Pediatric General Topics
The baby teeth your child develops first are very important! Even though they will eventually fall out, you need to keep them healthy as long as possible: decay in the primary teeth will lead to decay in the developing permanent teeth.
- Allow for proper nutrition.
- Act as guides for the permanent teeth to take up the correct position.
- Help strengthen and develop the musculature of the jaw.
- Affect speech development.
You can expect the four front teeth on top and bottom to fall out around age six or seven. Molars and cuspids (eye teeth) may last longer, usually until ten to thirteen years old.
When your baby is born, he already has teeth developed under his gums. They won’t erupt or come in until at least four months, but they are already there! The first teeth to come in will probably be the lower two front teeth, then the upper front teeth. By her third birthday, she should have all 20 teeth, though the order and time they came in will differ from your neighbor’s or sibling’s child.
Toward the end of kindergarten, around six years old, he’ll begin to lose the front teeth as his permanent teeth push their way through. As he gets to his pre-teen and teenage years, his permanent cuspids and molars make their way through, pushing out more primary teeth and increasing his tooth count from 20 to 28.
Approaching the end of his teenage years, the third set of molars (wisdom teeth) will make themselves known, either by erupting or moving toward the roots of the other molars. He may need to have them removed in order to maintain proper alignment and oral health. If the wisdom teeth are healthy and remain, he may have as many as 32 teeth.
Toothache: Keep the area clean and help your child rinse with warm water. If food particles are still stuck, use dental floss to remove it. If your little one is still feeling pain or if there is swelling, use a cold compress and contact our Chandler office immediately. Do not use aspirin or heat on the affected area.
Lacerations to Soft Tissue: Use gauze to apply gentle pressure to any bleeding areas. Cold compresses or ice may be used to reduce swelling. Visit the hospital emergency room if bleeding will not stop.
Knocked Out Teeth:
- Permanent Tooth: Find the tooth and rinse it with water only. Look at it carefully to make sure it is not broken. If it appears whole, try to put it back in the socket and bite down on a piece of gauze to hold it in place. Only touch the crown of the tooth and not the root. Never use soap or scrub it. If the tooth won’t go back in or is broken, put it in a clean cup with milk or the patient’s saliva. Come to the dentist IMMEDIATELY, as saving the tooth is a time sensitive procedure.
- Baby Tooth: Usually no treatment is necessary for an avulsed primary tooth. It is not an emergency, however you should contact our Chandler office during business hours to make sure no pieces are lodged inside of the mouth.
Broken or Chipped Teeth:
- Permanent Tooth: Call our office immediately. Use warm water to rinse the mouth and a cold compress to treat swelling. Save any fragments and bring them with you to the dentist. If we work quickly, we can keep infection away and save the broken tooth!
- Baby Tooth: Call our office in Chandler.
Hard Blow to the Head:
- Go to the closest emergency room immediately.
Possible Fractured/Broken Jaw:
- Go to the closest emergency room immediately.
Dental x-rays can be an important tool to care for your child’s dental health. Not only do they show where cavities are, but they can also be used to check developing permanent teeth, assess the extent of an injury, or even determine if bone disease is present!
Our orthodontist will use x-rays to determine a plan of care related to braces.
While most dentists order dental x-rays for their patients yearly, children at high risk for decay are recommended to have them with a thorough exam every six months by the AAPD.
But Don’t X-Rays Expose My Child to Radiation?
While x-rays do use radiation, the amount is negligible when compared to a day spent out in the sun or a ride on an airplane. Our dentists are careful to use protection like lead aprons and body shields to minimize any exposure. For the sake of comparison, your child is at greater risk from undiagnosed and untreated dental problems than from the x-rays!
The toothpaste you use for yourself may not be appropriate for your little one’s teeth. It may use abrasives or ingredients that are too hard on the enamel. Keep brushing those teeth for good dental health, but choose a toothpaste that has the seal of recommendation from the American Dental Association on the box or tube.
When you brush your child’s teeth, only use a small, pea-sized amount of toothpaste. Remind him not to swallow the toothpaste, but to spit it out. It should never be ingested due to the fluoride. Too much systemic fluoride can cause dental fluorosis, a mild discoloration of the permanent teeth that are still developing. While your child is too young to spit, use a training toothpaste without fluoride or no toothpaste at all.
You may have noticed an unusual noise coming from your child’s room at night, so you go and listen more closely. The sound is coming from her mouth, and her jaw seems clenched. What you are hearing is bruxism, or grinding the teeth. Most of the time, grinding is not a major problem, nor does it require treatment.
However, if you notice a lot of wear to your child’s teeth, like they are getting smaller, you should talk to one of our dentists about a night guard. This dental appliance will prevent further wear to the baby teeth. There are risks to wearing it, including choking, if it shifts while your child sleeps, as well as interference with jaw growth.
