Pedodontic Associates - Pearlridge

A child’s first visit to the dentist should be enjoyable. Children are not born with a natural fear of the dentist, but they can fear the unknown. Our office makes a special effort to use pleasant, non-frightening, simple words to describe each treatment. We want you and your child to feel at ease from the moment your family arrives at our office. American Academy of Pediatric Dentistry recommends... Children should visit the dentist by their first birthday. It is important that your child’s newly erupted teeth (erupting at six to 12 months of age) receive proper dental care and benefit from proper oral hygiene habits right from the beginning. Getting to know your teeth is fun! Download our Dynamite Dental Fun Kit! When new teeth arrive Your child’s first primary, or “baby,” teeth will begin to erupt between the ages of six to 12 months, and will continue to erupt until about age three. During this time, your child’s gums may feel tender and sore. To help alleviate this discomfort, we recommend that you soothe the gums by rubbing a clean finger or a cool, wet cloth across them. You may also choose to make use of a teething ring. Your child’s primary teeth are shed at various times throughout childhood. Permanent teeth begin erupting at age six, and continue until age 21. Adults have 28 permanent teeth (32, teeth including wisdom teeth). Adopting healthy oral hygiene habits As your child’s teeth erupt, be sure to examine them every two weeks, looking for lines and discoloration that may be caused by decay. Remember that sugary foods and liquids can attack a new tooth, so take care that your child brushes his or her teeth after feeding or eating. We recommend brushing two times a day for optimal oral hygiene. Brushing can be fun, and your child should brush as soon as the first tooth arrives. When a baby’s tooth erupts, parents should brush the tooth with a soft-bristled toothbrush and a grain of rice size amount of fluoridated toothpaste. We suggest reviewing proper tooth brushing procedures with your child. Flossing is also a part of good oral hygiene habits, and your dentist will discuss with you the right time to start flossing your child’s teeth. If you notice signs of decay, contact your dentist immediately. Preventing tooth decay with regular checkups Tooth decay is caused by sugars left in your mouth that turn into an acid, which can break down your teeth. Children are at high risk for tooth decay for a simple reason: many children and adolescents do not practice regular, good oral hygiene habits. Proper brushing and flossing routines combined with regular dental visits help keep tooth decay away. Your child should visit the dentist every six months for regular dental cleanings and checkups. We recommend fluoride treatments two to four times a year along with cleanings to keep teeth their strongest. Tooth sealants are also recommended because they “seal” the deep grooves in your child’s teeth, preventing decay from forming in these hard-to-reach areas. Sealants last for several years, but will be monitored at your child’s regular checkups.

Preventive dental care is important throughout life, especially at a young age. By practicing good oral hygiene at home and scheduling regular checkups with the dentist, your child can help keep their smile bright and healthy for many years to come. Here are a few simple ways to prevent the build-up of plaque and cavities: Make sure your child brushes their teeth at least twice a day with a soft-bristled toothbrush. Use fluoride toothpaste to remove food particles and plaque from the tooth surfaces. Also be sure your child brushes the top surface of the tongue; this will remove any extra plaque-causing food particles and help keep their breath fresh! Make sure your child cleans between teeth by flossing at least once a day. You can also use a mouthwash to help kill bacteria and freshen breath. Decay-causing bacteria can linger between teeth where toothbrush bristles can't reach. Floss and mouthwash will help remove plaque and food particles from between the teeth and under the gum line. Make sure your child eats a balanced diet, and try to avoid extra-sugary treats. Nutritious foods such as raw vegetables, plain yogurt, cheese, or fruit can help keep your child's smile healthy. Remember to schedule regular checkups with your child’s dentist every six months for a professional teeth cleaning. Ask your dentist about dental sealants, a protective plastic coating that can be applied to the chewing surfaces of the back teeth where decay often starts. If your child plays sports, be sure to ask your dentist about special mouthguards designed to protect your child’s smile. Brushing Instructions Brushing: Step 1 Place your toothbrush at a 45-degree angle to your gum. Brushing: Step 2 Brush gently back and forth. Brushing: Step 3 Brush the outer, inner, and chewing surfaces of each tooth. Brushing: Step 4 Use the tip of your brush for the inner surface of your front teeth. Flossing Instructions Flossing: Step 1 Wind about 18 inches of floss around your fingers as shown. Most of it should be wrapped around one finger, and the other finger takes it up as the floss is used. Flossing: Step 2 Use your thumbs and forefingers to guide about one inch of floss between your teeth. Flossing: Step 3 Holding the floss tightly, gently saw it between your teeth. Then curve the floss into a C-shape against one tooth and gently slide it beneath your gums. Flossing: Step 4 Slide the floss up and down, repeating for each tooth. If it’s been six months or more since your child’s last dental checkup, then it’s time to contact our practice and schedule an appointment!

