Frequently Asked Questions About Pediatric Denistry
What Is A Pediatric Dentist?
The pediatric dentist has an extra two to three years of specialized training after dental school and is dedicated to the oral health of children from infancy through the teenage years.
The very young pre-teens and teenagers all need different approaches in:
Dealing with their behavior
Guiding their dental growth and development
Helping them avoid future dental problems
The pediatric dentist is best qualified to meet these needs.
When Will My Baby Start Getting Teeth?
Teething, the process of baby (primary) teeth coming through the gums into the mouth, is variable among individual babies.
Some babies get their teeth early, and some get them late.
In general:
The first baby teeth to appear are usually the lower front (anterior) teeth
They usually begin erupting between the ages of 6-8 months
See “Eruption of Your Child’s Teeth” for more details.
Why Are The Primary Teeth Important?
It is very important to maintain the health of the primary teeth.
Neglected cavities can and frequently do lead to problems that affect the development of permanent teeth.
Primary teeth, or baby teeth, are important for:
(1) Proper chewing and eating
(2) Providing space for the permanent teeth and guiding them into the correct position
(3) Permitting normal development of the jaw bones and muscles
Affecting the development of speech
Adding to an attractive appearance
While the front 4 teeth last until 6-7 years of age, the back teeth (cuspids and molars) aren’t replaced until age 10-13.
Eruption Of Your Child’s Teeth
Children’s teeth begin forming before birth.
As early as 4 months:
The first primary (or baby) teeth to erupt through the gums are the lower central incisors
Followed closely by the upper central incisors
Although all 20 primary teeth usually appear by age 3, the pace and order of their eruption varies.
Permanent teeth begin appearing around age 6:
Starting with the first molars and lower central incisors
This process continues until approximately age 21
Adults have:
28 permanent teeth
Or up to 32, including the third molars (or wisdom teeth)
What’s The Best Toothpaste For My Child?
Tooth brushing is one of the most important tasks for good oral health.
Many toothpaste and/or tooth polishes, however, can damage young smiles.
They contain harsh abrasives, which can wear away young tooth enamel.
When looking for a toothpaste for your child:
Make sure to pick one that is recommended by the American Dental Association, as shown on the box and tube
These toothpastes have undergone testing to ensure they are safe to use
Remember:
Children should spit out toothpaste after brushing to avoid getting too much fluoride
If too much fluoride is ingested, a condition known as fluorosis can occur
If your child is too young or unable to spit out toothpaste, consider:
Providing them with fluoride-free toothpaste
Using no toothpaste
Using only a “pea-sized” amount of toothpaste
Does Your Child Grind His Teeth At Night? (Bruxism)
Parents are often concerned about the nocturnal grinding of teeth (bruxism).
Often, the first indication is:
The noise created by the child grinding on their teeth during sleep
Or, the parent may notice wear (teeth getting shorter) to the dentition
One theory as to the cause involves a psychological component:
Stress due to a new environment, divorce, changes at school, etc., can influence a child to grind their teeth
Another theory relates to pressure in the inner ear at night:
If there are pressure changes (like in an airplane during take-off and landing, when people are chewing gum, etc., to equalize pressure), the child will grind by moving his jaw to relieve this pressure
The majority of cases of pediatric bruxism do not require any treatment.
If excessive wear of the teeth (attrition) is present, then a mouth guard (night guard) may be indicated.
The negatives to a mouth guard are:
The possibility of choking if the appliance becomes dislodged during sleep
It may interfere with the growth of the jaws
The positive is obvious:
By preventing wear to the primary dentition
The good news is:
Most children outgrow bruxism
The grinding decreases between the ages of 6-9
Children tend to stop grinding between the ages of 9-12
If you suspect bruxism, discuss this with your pediatrician or pediatric dentist.
What Is Pulp Therapy?
The pulp of a tooth is the inner, central core of the tooth.
The pulp contains:
Nerves
Blood vessels
Connective tissue
Reparative cells
The purpose of pulp therapy in Pediatric Dentistry is to maintain the vitality of the affected tooth (so the tooth is not lost).
Dental caries (cavities) and traumatic injury are the main reasons for a tooth to require pulp therapy.
Pulp therapy is often referred to as:
“Nerve treatment”
“Children’s root canal”
“Pulpectomy”
“Pulpotomy”
The two common forms of pulp therapy in children’s teeth are pulpotomy and pulpectomy.
A pulpotomy removes the diseased pulp tissue within the crown portion of the tooth. Next, an agent is placed to prevent bacterial growth and to calm the remaining nerve tissue. This is followed by a final restoration (usually a stainless steel crown).
A pulpectomy is required when the entire pulp is involved (into the root canal(s) of the tooth). During this treatment, the diseased pulp tissue is completely removed from both the crown and root. The canals are cleansed, disinfected, and, in the case of primary teeth, filled with a resorbable material. Then, a final restoration is placed. A permanent tooth would be filled with a non-resorbing material.
What Is The Best Time For Orthodontic Treatment?
Developing malocclusions, or bad bites, can be recognized as early as 2-3 years of age. Often, early steps can be taken to reduce the need for major orthodontic treatment at a later age.
Stage I
Early Treatment: This period of treatment encompasses ages 2 to 6 years. At this young age, we are concerned with underdeveloped dental arches, the premature loss of primary teeth, and harmful habits such as finger or thumb sucking. Treatment initiated in this stage of development is often very successful, and many times, though not always, can eliminate the need for future orthodontic/orthopedic treatment.
Stage II
Mixed Dentition: This period covers the ages of 6 to 12 years, with the eruption of the permanent incisor (front) teeth and 6-year molars. Treatment concerns deal with discrepancies in jaw relationships and dental realignment problems. 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.
Stage III
Adolescent Dentition: This stage deals with the permanent teeth and the development of the final bite relationship.