Fortunately, bruxism doesn’t usually continue forever. Most children outgrow it by twelve years old. Call Kids Dental Center today to talk to one of our pediatric dentists about how tooth grinding at night can affect your child.
Many young children self sooth using thumbs, fingers, or pacifiers. It is an instinctive reflex that can help them feel secure, relaxed, and even sleepy! But it needs to stop at some point. It is, perhaps, easier when your child sucks on a pacifier, since those can be physically removed.
Thumbs and fingers require a little more patience in breaking the habit. Once permanent teeth begin to come in, thumb sucking needs to stop so that the teeth will align correctly.
Call our pediatric dentists in Chandler if you have questions about your child’s thumb or finger sucking. If you have concerns about thumb sucking or use of a pacifier, consult your pediatric dentist. Until you can come in for an appointment, these suggestions may be helpful:
- Usually, little ones suck their thumbs to soothe and comfort themselves. Try to find and address the source of their anxiety instead of focusing on the behavior.
- If your child is using the thumb to self sooth, try holding, rocking, or patting him for comfort. He may stop if he doesn’t need to comfort himself.
- Implement a reward system for when she keeps her thumbs out of her mouth during a hard time.
- Let our experienced pediatric dentist talk to your child about the effects of sucking and how he can stop.
- Use a bandage or sock over her hand at night to prevent sucking. We may suggest that she use a mouth appliance!
There are two main reasons a child may need pulp therapy: a cavity or injury to the tooth.
Although the primary teeth do fall out eventually, it is important to maintain them as long as possible since they act as guides to the new, permanent teeth. Pulp therapy is recommended when there is damage to the inner core of the tooth, to save it.
There are two types of pulp therapy: pulpotomies and pulpectomies. The purpose of both is to save the tooth, but the procedure is a little different.
Pulpotomy: The pulp of the tooth holds connective tissue, nerves and blood vessels. When the pulp decays, the dentist will scoop out the crown, or upper portion of the pulp, seal it with medicated filler, and cover it with a stainless steel crown or SSC.
Pulpectomy: A pulpectomy is closer to a root canal. The pulp is scooped out of the crown and the roots of the tooth, and it is sealed with medicated, resorbable material. A SSC is placed on top of it to restore the bite.
An overbite or other misalignment can be visible early, even at the age of two or three. You can take precautions so that your child will need less orthodontic treatment when they are older.
- Early Treatment (Stage I): Between the ages of 2-6 years old, the orthodontist is especially concerned about thumb and finger sucking as well as early loss of baby teeth. Treatment at this age can be effective enough that your child won’t need further treatment down the line.
- Mixed Dentition (Stage II): From 6 to 12 years, the baby teeth fall out and the permanent teeth appear. Treatment focuses on alignment and growth plate opening. The oral tissues are extremely responsive during this time, as they are still growing and forming. Orthodontics help guide teeth and the jaw to avoid crowding, allowing a healthy smile to emerge.
- Adolescent Dentition (Stage III): Once all the permanent teeth have come in, orthodontics can straighten crooked teeth and help develop a positive bite.
Oral Care In Infancy
Did you know that your baby’s teeth begin forming while you are pregnant? How you care for your teeth and gums can affect the health of your pregnancy and your baby’s dental health as well. Periodontal disease, commonly known as gum disease, has been linked to pre-term labor and low birth weight. Call our Chandler office today to find out the ways improved dental health can positively affect your pregnancy!
Some simple suggestions on how to protect your child’s teeth from bacteria and decay:
- Practice excellent oral hygiene. Brush and floss regularly so plaque doesn’t build up. Make a habit of visiting the dentist for cleanings and exams.
- Eat healthy, low sugar foods and drink water.
- Brush with an ADA recommended toothpaste and use an alcohol free mouthwash nightly.
- Keep it to yourself! Sharing food, cups, or utensils seems nice, but can spread the bacteria that cause cavities to your kids!
- Chew gum. Studies have shown that chewing xylitol gum during pregnancy can decrease the rate at which a child gets cavities.
Don’t wait until an emergency drives you to an unknown dentist by necessity. By the time your child is one year old, make a point to establish a relationship with your local dentist. This relationship, or Dental Home, is recommended by the American Academy of Pediatrics, the American Dental Association, and the American Academy of Pediatric Dentistry.
The Dental Home provides a place for treatment besides the emergency room, and increases the likelihood that your child will receive an appropriate level of preventive and routine dental care. Our board certified pediatric dentists in Chandler are always accepting new patients and have flexible schedules. We would be glad to provide your Dental Home!
The first visit to the dentist should be a happy experience. Prepare your child for the visit, using positive, age appropriate language; avoid fearful words like needle, hurt, drill, or pull. Explain that the dentist is a friend and helper who can answer any questions about their teeth that they have. Finally, reassure your child that you will be with them the whole time, as our open door policy allows and encourages your presence in the treatment room!
