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What Is A Pediatric Dentist?

The pediatric dentist has an extra 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. 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 of Pediatric Dentistry.

Why Are The Primary Teeth 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 4 teeth last until 6-7 years of age, the back teeth (cuspids and molars) aren’t replaced until age 10-13.

Eruption Of Your Child’s Teeth

general-dentistry Children’s 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 vary.
Permanent teeth begin appearing around age 6, starting with the first molars and lower central incisors. At the age of 8, you can generally expect the bottom 4 primary teeth (lower central and lateral incisors) and the top 4 primary teeth (upper central and lateral incisors) to be gone and permanent teeth to have taken their place. There is about a one to two-year break from ages 8-10 and then the rest of the permanent teeth will start to come in. This process continues until approximately age 21.

Adults have 28 permanent teeth or up to 32 including the third molars (or wisdom teeth).

Pediatric Dentistry – Dental Emergencies

Toothache: Clean the area of the affected tooth. Rinse the mouth thoroughly with warm water or use dental floss to dislodge any food that may be impacted. If the pain still exists, contact DENTAL WORKS. Do not place aspirin or heat on the gum or on the aching tooth. If the face is swollen, apply cold compresses and contact your dentist immediately.

Cut or Bitten Tongue, Lip or Cheek: Apply ice to injured areas to help control swelling. If there is bleeding, apply firm but gentle pressure with a gauze or cloth. If bleeding cannot be controlled by simple pressure, call or visit us as soon as possible.

Knocked Out Permanent Tooth: If possible, find the tooth. Handle it by the crown, not by the root. You may rinse the tooth with water only. DO NOT clean with soap, scrub or handle the tooth unnecessarily. Inspect the tooth for fractures. If it is sound, try to reinsert it in the socket. Have the patient hold the tooth in place by biting on a gauze or clean cloth. If you cannot reinsert the tooth, transport the tooth in a cup containing the patient’s saliva or milk, NOT water. If the patient is old enough, the tooth may also be carried in the patient’s mouth (beside the cheek). The patient must see a dentist IMMEDIATELY! Time is a critical factor in saving the tooth.

Knocked-Out Baby Tooth: Contact DENTAL WORKS. Unlike with a permanent tooth, the baby tooth should not be replanted due to possible damage to the developing permanent tooth.  In most cases, no treatment is necessary.

Chipped/Fractured Permanent Tooth: Time is a critical factor, contact DENTAL WORKS immediately so as to reduce the chance for infection or the need for extensive dental treatment in the future. Rinse the mouth with water and apply a cold compress to reduce swelling.  If you can find the broken tooth piece, bring it with you to the dentist.

Chipped/Fractured Baby Tooth: Contact US.

Possible Broken or Fractured Jaw: Keep the jaw from moving and take your child to the nearest hospital emergency room.

Dental Radiographs (X-Rays)  

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 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.

We, at DENTAL WORKS, are particularly careful to minimize the exposure of their 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, the dental radiographs represent a far smaller risk than an undetected and untreated dental problem. 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.

What’s The Best Toothpaste For My Child?  

Tooth brushing is one of the most important tasks for good oral health. Many kinds of toothpaste, and/or tooth polishes, however, can damage young smiles. They contain harsh abrasives, which can wear away young tooth enamel.

Use only a smear of toothpaste (the size of a grain of rice) to brush the teeth of a child less than 3 years of age. For children 3 to 6 years old, use a “pea-size” amount of toothpaste and perform or assist your child’s toothbrushing. Remember that young children do not have the ability to brush their teeth effectively on their own. Children should spit out and not swallow excess toothpaste after brushing.

Does Your Child Grind His Teeth At Night? (Bruxism)

general-dentistry 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. One theory as to the cause involves a psychological component. Stress due to a new environment, divorce, changes at school; etc. can influence a child to grind their teeth. Another theory relates to pressure in the inner ear at night. If there are pressure changes (like in an airplane during take-off and landing, when people are chewing gum, etc. to equalize pressure) 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 (nightguard) may be indicated. The negatives to a mouth guard are the possibility of choking if the appliance becomes dislodged during sleep and it may interfere with the growth of the jaws. The positive is obvious by preventing wear to the primary dentition.

The good news is 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 us at DENTAL WORKS.

Thumb Sucking  

Thumb or finger sucking or pacifiers can be quite soothing to infants and young children. So while we don’t want to completely discourage your child from thumb or pacifier sucking, we also don’t want it to go on for too long, because dental or skeletal deformations may develop as a result. Therefore, your child’s thumb-sucking should stop by the time he or she is three years old. If you’re having trouble convincing your child to stop sucking his thumb, let us know at your child’s next dental checkup. We have some tips.

general-dentistry

Pediatric Dentistry – 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 (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, 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.

