Friday, January 11, 2019

Children's Dentistry FAQ

These are a few Frequently Asked Questions we receive regarding children's dental care. We put them to Dr. Derek Martin and these are his answers:

Q: When should a child’s first dental appointment be?

A: In general, the ADA recommends children first be seen by age 1 or within 6 months of their first tooth erupting.

Q: What happens during a child’s first dental appointment?

A: Dental visits in young children are important, not only to examine the eruption and health of the "baby" teeth, but also will serve to build comfort and confidence between your child and the dentist from an early age. We will also have an opportunity to discuss home care, diet, teething habits, and any other concerns or questions the parents may have.

Q: Do children really need x-rays?

A: Dental X-rays are usually not needed in our very young patients, unless there is a specific concern. The first X-rays are taken around 5-6 years old (depending on the child's eruption pattern), or around the time of the first permanent molar eruption. These annual X-rays allow us to monitor the health of the baby teeth and see the underlying permanent teeth in development.

Q: What are sealants? Why does my child need sealants?

Sealants are a thin, plastic coating painted on the chewing surface (grooves) of the teeth. Brushing can not always get in all the "nooks and crannies" of the teeth, and so sealants are very important in "sealing out" food and bacteria that can cause decay.

Q: Why is fluoride recommended for my child’s teeth?

A: Fluoride has been shown to be extremely helpful in reducing tooth decay. Flouride is a naturally occurring mineral, and works in two ways: 1) by making tooth enamel stronger, and 2) by repairing or "remineralizing" enamel that has already been damaged from the acid that bacteria in your mouth release.

Q: Why do baby teeth with cavities need to be fixed?

A: Cavities in baby teeth are usually treated the same way as in adult teeth. Even though all the baby teeth will naturally be lost, it is important to maintain the health of baby teeth because they serve to hold space in the growing jaw, where eventually the adult teeth will erupt. Not only can cavities in baby teeth cause pain (just as in adult teeth), but just as important, if these baby teeth are lost early, issues with spacing/crowding of adult teeth can occur.

Q: When should my child have a consultation for braces?

A: As part of our routine dental exams, we constantly monitor a child's eruption pattern, spacing/crowding, and general tooth-to-jawsize relationship. Recommendations to have your child seen by a braces specialist (orthodontist) can be made anytime depending on the severity of crowding or other issues. However, children with crowding/spacing issues usually visit an orthodontist after the 12-year molars erupt.

Q: When should a baby start getting teeth?

A: Your child's first teeth will usually begin to erupt around 6 months. These are usually the lower central (front) teeth, followed couple of months later by the upper central teeth. However, eruption times and sequence can be different from one child to another. This is usually nothing to be concerned about. Routine, twice-yearly dental exams are important so we can monitor the progress of the baby teeth.

Q: What age should a child start losing baby teeth?

A: Just as with eruption of baby teeth, there is a range in the eruption of "adult" teeth that can vary from child to child. In general, the first "adult" teeth will appear around 6-7 years old. Around this age, the central "baby" teeth will be lost to make room for the "adult" central teeth. You will also begin to see the eruption of the child's first "adult" molar teeth. These teeth do not "replace" baby teeth, so you will see them erupt just behind the child's last "baby" molars on both the top and bottom jaw.

Q: My child’s adult tooth is coming in, but the baby tooth is not out yet. Is this bad?

A: Sometimes, due to the angle of eruption of the adult teeth, a "baby" tooth is not lost prior to the eruption of the same adult tooth. We will monitor as this happens, and often we simply recommend to wait a little longer to allow the baby tooth to naturally shed. As this "waiting game" goes on, there may be a point where removing the baby tooth becomes important for spacing issues.

Our general philosophy with these types of procedures in children is - "less is more". If we can let the mouth naturally do what it's meant to, this is usually the best option for children. If the "baby" teeth are being stubborn for long enough a period of time, we may recommend to gently "wiggle" it out (extract it) in our office.

Q: Should I brush my baby’s teeth?

A: Yes. Brushing your baby's teeth is very important for many reasons: First, it is important from a very young age, to instill good home-care habits in children, so when they mature into adolescence and adulthood, they continue good oral hygiene on their own. Second, maintaining the health of the baby teeth is important so that these teeth can be shed naturally and maintain space for the adult teeth in the child's growing jaw.

If your baby doesn't have teeth yet, take a damp cloth and rub it along the gums. Once the first teeth come in, we can give you an appropriately sized toothbrush. Fluoridated toothpaste should not generally be used until the child can spit it out. However, it's still important to regularly brush your child's teeth until they are old enough to do so themselves.

We hope you find this information helpful. If you ever have any questions or concerns about your child's oral health please give us a call and any of our dentists will be happy to consult with you.

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