DFC FAQs & Links

As a parent, you likely have many questions about our practice and our approach to children’s oral health care — especially if your child is visiting for the first time. That’s why DFC has assembled a list of FAQs and links in Weymouth, MA, for your convenience. You can find our pediatric dental FAQs here and our orthodontic FAQs here. For all other questions, feel free to reach out to our staff.

Pointers for Parents About Your Child’s First Visit

Boy Sitting At His Desk Smiling

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. Here are some tips we’ve found useful when it comes to helping him or her develop good lifelong oral care habits:

• 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.

• 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.

Articles of Interest

Amalgam vs. Composite Restorations

For more than 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.

Child With Mouth Open in Dentist Chair

Since the 1960s, 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 costlier 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 help 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 than 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 DFC, 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 or her own decision.

Preventing Sports Injuries

Young Boys on a Baseball Team

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 mouthguard.

A mouthguard 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 mouthguard helps prevent laceration and bruising.

A mouthguard 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 mouthguards. When choosing one, remember that a mouthguard should be flexible, comfortable, durable, odorless, tasteless, and easy to clean. A mouthguard should fit properly so that it protects your child’s mouth, but does not interfere with breathing or speaking.

The least expensive mouthguard 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 mouthguards 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 mouthguard is also sold in sporting goods stores. They’re called “boil-and-bite mouthguards” because they’re softened in boiling water and then formed to fit your child’s mouth. This type of mouthguard 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 mouthguard 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 mouthguard custom-made, the value is obvious.

Whatever type of mouthguard you choose, your child should wear it for any activity in which there is a chance of contact with other participants or hard surfaces. Mouthguards 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 mouthguard is a necessity. Half of all dental injuries can be prevented, and a mouthguard is an important aid in protecting your child’s teeth, face, and mouth.

1st Year Milestones by Eli C. Schneider, DMD

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.

Baby Squinting While Smiling

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 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 the 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 one or two 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 one 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, DMD

Boy Giving Thumbs Up in Dentist Chair

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 the 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 opportunities 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 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.