothpaste until your child can spit and clear his/her mouth – usually around age 2 or 3. You can use a wet wash cloth or a special finger tooth brush for the first few months. You should brush your child’s teeth for them one time a day until age 7 or 8. Give your child a turn and then follow up afterwards. This will help maintain good oral hygiene and positively reinforce the importance of good oral home care. Children often do not have the skill level to brush adequately until they can write their name in cursive. Supervision and occasional brushing of older children’s teeth is also recommended. The doctors can help you determine whether your child has the skill level to brush properly.
Flossing removes plaque between the teeth where a toothbrush can’t reach. Flossing should begin when any two teeth touch. You should floss your child’s teeth until he or she can do it alone. We will review proper brushing and flossing techniques at your child’s cleaning visits.
Pediatric dentistry is a dental specialty that focuses on the oral health of young people. Following dental school, a pediatric dentist has two to three years of additional specialty training in the unique needs of infants, children and adolescents, including those with special health needs. A pediatric dentist is the dental equivalent of a pediatrician in the medical community. Pediatric dentists see only children and are prepared to treat their special dental needs.
Healthy eating habits lead to healthy teeth. Children should eat a variety of foods from the five major food groups. Most snacks that children eat can lead to cavity formation. Frequency and duration of snacking play a role in tooth decay. Children who drink constantly from a sippy cup or who snack frequently have a greater chance for developing cavities. Bacteria in dental plaque eat simple sugars and produce acids, which attack tooth enamel. When a child is constantly drinking or eating, the attack on their enamel is continuous and will lead to significant tooth decay. Offer your child snacks of nutritious foods such as fruits, vegetables, low-fat yogurt, and low-fat cheese, which are healthier and better for your child’s teeth.
Radiographs (X-Rays) are a vital and necessary part of your child’s dental diagnostic process. Without them, certain dental conditions can and will be missed.
Radiographs detect much more than cavities. For example, radiographs are taken to evaluate erupting teeth, evaluate the results of an injury, diagnose bone diseases, or plan orthodontic treatment. Radiographs allow the dentist 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.
At Erickson Pediatric Dentistry & Orthodontics we follow the ADA (American Dental Association) and AAPD (American Academy of Pediatric Dentistry) recommendations for taking radiographs. Children with a high cavity risk should have radiographs every six months. Children with moderate to low caries risk, radiographs are recommended approximately once a year. A panoramic radiograph is recommended every three years starting at age 5 to 6 years old. This special film helps us monitor the growth and development of your child’s teeth and bones.
Exposure to radiation is always a concern. At Erickson Pediatric Dentistry & Orthodontics we have the newest in digital radiographic equipment. With digital radiographs the radiation exposure is extremely small. The risk is negligible. In fact, the dental radiographs represent a far smaller risk than an undetected and untreated dental problem.
Proper brushing and flossing removes bacteria and the left-over food particles that combine to create cavities. For infants, use a clean washcloth to wipe the plaque from teeth and gums. Avoid putting your child to bed with a bottle filled with anything other than water. See “early childhood caries” for more information.
For older children, you should brush their teeth at least twice a day. Also, watch the number of snacks containing sugar that you give your children.
The American Academy of Pediatric Dentistry (AAPD) recommends that your child’s first visit to the dentist be within 6 months of their first tooth erupting or by their first birthday. Routine visits will start your child on a lifetime of good dental health.
We may also recommend protective sealants or home fluoride treatments for your child. Sealants can be applied to your child’s molars to prevent decay on hard to clean surfaces.
A sealant is a clear or shaded white plastic material that is applied to the chewing surfaces (grooves) of the back teeth (premolars and molars), where 80% of decay happens on adult teeth. The sealant acts as a barrier to food, plaque and acid, thus protecting the decay-prone areas of the teeth. Studies have shown that sealants can reduce tooth decay by as much as 90%.
The American Dental Association (ADA) recommends that sealants be placed as soon as the first adult molars come in at age 6 or 7. Sealants should continue to be used as each adult molar tooth appears the mouth.
One serious form of decay among young children is Early Childhood Caries (Baby Bottle Tooth Decay). This condition is caused by frequent and long exposures of an infant’s teeth to liquids that contain sugar. Milk (including breast milk), formula, fruit juice and other sweetened drinks are some these liquids.
Putting a baby to bed for a nap or at night with a bottle filled with anything other than water can cause serious and rapid tooth decay. Sweet liquids pool around the child’s teeth giving the bacteria in plaque an opportunity to produce acids that dissolve tooth enamel. If you must give the baby a bottle as a comforter at bedtime, it should contain only water. If your child won’t fall asleep without the bottle and the usual beverage, gradually dilute the bottle’s contents with water over a period of two to three weeks.
After each feeding, wipe your baby’s gums and teeth with a damp washcloth to remove plaque. Place the child in your lap or on the floor so you can easily see into their mouth.