You know as an adult that sugary drinks should be limited and brushed away soon because they can cause decay. The same is true for infants. Putting your baby to bed with or right after a bottle seems like the most natural thing, but in reality it can cause serious decay in the teeth, even teeth that haven’t erupted yet.
Milk, formula, juice, and even breast milk contain sugars. Unless it is brushed or rinsed away, the liquid can pool around the teeth, allowing bacteria and plaque to build up, promoting rapid tooth decay. Some suggestions from our board certified pediatric dentists to prevent “bottle rot”:
- Over two or three weeks, gradually dilute the drink you give your baby at bedtime, until baby is used to all water.
- Don’t put the bottle in the crib or bed with your child.
- Use a damp washcloth or gauze to wipe baby’s gums or teeth after every feeding. This will get them used to cleaning the mouth and make them more receptive to tooth brushing.
Sippy cups are useful to transition a child from a bottle to a regular cup. However, when you fill it with sugary liquids like milk, juice, or sports drinks, it can allow bacteria to flourish and hasten the development of plaque and cavities. Fill it with water, instead!
Try to complete the transition to a regular cup by your baby’s first birthday to keep their teeth healthy!
Start taking care of your baby’s teeth and gums before their teeth come in. Follow these tips and get them used to having a clean mouth!
- Use a warm washcloth to wipe the gums after they eat.
- Once teeth come in, use a soft bristled brush with water only.
- Begin flossing when two teeth touch.
- When your child is able to spit, begin using a pea sized amount of fluoride toothpaste.
- Around 5 or 6 years old, allow him to begin brushing by himself with your supervision.
- Keep flossing until she is able to do it on her own.
- Supervise oral hygiene until around 8 or 9 years old to make sure teeth are getting cleaned!
The most important part of preventing cavities in young children is regular brushing of the teeth. When parents allow their children to brush solo too early, the teeth are left open to plaque and bacteria caused by leftover food. Continue to brush your child’s teeth until he or she is able to do a good job on his or her own.
Make and keep routine appointments for cleanings and exams every six months, as recommended by the American Academy of Pediatric Dentistry. Going as a part of a routine will establish healthy habits for life!
Molars can be difficult to clean because of their uneven surfaces. If the chewing surface of the tooth has deep grooves, it will allow food particles and bacteria to seep in and easily lead to a cavity. Ask one of our board certified pediatric dentists about dental sealants.
Dental sealants are protective coatings applied to the bite surface of the molars to prevent decay and ultimately prevent the necessity of pulp therapy for your little one.
A naturally occurring element, fluoride has been shown to have a positive effect on teeth when used topically. Because of this, it’s a regulated part of the water supply, and an ingredient in most toothpastes and mouth washes. It can also be found in supplements, formulas, and baby food like creamed spinach and infant cereals.
But how much fluoride should you ingest? It turns out, not a lot. Too much systemic fluoride, especially as a child, can cause fluorosis or discoloration of the teeth. The staining can be as minor as paperwhite spots or dark brown tarry splotches on the teeth. To avoid fluorosis, follow the following suggestions from our pediatric dentists:
- Avoid excessive fluoride supplements unless specifically recommended by your pediatrician or dentist.
- Use a fluoride free baby tooth cleanser for infants and until your child can spit.
- Only use a pea-sized amount of toothpaste for 2-5 year olds.
- Test the water at your house to determine how much fluoride your family is consuming.
Everyone has heard that sugar is bad for teeth. It’s actually not so much the sugar as the acid produced by its breakdown, and the bacteria it feeds. There is another option that is naturally sourced and can help protect your teeth from new decay: Xylitol! Xylitol comes from one of two plants: birch trees or corn cobs. It is an ingredient in many sugar free gums and can be purchased by the pound like sugar.
Studies show that chewing xylitol gum after birth and through the course of nursing can help reduce the likelihood of cavities by up to 70%. It has been shown to enhance the properties of other preventive measures. Consuming it in small amounts shows a dramatic reduction in decay, and in some cases, even a reversal of early phases of decay.
Tasty and sweet, the bottle of neon yellow sports drink helps your child rehydrate after sports in the summer sun. But sugar and acid content can erode and dissolve the enamel protecting his teeth. Once that protection is worn away, bacteria gets in and cavities form.
Instead of the expensive sports drinks, try having him drink water before, during, and after sports. Lost electrolytes can be regained with pieces of fruit like oranges, grapes, or apples. If you have questions about sports drinks and your child’s dental health, call our Chandler office!
In the meantime, if you still feel like he needs a bottle of bright orange or blue drink, try these suggestions to minimize any damage:
- Consume the smaller bottles, and only immediately after sports.
- Don’t use them to rinse; swallow them down quickly.
- Either dilute the drink by half with water, or alternate sips of water and sports drink.
- Only use water to wash or rinse a mouthguard.
- Try low fat chocolate milk instead of a sports drink to promote recovery after exertion!
For more information concerning pediatric dentistry, please visit the website for the American Academy of Pediatric Dentistry.