A: "First visit by first birthday" sums it up. Your
child should visit a pediatric dentist when the first
tooth comes in, usually between six and twelve months of
age. Early examination and preventive care will protect
your child’s smile now and in the future.
Q. Why so early? What dental problems could a baby have?
A: The most important reason is to begin a thorough
prevention program. Dental problems can begin early. A
big concern is Early Childhood Caries (also know as baby
bottle tooth decay or nursing caries). Your child risks
severe decay from using a bottle during naps or at night
or when they nurse continuously from the breast.
The earlier the dental visit, the better the chance of
preventing dental problems. Children with healthy teeth
chew food easily, learn to speak clearly, and smile with
confidence. Start your child now on a lifetime of good
dental habits.
Q. How can I prevent tooth decay from a bottle or
nursing?
A: Encourage your child to drink from a cup as they
approach their first birthday. Children should not fall
asleep with a bottle. At-will nighttime breast-feeding
should be avoided after the first primary (baby) teeth
begins to erupt. Drinking juice from a bottle should be
avoided. When juice is offered, it should be in a cup.
Q. When should bottle-feeding be stopped?
A: Children should be weaned from the bottle at 12-14
months of age.
Q. Should I worry about thumb and finger sucking?
A: Thumb sucking is perfectly normal for infants; most
stop by age 2. If your child does not, discourage it
after age 4. Prolonged thumb sucking can create crowded,
crooked teeth, or bite problems. Your pediatric dentist
will be glad to suggest ways to address a prolonged
thumb sucking habit.
Q. When should I start cleaning my baby’s teeth?
A: The sooner the better! Starting at birth, clean your
child’s gums with a soft infant toothbrush and water.
Remember that most small children do not have the
dexterity to brush their teeth effectively. Unless it is
advised by your child’s pediatric dentist, do not use
fluoridated toothpaste until age 2-3.
Q. Any advice on teething?
A: From six months to age 3, your child may have sore
gums when teeth erupt. Many children like a clean
teething ring, cool spoon, or cold wet washcloth. Some
parents swear by a chilled ring; others simply rub the
baby’s gums with a clean finger.
A: A healthy diet is a balanced diet that naturally
supplies all the nutrients your child needs to grow. And
what's a balanced diet? One that includes the following
major food groups every day: Fruits and Vegetables;
Breads and Cereals; Milk and Dairy Products; Meat, Fish
and Eggs.
Q: How does my child's diet affect her dental health?
A: She must have a balanced diet for her teeth to
develop properly. She also needs a balanced diet for
healthy gum tissue around the teeth. Equally important,
a diet high in certain kinds of carbohydrates, such as
sugar and starches, may place your child at extra risk
of tooth decay.
Q: How do I make my child's diet safe for his teeth?
A: First, be sure he has a balanced diet. Then, check
how frequently he eats foods with sugar or starch in
them. Foods with starch include breads, crackers, pasta
and such snacks as pretzels and potato chips. When
checking for sugar, look beyond the sugar bowl and candy
dish. A variety of foods contain one or more types of
sugar, and all types of sugars can promote dental decay.
Fruits, a few vegetables and most milk products have at
least one type of sugar.
Sugar can be found in many processed foods, even some
that do not taste sweet. For example, a peanut butter
and jelly sandwich not only has sugar in the jelly, but
may have sugar added to the peanut butter. Sugar is also
added to such condiments as catsup and salad dressings.
Q: Should my child give up all foods with sugar or
starch?
A: Certainly not! Many provide nutrients your child
needs. You simply need to select and serve them wisely.
A food with sugar or starch is safer for teeth if it's
eaten with a meal, not as a snack. Sticky foods, such as
dried fruit or toffee, are not easily washed away from
the teeth by saliva, water or milk. So, they have more
cavity-causing potential than foods more rapidly cleared
from the teeth. Talk to your pediatric dentist about
selecting and serving foods that protect your child's
dental health.
Q: Does a balanced diet assure that my child is getting
enough fluoride?
A: No. A balanced diet does not guarantee the proper
amount of fluoride for the development and maintenance
of your child's teeth. If you do not live in a
fluoridated community or have an ideal amount of
naturally occurring fluoride in your well water, your
child needs a fluoride supplement during the years of
tooth development. Your pediatric dentist can help
assess how much supplemental fluoride your child needs,
based upon the amount of fluoride in your drinking water
and your child's age and weight.
Q: My youngest isn't on solid foods yet. Do you have
suggestions for her?
A: Don't nurse your daughter to sleep or put her to bed
with a bottle of milk, formula, juice, or sweetened
liquid. While she sleeps, any unswallowed liquid in the
mouth supports bacteria that produce acids and attack
the teeth. Protect your child from severe tooth decay by
putting her to bed with nothing more than a pacifier or
bottle of water.
Q: Any final advice?
A: Yes. Here are tips for your child's diet and dental
health.
Ask your pediatric dentist to help you assess your
child's diet.
Shop smart! Do not routinely stock your pantry with
sugary or starchy snacks. Buy "fun foods" just for
special times.
Limit the number of snack times; choose nutritious
snacks.
Provide a balanced diet, and save foods with sugar or
starch for mealtimes.
