General Topics

What Is a Pediatric Dentist?

A pediatric dentist does two to three more years of specialized training after dental school and is dedicated to children's oral health from infancy through adolescence. Infants, pre-teens, and teenagers need different approaches in dealing with their behavior, guiding their dental growth and development, and helping them avoid future dental problems. A pediatric dentist is best qualified to meet these needs.

Why Are Primary Teeth Important?

Keeping your primary teeth healthy is essential, as neglected cavities can lead to problems that damage your permanent teeth. Primary or baby teeth are helpful for proper chewing and eating, and they also make room and guide permanent teeth into the correct position.

Thanks to primary teeth, your jaw bones and facial muscles develop normally. Baby teeth also affect speech and contribute to an attractive appearance. While your front four teeth last until you're 6 or 7 years of age, permanent teeth won't replace your back teeth (cuspids and molars) until you're 10 to 13 years old.

Eruption Of Your Child's Teeth

Children's teeth begin forming before birth. The first primary or baby teeth to erupt are lower central incisors at four months old, followed closely by upper central incisors. Although all 20 primary teeth usually appear by age 3, the pace and order of their eruption vary.

Permanent teeth appear around age 6, starting with the first molars and lower central incisors. Generally, permanent teeth take the place of your bottom (lower central and lateral incisors) and top four primary teeth (upper central and lateral incisors) when you turn eight. After a break from ages eight to ten, the rest of your permanent teeth will start to come out, which continues until approximately age 21.

Adults have 28 to 32 permanent teeth, including the third molars or wisdom teeth.

Dental Emergencies

Toothache

Clean the area of the affected tooth. Rinse the mouth thoroughly with warm water or use dental floss to dislodge any food remains. If you still feel pain, contact your child's dentist. Do not place aspirin or heat on the gum or the aching tooth. If your face is swollen, apply cold compresses and contact your dentist immediately.

Cut or Bitten Tongue, Lip, or Cheek

Apply ice to the injured area to help control the swelling. If you're bleeding, apply firm but gentle pressure with a gauze or cloth. Call a doctor or visit a hospital emergency room if blood still comes out.

Knocked Out Permanent Tooth:

If possible, find the tooth. Handle it by the crown, not by the root. Rinse the tooth with water only. Do not clean with soap, scrub, or handle the tooth unnecessarily. Inspect the tooth for fractures and, if it is sound, try to reinsert it in the socket. Have the patient hold the tooth in place by biting on a gauze or clean cloth. If you cannot reinsert the tooth, put it in a cup with the patient's saliva or milk (not water). If the patient is old enough, they may also carry the tooth inside their mouth next to the cheek. The person must see a dentist immediately, as time is critical in saving the tooth.

Knocked Out Baby Tooth

Contact your pediatric dentist. Unlike permanent teeth, a professional won't reimplant a baby tooth because it could damage the developing permanent tooth. In most cases, you won't need treatment.

Chipped/Fractured Permanent Tooth

Time is of the essence, so contact your pediatric dentist immediately to reduce the chance of infection or the need for extensive future dental treatment. Rinse the mouth with water and apply a cold compress to reduce swelling. If you can find the broken tooth piece, bring it to the dentist.

Chipped/Fractured Baby Tooth

Contact your pediatric dentist.

Severe Blow to the Head

Call 911 immediately or take your child to the nearest emergency room.

Possible Broken or Fractured Jaw

Keep the jaw from moving and take your child to the nearest hospital emergency room.

Read more about preventing dental emergencies during recreational activities and sports with mouthguards.

Dental Radiographs (X-Rays)

Radiographs, or x-rays, are necessary for your child's dental diagnostic process. Thanks to these images, professionals can avoid certain dental conditions.

Radiographs detect much more than cavities. For example, dentists may need them to survey erupting teeth, diagnose bone diseases, evaluate the results of an injury, or plan orthodontic treatment. X-rays allow dentists to diagnose and treat health conditions they can't detect during a clinical examination. If they find dental problems and provide early treatment, dental care becomes more comfortable for your child and more affordable for you.

The American Academy of Pediatric Dentistry recommends radiographs and examinations every six months for children with a high risk of tooth decay. On average, most pediatric dentists request x-rays approximately once a year, and a complete set every three years, be it a panoramic and bitewing or periapical and bitewing.

Pediatric dentists are particularly careful and try to minimize the exposure of their patients to radiation. With contemporary safeguards, the amount of radiation in a dental X-ray is minimal, and the risk is negligible. Dental radiographs represent a far smaller risk than an undetected and untreated dental problem. Dentists also provide lead body aprons and shields to protect your child. Today's equipment filters out unnecessary x-rays and restricts the x-ray beam to the area. Finally, high-speed film and proper shielding ensure that your child receives minimal radiation exposure.

What's The Best Toothpaste for My Child?

Tooth brushing is one of the most important habits for good oral health. However, many pastes and polishes damage young smiles because they contain harsh abrasives that wear away tooth enamel. When buying toothpaste for your child, pick one recommended by the American Dental Association, as shown on the box and tube. These kinds of toothpaste have undergone testing to ensure they are safe to use.

