Pediatric dentists have an extra two to three years of specialized training after dental school and are dedicated to the oral health of children from infancy through the teenage years; they are considered the pediatricians of dentistry. Infants, children, pre-teens, and teenagers all need different approaches when providing dental care and the pediatric dentist is the most qualified to meet their needs.
The American Academy of Pediatric Dentistry recommends that your child see a pediatric dentist by their first birthday or within 6 months after the first tooth erupts. By establishing a dental home early in life, your pediatric dentist will be proactive about counseling on development changes and providing guidance on oral development, diet and nutrition, fluoride adequacy, oral habits, injury prevention and oral hygiene.
The American Academy of Pediatric Dentistry and the American Dental Association recommend a dental check-up at least twice a year for most children and adults. However, some children require more frequent visits due to their risk for tooth decay or need for more frequent dental cleanings due to braces, poor oral hygiene and increased risk of periodontal disease. Your child's dentist will evaluate any specific needs and recommend a personal dental prevention plan for him or her.
Studies have shown that 6 months is the average time for plaque and tartar to form on the teeth and for tooth decay to be evident by a radiograph (xray).
At each continuing care visit with your child, the pediatric dentist will:
We know that on average, we will only see your child 2x a year, so it is very important to us that you have the best information to care for your child’s teeth at home. If ever there are questions that you have related to home dental care, please NEVER hesitate to ask for our guidance.
When choosing toothpaste for your child, the most important feature to look for is the American Dental Association (ADA) Seal of Acceptance to ensure the product’s safety and effectiveness. For children younger than 2 years of age, we recommend using a smear amount of fluoridated toothpaste with a soft, age-appropriate toothbrush; cleaning teeth begins as soon as teeth are present. Children 2-5 years old should use a small amount of toothpaste – about the size of a pencil eraser or a green pea. Practice spitting out toothpaste and assist with your child’s tooth brushing until they are at least 8 years old.
Dental caries, also known as tooth decay or a cavity, is a disease process that causes the breakdown of hard tooth structure. If untreated, caries can lead to severe pain, local infection, tooth loss, and even serious systemic infections. Babies often are inoculated or “catch” the bacteria that cause dental caries from their parents or family members. For this reason, it is important that parents attend to their own dental needs, striving to have excellent dental hygiene and, therefore, helping to prevent problems with their children’s teeth.
Here is what is happening in your child’s mouth: Teeth, which are primarily made of minerals, are in a constant state of back-and-forth de-mineralization and re-mineralization. When your child eats and drinks, certain types of bacteria create acid from the foods and fluids left on the teeth. The acid de-mineralizes or weakens the tooth enamel. In healthy mouths, the time between meals allows minerals from the saliva to become incorporated into the teeth, remineralizing the enamel and reversing the damage from the acid. In essence, the tooth heals itself. However, in unhealthy mouths, where there is an abundance of bacteria and a high incidence of juice, energy drink or snack consumption, the enamel never remineralizes and the tooth, instead of healing, develops decay. Therefore, the more parents can clean their children’s teeth, use appropriate amounts of fluoride and give the teeth time between food and drink consumption to recover, the better chance their teeth will have to win the battle for re-mineralization, be healthy, strong and caries free.
As children become older, they tend to become more independent and often increase their snacking and drinking of sugary liquids. We recommend that parents stay diligent at controlling their child’s nutrition, snacking habits, and oral hygiene. It is no coincidence that we see a lot of tooth decay in children who drink a lot of fruit juice. Therefore, we highly recommend that juices be limited to twice a day and during mealtimes and the child be given water freely throughout the day.
We strongly recommend that a parent continue to help a child to brush and floss his/her teeth until he/she is at least 8 years of age. A good rule of thumb is that if he/she cannot tie his/her shoes, he/she can’t do an adequate job of brushing and flossing his/her teeth. Continue to schedule and keep regular continuing care appointments for your child every 6 months.
We also see a great frequency of dental caries in teenagers due to the availability of soft drinks and sports drinks in school. Sports drinks are good to use following athletics to replenish fluids, but regular and indiscriminate use bathes the teeth in sugar and acid and leads to decay. We recommend a switch to flavored waters or plain water to give the teeth a break from the sugar-producing acid and provide a chance for them to re-mineralize and heal.
A Sealant is a hardened plastic material applied to the vulnerable grooves and pits on the chewing surface of the back teeth (premolars and molars). The sealant acts as a barrier to food debris, plaque and bacteria protecting these cavity prone areas of the teeth. Avoidance of sticky or hard foods, which can "pull" at or “break” the sealants will help them last longer.
