Pediatric Dentistry

WE WOULD LOVE TO MEET YOUR KIDS!!

WHEN Should I Bring My Child to the Dentist?

The ADA recommends a child should have their visit dental visit at age 1.  The primary purpose of this visit is aclamation.  Many children associate trips to any doctor with vaccinations, by bringing a child in early we can help them RELAX.  At this appointment, we will ensure that everything is developing normally and help them get acquainted with the office, their doctor, and their hygienist.  Typically, this first exam is done while your child sits on your lap.

You can help prepare your child for this visit by using positive language about the dentist when talking to your child.  If you are afraid of the dentist, try not to share your fears with your child. 

At this age, the child only needs to visit us once a year.  But once their permanent teeth start to erupt (usually at age 6), the child should start to have regular check-ups and cleanings every 6 months.  Many children develop their teeth earlier or later than the averages (see chart below) or at a different rate than their siblings.  ASK US if you have concerns.  Also, a child's baby teeth often have spaces.  This concerns many, but is a good thing!  These spaces (called primate spaces) allow room for the permanent teeth to erupt.

 Begin cleaning your child's teeth as soon as they erupt, by wiping teeth and gums with a clean, damp washcloth or a very soft infant toothbrush.  If your child takes a bottle to bed, put only water in the bottle.  Putting a child to bed with a bottle containing milk or juice, can easily lead to large amounts of decay commonly called baby bottle tooth decay.  This is a serious condition that can destroy your child's teeth.  It occurs when teeth are exposed, frequently and at length to liquids that contain even small amounts of sugar.

What Causes Cavities?

Our number one enemy in the fight against cavities is plaque.  Plaque is a sticky film of food and bacteria that forms constantly even on baby teeth.  This bacteria thrives on the sugar in food, and produce acid as a by-product when they break down sugar.  Like all acids, the acid produced by the bacteria is corrosive, which means that it dissolves other materials: In this case, dissolving enamel, causing a cavity.  Regular check-ups and dental sealants are effective ways to prevent or detect cavities early!

What are dental sealants?
Dental sealants are plastic coatings that are usually placed on the chewing (occlusal) surface of the permanent back teeth — the molars and premolars — to help protect them from decay.

Why are dental sealants placed on teeth?
The chewing surfaces of the molar and premolar teeth have deep grooves — "fissures" — that make them vulnerable to decay. These fissures can be deep, are difficult to clean, and can be narrower than even a single bristle of a toothbrush. Plaque accumulates in these areas, and the acid from bacteria in the plaque attacks the enamel and cavities can develop. Fluoride helps prevent decay and helps protect all the surfaces of the teeth, dental sealants provide extra protection for the grooved and pitted areas by providing a smooth surface covering over the fissured area. 

When are dental sealants placed?
The first dental sealant to be placed is usually on the fissure of the first permanent molar tooth, once the chewing surface of the tooth has erupted completely beyond the gum. This tooth grows in behind the baby teeth. If the chewing (occlusal) surfaces of these teeth are sealed, the dental sealant will help protect the tooth. Except for the wisdom teeth, which come through much later, the molars and premolars continue to erupt until eleven-thirteen years of age and the chewing surfaces of these teeth can be sealed after they have erupted beyond the gum.

Are dental sealants only placed on the chewing surface of molar and premolar permanent teeth?
Dental sealants are usually placed on the chewing surfaces of these teeth because these are the areas and teeth that typically have deep fissures. Dental sealants are sometimes also used on other permanent teeth if they have grooves or pits, to help protect these surfaces. In some children, the molars in the primary dentition (baby teeth) also have grooves that could benefit from dental sealants and in this situation we may recommend dental sealants on the chewing surfaces of these primary teeth.

What do dental sealants look like?
Dental sealants can be clear, white or have a slight tint depending upon the dental sealant used.

How are dental sealants placed?
Firstly the tooth surface is thoroughly cleaned with a paste and rotating brush by your dentist or hygienist.  Next the tooth is washed with water and dried. Then a solution that is acidic is placed on the fissured area of the tooth’s chewing surface for a number of seconds before being rinsed off. This creates a rougher surface that enables the dental sealant to attach to the tooth. After the tooth is dried again, the liquid dental sealant is placed on the tooth and hardened. Dental sealants are hardened by using a light that hardens the dental sealant. Once the dental sealant has hardened it becomes a hard plastic varnish coating, and you can chew on the tooth again.

How long does a dental sealant last?
Dental sealants can last many years. However, due toa child's bite and dietary habits, they may wash out prematurely.  If necessary, it is also possible to place a new dental sealant on the tooth. 

Do I still need to use fluoride if I have dental sealants?
Yes. Dental sealants only protect the surface area that they are placed on. Fluoride helps protect all the surfaces of the tooth from decay and cavities.

