FAQ

Pediatric Dentistry

Adolescence and Oral Care

There is evidence that demonstrates how periodontal disease may increase during adolescence due to lack of motivation to practice oral hygiene. Children who maintain good oral health habits up until the teen years are more likely to continue brushing and flossing than children who were not taught proper oral care.

Advice for Parents

Early diagnosis is important for successful treatment of periodontal diseases. Therefore, it is important that children receive a periodontal examination as part of their routine dental visits. Be aware that if your child has an advanced form of periodontal disease, this may be an early sign of systemic disease. A general medical evaluation should be considered for children who exhibit severe periodontitis, especially if it appears resistant to therapy.

An important step in the fight against periodontal disease is to establish good oral health habits with your child early. When your child is about a year old, you can begin using toothpaste when brushing their teeth. However, only use a pea-sized portion on the brush and press it into the bristles so your child won’t eat it. And, when the gaps between your child’s teeth close, it’s important to start flossing.

Serve as a good role model by practicing good oral health care habits yourself and schedule regular dental visits for family check-ups, periodontal evaluations, and cleanings.

Check your child’s mouth for the signs of periodontal disease, including bleeding gums, swollen and bright red gums, gums that are receding away from the teeth, and bad breath.

If your child currently has poor oral health habits, work with your child to change these now. It’s much easier to modify these habits in a child than in an adult. Since your child models behavior after you, it follows that you should serve as a positive role model in your oral hygiene habits. A healthy smile, good breath, and strong teeth all contribute to a young person’s sense of personal appearance, as well as confidence and self-esteem.

Cavity Prevention

Most of the time cavities are due to a diet high in sugary foods and a lack of brushing.

Limiting sugar intake and brushing regularly, of course, can help. The longer it takes your child to chew their food, the longer the residue stays on their teeth and the greater the chances of getting cavities.

Every time someone eats, an acid reaction occurs inside their mouth as the bacteria digests the sugars. This reaction lasts approximately 20 minutes. During this time the acid environment can destroy the tooth structure, eventually leading to cavities.

Consistency of a person’s saliva also makes a difference as thinner saliva breaks up and washes away food more quickly. When a person eats diets high in carbohydrates and sugars, they tend to have thicker saliva, which in turn produces more of the acid-producing bacteria that causes cavities.

Some general tips for cavity prevention:

• Limit frequency of meals and snacks.
• Encourage brushing, flossing, and rinsing.
• Watch what you drink.
• Avoid sticky foods.
• Make treats part of meals.
• Choose nutritious snacks

Early Childhood Tooth Decay

Gum Disease

While many people believe periodontal disease is an adult problem, studies indicate that gingivitis (the first stage of periodontal disease) is nearly a universal problem among children and adolescents. Advanced forms of periodontal disease are rarer in children than adults, but can occur.

Chronic gingivitis is common in children. It can cause gum tissue to swell, turn red, and bleed easily. Gingivitis is preventable and treatable with a regular routine of brushing, flossing, and professional dental care. If left untreated, it can eventually advance to more serious forms of periodontal disease.

Localized aggressive periodontitis can affect young healthy children. It is found in teenagers and young adults and mainly affects the first molars and incisors. It is characterized by the severe loss of alveolar bone, and ironically, patients generally form very little dental plaque or calculus.

Generalized aggressive periodontitis may begin around puberty and involve the entire mouth. It is marked by inflammation of the gums and heavy accumulations of plaque and calculus. Eventually it can cause the teeth to become loose.

Conditions that make children more susceptible to periodontal disease include:

• Type I diabetes
• Down syndrome
• Papillon-Lefevre syndrome

For example, in a survey of 263 Type I diabetics, 11 to 18 years of age, 10 percent had overt periodontitis.

Thumb Sucking

Thumb sucking is a habit that occurs in infants. Children usually give up thumb sucking by the age of four. If the child continues past the age when their permanent teeth start to erupt, they may develop crooked teeth and a malformed roof of their mouth. This results from the frequency, duration, intensity, and position of the digit in the child’s mouth. This can also affect the position of the upper and lower jaw and can also affect speech.

