If you have questions or concerns about pediatric dentistry, please contact our office.
When you visit our office, you can depend on our team to create the smile you’ve always wanted, while keeping your comfort and wishes in mind.
One of the most important components of pediatric dentistry is child psychology. Pediatric dentists are trained to create a friendly, fun, social atmosphere for visiting children, and always avoid threatening words like “drill,” “needle,” and “injection.” Dental phobias beginning in childhood often continue into adulthood, so it is of paramount importance that children have positive experiences and find their “dental home” as early as possible.
Pediatric dentistry (formerly Pedodontics/Paedodontics) primarily focuses on children from birth through adolescence. The American Dental Association (ADA), recognizes pediatric dentistry as a specialty, and therefore requires dentists to undertake two or three years of additional training after completing a general dentistry degree. At the end of this training, the American Board of Pediatric Dentistry issues a unique diploma (Diplomate ABPD). Some pediatric dentists (pedodontists) opt to specialize in oral care for children with special needs, specifically children with autism, varying levels of mental retardation, or cerebral palsy.
Pediatric dentists fulfill many important functions pertaining to the child’s overall oral health and hygiene. They place particular emphasis on the proper maintenance and care of deciduous (baby) teeth, which are instrumental in facilitating good chewing habits, proper speech production, and also hold space for permanent teeth.
Pediatric dentists educate the child using models, computer technology, and child-friendly terminology, thus emphasizing the importance of keeping teeth strong and healthy. In addition, they advise parents on disease prevention, trauma prevention, good eating habits, and other aspects of the home hygiene routine.
By continuously tracking growth and development, pediatric dentists are able to anticipate dental issues and quickly intervene before they worsen. Also, working towards earlier corrective treatment preserves the child’s self-esteem and fosters a more positive self-image.
Helping parents and children establish sound eating and oral care habits reduces the chances of later tooth decay. In addition to providing check ups and dental cleanings, pediatric dentists are also able to apply dental sealants and topical fluoride to young teeth, advise parents on thumb-sucking/pacifier/smoking cessation, and provide good demonstrations of brushing and flossing.
In some cases, pediatric dentists may discuss the possibility of early oral treatments with parents. In the case of oral injury, malocclusion (bad bite), or bruxism (grinding), space maintainers may be fitted, a nighttime mouth guard may be recommended, or reconstructive surgery may be scheduled.
According to AAPD (American Academy of Pediatric Dentistry) guidelines, infants should initially visit the pediatric dentist around the time of their first birthday. First visits can be stressful for parents, especially for parents who have dental phobias themselves.
It is imperative for parents to continually communicate positive messages about dental visits (especially the first one), and to help the child feel as happy as possible about visiting the dentist.
Pediatric dentists are required to undergo extensive training in child psychology. Their dental offices are generally colorful, child-friendly, and boast a selection of games, toys, and educational tools. Pediatric dentists (and all dental staff) aim to make the child feel as welcome as possible during all visits. There are several things parents can do to make the first visit enjoyable. Some helpful tips are listed below:
Sometimes infants become fussy when having their mouths examined. Having another adult along to soothe the infant allows the parent to ask questions and to attend to any advice the dentist may have.
Other children can distract the parent and cause the infant to fuss. Leaving other children at home (when possible) makes the first visit less stressful for all concerned.
Pediatric dentists and staff are trained to avoid the use of threatening language like “drills,” “needles,” “injections,” and “bleeding.” It is imperative for parents to use positive language when speaking about dental treatment with their child.
It is important to explain the purposes of the dental visit in a positive way. Explaining that the dentist “helps keep teeth healthy” is far better than explaining that the dentist “is checking for tooth decay and might have to drill the tooth if decay is found.”
Anxiety can be vastly reduced if the child knows what to expect. Age-appropriate books about visiting the dentist can be very helpful in making the visit seem fun.
There are several goals for the first dental visit. First, the pediatric dentist and the child need to get properly acquainted. Second, the dentist needs to monitor tooth and jaw development to get an idea of the child’s overall health history. Third, the dentist needs to evaluate the health of the existing teeth and gums. Finally, the dentist aims to answer questions and advise parents on how to implement a good oral care regimen. If you have questions or concerns about your child’s first dental visit, please contact our office.
In contrast to general anesthesia (which renders the child unconscious), dental sedation is only intended to reduce the child’s anxiety and discomfort during dental visits. In some cases, the child may become drowsy or less active while sedated, but this will quickly desist after the procedure is completed.
Sedation is used in several circumstances. Firstly, very young children are often unable to keep still long enough for the pediatric dentist to perform high-precision procedures safely. Sedation makes the visit less stressful for both children and adults and vastly reduces the risk of injury. Secondly, some children struggle to manage anxiety during dental appointments. Sedation helps them to relax, cope, and feel happier about treatment. Thirdly, sedation is particularly useful for children with special needs. It prevents spontaneous movement, and guides cooperative behavior.
Most pediatric dentists have several sedation options available, and each one comes with its own particular benefits. The dentist will assess the medical history of the child, the expected duration of the procedure, and the child’s comfort level before recommending a method of sedation.