Taking your baby off of the breast when he/she falls asleep can prevent baby tooth decay. Hold your baby while bottle-feeding. Always take a bottle filled with milk or juice away from the sleeping child.
If your child requires a bottle at bedtime provide a bottle filled with water. Instead of a bottle, try comforting your child with a pacifier or a favorite toy or blanket.
Brush your baby’s teeth with a soft toothbrush daily.
Signs and appearance of teeth displaying bottle caries:
- Upper front teeth that break easily
- Brown teeth with fragmented edges
- White chalky lines or spots near the gums
Children who have erupted teeth or are past the age to be weaned (one year old) are highly susceptible to rotted front teeth when being put to bed with a bottle containing milk, juice or other sugar-containing liquids. There is decreased salivary flow during sleep and clearance of the liquid from the teeth is slowed.
Your child’s teeth began forming even before they were born. As early as 4 to 6 months, the first primary (baby) teeth begin to erupt through the gums. The first teeth are the lower central incisors (front teeth), followed closely by the upper central incisors. All 20 primary teeth usually appear by age 3, however the pace and order of their eruption varies from child to child.
Permanent teeth begin appearing around age 6, starting with the adult first molars and lower central incisors. This process continues until approximately age 21.
Adults have 32 permanent teeth including the third molars (or wisdom teeth).
Permanent first molars will erupt behind the baby molars at age 6.
Since the eruption of primary teeth is a normal and natural process, these signs and symptoms are to be expected:
- Putting fingers and hands into the mouth
- Restlessness fretful behavior
- Increased salivation
Children may display other symptoms such as fever and systemic disturbances, such as croup, diarrhea, etc. These are coincidental to eruption and should be treated medically by the pediatrician as necessary.
Sore gums from teething often occur for a few days at a time between six months to age three.
Babies often get relief from a clean teething ring, cool spoon, cold wet washcloth or toothbrush. Chilled teething rings or rubbing a clean finger on the sore gum area often helps, too.
A mouth guard should be a top priority on your child’s list of sports equipment. Athletic mouth protectors, or mouth guards, are made of soft plastic and fit comfortably to the shape of the upper teeth. They protect a child’s teeth, lips, cheeks and gums from sports-related injuries. Any mouth guard works better than no mouth guard, but a custom-fitted mouth guard fitted by our doctor is your child’s best protection against sports-related injuries.
Fluoride is a natural occurring element, which in proper dosage, has been shown to significantly reduce dental decay. When fluoridated water has less than the ideal amount or is not available, fluoride supplements are recommended.
When supplements are needed, the administration of fluoride supplements should begin at 6 months of age and continue through the time of eruption of the second permanent molars (approx. 12 years of age).
Residents of the Colorado Springs area have benefited over the years from naturally occurring fluoride in the drinking water which hardens tooth enamel and increases caries resistance. However, the levels of fluoride in our drinking water vary greatly in different parts of our city. Consult with our doctors if you are wondering about the level in your neighborhood.
The pulp of a tooth is the inside soft tissue or “nerve” 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 can be maintained until the correct time for normal tooth loss (exfoliation).
Cavities (caries) and traumatic injury are the main reasons for a tooth to require pulp therapy.
Pulp therapy is often referred to as a “baby root canal”, pulpotomy or pulpectomy.
A pulpotomy removes the diseased pulp tissue within the crown portion of the tooth. A disinfecting agent which also calms the remaining nerve tissue is then placed in the tooth. This is followed by a final restoration (usually a stainless steel crown).
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, medicated and in the case of primary teeth, filled with a resorbable material. Then a final restoration is placed (usually a stainless steel crown).
Sucking is a natural reflex. Infants, babies and young children use thumbs, fingers, pacifiers and other objects on which to suck. It makes them feel secure and happy and provides 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 proper growth of the mouth and tooth alignment. 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.
Children should cease thumb sucking by the time their permanent front teeth are ready to erupt. Usually, children stop between the ages of two and four. Peer pressure causes many school-aged children to stop.
Pacifiers are not a 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 with us at your next visit.
A few suggestions to help your child get through thumb sucking:
- Do not scold your child for thumb sucking. Praise him when he does not.
- Children often suck their thumbs when feeling insecure. Focus on correcting the cause of anxiety, instead of the thumb sucking.
- Children who are sucking for comfort will feel less of a need when their parents provide comfort.
- Reward your child when he refrains from sucking during difficult periods, such as when being separated from their parents.
- Dr. Josh will encourage your child to stop sucking their thumb and explain what could happen if they continue.
- A friendly reminder for your child can often help if they want to stop the habit. A Band-Aid on the thumb or fingers after school and a glove that is difficult to remove at night.
If these approaches don’t work, we will be glad to work with you and your child to create a program that will help to empower your child and motivate them to stop their habit.