What is a Pediatric Dentist?
Your Child's First Dental Visit
Why are the Primary Teeth so Important?
Dental X-rays
Care of your Child's Teeth
Good Diet = Healthy Teeth
How Do I Prevent Cavities
Seal Out Decay
Baby Bottle Tooth Decay (Early Childhood Caries)
When will my Baby Start Getting Teeth?
Eruption of your Child's Teeth
Dental Emergencies
Fluoride
What's the Best Toothpaste for my Child?
Does your Child Grind his Teeth at Night? (Bruxism)
Thumb Sucking
Tongue Piercing - Is it Really Cool?
Tobacco - Bad News in Any Form
What is the Best Time for Orthodontic Treatment?
Mouth Guards

For information on special oral health care needs,
we've provided links to the following sites:

 Your Child’s First Dental Visit

An early start in regular dental care is an important step in your child’s road to total health. The American Association for Pediatric Dentistry recommends that children visit a dentist by age one. Unless you have a specific concern, we feel that two is an appropriate age for a child’s first dental visit. You can make the first visit to the dentist enjoyable and positive. Your child should be informed of the visit and told that the dentist and their staff will explain all procedures and answer any questions. The less “to-do” concerning the visit, the better.

 Why Are The Baby Teeth So Important?

 X-Rays (radiographs) are a vital and necessary part of your child’s dental diagnostic process. Without them, certain dental conditions can and will be missed.

Radiographs detect much more than cavities. For example, radiographs may be needed to survey erupting teeth, diagnose bone diseases, evaluate the results of an injury, or plan orthodontic treatment. Radiographs allow dentists to diagnose and treat health conditions that cannot be detected during a clinical examination. If dental problems are found and treated early, dental care is more comfortable for your child and more affordable for you.

The American Academy of Pediatric Dentistry (AAPD) recommends bitewing radiographs once a year for all children. Children who have an aggressive decay pattern often need radiographs every six months. The AAPD also recommends a panoramic radiograph every four years to assess tooth development and jaw growth.

Pediatric dentists are particularly careful to minimize the exposure of their patients to radiation. With contemporary safeguards, the amount of radiation received in a dental X-ray examination is extremely small, and the risk is negligible. In fact, the dental radiographs represent a far smaller risk than an undetected and untreated dental problem.  High-speed film and proper shielding assure that your child receives a minimal amount of radiation exposure.
[Back to Top]

Begin daily brushing as soon as the child’s first tooth erupts. A pea size amount of fluoride toothpaste can be used at the age of 2.  Please try to limit the swallowing of toothpaste.  By age eight, children should be able to brush their own teeth twice a day with supervision.

Proper brushing removes plaque from the inner, outer and chewing surfaces. When teaching children to brush, place toothbrush at a 45 degree angle; start along gum line with a soft bristle brush in a gentle circular motion. Brush the outer surfaces of each tooth, upper and lower. Repeat the same method on the inside surfaces and chewing surfaces of all the teeth. Finish by brushing the tongue to help freshen breath and remove bacteria.

Good oral hygiene removes bacteria and the left over food particles that combine to create cavities. For infants, use a wet gauze or clean washcloth to wipe the plaque from teeth and gums. Avoid putting your child to bed with a bottle filled with anything other than water. See "Baby Bottle Tooth Decay" for more information.

A sealant is a clear or shaded plastic material that is applied to the chewing surfaces (grooves) of the back teeth (premolars and molars), where four out of five cavities in children are found. This sealant acts as a barrier to food, plaque and acid, thus protecting the decay-prone areas of the teeth.
[Back to Top]

One serious form of decay among young children is baby bottle tooth decay. This condition is caused by frequent and long exposures of an infant’s teeth to liquids that contain sugar. Among these liquids are milk (including breast milk), formula, fruit juice and other sweetened drinks.

Putting a baby to bed (for a nap or at night) with a bottle other than water can cause serious and rapid tooth decay. Sweet liquid pools around the child’s teeth giving plaque bacteria an opportunity to produce acids that attack tooth enamel. If you must give the baby a bottle as a comforter at bedtime, it should contain only water.  If your child won't fall asleep without the bottle and its usual beverage, gradually dilute the bottle's contents with water over a period of two to three weeks. 

After each feeding, wipe the baby’s gums and teeth with a damp washcloth or gauze pad to remove plaque. The easiest way to do this is to sit down, place the child’s head in your lap or lay the child on a dressing table or the floor. Whatever position you use, be sure you can see into the child’s mouth easily.
[Back to Top]

Teething is variable among individual babies. Some babies get their teeth early and some get them late.  The first baby teeth are typically the lower front (anterior) teeth and usually begin erupting between the age of 6-8 months. See "Eruption of Your Child’s Teeth" for more details.
[Back to Top]

Children’s teeth begin forming before birth and erupt as early as four months of age.  The first primary (or baby) teeth to erupt are most often the lower central incisors, followed closely by the upper central incisors. Although all twenty primary teeth usually appear by age three, the pace and order of their eruption varies.