Suggestions to break the habit:

• Wait till the time is right (low stress).
• Motivate your child (show examples of what could happen to their teeth and fingers/thumbs).
• Use a reward system (small incentives will encourage your child to stick with it).

Tooth Brushing

Brushing & Flossing Instructions
Children’s hands and mouths are different than adults. They need to use toothbrushes designed for children. Both adults and children should use brushes with soft, rounded bristles for gentle cleaning. Change to a new brush about every two months.

Wipe infant’s teeth gently with a moist, soft cloth or gauze square. As babies grow, use a child’s toothbrush with a small, pea-sized dab of toothpaste. By age two or three begin to teach your child to brush. You will still need to brush where they miss. Dentists and hygienists often advise children to use a gentle, short, circular motion to remove plaque. When children are older, they can switch to this method.

Hold the brush at a 45 degrees angle towards teeth and gums. Move brush back and forth with short, circular strokes, about a half tooth wide.

• Brush the inside and outside surfaces of each tooth, top and bottom.
• Hold the brush flat on top of the teeth and brush the chewing surfaces.
• Gently brush the tongue to remove debris.
• Floss between teeth daily.

When to Begin Brushing
Once your child’s teeth begin erupting, you can begin cleaning them by wiping them with a moist washcloth. As your child gets more teeth, you can begin to use a soft child’s toothbrush. You should use just a pea-sized amount of toothpaste (such as Baby OraGel) until your child is able to spit it out (too much fluoride can stain their teeth).

For most toddlers, getting them to brush their teeth can be quite a challenge. Some suggestions for making tooth brushing less of a battle can include:

• Let your child brush your teeth at the same time.
• Let your child pick out a few toothbrushes with his favorite characters and giving him a choice of which one he wants to use each time (this will give him some feeling of control over the situation).
• Let your child brush his own teeth first (you will likely have to “help out”).
• Let your child read some children’s books about tooth brushing.
• Have everyone brush their teeth at the same time.

To help your child understand the importance of brushing, it can be sometimes fun and helpful to let them eat or drink something that will “stain“ their teeth temporarily and then brush them clean.

It can also be a good idea to create a “tooth brushing routine”. And stick to the same routine each day.

Tooth Eruption

The first baby teeth come into the mouth are the two bottom front teeth. You will notice this when your baby is about six to eight months old. Next to follow will be the four upper front teeth and the remainder of your baby’s teeth will appear periodically. They will usually appear in pairs along the sides of the jaw until the child is about 2-1/2 years old.

At around 2-1/2 years old, your child should have all 20 teeth. Between the ages of five and six, the first permanent teeth will begin to erupt. Some of the permanent teeth replace baby teeth and some don’t. Don’t worry if some teeth are a few months early or late as all children are different.

Baby teeth are important as they not only hold space for permanent teeth, but they are important for chewing, biting, speech, and appearance.

For this reason it is important to maintain a healthy diet and daily hygiene.

What to Tell Your Child

Sometimes parents in the eagerness to prepare their children over-explain.

We suggest that you casually mention a few days ahead that “We are going to visit the dentist soon.” Then, when the day arrives, mention it again. Please convey the feeling that dental visits are a part of growing up. Please don’t offer rewards or indicate in any way that there is anything to fear. We are trained to spend extra time with your child to explain procedures and instruments to them in a way that makes sense for their age and maturity level.

Your child’s reaction to the first few dental visits sets the stage for his/her entire lifetime of dental experiences. In an attempt to keep the initial experience as pleasant as possible, we may complete only a thorough examination. For children under the age of 3 this may be done in the parent’s lap for child comfort. Older children will receive a cleaning and any necessary x-rays at the visit. We then will build upon each visit that your child comes to our office to always give them something new to experience. This way, each visit is seen as a fun experience, where a sense of accomplishment is given to each child.