Don't put your young child to bed with a bottle of milk,
formula, or juice.
If your child chews gum or sips soda, choose those
without sugar.
Q: How does a pediatric dentist help with dental
anxiety?
A: Pediatric dentists have special training in helping
anxious children feel secure during dental treatment.
And, pediatric dental offices are designed for children.
Staff members choose to work in a pediatric dental
practice because they like kids. So, most children are
calm, comfortable and confident in a pediatric dental
office.
Q: How will a pediatric dentist help my child feel
comfortable?
A: Pediatric dentists are trained in many methods to
help children feel comfortable with dental treatment.
For example, in the "Tell-Show-Do" technique, a
pediatric dentist might name a dental instrument,
demonstrate the instrument by using it to count your
child's fingers, then apply the instrument in treatment.
The modeling technique pairs a timid child in dental
treatment with a cooperative child of similar age.
Coaching, distraction, and parent participation are
other possibilities to give your child confidence in
dentistry. But by far the most preferred technique is
praise. Every child does something right during a dental
visit, and pediatric dentists let children know that.
Q: Should I accompany my child into treatment?
A: Infants and some young children may feel more
confident when parents stay close during treatment. With
older children, doctor-child communication is often
enhanced if parents remain in the reception room.
Q: What if a child misbehaves during treatment?
A: Occasionally a child's behavior during treatment
requires assertive management to protect him or her from
possible injury. Voice control (speaking calmly but
firmly) usually takes care of it. Some children need
gentle restraint of the arms or legs as well. Mild
sedation, such as nitrous oxide/oxygen or a sedative,
may benefit an anxious child. If a child is especially
fearful or requires extensive treatment, other sedative
techniques or general anesthesia may be recommended.
A: Conscious sedation is a management technique that
uses medications to assist the child to cope with fear
and anxiety and cooperate with dental treatment.
Medications and dosages should be selected that are
unlikely to cause loss of consciousness in the patient.
Q: Who should be sedated?
A: Children who have a level of anxiety that prevents
good coping skills or are very young and do not
understand how to cope in a cooperative fashion for the
delivery of dental care should be sedated. Conscious
sedation is often helpful for some children who have
special needs.
Q: Why utilize conscious sedation?
A: Conscious sedation aids in allowing a child to cope
better with dental treatment. This can help prevent
injury to the child from patient movement and promote a
better environment for providing dental care
Q: What medications are used?
A: Many different medications can be used for conscious
sedation. Your pediatric dentist will discuss different
options for your child.
Q: Is sedation safe?
A: Sedation is safe when administered by a trained
pediatric dentist who follows the sedation guidelines of
the American Academy of Pediatric Dentistry. Your
pediatric dentist will discuss sedation options and
patient monitoring for the protection of your child.
Q: What special instructions should I follow before the
sedation appointment?
A: In order to alleviate potential anxiety in your
child, your pediatric dentist may recommend minimal
discussion of the dental appointment with your child.
Should your child become ill, contact your pediatric
dentist to see if it is necessary to postpone the
appointment. It is very important to follow the
directions of your pediatric dentist regarding fasting
from fluids and foods prior to the sedation appointment.
Q: What special instructions should I follow after the
sedation appointment?
A: Your pediatric dentist will not discharge your child
until the child is alert and ready to go. Children who
have been sedated are usually requested to remain at
home for the rest of the day with adult supervision.
Your pediatric dentist will discuss specific
post-sedation instructions with you, including
appropriate diet, physical activity, and requested
supervision.
A: The American Association of Orthodontists recommends
that all children get a check-up with an orthodontist no
later than age seven. Although only a few orthodontic
problems need to be corrected at that age, an early exam
allows the orthodontist to offer advice and guidance as
to when the appropriate age to start treatment would be.
Let your orthodontist guide you as to when to start
treatment. Feel free to ask questions about the timing
of treatment.
Q: How long will my treatment take?
A: The length of treatment varies depending on the
complexity of the orthodontic problem that requires
correction, growth and tissue response to treatment as
well as the level of patient cooperation during their
treatment. Orthodontic care requires a team approach in
which the family dentist, the orthodontist and the
patient play key roles that can impact the length of
treatment and the quality of the end result. Generally,
the length of comprehensive orthodontic treatment can
range from approximately 18 months to 30 months,
depending on treatment options and individual
characteristics.
Q: What are the stages of treatment?
A: Generally, there are two or three stages of
orthodontic treatment. Most patients will benefit from
an active corrective stage followed by a retention
stage. Some patients will benefit from two active
treatment stages often referred to as two-phase
treatment. The goals of each stage should be discussed
with the orthodontist so that patients and/or parents
have realistic expectations.
Q: Are there different types of braces?
A: Braces differ from one another in many ways.
How they attach to the teeth varies. Most attach on the
cheek side of the teeth, while some attach on the tongue
side. These are called “lingual” braces. Braces
vary in appearance. Some braces are clear, nearly
invisible, while others are made of stainless steel and
may or may not have colored elastics around them. All
braces are designed to enable the orthodontist to move
teeth in three dimensions. The mechanics or techniques
used for moving teeth vary as well. Talk with your
orthodontist about his or her approach to orthodontic
treatment.