Practicing good oral hygiene means maintaining your child’s smile by visiting the dentist regularly and taking care of their teeth and gums in between checkups. Our practice wants to make sure that your child gets the most out of their office visits, and that their teeth stay healthy for life! We’ll work with you to provide complete dental care, and show you how to maintain your child’s smile at home with the right dental products for you and your family. Dental Cleanings and Regular Checkups Regular dental checkups are an important part of maintaining good oral health. During regular checkups, the hygienist will: Check for any problems that may not be seen or felt Look for cavities or other signs of tooth decay Inspect the teeth and gums for gingivitis and signs of periodontal disease Provide a thorough teeth cleaning, rinse, and polish Visiting the dentist every six months gives you and your child the chance to talk with your doctor and receive answers for any questions you may have about your family’s oral health. Checkups are also a great way to find out about new treatments that may benefit your child’s smile. Choosing the Right Toothpaste and Toothbrush From toothpaste and mouthwash to toothbrushes and dental floss, it’s important to choose the right products. Keep in mind that when you’re looking for a new toothpaste or toothbrush be sure to choose one that has been approved by the American Dental Association (ADA). Your dentist can also help by recommending certain dental products for use at home. Learn More Did you know that at birth, people already have 20 primary (baby) teeth that begin erupting after six months, and that by age 21 there are no more primary teeth and all 32 permanent teeth have erupted? Getting to know your teeth can be fun and educational!

Using the most advanced dental technology possible is just as important as staying up to date on the latest treatment techniques. Because our practice is dedicated to providing your child with the safest and most convenient treatment options available, we utilize advanced digital X-ray technology in our office. Is a digital X-ray really safer? Because we care about your child’s bodily health and well-being, we believe that reducing the amount of radiation exposure is extremely important. Although the amount of radiation used in dental X-rays is very small, the effect is cumulative, so all radiation counts. Digital X-rays can reduce your child’s exposure to radiation by up to 80 percent! What are the advantages of digital X-rays? We want your little one to be as comfortable as possible during their appointment, and digital X-rays eliminate the need to bite down on a sharp piece of film encased in plastic. There is no need to wait for the X-ray film to be developed before it can be viewed, so the entire checkup can be a lot shorter. The digital images can be enlarged and manipulated, giving the doctor a clear, more detailed look at your child’s teeth. Because your child can see the image enlarged on a screen, they can better understand why taking care of her teeth is important. It’s better for the earth! There is no need to use harmful chemicals to process film. Our practice is focused on making your child’s dental experience as comfortable as possible. At your next appointment, we’ll be happy to answer any questions you may have.