What is Fluoride?
Fluoride is a naturally occurring element that can help to prevent tooth decay by strengthening teeth. Experts say the best way to prevent tooth decay is to use several sources of fluoride.

Fluoride is found naturally in water sources in small but traceable amounts, and in certain foods such as meat, fish, eggs and tea. Fluoride also is added to water in some areas and to toothpastes, rinses and professional treatments. 

What It's Used For
Enamel, the outer layer of the crown of a tooth (the visible part), is made of closely packed mineral crystals. Every day, minerals are lost and gained from inside the enamel crystals through processes called demineralization and remineralization. Demineralization occurs when acids, formed from the combination of plaque bacteria and sugar in your mouth, dissolve the crystals and the spaces between them. But this process is balanced by remineralization, in which minerals such as fluoride, calcium and phosphate are deposited inside the enamel, building it back up. Too much demineralization without enough remineralization to repair the enamel leads to tooth decay.

Fluoride strengthens teeth by helping to speed remineralization and disrupt the production of acids by bacteria. Fluoride can be incorporated into teeth in two ways. When children swallow fluoride in small doses (through food, supplements or fluoridated water), it enters the bloodstream and becomes incorporated in their developing permanent teeth, making it harder for acids to cause demineralization. Fluoride also can enter teeth directly in the mouth when it is applied at the dental office, when you brush with fluoride toothpaste or use a fluoride rinse and when fluoridated water washes over your teeth as you drink.

Fluoride treatments commonly are given to children as their teeth are developing. If your child has a history of cavities or is at high risk of decay, he or she should use additional fluoride to promote remineralization. Often, children get fluoride treatments every six months for extra protection against cavities, even if they already drink fluoridated water.

If your child has a history of cavities or is at high risk of decay, he or she should use additional fluoride, such as fluoride mouth rinses, to promote remineralization. These rinses, recommended for children over the age of 6, are found in the mouthwash section of most stores. Prescription fluoride rinses and gels that provide a higher level of fluoride also are available (such as MI Paste or Prevident).

Fluoride treatments help all teeth and help to prevent decay in both children and adults. Anyone who is at risk of dental decay is a good candidate for fluoride treatments. Factors that increase the risk of tooth decay include a history of cavities, poor enamel development, infrequent dental visits, poor brushing habits and dietary factors, especially frequent snacking.

Preparation
Before you have an in-office fluoride treatment, your teeth should be clean. Before using fluoride rinses or gels at home, thoroughly brush and floss your teeth. It's a good idea to use fluoride products at night before bedtime so there is less opportunity for them to be washed or rinsed away.

How It's Done
The fluoride treatments you receive in a dental office have a higher concentration of fluoride than over-the-counter fluoride mouthwash or toothpaste. They are used for both children and adults. Dental-office treatments also are different chemically and stay on the teeth longer.

Fluoride is applied as a foam or varnish during a dental appointment. The teeth are dried so the fluoride doesn’t become diluted. Fluoride can be applied by using a tray that looks like a mouth guard for one to four minutes. Fluoride also can be painted directly on the teeth. It comes in a variety of flavors, but it should never be swallowed.

Everyone should use fluoridated toothpaste. Be careful with young children because they are more likely to swallow the toothpaste instead of spitting it out. Use only a pea-sized amount of toothpaste when they brush, and encourage them to spit out as much as possible. Avoid flavored toothpastes that may encourage swallowing.

When used properly, fluoride is safe and effective. Young children, in particular, should be supervised during in-office treatments and when using fluoride products at home. If too much fluoride is swallowed, young children may become nauseous. Also, too much fluoride can cause spots to form on the enamel of any developing teeth. These spots will be visible when these teeth erupt into the mouth.  ASK US if you have concerns!

How do I Know if My Child and I Are Getting Enough Fluoride?
If your drinking water is fluoridated, then brushing regularly with a fluoride toothpaste is considered sufficient for adults and children with healthy teeth at low risk of decay.  CHICAGO does have fluoridated water.  However, increased supplementation may be needed if you routinely drink bottled or filtered water.  Over the counter fluoride rinses such as ACT or we may even recommend the use of prescrition pastes such as Prevident or MI Paste to help protect your teeth from decay.

Does My Child Need a MOUTHGUARD?

The majority of mouth injuries occur in children between the ages of seven and fourteen, while they are just joining a team or engaging in only casual sports for fun.  Any activity that could result in a fall or a blow to the head puts your child at risk for mouth injuries.  Mouthguards can help protect your children from these expensive and painful injuries.

Custom-made mouthguards fit better and will help your child wear their guard more often and protect their smile!  In fact, recent research indicates that over the counter mouthguards do little to protect your child's teeth at all.