What is a Pediatric Dentist?

Children present a very unique set of physical and emotional traits when compared to adults.  They are constantly growing and changing.  They have different needs and encounter different problems.  A pediatric dentist is specially trained to manage these differences, much like the way a pediatrician is trained after medical school to care for children.  After completing dental school, pediatric dentists go on to train for an additional 2-3 years to learn all the unique needs of children, and how best to manage them.  Their expertise includes things like how to manage the behavior of young children, how best to care for children with special health care needs, how to manage dental injuries and trauma, and how to prevent dental disease starting at a very early age while giving them a positive association with going to the dentist.

How early should I bring in my child?

We feel very strongly that every child should visit the dentist at a very early age.  There are many reasons for this, but none more important than teaching a child not to fear the dentist.  The younger a child is when introduced to the dental office, the easier it is for them to develop a positive association with it.  Another very important reason is the chance we can detect and manage early signs of oral disease or abnormalities before they become a more difficult problem to solve.  Last, it provides parents with the resources and education to give their child the very best chance of growing up with a bright and healthy smile.  Reasons like these have lead the most respected professional organizations, including the American Academy of Pediatric Dentistry, American Academy of Pediatrics, and the American Dental Association, to recommend that a child makes their first trip to the dentist by his/her 1st birthday.  Since it is highly variable when kids will get their first teeth, a better gauge is to schedule an appointment 6 months after the first teeth come in.  For most this is between 1 and 1 and a half years old.

Why are the baby teeth important?

All teeth are important whether they will fall out or not.  If teeth are not cared for, they will become diseased with cavities and can lead to significant pain, infection, and swelling.  These problems can even lead to a child being hospitalized, like the child pictured.  Studies have also shown that children with dental disease do not perform as well in school due to pain, lack of sleep, and inability to eat due to their dental pain.  Baby teeth are also very important for guiding the permanent teeth into the correct position.  If baby teeth are lost before they are ready to fall out because of dental disease, this can lead to spacing problems that require expensive and lengthy orthodontic treatment with braces.  This treatment may not have been needed if the baby teeth were properly cared for from the beginning.   For these reasons, we strongly encourage parents to care for their child’s teeth so they can grow and develop a healthy smile, and have a positive association with the dentist that will ensure they move into adulthood knowing how important oral health is and taking the steps to continue that throughout life.

When will my child’s teeth come in?

Typically, children start getting teeth between 6 and 12 months of age.  By the time they are three, they usually will have all 20 baby teeth.  It is important to begin brushing your child’s teeth as soon as they grow in to the mouth, since the germs that cause cavities can begin to colonize the mouth once teeth are present.

What should I do in a dental emergency?

• Toothache: Teeth can be painful for many reasons, but it is usually an indication that there is active disease in your child’s tooth that needs to be taken care of as soon as possible.  If left untreated, a toothache can progress to an abscess and infection, potentially spreading beyond the mouth causing significant swelling and illness.
• Dental/facial trauma:
  • Chipped/Broken Tooth: Depending on the extent of injury, this can cause a very sensitive tooth.  It can occasionally result in the nerve becoming infected.  This is a condition that should be discussed with our office as soon as possible to determine the appropriate course of action.
  • Knocked out permanent tooth: This is a very serious emergency that requires IMMEDIATE treatment!  If the tooth is recovered and in one piece, the best chance it has of surviving is to immediately replace it in the place it came from.  To do this, do not handle the tooth by the root (the part above/below the gum line).  If there is visible dirt and debris, rinse it under water while holding it by the crown (the part of tooth visible in the mouth).  Then, using firm and quick pressure, place it back in to the hole it came from.  Bite lightly on a washcloth, cotton rag, etc. to hold it in place.  Phone our office immediately.

• Knocked out baby tooth: There is no chance to save a baby tooth once it had been knocked out.  Do not attempt to replace it, as it may cause damage to the permanent tooth that will replace it as your child gets older.  Call our office as soon as possible to discuss the best way to care for this.
• Cut or Bitten cheek, tongue, lip, gums: Apply pressure to stop or slow the bleeding. If the wound is severe or doesn’t stop bleeding within 60-90 minutes, call our office or go to the Emergency Room at the hospital immediately. The wound may require stitches to stop the bleeding, prevent infection and to help it properly heal.
• Swelling/Abscess: This is a sign of an infected tooth or gums.  It will require treatment to heal the infection.  Treatment possibilities include the use of antibiotics to control the spread of infection, and removal of the diseased tooth/teeth.
• Bleeding: Some bleeding is to be expected after having a tooth removed, and may occasionally occur after cavities have been fixed with fillings or silver crowns.  If unusual or sustained bleeding occurs (more than 60 minutes), place cotton gauze firmly over the bleeding area and bite down or hold in place for fifteen minutes.  Repeat as necessary.  This can also be accomplished with a tea bag.  Tea has blood-clotting properties and has been used for many generations to treat excessive bleeding.

Is the radiation from the x-rays dangerous?

Not according to any scientific research.  It is true that radiation exposure on a large scale can have adverse health effects.  However, the radiation exposure from dental x-rays is significantly less than the amount of radiation we are naturally exposed to in everyday life.  We use the latest digital x-ray technology at Greenlake Kids Dentistry, which further reduces the radiation exposure when compared to the conventional film techniques.  In numeric terms, the standard x-ray examination of 4 x-rays taken twice per year is equivalent to 0.8% of the natural radiation we are exposed to each year in the U.S. (Source: Oral Radiology: Principles and Interpretation, 3rd Edition, Mosby – Year Books, Inc)

Do you use mercury in your fillings?

Not routinely.  There is an occasional situation where the silver amalgam fillings are the standard of treatment, but we routinely use other materials that are better suited to the unique needs of our pediatric patients.

What is nitrous oxide and how do you use it?

Nitrous Oxide is a medical gas used in combination with oxygen to produce a mild sedative effect in young and fearful patients.  Of all the medical gases used in anesthesia today, nitrous oxide is considered significantly more safe to use and much easier to recover from.  We find great success using this method of sedation with patients that show some fear, anxiety or apprehension related to receiving dental treatment.