Why Pediatric Dentist?
Pediatric Dentistry is a specialty in dentistry that focuses on the oral health and unique needs of young people. All dental specialists begin their training by completing 4 years of dental school and then continue their dental education with 2 to 3 years of additional rigorous training to become a specialist in pediatric dentistry. The specialized program of study and hands on experience prepares pediatric dentists to meet the needs of your infants, children and adolescents, and children with special health care needs.
Our pediatric dentists enjoy working with children and bring to each patient our expertise in childhood development and behavior. Because our office is geared toward children, you will find that our staff, as well as our office design and decorations, all work together to provide an especially friendly and comfortable environment for children.
Infant and Toddler Oral Care
Caring for Gums
Even before your baby’s first tooth appears, her gums can benefit from your careful attention. After breast- or bottle-feeding, wrap one finger with a clean, damp washcloth or piece of gauze and gently rub it across your baby’s gum tissue. This practice both clears your little one’s mouth of any fragments of food and begins the process of building a good habit of daily oral care.
Baby’s First Tooth
When the first tooth makes an entrance, it’s time to upgrade to a baby toothbrush. There are usually two options: a long-handled toothbrush that you and your baby can hold at the same time or a finger-puppet-like brush that fits over the tip of your pointer finger. In each case the bristles are soft and few.
At this stage, toothpaste isn’t necessary; just dip the brush in water before brushing. If your little one doesn’t react well to the introduction of a toothbrush, don’t give up. Switch back to a damp washcloth for a few months, then try the toothbrush again. During the teething process your child will want to chew on just about anything and a baby toothbrush with a teether can become a favorite toy during this period.
Brushing with Toothpaste
When a few more teeth appear, you can start using toothpaste with your child’s brush. However, for the first two years, be sure to choose toothpaste that does not contain fluoride, unless advised to do so because too much fluoride ingested can be dangerous for youngsters. At this stage, use only a pea size amount of toothpaste. From the beginning, have your little one practice spitting the toothpaste out after brushing to prepare the child for fluoride toothpaste.
Diet can influence and play a significant role in a child’s risk to develop cavities. Plaque acids form 20 minutes after the introduction of food or liquid in the mouth. Frequency and duration of foods can influence the development of plaque acids and cause subsequent decay. Some foods are stickier and are retained in grooves like raisins, fruit roll-ups, gummy bears and sugary cereals. The longer food is retained by the teeth, the longer the saliva can produce plaque acids, which dissolve enamel and create decay. Limiting the frequency and type of foods can decrease your child’s risk to developing decay.
The AAPD guidelines state that infants should not be put to sleep with a bottle. The guidelines also recommend that if a child is breastfed, nighttime feedings should be avoided after the eruption of the first primary tooth. In the event that a bottle is used at night, it should contain only water. A cup should be introduced at 6 months of age and the child should be weaned from the bottle by 12 months of age. Parents should also limit the amount of snacks and beverages that are offered between meals.
First Visit to the Dentist
It’s recommended that you bring your baby in for a visit within six months of the first tooth’s eruption – usually around her first birthday. Since decay can occur in even the smallest of teeth, the earlier your baby visits us, the more likely she is to avoid problems. We’ll look for any signs of early problems with your baby’s oral heath, and check in with you about the best way to care for her teeth. Remember that preparing for each dental visit with a positive attitude goes a long way toward making your child comfortable with regular checkups.
Setting a Good Example
As part of the natural learning process, little ones are expert mimics, and you can take advantage of this talent. Brush and floss daily while your child is watching, and she’ll intuit at an early age the importance of your good habits. As soon as she shows interest, give her a toothbrush of her own and encourage her to “brush” with you. (You’ll find toothbrushes with chunky, short handles that are easy for her to grip.) Most children don’t have the dexterity necessary to thoroughly clean their own teeth until they’re about six or seven, so you’ll have to do that part of the job for her. Try different tactics to make brushing fun: flavored toothpaste, a toothbrush with a favorite character on it, or singing songs about brushing. The primary goal is to instill healthy oral habits at an early age to set your child up for a lifetime of healthy, cavity-free teeth!
