For Parents

Pointers | Frequently Asked Questions | Articles of Interest | 1st Year Milestones
Cavity Free Holidays

Pointers for Parents About Your Child's First Visit

Please:

Set a good example by brushing and flossing your own teeth every day.
Try to make the first dental visit a fun adventure for your child.
Be prepared to let your child go into the treatment area alone. At the conclusion of the visit, we will discuss our findings and recommendations with you.
Don't bribe your child to go to the dentist or threaten a visit as punishment.
Don't let your child know of any anxiety YOU may have about dental visits. Remember, a pediatric dental office will probably be a new experience for you, too.
Avoid what appear to be reassuring comments like "Don't worry, the doctor won't hurt you." This serves only to raise your child's anxiety level. Talk about the visit in a positive, matter of fact way.

Your aim as a parent and ours as pediatric dentists are the same -- to make the process of dental care a pleasant one for your child.

Frequently Asked Questions

Questions and Answers about Infant Oral Health Care
by Eli C. Schneider, D.M.D.

Q. When should my child first see a dentist?

A. The ideal time for your child's first dental visit is between six and twelve months of age, usually by the time the first tooth erupts. My personal experience - and my review of the scientific evidence - has shown clearly that early preventive care will protect your child's smile now and in the future. By starting early, we can enable your child to enjoy the lifelong benefits of a healthy mouth.

Q. What dental problems could my child have? She's just a baby!

A. Unfortunately, some dental problems begin very early in life. A primary concern is baby bottle tooth decay, a serious dental condition caused by long, frequent exposure to such liquids as milk, formula and fruit juice. Another concern is gum disease. Recent studies show that 40 percent of children two and three years old have at least mild inflammation of gum tissues. The earlier the dental visit, the better the chances of preventing tooth decay and other problems. Strong, healthy teeth help your child chew food easily, learn to speak clearly and feel good about her appearance. We would like to get her started now on a lifetime of positive dental habits.

Q. What happens at the first 'regular' dental visit?

A. The first 'regular' dental visit is usually scheduled at about age three when your child is old enough to accept it as a positive -- even fun -- experience. After you share the child's medical history with us , a hygienist will check your child's teeth and gums. She may clean your child's teeth and apply topical fluoride to help protect the teeth against decay. Once the hygienist has gained your child's confidence, she will introduce her to me. I will gently examine your child for decay and other problems, evaluate the effects of any oral habits such as thumbsucking, and make sure your child is receiving adequate fluoride for optimum dental health benefit.

X-rays may be necessary to discover hidden decay and check on the progress of your child's permanent teeth under the gums. Most important, you will review how to clean and care for your child's teeth now that she is somewhat older. You play the leading role in keeping her smile bright and healthy.

Q. I don't understand all the fuss about baby teeth. They just fall out anyway!

A. Primary teeth are important to your child's future dental health because they help with proper chewing and eating, aid in speech development and add to an attractive appearance. A child who can chew easily, speak clearly and smile confidently at parents and friends is a happier child.

Primary teeth permit normal development of the jaw bones and muscles. They save space for the permanent teeth and guide them into position. If a baby tooth is lost too soon, the teeth beside it may tilt, causing permanent teeth to come in crooked. In addition, your child's general health can be affected if diseased baby teeth are not treated.

Finally, because some primary molars are not replaced until a child is 12 or 14, these teeth must serve your child for five or ten years, or more. Early care is essential to achieve a lifetime of good dental health for your child.

Q. Aren't early visits for kids just a way for dentists to make more money?

A. Actually, quite the opposite is true. Early visits help PREVENT dental problems and thus save money for parents. By getting an early start, we not only protect your child's health, we keep dental care affordable. Such preventive treatments as fluorides and sealants are much less expensive than fillings, crowns and other services your child may need if teeth are neglected.

Q. How often should my child see a dentist?

A. Every child is different, so every child has differing dental needs. However, a good rule of thumb is a dental visit every six months. After examining your child, we will be able to recommend the best schedule for her dental needs.

Q. What should I tell my child about the first dental visit?

A. Please tell your child that a pediatric dentist is a friendly doctor who will help her stay strong and healthy. Be positive and matter-of-fact, as you would about any new experience. For example, smile at your child and say, "The doctor will help keep your teeth looking nice (pretty, shiny, bright)." Or say, "The doctor will count your teeth and check your smile." Do not share any anxiety you may feel about visiting the dentist, and do not allow anyone to tell your child scary stories about dental treatment.

Pediatric dentists have extensive advanced training in dental treatment for children, a minimum of two years beyond dental school. We devote our dental skill to the care of infants, children, adolescents and young patients with developmental disabilities. We pride ourselves on our ability to make a dental visit pleasant, relaxing, even fun for children.

