Frequently Asked Questions

1.  Why should my child see a dentist at one year of age?

The one year / first dental visit will include:

• Evaluation of the child: growth, habits, abnormalities or disease
• Risk assessment for future problems: growth expectations and future cavities
• Preventive information for the parent: oral hygiene techniques and responses to dental injuries
• Responses to parents’ questions.

2.  Until what age should I help my child with brushing of his or her teeth?  Should I be flossing my child’s teeth?        

Brushing: help until about 6 years of age or when they can print clearly or tie their shoelaces.  Monitor after that time.  Remember to use only a pea-sized amount of toothpaste for preschool children.

Flossing: begin when teeth are in contact and done by the parent until about 8 years or when the child can write script (cursive) clearly .   Monitor after that age.

Help may be needed beyond these ages with both procedures if the children are wearing braces or space maintainers.

3.  I am confused about fluorides.    What should be given to my child. What does it do for the teeth?

Fluoride taken systemically or internally aids in the development of teeth.  It should be available from 6 months of age until the mid-teens.  Systemic use also provides fluoride in the saliva which is used for remineralizing tooth surfaces.   The best and least expensive delivery is via water fluoridation, but prescription tablets or drops are appropriate when fluoridated water is not available.

Topical fluorides should be used in toothpaste after age 2.  Only a pea-sized portion of toothpaste should be used by preschool children. This may be supplemented by rinses, gels and varnish which are higher dose applications.  Topical fluoride use should continue throughout your child’s lifetime.

What it does: fluorides help in the formation of larger and more acid resistant crystals in the enamel and dentin layers of the tooth.  Topical and systemic applications remineralize and strengthen areas weakened by foods, acids and bacteria.                                                     

4.  My child sucks a pacifier.  Is that worse than thumb sucking? At what age will this sucking begin causing problems?

All non-nutritive sucking may have an effect on facial / oral growth by distorting bones and modifying the relationship of the upper to lower teeth.  These effects tend to vary with duration, frequency and strength of the sucking habit.  However, pacifier sucking is generally much easier to halt at about age 2-3 years and rarely reverts to thumb / finger sucking.  In addition, the American Academy of Pediatrics encourages pacifier sucking at bedtime for the first year of like as this seems to reduce breathing problems associated with some sleeping positions and the possibility of SIDS.        

5.  Why does the dentist want to take x-rays when there are no cavities? 

A thorough examination cannot be done by simply looking at the teeth.  In dentistry, diagnosis also involves an evaluation of the areas between the teeth as well as an assessment of the child’s newly formed and unerupted teeth.  For these reasons, x-ray images are necessary. 
The amount of radiation exposure is very minimal.  The frequency of x-rays is limited and dependent on the child’s cavity history.  In addition, future cavity risk and any abnormal growth or trauma (accident) findings will determine the need for x-rays.         

6.  Why fix baby teeth?    Aren’t they going to fall out soon? 

Primary teeth are present for a great deal of the child’s growing period, some until the child is 12 years old.  Cavities can lead to pain, infection and lack of proper function and eating, as well as cavities on the adjacent permanent teeth.  These permanent first molars are often erupting by age 6.     

7.  Do sealants really work to prevent cavities? 

Sealants are very effective in preventing cavities because they block the collection of food and bacteria on the grooved surfaces of the back teeth.  They are not useful between the teeth and therefore flossing is needed in those areas.  Sealants are particularly effective on first permanent molars when applied  shortly after their eruption, which is usually at the age of 6.  The sealants are applied in a “non-invasive”, bonded manner to these surfaces, may be easily evaluated or reapplied, and are relatively inexpensive.          

8.  My child has crooked (or crowded teeth).  When should he or she be seen by an orthodontist?

Pediatric dentists are knowledgeable about early growth and can evaluate eruption of the primary teeth.  At rare times, early orthodontic analysis and intervention is needed prior to age 6.  As permanent teeth erupt (mixed dentition), a full growth space and positional) evaluation may be indicated.  This is generally done after 7 or 8 years of age.    

9.  How do you obtain cooperation from a very young child who needs treatment? 

A v ariety of techniques are available and their use is dependent on the child’s age and developmental abilities.  These techniques include attention getting and word selection choices, distraction and sequential explanations, and demonstrations (“tell, show, do”).  At times, holding or restraining the child may be necessary for an adequate examination.  This is often done in a position or manner similar to those used by the pediatrician for a physical examination or short procedure.  For young children, cooperation for more extensive treatment often requires distraction techniques such as talking, storytelling and listening to music or stories.  These approaches may be enhanced by the use of nitrous oxide or selective medications. Restraint or sedation-anesthesia may be indicated when complex treatments require levels of cooperation similar to those needed for medical or surgical procedures such as ear tube placement.  A thorough discussion and selection of the appropriate choices for your child should precede any treatment.            

10. What should be done if my child has an accident (that breaks or displaces a tooth)?

Accidents may occur at any age and the severity may be difficult to determine at the time of injury.  In general, stabilize your child to prevent further immediate injury and call the dental office (or answering service if it is outside of normal office hours) for specific advice concerning your child’s problem.  Time may be of critical importance.  Try to speak with the dentist as soon as possible so that your child may receive the appropriate care in a timely manner.