Teenage Dental Care
A bright smile with fresh breath means a healthy mouth! It also means that you can talk and laugh with confidence. During these growing years your face and jaws will undergo many changes. KEEP up with your dental checkups. Professional teeth cleaning, fluoride treatments and sealants are important ways to enhance your dental health and monitor for adverse growth changes. Did you know that:
- You have not outgrown TOOTH DECAY. In fact, it is more of a problem for teenage patients than it is for young children. Teenage children have more acidic mouths and diets which lead to more demineralization of the enamel of teeth. SNACK SMART! Most snack foods and drinks including sports drinks have large amounts of sugar and carbohydrates in them which cause damage to the teeth and gums. EAT INTELLIGENTLY! When on the run, eat more fruits, cheeses, and nuts. These are nature’s cavity fighters!
- GUM DISEASE (gingivitis) is a risk to your dental and medical health. It is also a threat to your appearance. Gum disease causes red, swollen, bleeding gums, AND bad breath! Good habits and practicing prevention twice a day is important. TAKE the time to brush and floss prior to falling asleep at night with a fluoridated tooth paste. You only need to do this for the teeth your want to keep!!!
- You have all your PERMANENT (adult) teeth with the exception of your wisdom teeth by the age of 14. WEAR a mouth guard for all contact sports! Our office has a variety of mouth guards for teenagers with and without braces that can be adapted to their mouth for the best protection.
- The warnings you hear and read about are TRUE! DON’T smoke or chew tobacco! Besides lung and heart problems smoking tobacco can and does cause oral cancer. Tobacco use is estimated to account for 90% of cancers of the oral cavity and throat. If you notice changes in your mouth, have an oral cancer screening done immediately.
Dentistry for the Fearful Child
As a part of the natural learning process, children are expert mimics. They take their cues from their parents and caregivers. Children perceive how a parent acts or talks about the dentist. Be positive about the visits and what is being done for your child. We like to partner with parents to help fearful children overcome fears and develop confidence over time. It is important that parents be candid with us about their children’s health and their concerns for their well being out of earshot of the child.
Our office likes to use a “Tell, Show and Do” technique with young and fearful children. This method prepares children for what we are going to do prior to accomplishing the tasks and letting them feel or touch objects being used is also most helpful. We also utilize distraction techniques such as songs, TV, and conversation to reduce children’s stress. Sometimes it takes several visits to accomplish all of our goals. Be patient if asked to return again for other visits.
In order to improve the chances of your child having a positive experience in our office, we are selective in our use of words. We try to avoid words that scare children due to previous experiences. Please support us by not using contrary words that are often used for dental care.
OUR WORD CHOICE:
- Check out Smile/Count Teeth
- Tooth Counter
- Tickle Teeth
- Sleepy Juice
- Sugar Bugs
- Shower Brush
- Wiggle a Tooth Out
POOR Word Choices:
- Explorer or Polker
- Tooth Cleaning
- Needle or Shot
- Pull Tooth
Although parents are always welcome in the treatment area of our office, some children do better without a parent present. The age of your child and their previous dental experiences are just two of the factors that will help us determine the best way to treat your child. If we suggest that your child may do better with you out of sight, please do not feel that you are abandoning your child. We love children at this practice and will always support him or her at all times. When a parent is present, we suggest that you allow us to prepare your child and be a SILENT OBSERVER. This allows us to establish communication with your child and give him or her the proper information that they need to hear to make the visit successful. Support your child with gentle touches and love.
Systematic Fluoride is utilized to strengthen developing teeth and is needed until approximately age 10-12 when all the crowns of the permanent teeth are fully formed. Systematic fluoride is ingested through our water supply. If you have well water or drink bottled water, then your child may need a fluoride supplement to keep their developing teeth strong and healthy.
Topical Fluoride is found in toothpaste and certain mouth rinses. It is also found in the high concentrated fluoride dentists apply at check-ups. Topical fluoride clinically soaks into the outer layer of teeth present in the mouth and makes them stronger and more impervious to breakdown from plaque and mouth acids. If your child is prone to decay, then a nightly fluoride rinse such as ACT or Phosflur will aid in preventing decay from progressing.
