General Questions about Pediatric Dentistry

? What is pediatric dentistry?

As pediatric dentists, we specialize in taking care of kids! Our doctors had extra years of training after dental school to dedicate themselves to working with children. We are passionate about serving kids and educating them on good dental health. Babies, toddlers, and adolescents all need unique approaches with dental care, home care, development and behavior. We focus on giving your child the individualized approach that they need.

? Why are baby teeth important?

Baby teeth, also known as primary teeth are important to maintain for several reasons. Neglected decay can affect the permanent teeth developing underneath. They also assist is proper chewing and eating, creating room for the new teeth to erupt in the right position, they allow for normal development of the jaw and muscles. They can affect speech and your child’s facial appearance.

? When will my child’s teeth come in?

Believe it or not, your child’s teeth start forming when they are still in mommy’s belly! The first baby tooth can erupt through the gums as early as 4 months of age. Typically, the bottom front two teeth are the first to erupt. We call these the lower central incisors which are closely followed by the upper central incisors or your child’s “two front teeth”. By age three, we expect most if not all of your child’s 20 primary teeth to appear.

Permanent teeth normally start erupting around the age of 6 beginning with the molars. As an adult, you should expect to have 32 permanent teeth including your wisdom teeth.

Click on the link below to learn more about your teeth:

x Dental X-rays

Dental x-rays (radiographs) are an essential diagnostic tool. Without the use of them, certain dental problems may be missed. They are not only used to detect cavities but to see erupting teeth, diagnose bone disease, assess trauma or plan for braces (orthodontic treatment).

If your child has a high risk for tooth decay, the American Academy of Pediatric Dentistry recommends exams with x-rays every 6 months. Typically, most pediatric dentists recommend x-rays once per year or every other cleaning appointment. Every 3 years, it may be recommended for your child to have a panoramic x-ray taken for growth and development.

? Concerned about your kids having dental x-rays?

Let us help calm your fears! We are concerned about radiation too, so we want you to have the facts you need to make an educated decision when it comes to your children.

We want you to know the truth about dental x-rays. Just to break it down for you, below is chart of the radiation doses you receive from different x-rays.

An annual maximum occupational exposure for radiation workers in the United States is 5,000 millirems (measure for radiation). When you spread low doses out over a period of time, it’s not as destructive to the body because it has time to recover.

High dose group includes:

  • Mammography 1000
  • Pelvimetry 875
  • Lower spine 450
  • Middle spine 347

Medium dose group includes:

  • Abdomen 147
  • Ribs 143
  • Pelvis 133
  • Skull 78
  • Hip 72

Low dose group includes:

  • Neck 52
  • Femur 21
  • Full mouth dental series (digital) less than 1
  • Dental bitewing (digital) less than .05

To put this in perspective, you would need to have 2,000 dental x-rays to equal the radiation in 1 mammogram. To reach that maximum safety dose, we would have to take approximately 10,000 dental x-rays. On average people receive 3 dental bitewings worth of radiation a day just from being outside in the sun or around concrete buildings and roads. Knowing how low the dose is, let’s talk about the benefits.

Here are just a few benefits of dental x-rays:

  • Detecting hidden decay
  • Detecting the presence of a cyst or tumor
  • Determining the presence of permanent teeth
  • Detecting oral cancer problems
  • Detecting root involvement with the sinuses
  • To help determine whether or not to remove primary teeth
  • To determine if extra teeth are present

The list goes on and on. I hope you feel safe and secure when your child gets his or her next set of dental x-rays!

What would you recommend for…?

Tooth Paste

Brushing your child’s teeth is one of the most important things you can do at home for your child’s teeth. We recommend using a toothpaste that is recommended by the ADA (American Dental Association). Some pastes can contain things that are too tough for your child’s young tooth enamel. We do carry several types in our office, ask us for more details.

Teeth Grinding

Childhood teeth grinding is also referred to as Bruxism. Parents frequently come in with concerns of the noise they hear their kids teeth are making at night. You may also notice the effect that grinding has on the height of your child’s teeth. Teeth can get shorter from the stress that grinding has on the dentition. There are several theories surrounding why kids often grind their teeth at night. The two most common are; stress due to changes in environment (home, school etc.) and pressure in the inner ears at night (like chewing gum while flying).

Either way, the majority of kids with pediatric Bruxism do not need treatment. If there is evidence of excessive wear on your child’s teeth, one of our doctors may recommend a night guard. Most children will outgrow this condition between the ages of 9-12, and it will decrease over time as they reach the 6-9 age range.

Thumb Sucking

Sucking on a thumb or fingers is a natural reflex that starts during infancy. Babies use fingers or pacifiers to help them feel secure or content. It is also a relaxing habit for babies and toddlers that can help induce sleep.

Thumb sucking becomes a problem when it continues after the eruption of the permanent teeth because it can affect the growth of the mouth and the proper placement of the new teeth coming in. Pacifiers are no different, they affect the mouth in the same way however they are easier to control than finger habits.

We recommend that your child should stop sucking their thumb between the ages of 2-4. When your child does stop sucking their thumb, fingers or pacifier, bring them into our office to get a picture taken and posted on our thumb wall. We also will give them a Chick-Fil-A gift card and give them a lot of positive reinforcement.

Pulp Therapy or Child Root Canals

The pulp of the tooth is the inner core of the tooth which contains nerves, blood vessels, tissue and cells. We use pulp therapy in pediatric dentistry to maintain the integrity of the tooth that has been affected so that the tooth is not lost.

There are several reasons that a tooth can require pulp therapy including cavities (dental caries) and traumatic injury. We also refer to pulp therapy as nerve treatment, a pulpectomy or a pulpotomy or a children’s root canal.
Pulpotomies are where we remove the diseased pulp tissue within what’s known as the crown portion of the tooth. We use a special material that calms the nerve that remains in the tooth and prevents any bacteria from growing. The last step to this procedure typically includes crowning the affected tooth. Stainless steel are the most commonly used crown with children because of their durability.

A pulpectomy is necessary when the entire pulp is affect, all the way into the root canal of the tooth. In this procedure we remove the infected pulp tissue from the crown and the root of the tooth. We then cleanse and disinfect the canals. For primary teeth, we then fill with a resorbable material before the final restoration is placed. Permanent teeth get filled with a non-resorbable material.

When Does my Child Need Braces?

Around 2 or 3 we can start to see “bad bites” starting to form in children. Taking early steps can help reduce the need for or length of time in orthodontic care in the future for your child.

Stage I Orthodontics (Early Treatment)
This treatment can range from 2 to 6 years of age. There are several things we look for at this age including under developed arches, losing baby teeth prematurely and harmful habits such as finger/thumb sucking. When treatment can be used at this age it is often very successful.
Stage II Orthodontics (Mixed Dentition)
Between the ages of 6-12 years old, we start to see the eruption of the permanent front teeth and the 6 year molars. In this state we are looking at the jaw malocclusion and dental alignment issues. This is typically a great age to state orthodontic treatment as indicated for your child. Treatment at this age is ideal due to the responsiveness from both the soft and hard tissue to the orthodontic movement.
Stage III Orthodontics (Adolescent Dentition)
In the final stage we are dealing with your child’s permanent teeth and the final bite relationship. The length of time will range based on the needs of your individual child.

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