Below are common questions and our answers about the best way to care for children’s teeth.

Office Visits:

The American Academy of Pediatric Dentistry (AAPD) recommends that you bring your baby in for a visit within six months of the first tooth’s eruption. This visit usually takes place around their first birthday. Because decay can occur in even the smallest of teeth, the earlier your baby visits us, the more likely they may avoid getting cavities. We’ll also look for any other signs of early problems with your baby’s oral health such as frenum attachments that may prevent your baby from eating properly.

All dental specialists (pediatric dentists, orthodontists, oral surgeons, and others) begin by completing dental school, then continuing their education with several years of additional specialized training. During training in the field of pediatric dentistry, pediatric dentists gain extensive knowledge and experience in treating infants, children, and adolescents. Our pediatric dentists enjoy working with children and bring to each patient their expertise in childhood development and behavior.

Because our office is geared toward young visitors, you’ll find that our staff, office design, decorations, and activities all work together to provide an especially friendly and comfortable environment for children. While the first visit typically consists of a comprehensive exam, x-rays if needed, and cleaning, the process is simple for your child. The doctor will check your child’s teeth for placement and health and will look for any potential problems with the gums and jaw. We will also answer any questions you have about how to care for your child’s teeth as they develop and provide you with materials containing helpful tips that you may refer to at home.

The best preparation for your child’s first visit to our office is promoting a positive attitude. Let your child know that it’s important to keep their teeth and gums healthy and that the doctor will help them do that. We also encourage your child to bring their favorite stuffed animal or toy with them to this new experience in order to bring them additional comfort. Remember that your dentist is specially trained to handle fears and anxiety, and our staff excels at putting children at ease during treatment.

If your child is curious of what happens at their first visit, you can use the following child-friendly dental terminology to help prepare them:

Dental Terms       Child-friendly Terms

Plaque/Tarter      Sugar Bugs

Polisher               Spin Brush/”sparkling” your teeth

Suction                Mr. Thirsty

X-rays                 Pictures

Exam                  Counting Teeth

Fluoride              Tooth Vitamins

Check-up exams and cleanings are recommended every six months for children who are able to maintain healthy dental hygiene. Depending on the circumstances of your child’s oral health, such as higher amounts of tartar and plaque build-up or orthodontic appliances, we may recommend more frequent visits. Your child will receive a toothbrush grade to allow you to help track and monitor the success of your child’s dental hygiene.

For our patients that need additional oral hygiene instructions, we offer a special cleaning visit three months after their regular visit called a self-prophy. Patients will get dedicated one-on-one time with one of our specially trained hygienists in order to identify any difficulties your child may have with keeping up with their dental hygiene. Your child will bring their toothbrush and home oral hygiene products to learn with our hygienists how to carry on daily home care for a successful dental future.

Thumb-sucking and Pacifiers:

Most children begin sucking their thumb or finger from a very young age; many even start inside the womb. Sucking is a natural reflex for an infant and serves an important purpose such as in some children providing a sense of security and contentment. It can also be relaxing which is why many children suck their thumbs as they fall asleep.

According to the American Dental Association (ADA), most children stop thumb-sucking on their own between the ages of two and four. They simply grow out of a habit that is no longer useful to them. However, some children continue sucking beyond the preschool years. If your child is still sucking their thumb when permanent teeth start to erupt, it may be time to take action to help them to break the habit.

Thumb-sucking or using a pacifier may affect your child’s dental development and/or oral health, however every child is different. We can help you assess your child’s needs during their check-up visits. For thumb-suckers, take note of how your child sucks their thumb. If they suck passively with their thumb gently resting inside their mouth, they are less likely to cause damage. If, on the other hand, they are an aggressive thumb-sucker, placing pressure on the mouth or teeth, the habit may cause problems with tooth alignment and proper mouth growth. For children using pacifiers, the type of pacifier that is used is critical in helping the mouth form correctly as your child is growing. Extended sucking of a thumb or pacifier may lead to a need for orthodontic treatment in the future.

There are two brands of pacifiers that can have a decreased effect on your child’s dentition. The NUK has an orthodontic nipple (slightly flattened on the bottom) in order to allow for greater healthy tongue movement. The MAM is made of an ultra soft silicone material that flattens when used allowing for less resistance. Both of these brands are recommended for the most optimal outcome when using a pacifier.