Preventing Problems Before They Start The health of your child’s teeth and mouth is very important to the well-being of his or her entire body, and while routine brushing and flossing at home is necessary to keep your child’s smile looking its best, visiting the dentist for a comprehensive exam and cleaning is essential. The American Dental Association recommends that your child visit the dentist every six months to ensure his or her teeth stay healthy and smile stays beautiful. By routinely seeing the dentist for exams and cleanings, your child can: Prevent tooth decay, gum disease, and bad breath Avoid costly and extensive dental procedures Have white teeth by reducing staining from food and drinks Shorten the time spent in the dentist’s office Have a smile that will last a lifetime The Exam During your child’s exam, the dentist will thoroughly examine your child’s teeth and gums for signs of tooth decay, gum disease, and other health problems. The dentist may also want to take X-rays to see what is happening beneath the surface of the teeth and gums. Whether these X-rays are traditional or digital, the images provided will help the dentist discover dental issues not visible to the naked eye. Professional Cleanings The dental hygienist will begin your child’s cleaning by exploring the surface of the teeth to determine if there are any cavities and to examine the quality of existing fillings. The dental hygienist will then perform a periodontal exam to make sure your child’s gums adhere tightly to the teeth, and no periodontal disease or bone loss is present. Next, the hygienist will carefully clean your child’s teeth with a variety of tools to remove any hard mineral buildup (tartar) from the teeth. Then, the hygienist will floss your child’s teeth, use a polishing compound, and apply fluoride. Cleanings usually aren’t painful, but if your child has any anxiety about the dental exam, be sure to let the hygienist know. If the dentist or hygienist finds tooth decay or gum disease, they will talk to you about changing your child’s brushing or flossing habits. In severe cases, they may recommend antibiotics or other dental treatments. If your child’s teeth and gums appear to be healthy, the dentist will probably recommend that your child continue his or her brushing and flossing routine as usual.

Gum disease, also known as gingivitis or periodontal disease, is an infection that occurs in the gums, deep tissues, and bones that support the teeth. It can affect children if proper oral health practices aren’t followed. If the disease is not treated, gum disease can ultimately lead to tooth loss. How Gum Disease Starts Your child’s mouth naturally produces a sticky substance called plaque. Without adequate brushing and flossing, this plaque builds up on the teeth. The bacteria in plaque produce poisons, or toxins, which irritate the gums and cause infection. As the infection increases in severity, it breaks down the bones and tissues that hold your child’s teeth in place. Gingivitis and Periodontitis The initial stage of gum disease, known as gingivitis, is the mildest form of gum disease and is common in children. During this stage, the gums become swollen and red, and may bleed after brushing or flossing. Gingivitis is frequently painless, so your child might not mention it is bothering them. With professional treatment and daily attention to oral hygiene, gingivitis can be reversed before it progresses. Untreated gingivitis may develop into periodontitis, the more extreme form of gum disease. Aggressive periodontitis can affect your child even if he or she is otherwise healthy. Localized aggressive periodontitis is found in teenagers and young adults. It mainly affects the first molars and incisors, and is characterized by the severe loss of jaw bone. Generalized aggressive periodontitis may begin around puberty and involve the entire mouth. It is marked by inflammation of the gums and heavy accumulations of plaque and tartar. Eventually it can cause the teeth to become loose. Signs of Gum Disease Because gum disease can exist without pain or discomfort, it’s important to be aware of the possible warning signs that may indicate a problem. Gums appear red or swollen Gums feel tender Gums bleed easily during brushing or flossing Gums recede or pull away from the teeth Persistent bad breath Loose teeth Any change in the way teeth come together in the biting position If you suspect that your child may be suffering from gingivitis or periodontitis, make an appointment with your pediatric dentist immediately. We can diagnose the problem, determine how far the disease has progressed, and recommend an appropriate treatment.

Sports dentistry is the prevention and treatment of dental injuries and related oral diseases, as well as the sharing of information and equipment designed to help protect the teeth, mouth, jaw, and face of athletes of all ages. Injuries to the teeth and mouth are common among athletes. It’s important to protect your child’s smile if he or she plays sports, for aesthetics as well as health reasons. Common Dental Injuries in Sports Tooth knocked out: Time is the most important factor when trying to save a tooth, so get to your dentist as soon as possible. In general, there is a 30-minute window of opportunity to re-implant the tooth in the socket. Do not try to re-implant the tooth yourself. The best liquid to transport a tooth in is cold milk. If milk is not available, use saliva (if possible), saline, or if nothing else is available, water. Don’t let the tooth dry out and don’t wrap it in anything. Don’t touch the tooth root if you can avoid it. Tooth chipped/cracked: Your dentist will likely use an X-ray of the tooth to determine the treatment necessary. For a serious chip that exposes the pulp of the tooth, get to your dentist as soon as possible. If a tooth is chipped or cracked, sometimes the tooth can be fixed with a filling or bonding alone. Sometimes a tooth is cracked or chipped in a way affecting the nerve of the tooth, and a more complicated treatment may be needed. Tooth displaced: If a tooth is moved due to trauma, see your dentist as soon as possible. Do not try to move the tooth back on your own. For any mouth discomfort before you get to the dentist, apply ice. Preventing Injury One of the best ways to prevent injury to your child’s teeth and mouth is to have him or her to wear a mouthguard while playing sports. There are several types of mouthguards to choose from, and your doctor can help you choose the best one for your child’s particular needs.