The grooves and depressions that form the chewing surfaces of the back teeth are extremely difficult (if not impossible) to clean of bacteria and food. As the bacteria reacts with the food, acids form and break down the tooth enamel, causing cavities. Recent studies indicate that 88 percent of total cavities in American school children are caused this way.
Tooth sealants protect these susceptible areas by sealing the grooves and depressions, preventing bacteria and food particles from residing in these areas. Sealant material is a resin typically applied to the back teeth, molars and premolars and areas prone to cavities. It lasts for several years but needs to be checked during regular appointments.
If you participate in a contact sport, you will need a mouth guard that is designed to protect your teeth. Dr. Light stocks different types of mouth guards for all appliances. Remember to ask a staff member or Dr. Light about a mouth guard if you play sports.
All of our doctors have extensive training in laser technology and are well versed on the uses of this wonderful tool to help make your child’s visit to the dentist stress free. Suitable for both children and adults alike, the laser is a safe and effective method to eliminate decay and treat soft tissue lesions. Using laser dentistry, our dentists are able to deliver a precise treatment that is more comfortable, quicker, and provides more stunning results.
Benefits of laser therapy
- There are several benefits to receiving a laser therapy dental treatment.
- Many laser treatments do not require anesthesia, and the recovery time is much quicker than with traditional treatment methods.
- Treatments are more comfortable.
- There is potentially less of a chance of bacterial infection because laser treatments are so precise.
Two types of laser dentistry
There are two different types of laser dentistry: hard tissue and soft tissue. Our practice utilizes both!
Hard Tissue Lasers are used to detect cavities, remove dental caries and bacteria, improve retention of sealants and fillings and improve tooth sensitivity. It allows our dentists to only remove affected carious enamel and preserves more intact tooth structure. The laser often has a numbing affect when working on teeth. Thus eliminating the need for “Shots” or local anesthesia for most patients.
Soft Tissue Lasers are used to treat gum and mouth tissues with the use of a topical anesthetic applied with a Q-tip. Dr. Light can perform soft tissue procedures that include reshaping the gum line, exposing an impacted tooth, removing excess tissue, treating canker/mouth sores and improving muscle frenum attachments.
Pacifiers, bottles, fingers and thumbs past early toddler age affect more than just the shape of the teeth and dental arch. When a habit persists, children cannot learn the proper placement of the tongue at rest or the adult swallow pattern. Speech and articulation can also be delayed or affected with persistent use of a pacifier or thumb. Swallowing and chewing can also be adversely affected. Persistent habits can directly affect the bite and development of the dental arches causing the need for interceptive orthodontic treatment as well.
Pediatricians and Pediatric Dentists recommend the cessation of bottle usage and pacifiers by the 1st birthday. For those children who have persistent sucking habits our office has a reward program for those children who give up their pacifiers to the “Pacifier Fairy” and children who stop sucking thumbs or fingers.
The main consideration in stopping any habit is the person’s desire to make a change. If a patient really does want to stop a sucking habit, the following instructional outline will help to accomplish that goal.
The approach to stopping the habit centers around a day by day change in behaviors which will eventually become the new pattern of behavior. Consequently we advise you to give special effort and attention to these instructions each day which serves as positive reinforcement. Gradually the habit will be eliminated.
- Post a calendar in a conspicuous place in your child’s room or in the house. This will be used for daily record of your child’s progress. Each day should have an entry. A sticker or star for good days and a “OOPs” for a day that your child forgot.
- Before going to bed at night, place adhesive tape, a sock or a glove on the hand/ finger/thumb that your child sucks. This is a helpful reminder during the night not to suck, especially when your child is asleep.
- When riding in the car or watching T.V., be sure to have some activity that occupies the hands. Some suggestions are coloring books, hand games or other crafts.
- Keep some sugarless chewing gum handy so that your child might chew instead of sucking if the urge strikes.
We recommend that you start with small projects like stopping the habit during the day first. Once that is accomplished, you can progress to stopping the habit at night. Positive reinforcement and patience is important to helping your child in stopping the sucking habit. Once your child has stopped, please let us celebrate it by letting them pick out a special prize at our office.
Our office utilizes digital x-ray systems for all intraoral and extra-oral films taken. The use of digital films, along with the use of protective aprons shields, allows us to reduce the radiation exposure to our young patients. Digitalization of dental films also allows us to share x-rays with parents and colleagues via email.