Always be supportive and positive and give praise when they are not engaged in sucking their thumb or pacifier.

For thumb sucking:

Try placing a bandage on their thumb or a sock over their hand at night. Encourage them that it is just a way to help him remember to avoid sucking. If you notice your child sucking when they’re anxious, work on alleviating their anxiety rather than focusing on the thumb-sucking.

For pacifiers:

Slowly decrease the amount of time your child has their pacifier. If you begin to see that they begin thumb-sucking, give them back their pacifier until a time that they do not form a new sucking habit in its place.

Start a progress chart and let them put a sticker up every day that they don’t suck their thumb or pacifier. Choose your incentives and rewards to reflect the progress you would like to make. If they make it through a week without sucking, they may get to choose a prize (trip to the zoo, new set of blocks, etc.) When they have filled up a whole month, reward them with something great (a ball glove or new video game); by then the habit should be over. Making your child an active participant in their treatment will increase their willingness to break the habit.

Allow us to help in your progress if needed. Please let us know ahead of time if there is any verbiage we need to use during your child’s check-up appointments such as “pacifier fairy” to allow us to support you and your child.

Cleaning and Exams:

We offer a fluoride varnish to all of our patients at their cleaning appointments. Patients are able to eat and drink immediately after this topical application. The American Academy of Pediatric Dentists (AAPD) supports the use of routine fluoride treatments in order reduce cavity risk and reverse enamel demineralization.

We also respect the requests of parents who ask that we not apply fluoride during these visits. We support your decisions and encourage all of our parents to feel comfortable and confident in the choices they make concerning their children’s dental care. For more information about the benefits of fluoride go to: (insert link)

Our doctors follow the guidelines of the American Dental Association (ADA) to determine the frequency in which to take X-rays. There are several different types of X-rays that are typically taken at different intervals as illustrated by our chart below.

At any time, additional X-rays may be needed in order to monitor growth and development or areas of trauma and active disease that are not detectable to the naked eye. Your child’s safety is our top priority that is why our patients wear a full apron with a thyroid collar. Our digital X-ray system exposes your child to significantly less ionizing radiation than your child receives from the sun on any typical day.

Our patients have the unique chance to learn more about their dental and health needs with hands on activities through our Learning Lab. During your child’s dental cleaning our highly trained team may identify an opportunity to further their knowledge about a variety of dental and health related topics. An additional 10 minutes during their cleaning appointment may help inspire your child to eat less sugar as they explore the sugar content of their favorite snacks. Our experiments are designed to encourage self-discovery and motivate our patients to make better dental and health choices.

Infant Care:

Your baby’s first tooth is usually comes in around six months and is typically the bottom left front tooth. However, many children experience tooth eruption patterns that differ from the norm. It can take up to two years in some cases to have the first tooth come in. The important thing to remember is to make the correct food choices that coordinate with the teeth present in your baby’s mouth. Without back teeth (typically first baby molars are present by age one) your child may not be able to properly chew whole foods to a consistency that can be properly broken down. This may cause digestive issues. We can also partner with your child’s pediatrician to help find a solution should these issues arise.

Even before your baby’s first tooth appears, we recommend you clean their gums after breast- or bottle-feeding. Wrap one finger with a clean, damp washcloth or piece of gauze and gently rub it across your baby’s gum tissue. This practice both clears your little one’s mouth of any fragments of food and begins the process of building a good habit of daily oral care.

When that first tooth makes an entrance, it’s time to upgrade to a baby toothbrush. There are usually two options: a long-handled toothbrush that you and your baby can hold at the same time or a finger-puppet-like brush that fits over the tip of your pointer finger. At this stage, toothpaste isn’t necessary; just dip the brush in water before brushing. If your little one doesn’t react well to the introduction of a toothbrush, don’t give up. Switch back to a damp washcloth for a few months, then try the toothbrush again. During the teething process, your child will want to chew on just about anything. A baby toothbrush with a teether can become a favorite toy during this period, for you and your baby.

When a few more teeth appear, you can start using a lentil-sized amount of training toothpaste (does not contain fluoride). At age two you may start using toothpaste containing fluoride- most children’s toothpaste contain the proper amount of fluoride. Smear the toothpaste across the brush to distribute it across the bristles. Be sure to choose a toothbrush with soft bristles and a small head. As more teeth begin to come in, be sure to lift up your baby’s lips and chase along the gum line with their toothbrush to reach the back teeth.

