Prevention is an important focus and one of the most important aspects of preventing or minimizing tooth decay, destruction, infection, pain, tooth loss and improper eruption of permanent teeth. The ADA recommends that children be seen by a dentist at 1 year of age, or 6 months after their first tooth has erupted. By the age of three, most children have 20 teeth often referred to as “baby teeth.” Children are born with these teeth, although they do not appear until several months of age. Although these teeth will eventually fall out – usually beginning around the child’s sixth birthday – they are still susceptible to decay until that time. During childhood, the dentist will inspect the baby teeth for cavities and signs of decay, as well as ensure the teeth are erupting normally and the skeletal structure is developing adequately to house the teeth. As the child grows, dental visits continue according to a schedule determined ty the dental care providers.
What to Expect
The hygienist will teach you about tooth eruption patterns, how to clean your child’s teeth, proper diet and determine whether fluoride treatment should be considered to strengthen the teeth. Tooth eruption charts are complimentary. The dentist will assess growth, development and general oral health. X-rays of the teeth are usually performed at age 3-4, depending upon the health status of the child at examination. Toothbrush cleanings are usually performed at the young initial exam, progressing to the polisher as allowed by the child. Careful hand cleaning called “instrumentation” usually begins at age 4-5.
Patients are also instructed on proper home dental care and advised of day-to-day habits that could cause early decay and adverse changes in skeletal development. Caution may be given about:
- Pacifier use beyond age of 2 years old
- Thumb, finger or blanket sucking
- Sending children to bed with bottles or sugary beverages
- Using fluoridated toothpastes prior to age of two
- Speech development and tongue thrusting habits
- Monitoring verses treating improper frenulum attachments
Our goal is not only to monitor and ensure dental health for your child, it is also to create a positive dental experience. A tour of the office, a ride in the chair, a new toothbrush & tooth timer, watching a favorite movie on a screen above the chair, (painting fingernails or placing temporary tattoos have even been encountered), and a trip to the toy machine sets the stage for enjoyable healthy trips to the dentist for a lifetime. At-home dental care is equally important as visiting the dentist on a regular basis. Even before the teeth erupt in a child’s mouth, the gums should be gently washed each day. Twice-daily brushing should begin as soon as the teeth break through the gums although the teeth may initially be cleansed using water, rather than toothpaste.
As the child gets older, it is safe to begin using children’s toothpaste as recommended by the dental provider. Children need assistance and monitoring for thorough tooth brushing until the age of 11. It is recommended that they brush for 2 minutes, alternating areas of the toothbrush. Colored mouth rinses are available over the counter that can indicate areas that plaque remains on the teeth. This is a good teaching tool to use as soon as the child has learned how to expectorate (spit.) We have found that children enjoy learning how to brush their teeth in the shower. They spend more time brushing and aren’t as messy in the bathroom! Don’t forget to floss,….their teeth are often prone to decay “in between the teeth” where the toothbrush can’t reach.
Sealants are thin layers of resin that are painted on the pits, fissures, and grooves of permanent molars to prevent decay on these surfaces. The majority of decay on back teeth starts in the grooves and pits of chewing surfaces, especially during the first few years after their eruption. Sealing these surfaces with composite resins prevents this kind of decay. Sealants are one of the most effective methods of preventing decay on the surfaces where they are placed. Although it is still a possibility that decay may develop on surfaces in-between teeth, sealants significantly reduce the overall chance of having cavities.
Treating Decay in Children
If decay (cavity) is found in a child’s mouth, it is very important to have it treated quickly. Primary (baby) teeth are smaller and have a much softer/thinner layer of protective enamel than adult teeth, allowing acids and plaque to dissolve portions of the enamel and allowing infection to enter into the tooth causing a hole or “cavity.” Decay is an infection caused by Streptococcus mutans bacteria. It cannot be brushed away or treated with antibiotics. Once the surface is damaged, it must be repaired by the dentist, it cannot heal. Cavities in teeth continue to enlarge and can enter into the nerve chamber (the pulp), causing pain and infection (eventually abscess), tooth loss and overall ill health of the child. Baby teeth are important for chewing but also hold space and function as a road map for adult teeth to erupt properly. Early loss of a baby tooth can cause changes in the bite leading to a lifetime of consequences. The cavity is filled with a strong white composite restoration.
Comfortable Pediatric Dentistry
Going to the dentist can be stressful for a child. We strive to make the visit as pleasant, playful and fun as possible. We are trained with many techniques that keep the visit as stress free and comfortable as possible. Using gentle language, tell-show-do techniques, answering questions, play therapy, headphones and movies, pre-numbing jelly prior to gentle slow injections (by the magic wand) if needed, nitrous oxide laughing gas, pillows and blankets, kind touch with lots of hugs help children cope with the experience quite well. In some situation, mild intravenous sedation may be an option. We follow a well-tested protocol that is safe and effective. Our dental anesthesiologist uses top quality monitoring equipment and our doctors have advanced training in emergency preparedness.