We recommend taking intraoral x-rays on children once the baby teeth are touching each other, around age 4 or 5. This allows us to detect decay and dental problems that cannot be viewed clinically. The American Academy of Pediatric Dentistry recommends that intraoral dental films be updated yearly. If your child is at high risk for dental problems we may suggest more frequent evaluations with x-rays.
Extra-oral films such as a Panoramic film are utilized to study your child’s growth and development of underlying structures. Extra-oral Films are usually taken when the permanent molars and incisors erupt between ages 6-9 and thereafter as needed to monitor development.
A bitewing radiograph is commonly used to examine conditions that cannot be diagnosed using a clinical exam alone, such as decay between the teeth and changes to the bone structure, caused by periodontal disease.
During the procedure, we will place a lead apron over your child’s upper body to reduce radiation exposure and position a small packet of X-ray film inside their mouth. Biting the tab on the side of the packet allows us to capture the crowns of numerous upper and lower teeth on one small film.
Bitewing X-rays provide us with important information that allow us to treat minor dental problems before they can cause serious damage to the mouth and teeth.
Periapical x-rays are commonly used when the roots, apex or nerve of the tooth needs to be analyzed. We take these only if we suspect decay, trauma to the root of the tooth. During this procedure we place a lead shield over your child’s body and thyroid structure to minimize radiation exposure. We position a digital film inside the mouth to capture the crown, root and apex of the tooth.
Panoramic radiographs are commonly used to analyze the underlying developing structures. The panoramic film shows all the upper and lower teeth, sinuses, developing teeth, and joint and jaw relationships. These are 1st taken in our office when the permanent incisors have erupted (between the ages of 6-9). The panoramic film allows us to examine tooth development and jaw relationships on one film with low dosage of radiation. As your child grows and develops, periodic panoramic films will be updated to monitor the proper growth and development of your child’s orofacial structures and finally to determine the viability of your child’s wisdom teeth.
Teeth and Development
Common Dental Problems
All children are born with no bacteria in the mouth. As they grow intraoral bacteria is introduced by the parents and by the things that are placed in the mouth. The dental health of the parents has a direct correlation with the dental health of the child.
Intraoral bacteria create plaque within 20 minutes of carbohydrates being introduced through food or drink. The plaque matrix is formed on the tooth structure from bacterial by-products and is acidic in nature. If plaque is left on the tooth structure it eventually will demineralize the enamel of the tooth and cause a cavity.
To aid in preventing tooth decay we recommend the following:
- Removing the plaque matrix from the mouth through effective oral hygiene methods. Brushing and flossing on a regular basis with parental supervision. Children do not have good motor dexterity until approximately 10 years of age and need parents help to be completely effective in removal of plaque.
- Limiting refined sugar and foods high in acid in the diet. All foods contain carbohydrates in some form which the oral bacteria live on. It is not only the amount of candy or sweets your children eat. Fruit drinks and soda pops, diet or regular, are high in acid as well as sugar. Potato chips and tortilla chips are also foods high in acid. Limiting the frequency of how often food and drink are consumed is also helpful in reducing the plaque acids in the mouth. If your child is to have sweets it is best to do it at mealtime instead of snack time. Good snacks that are low in acid production are cheese, apples, popcorn and pretzels.
- Introducing Fluoride orally. Fluoride inhibits the demineralization of the tooth surface and actually hardens the outer surface of enamel. Topical fluoride must be used daily to be effective. It is found in toothpaste and fluoride rinses such as ACT and PHOSFLUR. The fluoride rinses should be swished for twenty seconds and spit out. To keep fluoride actively working on the teeth while sleeping, it’s best not to drink or eat after its use.
- Chewing sugarless chewing gum after meals for 15-20 minutes helps reduce cavities by reducing plaque acids in the mouth, stimulating saliva flow, and mechanically cleansing the mouth of oral debris. Sugarless chewing gum with Xylitol inhibits the growth of oral microflora. Studies have shown that parents who also chew sugarless chewing gum 3 to 4 times daily after meals has a positive effect on their children’s dental caries rate.