Flossing is recommended for your baby in any area in which their teeth are touching. These spaces are plaque and bacteria traps in which cavities typically first appear (usually the back teeth). Daily flossing can help decrease your baby’s cavity risk. If there are no teeth touching, then you may forego this step in your baby’s daily routine. Please remember that teeth do move and shift as new teeth come in. An area that has space, may not keep that space throughout your baby’s childhood. We can check the spacing during your child’s cleaning appointments as your baby grows and recommend new developing flossing sites.

For our babies and toddlers, we use a lap exam position to clean and exam your child in the privacy of one of our consultation rooms. It is a position in which a parent or guardian sits knee to knee with one of our clinicians. The child begins facing the parent or guardian with one leg on either side of them. The child is then gently lowered back onto a cushion and the cleaning and/or examination can be done with ease and comfort. This technique is encouraged for home use in order to allow your child to gain familiarity with the process as well as allow for easy access to brushing and flossing. If done about once a day at home, it translates very successfully at the dental office.

Your child’s initial lap exam may be unfamiliar and cause some reluctance in their behavior in the office, but with positive reinforcement at home with lap exams done daily and continuous visits, we can grow our relationship with your child and begin their steps to a happy and healthy dental life. Typically at age three, when more communication can be comprehended by your child, we graduate them into our “big boy” or “big girl” chair to begin treatment in our pediatric dental chairs.

Yes, any teeth that have erupted are susceptible to cavities. Baby Bottle Syndrome or Early Childhood Caries is the rapid decay of baby teeth in an infant or child from frequent exposure, for long periods of time, to liquids containing sugars (including bottles filled with formula, juice, soda, and even breast milk). This commonly occurs in the upper front teeth as children fall asleep with these liquids still present pooled around the teeth. We recommend avoiding allowing your child to sleep directly after feeding unless it is with water. As you wean your child from this behavior, you can use Spiffies to remove any excess liquids around their teeth. Spiffies are pre-moistened Xylitol (anti-cavity) wipes.

Home Care:

It is common to aid your child in brushing and flossing until the age of nine. We can help guide you during your child’s cleaning appointments to areas that need more attention. Brush their teeth at least twice a day (once in the morning and once at night) with a soft-bristled toothbrush for two minutes. Use fluoride toothpaste to remove food particles and plaque from the tooth surfaces. Lift their lips up to follow along the gum line with a toothbrush. If your child wants to be more independent in brushing, you can allow them to brush first then you can go back and brush after to adequately remove residual plaque and food particles.

At age two you may start using toothpaste with fluoride. For ages two to three use an amount comparable to the size of a grain of rice. For ages four to five use an amount similar to the size of a lentil. For ages six and up use a pea-sized amount. Smear the toothpaste across the toothbrush to minimize the swallowing of toothpaste. Encourage your child to spit out and rinse excess toothpaste. It is not necessary to wait until your child can spit to use fluoride toothpaste as long as you are using the correct amount of toothpaste.

Clean between your child’s teeth by flossing at least once a day. Decay-causing bacteria can linger between teeth where toothbrush bristles can’t reach. Floss will help remove plaque and food particles from between the teeth and under the gum line. We encourage the use of any form of floss that will keep their teeth clean. You can use a small floss pick while they have only baby teeth. Once the permanent teeth begin to come in, you can graduate them to a flosser with a longer handle to reach further back (typically at age six, they begin to lose front teeth and gain extra teeth in the back).

We encourage your child to eat a balanced diet and try to avoid extra-sugary and/or highly acidic treats. Nutritious foods such as raw vegetables, plain yogurt, cheese or fruit can help keep your smile healthy.When helping your child with their eating habits keep in mind that the frequency and consistency of their foods and drinks can affect their cavity risk. Avoid having your child eat throughout the day (grazing). Instead, allow for scheduled mealtimes and snack times. Also, avoid sticky foods that can linger on the tops of teeth such as gummy fruit snacks and raisins.

Remember that juices, even natural fruit juices, usually contain sugar that can increase cavity risk. And, even though diet soda drinks don’t have sugar in them, they still contain acids that can eat away at enamel. Limit these drinks to mealtimes and dilute them if possible. Anything else throughout the day should be water.