If your child is under three years old, make them use only a smear of toothpaste (the size of a grain of rice) to brush their teeth. For children of 3 to 6 years, use a "pea-size" amount of toothpaste and perform or assist your child's toothbrushing. Remember that young children don't usually know how to brush their teeth effectively on their own. Finally, children should spit out and not swallow excess toothpaste after brushing, as it can harm their well-being.

Does Your Child Grind Their Teeth at Night? (Bruxism)

Parents are often concerned about the nocturnal grinding of teeth (bruxism). Often, the first sign of this condition is the noise a child makes while forcing their teeth against one another. A parent may also notice their kid's teeth are smaller due to dentition. One theory for the source of bruxism involves a psychological component. Stress due to a new environment, divorce, or changes at school can make a child grind their teeth. Another possible explanation relates to pressure in the inner ear at night. If pressure changes, the child will try to relieve it by moving their jaw and grinding. This mechanism is similar to chewing gum to equalize pressure during a plane take-off or landing.

Most cases of pediatric bruxism do not require any treatment, but if excessive wear of the teeth (attrition) is present, professionals might advise using a nightguard. As effective as this method can be, there are still some adverse effects. For instance, you could choke if the appliance becomes dislodged during sleep, and the tray may interfere with jaw growth. However, nightguards are effective when preventing wear to the primary dentition.

The good news is most children outgrow bruxism. The grinding decreases between ages 6 and 9, and kids tend to stop grinding when they turn 9 to 12. If you think your child suffers from bruxism, discuss this with your pediatrician or pediatric dentist.

Thumb Sucking

Young children usually suck their thumbs, fingers, pacifiers, and other objects as a natural reflex. This habit makes them feel safe and happy and provides a sense of security during difficult times. Since thumb sucking is relaxing, it can also induce sleep.

Thumb sucking that persists beyond the eruption of permanent teeth can interfere with proper mouth growth and teeth alignment. How intensely a child sucks on their fingers or thumbs will determine whether they have future dental problems. Children who rest their fingers passively in their mouths are less likely to have oral issues than those who vigorously suck their thumbs.

Your child should cease thumb-sucking by the time their permanent front teeth are ready to erupt. Usually, children stop between the ages of two and four due to peer pressure at school.

Pacifiers are no substitute for thumb sucking, as they have the same detrimental effect on your child's teeth. However, you can control and change how much your kid uses their pacifier more easily than you can thumb-sucking. Talk to your pediatric dentist if you're concerned about your child using a pacifier or sucking their fingers.

Here're a few suggestions to help your child get through thumb-sucking:

  • Children often suck their thumbs when feeling insecure. Focus on correcting the cause of anxiety instead of thumb-sucking.
  • Children sucking for comfort will feel less of a need when their parents make them feel safe.
  • Reward children when they refrain from sucking during difficult periods, like when separated from their parents.
  • Your pediatric dentist can encourage children to stop sucking and explain what could happen if they continue.
  • If these approaches don't work, try bandaging the thumb or putting a sock on the hand at night. Your pediatric dentist may also recommend using a mouth appliance.

What Is Pulp Therapy?

The pulp is the inner, central core of the tooth and contains nerves, blood vessels, connective tissue, and reparative cells. The purpose of pulp therapy in pediatric dentistry is to maintain the vitality of the affected tooth, so you don't lose it.

Dental caries, also known as cavities, and traumatic injuries are the main reasons for needing tooth pulp therapy. This treatment is often referred to as "nerve treatment," "children's root canal," "pulpectomy," or "pulpotomy."

During a pulpotomy, a dentist removes the diseased pulp tissue within the tooth crown and places an agent to prevent bacterial growth and calm the remaining nerve tissue. Then, they make a final restoration by fixing a new crown, usually made of stainless steel.

You will need a pulpectomy when an infection has reached the root canal of your tooth. During this treatment, a professional removes the diseased pulp tissue in the crown and root and cleanses the canal. If it's a primary tooth, your dentist will fill it with a resorbable material; otherwise, they'll use a non-reabsorbing material. Finally, they place a permanent restoration to protect your tooth.

When Is the Best Time for Orthodontic Treatment?

You can recognize developing malocclusions, or bad bites, as soon as your child turns two or three years old. Often, dentists and parents can take early steps to reduce the need for major orthodontic treatment in the future.

Stage I 

Early Treatment: This period encompasses years 2 to 6. At this young age, dentists are concerned with underdeveloped dental arches, the premature loss of primary teeth, and harmful habits such as finger or thumb sucking. Treatment in this stage of development is often effective, and, as a result, sometimes children don't need to correct their teeth when they're older.

Stage II 

Mixed Dentition: This period covers the ages 6 to 12 when permanent front incisors and 6-year molars erupt. It's an excellent stage to start treatment because your child's hard and soft tissues are usually very responsive to orthodontic or orthopedic procedures. Treatment usually focuses on jaw and teeth misalignment.

Stage III

Adolescent Dentition: This stage deals with permanent teeth and the development of the final bite relationship.

Adult Teeth Coming in Behind Baby Teeth

Adult teeth erupting behind baby teeth is a very common occurrence in children, and it's usually the result of a lower primary tooth not falling out when it should. In most cases, if the child starts wiggling the baby tooth, it falls out on its own within two months. If it doesn't, please contact your pediatric dentist and they will extract the tooth, leaving room for the permanent tooth to slide into the proper place.

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