What Is The Best Time For Orthodontic Treatment?

Developing malocclusions, or bad bites can be recognized as early as 2-3 years of age. Often, early steps can be taken to reduce the need for major orthodontic treatment at a later age.

Stage I – Early Treatment: This period of treatment encompasses ages 2 to 6 years. At this young age, we are concerned with underdeveloped dental arches, the premature loss of primary teeth, and harmful habits such as finger or thumb sucking. Treatment initiated in this stage of development is often very successful and many times, though not always, can eliminate the need for future orthodontic/orthopedic treatment.

Stage II – Mixed Dentition: This period covers the ages of 6 to 12 years, with the eruption of the permanent incisor (front) teeth and 6-year molars. Treatment concerns deal with jaw mal-relationships and dental realignment problems. This is an excellent stage to start treatment when indicated, as your child’s hard and soft tissues are usually very responsive to orthodontic or orthopedic forces.

Stage III – Adolescent Dentition: This stage deals with the permanent teeth and the development of the final bite relationship.

Adult Teeth Coming in Behind Baby Teeth

This is a very common occurrence with children, usually the result of a lower, primary (baby) tooth not falling out when the permanent tooth is coming in.  In most cases, if the child starts wiggling the baby tooth, it will usually fall out on its own within two months. If it doesn’t, then contact DENTAL WORKS, where we can easily remove the tooth.  The permanent tooth should then slide into the proper place.

Tooth-Colored Fillings

In most cases, we repair a cavity with a tooth-colored filling. Made of composite resin materials, these fillings blend seamlessly with the shading of your child’s natural smile. Moreover, the material is strong, durable and requires less tooth preparation than a metal filling. That means your child spends less time with a dental drill in his or her mouth.

general-dentistry

Dental Crowns

If tooth decay is so severe that a filling will not do, then a dental crown may be the best solution. A crown may also be called for in case of an injury that damages a tooth. A crown, which can be made of porcelain, metal or ceramics, completely covers a tooth. The doctor will prepare the tooth by removing decay and contouring the tooth. Then, the customized crown is cemented into place.

Root Canal Therapy

For an infected tooth, root canal therapy may be necessary. Please don’t think that your child will be in pain during a root canal. To the contrary, a root canal is designed to eliminate the pain of an infected tooth. With special tools, Doctor accesses the tooth’s innermost pulp chamber to remove the infection and replace it with a biocompatible material. The dentist completes the treatment with a protective dental crown.

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Early Infant Oral Care

Perinatal & Infant Oral Health
 

All pregnant women receive oral healthcare and counseling during pregnancy. Research has shown evidence that periodontal disease can increase the risk of preterm birth and low birth weight. Talk to us at DENTAL WORKS about ways you can prevent periodontal disease during pregnancy.

Additionally, mothers with poor oral health may be at a greater risk of passing the bacteria which causes cavities to their young children. Mother’s should follow these simple steps to decrease the risk of spreading cavity-causing bacteria:

1. Visit your dentist regularly.
2. Brush and floss on a daily basis to reduce bacterial plaque.
3. Proper diet, with the reduction of beverages and foods high in sugar & starch.
4. Use a fluoridated toothpaste recommended by the IDA and rinse every night with an alcohol-free, over-the-counter mouth rinse with .05 % sodium fluoride in order to reduce plaque levels.
5. Don’t share utensils, cups or food which can cause the transmission of cavity-causing bacteria to your children.
6. Use of xylitol chewing gum (4 pieces per day by the mother) can decrease a child’s caries rate.

When Will My Baby Start Getting Teeth?

Teething, the process of baby (primary) teeth coming through the gums into the mouth, is variable among individual babies. Some babies get their teeth early and some get them late. In general, the first baby teeth to appear are usually the lower front (anterior) teeth and they usually begin erupting between the age of 6-8 months.

Baby Bottle Tooth Decay (Early Childhood Caries)  

One serious form of decay among young children is baby bottle tooth decay. This condition is caused by frequent and long exposures of an infant’s teeth to liquids that contain sugar. Among these liquids are milk (including breast milk), formula, fruit juice, and other sweetened drinks.

Putting a baby to bed for a nap or at night with a bottle other than water can cause serious and rapid tooth decay. Sweet liquid pools around the child’s teeth giving plaque bacteria an opportunity to produce acids that attack 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 its usual beverage, gradually dilute the bottle’s contents with water over a period of two to three weeks.