Teeth whitening is an optional cosmetic procedure in which parents can decide if/when they would like for their child to do it. We believe that a child’s smile can greatly affect their self-esteem and in some cases mean more to a child than just enhancing their appearance. When making this choice, it is important to keep the following in mind:

– Permanent teeth are naturally darker/more yellow than baby teeth. It is very typical to see a difference in teeth shades when comparing permanent teeth to baby teeth. As more permanent teeth come in, your child will gain a more uniform color.

– Stains on the outside of your child’s teeth can be removed during their cleaning appointments. Whitening products will not be able to remove these stains.

– If you choose to whiten your child’s teeth, we recommend trying over the counter whitening products first before using professional strength products. Some whitening products can cause an allergic reaction resulting in tissue sloughing. If your child experiences this, have them discontinue that product.

– Customized whitening trays can be made once all permanent teeth have erupted and after orthodontic treatment (if recommended). If your child has mixed dentition (both permanent and baby teeth) then we offer a whitening system with universal trays.

Brushing your child’s tongue can help remove odor causing bacteria. Be sure to include it in their daily home oral care regimen to improve bad breath. If your child is a mouth breather or has increased their mouth breathing through an illness or allergies, be aware that increased air flow through the mouth can decrease the washing effect of saliva and cause an odor. Keep your child hydrated and drinking water to help remove any remaining bacteria. Additionally, over the counter mouthwash may help however we advise that you avoid using any mouthwash containing alcohol if your child is a mouth breather as it will cause increased mouth dryness and reverse your efforts.

Cavity Prevention:

Although they don’t last as long as permanent teeth, your child’s first teeth play an important role in their development. While they’re in place, these primary teeth help your little one speak, smile, chew properly and hold space in the jaw for permanent teeth. If a child loses a tooth too early (due to damage or decay), nearby teeth may encroach on that space, which can result in crooked or misplaced permanent teeth.

We take the necessary precautions (x-rays) to investigate your child’s tooth eruption pattern in order to help you make an educated decision on their dental care. The following eruption chart illustrates the typical amount of time a baby tooth stays in a child’s mouth.

There are several factors that come together in order to cause a cavity. Alone these factors may not cause decay, but if these factors overlap constantly, then your child will have an increased cavity risk.

Certain types of bacteria live in our mouths. When these bacteria come into contact with sugary foods left behind on our teeth after eating, acids are produced. These acids attack the enamel on the exterior of the teeth, eventually eating through the enamel and creating holes in the teeth, which we call cavities.

Be sure that your child brushes at least twice a day with a fluoride toothpaste. Flossing daily will remove bacteria and food between the teeth that brushing can’t. Avoid sugary foods especially sticky sweets such as fruit roll ups, gummies, or raisins, and drinks such as juices and sodas. Limit snacking and maintain a healthy balanced diet. And finally, make regular appointments so that we can check the health of your child’s teeth and provide professional cleanings.

Sealants fill the deep grooves and crevasses on the tops and sides of teeth that are difficult to brush and therefore are susceptible to decay. We recommend sealants as a safe, simple preventative way to help your child avoid cavities, especially for molars, which are hardest to reach.

Frenectomies:

A frenectomy is the removal of a small fold of tissue (frenum) either under the tongue or lip to free the attached structures involved. It can be performed when the frenum is considered too short and is prohibiting normal oral functions such as eating and speaking or if it is preventing the proper spacing of teeth. This also can be referred to as a tight frenum, a low frenum, tongue-tied, or lip-tied.

We have advanced laser technology that we use in order to increase patient comfort and decrease procedure time. We are able to do the treatment in-house at our office with our highly-trained staff and child-friendly environment.

On infants just days old that need a frenectomy in order to begin eating, we typically can perform it on the same day. Infants can feed immediately after the procedure. The overall health of your child is our top priority.

For nursing mothers and infants some of the signs that baby may have a tongue-tie and/or lip-tie are difficulty latching or unproductive, sustained sucking. This can lead to cracked or bleeding nipples, pain in nipples from biting, and breast engorgement. It may also be a factor in poor weight gain, colic, or reflux in these babies.