Your teeth expand and contract in reaction to changes in temperature. Hot and cold food and beverages can cause pain or irritation to people with sensitive teeth. Over time, tooth enamel can be worn down, gums may recede or teeth may develop microscopic cracks, exposing the interior of the tooth and irritating nerve endings. Just breathing cold air can be painful for those with extremely sensitive teeth.
Gum, or periodontal, disease can cause inflammation, tooth loss and bone damage. Gum disease begins with a sticky film of bacteria called plaque. Gums in the early stage of disease, or gingivitis, can bleed easily and become red and swollen. As the disease progresses to periodontitis, teeth may fall out or need to be removed by a dentist. Gum disease is highly preventable and can usually be avoided by daily brushing and flossing. One indicator of gum disease is consistent bad breath or a bad taste in the mouth.
Daily brushing and flossing helps to prevent the buildup of food particles, plaque and bacteria in your mouth. Food particles left in the mouth deteriorate and cause bad breath. While certain foods, such as garlic or anchovies, may create temporary bad breath, consistent bad breath may be a sign of gum disease or another dental problem.
Apthous ulcers are intraoral ulcers caused by a localized bacterial infection. Unlike a herpetic ulcer on the lips or the side of the mouth, they are not contagious and cannot be spread from one person to another. They take from 7 to 10 days to heal. Some patients have susceptibility to forming these ulcers especially during times of stress. The following are ways to treat the ulcers to aid in healing and reduce mouth pain.
- Lysine in powder form can be sprinkled on food daily to reduce frequency of mouth ulcers. (Available from Whole Foods)
- Use toothpaste without SLS (sodium laurel sulfate) a foaming agent: Rembrandt canker sore kit, Original Toms of Maine toothpaste, Burt’s Bees organic toothpaste are some examples.
- Break Vitamin E capsule in half and rub on ulcer site.
- Chlorohexadine Rinse to reduce bacterial content in mouth (Perioguard and Peridex are prescription rinses that can be purchased from the office or a prescription can be written for you)
- We can place Debactorol on affected sites to necrotize the ulcer and heal it within 24 hours.
Wisdom teeth are types of molars found in the very back of your mouth. These teeth usually appear in late teens or early twenties but may become impacted (fail to erupt) due to lack of room in the jaw or angle of entry.
When a wisdom tooth is impacted, it may need to be removed. If it is not removed, you may develop gum tenderness, swelling, or even severe pain. Impacted wisdom teeth that are partially or fully erupted tend to be quite difficult to clean and are susceptible to tooth decay, recurring infections, and even gum disease.
Each patient’s situation is unique. At the appropriate time we will usually take a panoramic X-ray to determine if your wisdom teeth will need to be removed.
Wisdom teeth are typically removed in the late teens or early twenties because there is a greater chance that the teeth’s roots have not fully formed and the bone surrounding the teeth is less dense. These two factors can make extraction easier, as well as making the recovery time much shorter.
Once your wisdom teeth have been extracted, the healing process begins. Healing time varies depending on the degree of difficulty related to the extraction. Your oral surgeon will share with you what to expect and provide instructions for a comfortable, efficient healing process.
When should my child first see a dentist and why?
Traditionally, age 3 was thought to be the proper age. However, the goal is to prevent disease rather than treat the result of disease. Therefore, early intervention is highly recommended.
The American Academy of Pediatric Dentistry (AAPD) recommends that an initial oral evaluation should occur within 6 months of the eruption of the first primary tooth and no later than 12 months of age. The purpose of this first visit is to assess individual risk and to educate the parent in reducing such risk. The clinical examination is an essential part of the child’s first dental visit and is an important part of risk assessment. Older children can be seen in the dental chair either alone or sitting in the caregiver’s lap, depending upon their level of cooperation and the dentist’s preference. If the child is hesitant, it is not necessary for the very young patient to sit in a dental chair. The dentist and the caregiver can sit knee-to-knee facing each other.
What happens during my child’s first visit to the dentist?
The first visit is usually short and simple. In most cases, we focus on getting to know your child and giving you some basic information about dental care. Our doctors will check your child’s teeth for placement and health, and look for any potential problems with the gums and jaw. If necessary, we may do a bit of cleaning. We will also answer any questions you have about how to care for your child’s teeth as they develop, and provide you with materials containing helpful tips that you can refer to at home.