After each feeding, wipe the baby’s gums and teeth with a damp washcloth or gauze pad to remove plaque. The easiest way to do this is to sit down, place the child’s head in your lap or lay the child on a dressing table or the floor. Whatever position you use, be sure you can see into the child’s mouth easily.

Sippy Cups

Sippy cups should be used as a training tool from the bottle to a cup and should be discontinued by the first birthday. If your child uses a sippy cup throughout the day, fill the sippy cup with water only (except at mealtimes). By filling the sippy cup with liquids that contain sugar (including milk, fruit juice, sports drinks, etc.) and allowing a child to drink from it throughout the day, it soaks the child’s teeth in cavity-causing bacteria.

Prevention

How to Care for Your Child’s Teeth
 

Children’s dentistry actually begins with you. Even before your child has any teeth, dental care is important. Those beautiful pearly whites are just waiting to erupt through the gums. So, after every feeding, be sure to wipe your baby’s gums with a soft, damp washcloth. This will remove plaque and any formula or breastmilk. If you are bottle-feeding, don’t let your baby fall asleep with a bottle of milk or juice, which both contain sugars that can cause cavities to develop.

Once that first little tooth arrives, it’s time to start brushing. Use a soft baby toothbrush that is moistened with water. There’s no need to use toothpaste yet. As your child grows and more teeth erupt, you can add a minimal amount of fluoride toothpaste.

Try to minimize the amount of toothpaste your child swallows. If your child is too young to spit, then just smear a small amount of toothpaste on the brush. As they learn to spit, you can use a pea-size amount of toothpaste. You’ll need to help your children brush and floss at least until they are seven or eight years old. When they start brushing and flossing on their own, they still might need your help. They should brush their teeth at least two times each day. Very often, toothpaste for adults contains abrasives that can be damaging to developing teeth. Flossing should happen every night before bed and may need supervision longer than brushing.

In keeping with the recommendation of the Indian Academy of Pediatric Dentistry, we would like to begin seeing your children for regular checkups on or before their first birthdays. Starting this young, your children will become accustomed to seeing the dentist and will begin a lifelong foundation of dental health care.

Nutrition Advice from DENTAL WORKS Children’s Dentist
 

Just as the rest of your children’s growing bodies need good nutrition to develop, so do their teeth. A nutritious and well-balanced diet is required for healthy teeth and gums. Ideally, your child’s daily diet should include one or more servings of milk, fruits, vegetable, meat or beans, grains, and essential oils.
For more information about your child’s oral health, or to schedule an appointment, call at DENTAL WORKS.

Pediatric Dentistry – How Do I Prevent Cavities?

Good oral hygiene removes bacteria and the leftover food particles that combine to create cavities. For infants, use a wet gauze or 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.

For older children, brush their teeth at least twice a day. Also, watch the number of snacks containing sugar that you give your children.

Your pediatric dentist 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.

Seal Out Decay

A sealant is a protective coating that is applied to the chewing surfaces (grooves) of the back teeth (premolars and molars), where four out of five cavities in children are found. This sealant acts as a barrier to food, plaque, and acid, thus protecting the decay-prone areas of the teeth.

Before Sealant Applied

After Sealant Applied

Fluoride Treatments and Dental Sealants

Fluoride is a natural mineral that attracts other minerals and thereby strengthens tooth enamel. In addition, fluoride inhibits the growth of bacteria that can cause a cavity. Therefore, we may recommend fluoride treatments. On the other hand, too much fluoride can be harmful to your children’s smiles. With too much fluoride in their diets, children can develop fluorosis, which causes white spots or streaks to develop on their teeth. In severe cases, tooth enamel may turn brown. To prevent fluorosis, make sure your children do not swallow fluoridated toothpaste. Until you know they can spit, either eliminate toothpaste or use a very small amount.

Dental sealants form a solid layer of protection on top of your children’s molars to help them in the battle against tooth decay. Sealants start out as a liquid plastic that we “paint” on the chewing surface of your children’s teeth. Once dried with a curing light, sealants are a barrier between the bacteria that cause cavities and your children’s deeply grooved and pitted molars.

Mouth Guards  

Whether a child is engaging in collision sports such as hockey and football or simply part of a dance class or track team, acrylic mouth guards protect young mouths from soft tissue lacerations, chronic teeth clenching and grinding, tooth avulsion, chips, and cracks. The stability and strength conferred by a mouthguard also reduce the chances of jaw fracture and dislocation.

Formed from BPA-acrylic according to oral impressions taken at DENTAL WORKS, a sports mouthguard takes an impact so a child’s teeth, gums, and jaw don’t have to. Mouthguards protect better and are more comfortable than store-bought appliances.

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