There are numerous long-term effects of leaving lip and/or tongue-ties uncorrected. As children develop language, a tongue-tie can often cause articulation problems, while older children may begin to see gum recession or poor food cleansing, and ultimately, cavities. A lip-tie can create an abnormal gap between the upper front teeth that is very difficult for even orthodontists to correct, due to the thickness and height of the tissue. A lip-tie can also make brushing very painful, as lifting the lip up to brush the gumline is restricted.

Dental Emergencies:

Even children’s sports involve contact, and we recommend mouthguards for children active in sports. If your little one plays baseball, soccer, or other sports, ask us about mouthguards made to protect their teeth, lips, cheeks, and gums.

If your child has a bitten lip or tongue severe enough to cause bleeding, clean the bite gently with water and use a cold compress (a cold, wet towel or washcloth pressed firmly against the area) to reduce or avoid swelling. If needed, contact us to help determine how serious the bite is. We are always available after hours for emergency calls.

The area of trauma may become ulcerated afterwards. It usually takes the mouth about two weeks to return to normal however, if the trauma continues (accidently biting it again), the healing process can be prolonged an additional two weeks from the most frequent trauma. You can use products such as Kanka or Children’s Orajel in order to help numb the areas for 8-10 minutes for temporary relief.

If your child has something caught between their teeth, use dental floss to gently remove it. Never use a metal, plastic, or sharp tool to remove a stuck object. Food or small particles may float underneath the gums and cause swelling and bleeding. Keep those areas clean by continuing to brush and floss daily. If you are unable to remove the item, contact us to help determine if your child needs to come in for us to remove it.

f your child has chipped or broken a piece off of a tooth, rinse their mouth with warm water, then use a cold compress to reduce swelling. Try to locate and save the tooth fragment that broke off. Call us immediately.

You can help your child avoid dental emergencies. Child-proof your house to avoid falls. Don’t let your child chew on ice, popcorn kernels, or other hard foods. Always use car seats for young children and require seatbelts for older children.

f your child’s permanent tooth has been knocked out, find the tooth and pick it up by the crown. DO NOT TOUCH THE ROOTS. If it is dirty, rinse it gently with cold water briefly (10 seconds). Try to replant the tooth back from where it fell out if possible. Call us immediately on our main line 214-696-3082 and select the emergency option or head to the hospital if we are unable to immediately assist you.

If you are unable to replant the tooth, then place it in a cup of milk or have your child spit into a cup to gather saliva and transport the tooth in that. If you act quickly it’s possible to save the tooth.

The likelihood of being able to save the tooth dramatically decreases after 60 minutes from when the tooth falls out.

Encourage your child to wiggle their loose tooth if it is expected to fall out soon. The more a tooth is played with, the more likely it will be able to fall out without any resistance. As a permanent tooth begins to grow in, it dissolves the baby tooth root. Wiggling the loose tooth will help this process in dissolving the roots. Once the baby tooth falls out, the permanent tooth will have an appropriate space to grow into.

If your child has a very loose tooth, it should be removed to avoid being swallowed or inhaled. You can use Kanka or Children’s Orajel to numb the area then using a twisting motion (like twisting off a bottle cap) remove the tooth.

If the baby tooth root does not properly dissolve, we may need to help extract the tooth in order to allow the permanent tooth to grow in. In these cases there will be a permanent tooth erupting around the baby tooth without any signs of the baby tooth coming out on its own. Sometimes it’s described as having two sets of teeth.

If you know or suspect your child has sustained a broken jaw, use a cold compress to reduce swelling. Call us immediately on our main line 214-696-3082 and select the emergency option or head to the hospital if we are unable immediately assist you. In many cases a broken jaw is the result of a blow to the head. Severe blows to the head can be dangerous and even life-threatening.

If your child complains of a toothache, rinse his or her mouth with warm water and inspect the teeth to be sure there is nothing caught between them. If pain continues, use a cold compress to ease the pain. Do not apply heat or any kind of aspirin or topical pain reliever directly to the affected area, as this can cause damage to the gums. Children’s pain relievers may be taken orally. Schedule an appointment immediately in order for us to determine the cause of their discomfort.

In order to assist us in making a correct diagnosis, please take note of how long your child has been having a toothache. Try to have them recall if there was anything specific that they were eating, drinking, or doing when they first felt it. Record how often they feel discomfort and at what level (can range from it bothers them only a little to it keeps them from eating).

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