Articles of Interest

Amalgam vs. Composite Restorations | Preventing Sports Injuries

Amalgam vs. Composite Restorations

For over 100 years, teeth have been restored with amalgam restorations. Amalgam is a metallic colored mixture of silver, tin, and various trace metals that is bound tightly with mercury. Once the amalgam hardens, it is virtually impossible to release any free mercury from the restoration. Many billions of teeth have been restored successfully with this time tested and durable material.

Since the 1960’s various white, tooth colored restorative materials have been developed. Some of the early alternatives were either not strong enough to withstand the forces of chewing or dissolved slowly in the mouth over time. In more recent decades, composites were developed. Composites are silica quartz filled polymers that come in various white shades to match nearly any tooth color. Composites adhere to teeth by chemically bonding to tooth structure – both enamel and the underlying dentin. This adhesiveness along with their tooth color has been their primary advantage. They have proven to be nearly as strong and durable as amalgam.

Placement of tooth colored composite restorations is technically more demanding than placement of amalgam restorations. Composites require various additional steps and equipment to successfully bond to tooth structure. They are also very sensitive to salivary contamination during placement. Composite restorations are more costly since they require more time and skill on the part of the dentist, and the material itself is more expensive than amalgam.

Many parents choose composite restorations simply because they are tooth colored. There are, however, certain clinical situations where composites are preferable. For example, if a tooth has a very large cavity where the remaining sides of the tooth are thin, composite is a better restoration because its adhesive properties actually helps keep this tooth intact after restoration. If amalgam is used in this type of situation, it is not uncommon for the thin remaining tooth structure to fracture away from the amalgam restoration.

Another example where composite is preferred is when decay is found in a corner of a tooth instead of in the center. Since amalgam attaches to the tooth mechanically rather than chemically, the base of an amalgam restoration must always be wider that the surface. To make the base wider in the corner of a tooth requires removing an unnecessarily large amount of healthy tooth structure simply to hold the amalgam in place. Composite, on the other hand, actually bonds to the tooth structure and this adhesiveness requires removal of very little tooth structure beyond the decay itself.

Whether composite is used for its cosmetic benefit or its adhesive qualities, insurance companies generally prefer to pay only for the less expensive alternative - amalgam. Insurance companies all ‘allow’ use of composite, however, but hold the parent responsible for the difference in cost between that insurance company’s amalgam fee and the cost of the composite.

We, at Dentistry for Children, offer both materials since they both have their advantages and disadvantages. If a particular tooth requires a composite restoration, we discuss that with the parent. If the choice is purely a cosmetic one, we leave it up to the parent to make his/her own decision.

Preventing Sports Injuries

With sports season in full swing, parents should be aware that dental injuries are the most common type of injuries to the face, and 60% of facial injuries occur during sports. An athlete is 60 times more likely to suffer damage to the teeth when not wearing a mouth guard.

A mouth guard is a flexible piece of plastic that fits around the upper teeth and protects them from injury. In addition to protecting against direct damage to the teeth by cushioning the lips and cheeks from the teeth or orthodontic appliances, a mouth guard helps prevent laceration and bruising. A mouth guard can also prevent serious injuries caused when the lower jaw is jammed into the upper jaw, including concussion, cerebral hemorrhage, jaw fractures and neck injuries.

There are several types of mouth guards. When choosing one, remember that a mouth guard should be flexible, comfortable, durable, odorless, tasteless, and easy to clean. A mouth guard should fit properly so that it protects your child's mouth, but does not interfere with breathing or speaking.

The least expensive mouth guard is a stock one sold in sporting goods stores. They come in small, medium, and large and are held in place by biting down. The disadvantage of these mouth guards is that the fit is not adjustable and may not protect your child's teeth as well as a more fitted model would. Holding these guards in place requires that your child bite down, so they can interfere with speech and breathing.

The most commonly used type of mouth guard is also sold in sporting goods stores. They're called "boil and bite mouth guards," because they're softened in boiling water and then formed to fit your child's mouth. This type of mouth guard costs a little more than the stock types, but because it is formed around your child's teeth, it fits and protects your child's mouth better. However, it still may not cover all the teeth properly.

The best mouth guard for preventing injury is one that is custom made for your child by our office. This type is a bit more expensive, but it is the most effective at protecting your child's mouth, face and head. Because it is custom fit to your child's teeth, it's also the most comfortable to wear. When you consider that the cost of fixing one broken tooth is many times more expensive than having a mouth guard custom made, the value is obvious.

Whatever type of mouth guard you choose, your child should wear it for any activity in which there is a chance of contact with other participants or hard surfaces. Mouth guards aren't just for football and hockey. If your child rides a bicycle, participates in gymnastics, volleyball, skateboarding, baseball, basketball or any sport or activity in which a facial or dental injury might occur, a mouth guard is a necessity. Half of all dental injuries can be prevented, and a mouth guard is an important aid in protecting your child's teeth, face and mouth.

1st Year Milestones

by Eli C. Schneider, D.M.D.

Most parents think of the dentist as a repairman. If their child has tooth decay or suffers a traumatic injury, they call their dentist to repair the damage.