The pediatric dentist may recommend laughing gas for children who exhibit particular signs of nervousness or anxiety. Nitrous oxide is delivered via a mask, which is placed over the child’s nose. Nitrous oxide is always combined with oxygen, meaning that the child can comfortably breathe in through the nose and out through the mouth.
Laughing gas relaxes children extremely quickly, and can produce happy, euphoric behavior. It is also quick acting, painless to deliver, and wears off within a matter of minutes. Before removing the mask completely, the pediatric dentist delivers regular oxygen for several minutes, to ensure the nitrous oxide is eliminated from the child’s body. On rare occasions, laughing gas may cause nausea. For this reason, most pediatric dentists suggest minimal food intake prior to the appointment.
Children who are uncooperative, particularly anxious, or unable to control their muscles for prolonged periods, may be offered an oral sedative. Oral sedatives come in many different forms (usually tablets, pills, and liquids), and may make the child feel drowsy. If oral sedatives are to be used, the pediatric dentist may require parents to prepare the child before the appointment.
Some common preparatory measures may include: limiting food and fluid intake prior to the appointment, having the child wear comfortable clothing to the appointment, and preparing to stay with the child for several hours after the appointment.
Oral sedatives rarely produce serious side effects; nausea is among the most common.
General anesthetic (which puts the child in a deep sleep), is rarely used in dental work unless:
General anesthetic requires more intensive preparation before the treatment and a longer period of recovery after the treatment. Conscious sedation is usually favored wherever possible.
Other less common ways to administer sedatives include intravenous (IV sedation), the use of suppositories, and even the use of a nasal spray. In most cases, the method of delivery may change, but the chemical nature of the sedative remains the same.
The initial growth period for primary (baby) teeth begins in the second trimester of pregnancy (around 16-20 weeks). During this time, it is especially important for expectant mothers to eat a healthy, nutritious diet, since nutrients are needed for bone and soft tissue development.
Though there are some individual differences in the timing of tooth eruption, primary teeth usually begin to emerge when the infant is between six and eight months old. Altogether, a set of twenty primary teeth will emerge by the age of three.
The American Academy of Pediatric Dentistry (AAPD) recommends a first “well-baby” dental visit around the age of twelve months (or six months after the first tooth emerges). This visit acquaints the infant with the dental office, allows the pediatric dentist to monitor development, and provides a great opportunity for parents to ask questions.
In general, teeth emerge in pairs, starting at the front of the infant’s mouth. Between the ages of six and ten months, the two lower central incisors break through. Remember that cavities may develop between two adjacent teeth, so flossing should begin at this point.
Next, the upper central incisors typically emerge between 8 and 12 months—sometimes simultaneously with the lower ones. Teething can be quite an uncomfortable process for the infant. Clean teething rings and cold, damp cloths can help ease the irritation and discomfort.
Between the ages of nine and sixteen months, the upper lateral incisors emerge – one on either side of the central incisors. Around the same time, the lower lateral incisors emerge, meaning that the infant has four adjacent teeth on the lower and upper arches. Pediatric dentists suggest that sippy cup usage should end when the toddler reaches the age of fourteen months. This minimizes the risk of “baby bottle tooth decay.”
Eight more teeth break through between the ages of thirteen and twenty-three months. On each arch, a cuspid or canine tooth will appear immediately adjacent to each lateral incisor. Immediately behind (looking towards the back of the child’s mouth), first molars will emerge on either side of the canine teeth on both jaws.
Finally, a second set of molars emerges on each arch – usually beginning on the lower arch. Most children have a complete set of twenty primary teeth before the age of thirty-three months. The pediatric dentist generally applies dental sealant to the molars, to lock out food particles, bacteria, and enamel-attacking acids.
Primary teeth preserve space for permanent teeth and guide their later alignment. In addition, primary teeth help with speech production, prevent the tongue from posturing abnormally, and play an important role in the chewing of food. For these reasons, it is critically important to learn how to care for the child’s emerging teeth. If you have questions or concerns about the emergence of your child’s teeth, please contact your pediatric dentist. Here are some helpful tips:
The AAPD recommends a pea-sized amount of ADA approved (non-fluoridated) toothpaste for children under two years old, and the same amount of an ADA approved (fluoridated) toothpaste for children over this age. The toothbrush should be soft-bristled and appropriate for infants.
Flossing an infant’s teeth can be difficult, but the process should begin when two adjacent teeth emerge. The pediatric dentist will happily demonstrate good flossing techniques.
Sugars and starches feed oral bacteria, which produce harmful acids and attack tooth enamel. Ensure that the child is eating a balanced diet and work to reduce sugary and starchy snacks.
Children who see parents brushing and flossing are often more likely to follow suit. Explain the importance of good oral care to the child; age-appropriate books often help with this.
The pediatric dentist monitors oral development, provides professional cleanings, applies topical fluoride to the teeth, and coats molars with sealants. Biannual trips to the dental office can help to prevent a wide range of painful conditions later.