Fluoride is naturally occurring substance that is widely used to prevent cavities. Fluoride is found in toothpaste, rinses, gels and most city water supplies. The indications for administering the various forms of fluoride primarily depend on the age of the child, their cavity-history and perceived susceptibility to develop cavities in the future, and whether they drink fluoridated water. When used properly, the various forms of fluoride will enhance the oral health status of infants and children. As is true of many other substances, improper use of fluoride has the potential to produce objectionable side effects. Excessive fluoride ingestion by preschool-aged children can lead to dental fluorosis, which is chalky white and even brown discoloration of the permanent teeth. Being aware of a child's potential sources of flouride can help parents prevent the possibility of dental fluorosis.

Some of these sources are:

• Swallowing too much fluoridated toothpaste at an early age.
• The inappropriate use of fluoride supplements.
• Hidden sources of fluoride in the child’s diet.

Parents can take the following steps to decrease the risk of fluorosis in their children’s teeth:

• Use baby tooth cleanser on the toothbrush of the very young child.
• Place only a "pea sized" drop of children’s toothpaste on the brush when brushing.
• Account for all of the sources of ingested fluoride before requesting fluoride supplements from your child’s physician or pediatric dentist.
• Avoid giving any fluoride-containing supplements to infants until they are at least 6 months old.
• Obtain fluoride level test results for your drinking water before giving fluoride supplements to your child (check with local water utilities).

Tooth brushing is one of the most important tasks for good oral health. When looking for a toothpaste for your child make sure to pick one that is recommended for children by the American Dental Association. These toothpastes have undergone testing to insure they are safe to use. Many adult toothpastes contain whiteners, and/or tooth polish that can damage young smiles. They contain harsh abrasives which can wear away young tooth enamel.

Parents are often concerned about the nocturnal grinding of teeth (bruxism).  The first indication is the noise created by the child grinding on their teeth during sleep. The parent may notice wear (teeth getting shorter) to the dentition. The causes of bruxism are multi factorial and difficult to pinpoint, however, they are usually self limiting.

Sucking is a natural reflex. Infants and young children may suck thumbs, fingers, pacifiers and other objects. It may make them feel secure and happy or provide a sense of security at difficult periods. Since thumb sucking is relaxing, it may induce sleep.

Thumb sucking that persists beyond the eruption of the permanent teeth can cause problems with the proper growth of the mouth and tooth alignment. The intensity of the sucking will determine whether or not dental problems result. Children who rest their thumbs passively in their mouths are less likely to have difficulty than those who vigorously suck their thumbs.

Children 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. Peer pressure causes many school-aged children to stop.

Pacifiers are no substitute for thumb sucking. They can affect the teeth essentially the same way as sucking fingers and thumbs. However, use of the pacifier can be controlled and modified more easily than the thumb or finger habit. If you have concerns about thumb sucking or use of a pacifier, consult your pediatric dentist.

A few suggestions to help your child get through thumb sucking:

There are many risks involved with oral piercings including chipped or cracked teeth, blood clots, or blood poisoning. Your mouth contains millions of bacteria, and infection is a common complication of oral piercing. Your tongue could swell large enough to close off your airway!

Common symptoms after piercing include pain, swelling, infection, an increased flow of saliva and injuries to gum tissue. Difficult-to-control bleeding or nerve damage can result if a blood vessel or nerve bundle is in the path of the needle.

Tobacco in any form can jeopardize your child’s health and cause incurable damage. Teach your child about the dangers of tobacco.

Smokeless tobacco, also called spit, chew or snuff, is often used by teens who believe that it is a safe alternative to smoking cigarettes. This is an unfortunate misconception. Studies show that spit tobacco may be more addictive than smoking cigarettes and may be more difficult to quit. Teens who use it may be interested to know that one can of snuff per day delivers as much nicotine as 60 cigarettes. In as little as three to four months, smokeless tobacco use can cause periodontal disease and produce pre-cancerous lesions called leukoplakias.

If your child is a tobacco user you should watch for the following that could be early signs of oral cancer:

• A sore that won’t heal.
• White or red leathery patches on the lips, and on or under the tongue.
• Pain, tenderness or numbness anywhere in the mouth or lips.
• Difficulty chewing, swallowing, speaking or moving the jaw or tongue
• A change in the way the teeth fit together.

Because the early signs of oral cancer usually are not painful, people often ignore them. If it’s not caught in the early stages, oral cancer can require extensive, sometimes disfiguring, surgery. Even worse, it can kill.

Developing malocclusion (improper bite) can be recognized as early as two or three years of age.  Early steps can often be taken to reduce the need for major orthodontic treatment at a later age.

Phase I Orthodontic Treatment:  Treatment between the ages of six and twelve coincides with the eruption of the permanent incisor (front) teeth and six-year molars. This is an excellent stage to start treatment, when indicated, as your child’s hard and soft tissues are usually very responsive to orthodontic or orthopedic forces. Patients who have phase I treatment often need a second phase of treatment after all the permanent teeth have erupted.

When a child begins to participate in recreational activities and organized sports, injuries can occur. A properly fitted mouth guard is an important piece of athletic gear that can help protect your child’s smile. Mouth Guards should be used during all activities that could result in a blow to the face or mouth.

Mouth guards help prevent broken teeth, and injuries to the lips, tongue, face or jaw. A properly fitted mouth guard will stay in place while your child is wearing it, making it easy for them to talk and breathe.