Nitrous oxide/oxygen ("Happy" air or "Laughing" gas) is a blend of two gases, oxygen and nitrous oxide. When it is inhaled, it has a calming effect on the patient. The relaxed state it produces in the patient allows him/her to respond more favorably to treatment. Nitrous oxide/oxygen is very safe. Your child will remain fully awake and alert and can respond easily to stimuli. It is eliminated quickly from the body with normal breathing of oxygen and room air.
Our philosophy is to use as many disposable items as possible. Prophy cups, suction tips, and the like are single-use only and thrown out after each patient. The chair and other areas in the treatment room are cleaned with a sterilant/disinfectant that kills bacteria and viruses. All items that cannot be disposed of, such as handpieces and instruments are rinsed, scrubbed with a brush and placed in an ultrasonic cleaner to remove debris. After the debris has been removed, they are placed in one of our steam autoclaves that sterilize using extremely high temperatures and pressure.
Fluoride is an element which works to increase the resistance of your tooth to dental decay, enhance remineralization of “weaker” surfaces, and reduce the cariogenic potential of dental plaque. It is important to get the proper dose of fluoride, as too little or too much can be bad for the teeth.
In general, there is not much of a need to supplement a child for fluoride as there was decades ago. Most Central Florida homes receive fluoridated water. In addition to home drinking water, other sources of fluoride include toothpastes, rinses, and processed foods produced with fluoridated water, such as juices and canned foods. Talk with your dentist about your child’s fluoride sources to make sure they are getting the correct amount.
Teeth grinding, or bruxism, in children is not uncommon and is usually not related to stress, as it commonly is for adults. For children, bruxism is typically related to the anatomy of the immature jaw joint, and it typically ceases once the permanent teeth are present and the jaw joints mature.
It is normal for the permanent (adult) teeth to appear more yellow or grey in color when compared to baby teeth. This will become less obvious as baby teeth are lost and more adult teeth are present. Other factors can cause the teeth to be “yellow” such as staining, poor oral hygiene or areas of enamel hypoplasia (sometimes referred to as a “birthmark” on the tooth). Address any concerns you have about discoloration with your pediatric dentist.
It is not uncommon for children to express tooth sensitivity to hot and cold. The enamel of primary teeth is not as thick as that of permanent teeth. Some teeth, however, such as the 6 year molars, can develop with “softer” enamel and, as a result, are more sensitive to temperature changes than other teeth. This is referred to as enamel hypoplasia. If this is an issue with your child, please discuss it with the dentist at your next visit.
A complete evaluation of your child’s dental alignment, including space maintenance, arch development and eruption guidance, is part of each continuing care visit. Early treatments may be recommended and can be effective in allowing for the normal eruption of the permanent teeth.
There is no getting around the fact that some dental treatments can cause discomfort. Our objective is to make your child as comfortable as we can while completing his/her dental treatment. The options that we use for managing comfort are topical anesthetics, local anesthetics, nitrous oxide (laughing gas), oral sedation and IV sedation with an anesthesiologist – also called "deep conscious sedation." In some cases, we utilize an outpatient surgery center for the benefit and use of general anesthesia. You will always have the opportunity to discuss the available options for your child with your dentist and dental team! Talk with the dentist to determine the best approach for comfort management during your child’s dental treatment.
Primary teeth, sometimes called “baby teeth,” are important to your child’s health and development and should be cared for just as you would for permanent teeth. Primary teeth serve critical functions as a child learns to eat and speak and they are important for the normal growth and development of the face. In addition, they maintain space on the dental arch and guide the eruption of the permanent teeth. While some primary teeth are typically replaced around age 6, the back teeth (molars) remain in until age 12 or beyond. Without proper care, these teeth can decay and possibly cause toothaches, gum disease, and serious health problems. For these reasons, primary teeth are important and require good daily hygiene and regular professional attention, just like permanent teeth.
Teeth should be kept clean the moment they enter the mouth. Clean your infant’s or toddler’s teeth with a wet washcloth, a finger toothbrush or child’s toothbrush with soft bristles. Prior to age two, infants can use a training (non-fluoridated) toothpaste or a smear of fluoridated toothpaste.
Pediatric dentists are specialists with children’s dental development. Your child’s complete dental condition, including potential orthopedic (concerning the positioning of facial bones) and orthodontic (concerning the positioning of the teeth) conditions will be evaluated at every continuing care visit. The pediatric dentist will inform you when your child is ready for an orthodontic evaluation. Pediatric Dentistry of Central Florida provides orthodontic care and you can schedule an appointment with our orthodontist when your child is ready.