How can I prepare my child for his first dental appointment?
The best preparation for your child’s first visit to our office is maintaining a positive attitude. Children pick up on adults’ apprehensions and if you make negative comments about trips to the dentist, you can be sure that your child will fear an unpleasant experience and act accordingly. Show your child the pictures of the office and staff on the website. Let your child know that it’s important to keep his teeth and gums healthy, and that the doctor will help him do that. Remember that your dentist is specially trained to handle fears and anxiety, and our staff excels at putting children at ease during treatment.
Baby teeth aren’t permanent. Why do they need special care?
Although they don’t last as long as permanent teeth, your child’s first teeth play an important role in his development. While they’re in place, these primary teeth help your little one speak, smile and chew properly. They also hold space in the jaw for permanent teeth. If a child loses a tooth too early (due to damage or decay) nearby teeth may encroach on that space, which can result in crooked or misplaced permanent teeth. Also, your child’s general health is affected by the oral health of the teeth and gums.
What’s the best way to clean my baby’s teeth?
Even before your baby’s first tooth appears, we recommend you clean his gums after feedings with a damp, soft washcloth. As soon as his first tooth appears, you can start using a toothbrush. Choose a toothbrush with soft bristles and a small head. You can most likely find a toothbrush designed for infants at your local drugstore.
At what age is it appropriate to use toothpaste to clean my child’s teeth?
Once your child has a few teeth, you can start using toothpaste on the brush. Use only a tiny amount for each cleaning, and be sure to choose toothpaste without fluoride for children under two, as too much fluoride can be dangerous for very young children. Always have your child rinse and spit out toothpaste after brushing, to begin a lifelong habit he’ll need when he graduates to fluoride toothpaste. Children naturally want to swallow toothpaste after brushing, and swallowing too much fluoride toothpaste can cause teeth to stain. You should brush your child’s teeth for him until he is ready to take on that responsibility himself, which usually happens by age six or seven.
What causes cavities?
Certain types of bacteria live in our mouths. When these bacteria come into contact with sugary foods left behind on our teeth after eating, acids are produced. These acids attack the enamel on the exterior of the teeth, eventually eating through the enamel and creating holes in the teeth, which we call cavities.
How can I help my child avoid cavities?
Be sure that your child brushes his teeth at least twice a day with fluoride toothpaste. Flossing daily is also important, as flossing can reach spots between the teeth that brushing cannot. Check with your pediatric dentist about a fluoride supplement which helps tooth enamel be harder and more resistant to decay. Avoid sugary foods and drinks, limit snacking, and maintain a healthy diet. And finally, make regular appointments so that we can check the health of your child’s teeth and provide professional cleanings.
Does my child need dental sealants?
Sealants cover the pits and fissures in teeth that are difficult to brush and therefore susceptible to decay. We recommend sealants as a safe, simple way to help your child avoid cavities, especially for molars, which are hardest to reach.
My child plays sports. How can I protect his teeth?
Even children’s sports involve contact, and we recommend mouthguards for children active in sports. If your little one plays baseball, soccer, or other sports, ask us about having a custom-fitted mouthguard made to protect his teeth, lips, cheeks, and gums.
What should I do if my child sucks his thumb?
The large majority of children suck their thumbs or fingers as infants, and most grow out of it by the age of four, without causing any permanent damage to their teeth. If you child continues sucking after permanent teeth erupt, or sucks aggressively, let us know and we can check to see if any problems may arise from the habit.
When should my child have dental X-rays taken?
We recommend taking X-rays around the age of four or five. The first set consists of simple pictures of the front upper and lower teeth, which familiarizes your child with the process. Once the baby teeth in back are touching each other, X-rays are recommended every two years. Permanent teeth start coming in around age six and X-rays help us make sure your child’s teeth and jaw are healthy and properly aligned. If your child is at a high risk of dental problems, we may suggest having X-rays taken at an earlier age. Our office utilizes digital X-ray systems and shields to reduce radiation exposure to our young patients.
For more information please visit the American Academy of Pediatric Dentistry http://www.aapd.org/