Pediatric dentists are much more than "Dr. Fix It". They can help prevent your child from getting dental decay or even injuries. They can also help avoid or decrease the severity of later orthodontic problems. They can help keep your child's smile straight and cavity free.

Your child's first birthday is the time to start thinking about pediatric dentistry as a prevention resource.

Bring your child in to see the pediatric dentist before any problems have had a chance to develop. This will not be a dental visit like the ones you are used to. Your one year old will, of course, not be expected to sit in the dental chair and have her teeth cleaned and fluoride applied. Instead, the pediatric dentist will ask you a few questions about your child's development, medical history and her nursing and eating habits. He will have your child lie down on your lap for a brief exam -- perhaps giving her a stuffed animal to hold to momentarily divert her attention. The pediatric dentist realizes that at age one, your child doesn't yet have very many teeth or very much patience, so the exam will be mercifully short.

With information the pediatric dentist has gathered, he is then able to undertake the most important part of this first visit -- counseling you, the parent. He will demonstrate the best way to brush your child's teeth and the best time to do it. He will consult on your child's diet -- not just about what foods to avoid, but also about the importance of when certain foods are eaten, the effect their consistency can have on your child's teeth and even the order in which they're eaten.

The pediatric dentist will also make sure your child's water or vitamin supplements provide the appropriate amount of fluoride. The appropriate dose varies, depending on the child's age, water intake and where you live. Thumb and pacifier habits will be discussed. The pediatric dentist will advise you which habits are age appropriate and which aren't and will offer helpful advice on how and when to deal with harmful habits before they lead to orthodontic problems.

Nursing bottles containing milk or juice are often used by parents as pacifiers. When a young child falls off to sleep with such a bedtime bottle, severe dental decay can result -- most commonly when the child is only 1 or 2 years old. This decay frequently leads to abscess and infection necessitating hospitalization, general anesthesia and multiple extractions and fillings. The pediatric dentist will counsel you about any bedtime or naptime bottle your child may be taking to prevent these all too common consequences.

The most frequent sentiment expressed by parents of young children with serious decay or bite problems who are undergoing extensive dental treatment is regret that nobody gave them preventive information earlier. A visit to the pediatric dentist at age 1 will give you the information you need to avoid many of these problems. It could well turn out to be your child's single most important dental visit of her lifetime -- possibly saving you and your child many less pleasant dental visits later.

Cavity Free Holidays

by Eli C. Schneider, D.M.D.

The holiday season may bring to mind pleasant thoughts of gifts, family and business celebrations, candy canes and sugar plums. However, while parents may be watching out to avoid those unwanted extra pounds, their active children may be retaining not calories but cavities from holiday sweets.

This need not be so, at least as far as the children are concerned. It is possible to indulge the children a bit as long as parents are aware of some important dental health guidelines. Tooth decay is caused by prolonged contact of sugars and even starches with bacteria that are almost always present on the surfaces of everyone's teeth. These bacteria break down food sugars into acids that destroy tooth enamel. They produce cavities if allowed to remain on the teeth for any length of time. Brushing and flossing, of course, are intended to remove this bacterial film known as plaque from the teeth.

The most crucial time to brush and floss is at bedtime when the whole day's accumulated plaque needs to be removed. Studies have shown that decay progresses much more rapidly during sleep because salivary flow is significantly reduced.

But, let's face it. You can't brush and floss your child's teeth every time he or she consumes some sweets. That's why it's critical to think about some other factors that are equally important. The frequency with which your child indulges in sweets, the time of day and the stickiness of the sweets all make a difference. Every time your child has a sweet snack like a cookie or candy, some of that food remains in the mouth adhering to the teeth. The amount that remains is essentially the same whether your child had one cookie or many. Therefore, you create more opportunity for decay by spreading her sweet snacks out in little bits and pieces during the course of the day than by consolidating them into only one or two sessions. The same amount of sweets will present less opportunity for decay if given all at once instead of piecemeal.

In addition, the time of day becomes important. If this one major sweet snacking session is an hour or two before bedtime (when your child's teeth will be brushed anyway), then the bacteria will not get much of a chance to wreak their havoc. However, if this major snacking session was earlier in the day, the bacteria have plenty of time to break down the sweets and to start producing decay causing acids.

The stickiness of your child's snacks is another important factor. The stickier the snack, the more it will adhere to your child's teeth and thus increase the likelihood of decay. The same amount of sugar in liquid form, for example, will leave much less residue on the teeth than in solid form. Similarly, solids like cookies will leave less residue than really sticky sweets like caramels. Sticky, sugary foods don't just have to be gooey candies. They can be apparently healthy things like raisins. They can also be gooey candy masquerading as healthy foods like fruit roll ups. Don't let the word fruit on the label fool you.

Such commonsense guidelines will help parents to control what treats their child eats and when and how frequently she eats them. And, of course, parents should be sure to brush and floss a child's teeth at bedtime. Your dental health gift for your family will be an enjoyable and cavity free holiday season.