Orthopedic changes can result from intense and prolonged use of thumb/finger sucking or pacifiers. This habit is known as “non-nutritive sucking”. This is typically not an issue until age 4 as most children break the habit on their own between 2 and 4 years of age. Sucking is a normal reflex for infants and, as you are probably aware, can soothe them. Children usually stop sucking their thumb/finger naturally as they get more active and begin to require both hands for their activities, like holding toys, climbing on furniture and coloring. Pacifier habits are easier to break therefore we recommend you introduce a pacifier to your child should they have a need for “non-nutritive” sucking. Always use an orthodontic pacifier such as the Nuk Orthodontic Pacifier from Gerber® or the MAM® Orthodontic Pacifiers. You should work towards completely weaning your child from pacifier use by age 3.
Children who suck their thumbs frequently or with great intensity after the age of 4 or 5 ARE at risk for dental or speech problems. Such problems include the improper growth of the jaws, malalignment of the teeth and shape of the dental arches. A child may also develop speech problems, including mispronouncing Ts and Ds, lisping, and tongue thrusting. Questions regarding oral habits are common, so please do not hesitate to ask yours!
If you are concerned about your child’s thumb sucking or pacifier habit, talk with the dentist about your child’s dental condition, and what you can do to help your child quit their habit. A good book about thumb sucking is David Decides About Thumbsucking: A Story for Children, A Guide for Parents, by Susan Heitler, Ph.D.
When your child’s first permanent molars erupt (age 6), we may suggest taking their first panoramic radiograph. This radiograph is critical for us to see the presence, or absence, of the permanent teeth as well as their shape and eruption pattern. We are also able to evaluate the development of the jaw joint (temporomandibular joint) and the presence of many pathological conditions that affect the jaws. This radiograph is critical to many decisions that we make concerning your child’s restorative and orthodontic care. Follow up panoramic xrays are taken every 3 to 5 years depending on your child's needs.
We are very supportive of the use of mouth guards in any contact sports, including football, soccer, and hockey. Mouth guards not only protect the teeth, but can reduce concussions, brain injuries, and injuries to the joints. A mouth guard must be comfortable and not cumbersome, so your child or teenager will use it. Custom mouth guards are ideal and we can make a custom one for your child.
We encourage the use of sugarless gum to help prevent tooth decay! Sugarless gum can actually help clean the biting surfaces of the molars and stimulate saliva production. This brings minerals to the surface and helps the teeth heal. Keep in mind that gum with sugar is very bad for the teeth. Chewing gum that contains xylitol has been shown to help lower the risk for decay through its effects on inhibiting dental plaque acid production and growth of cavity causing bacteria and reducing overall plaque accumulation. An example of a xylitol containing chewing gum is Spry.
Talk with the dentist if your teenager is grinding his/her teeth. At this age, teeth grinding can lead to jaw joint problems from the stress of overworking the jaw muscles and lead to premature “wear” of the permanent teeth. Often a custom made night guard allows the muscles to rest at night, reduces the pain, and protects the teeth and jaw joints.
Most parents and teenagers are aware that smoking cigarettes is bad for their health, can damage their mouth and lungs, and stain their teeth. It is also important to note that smokeless tobacco is especially dangerous because the nicotine is absorbed directly through the gums. Studies show the incidence of cancer of the mouth increases as a direct result of its use. It is important to understand that tobacco in any form is very detrimental to oral health, and we strongly advise against its use.
Many teenagers are concerned with personal appearance and having healthy white teeth can boost their self esteem. While excellent oral hygiene and regular checkups are the best way to a beautiful smile, some teenagers may want to try whitening their teeth for extra dazzle. Over-the-counter teeth whitening products can be safe and effective, but consult with the dentist prior to using them to be sure. For a faster and more effective result, we can provide cosmetic teeth whitening with custom trays. With this process, a chemical reaction occurs within the tooth to produce fast and stable results. Talk with the dentist if your teenager is interested in this process.
Many parents are concerned with bad breath (halitosis) with their children. Our advice for this issue is to adequately brush teeth, gums and tongue, and floss every day. We have found that Crest Pro-Health™ toothpaste has been shown to be very effective in reducing bacteria and can improve freshness of breath. Colgate Total™ toothpaste is another good option. It is important to note that if your child, at any age, has allergies, asthma, or sinus infections, he will often have secondary halitosis that can’t be brushed or rinsed away. In these cases we recommend seeing your child’s physician to address the primary cause.