Regular Exams and Cleanings Regular exams are an important part of maintaining your child's oral health. During your child’s regular exam, we will: Check for any problems that may not be seen or felt Look for cavities or any other signs of tooth decay Inspect the teeth and gums for gingivitis and signs of periodontal disease Perform a thorough teeth cleaning Each regular exam includes a detailed teeth cleaning, in which we will clean, polish, and rinse the teeth to remove any tartar and plaque that have built up on the tooth’s surface. Visiting our office every six months gives you the chance to talk to the doctor about any questions you may have about your child’s oral health. Regular exams are offered by appointment only, so please contact our practice today to schedule your child’s next dental exam and teeth cleaning. Bonding Bonding is a conservative way to repair slightly chipped, discolored, or crooked teeth. During dental bonding, a white filling is placed onto your child's tooth to improve its appearance. The filling “bonds” with the tooth, and because it comes in a variety of tooth-colored shades, it closely matches the appearance of your child's natural teeth. Bonding is less expensive than other cosmetic treatments and can usually be completed in one visit to our office. However, bonding can stain and is easier to break than other cosmetic treatments, such as porcelain veneers. If it does break or chip, tell your doctor. The bonding can generally be easily patched or repaired in one visit. Crowns Crowns are a restorative procedure used to improve a tooth’s shape or to strengthen a tooth. Crowns are most often used for teeth that are broken, worn, or have portions destroyed by tooth decay. A crown is a “cap” cemented onto an existing tooth that usually covers the portion of the tooth above the gum line. In effect, the crown becomes the tooth’s new outer surface. Crowns can be made of composite resin (white filling material), zirconium, or stainless steel. Your doctor can advise which one is the best and why in your child's case. Extractions There are times when it is necessary to remove a tooth. Sometimes a baby tooth has misshapen or long roots that prevent it from falling out as it should, and the tooth must be removed to make way for the permanent tooth to erupt. At other times, a tooth may have so much decay that it puts the surrounding teeth at risk of decay, so the doctor may recommend its removal. Infection, orthodontic correction, or problems with a wisdom tooth can also require removal of a tooth. When it is determined that a tooth needs to be removed, your child’s dentist may extract the tooth during a regular checkup or may request another visit for this procedure. The root of each tooth is encased within the jawbone in a “tooth socket”, and the tooth is held in that socket by a ligament. In order to extract a tooth, the dentist must expand the socket and separate the tooth from the ligament holding it in place. While this procedure is typically very quick, it is important to share with the doctor any concerns or preferences for sedation. Fillings Fillings can be done with amalgam (silver in color), composite resin (white in color), or glass ionomer (white in color). Fluoride Fluoride is effective in preventing cavities and tooth decay and in preventing plaque from building up and hardening on the tooth’s surface. A fluoride treatment in a dentist’s office takes just a few seconds. Depending on your child’s oral health or the doctor’s recommendation, a fluoride treatment may be required every three, or 6 months. Mouthguards Whether your child wears braces or not, protecting his or her smile while playing sports is essential. Mouthguards help protect the teeth and gums from injury. If your child participates in any kind of full-contact sport, the American Dental Association recommends that he or she wear a mouthguard. Choosing the right mouthguard is essential. There are three basic types of mouthguards: the pre-made mouthguard, the “boil-and-bite” fitted mouthguard, and a custom-made mouthguard from the dentist. When you choose a mouthguard, be sure to pick one that is tear-resistant, comfortable and well-fitted for your mouth, easy to keep clean, and does not prevent your child from breathing properly. Your dentist can show your child how to wear a mouthguard properly and how to choose the right mouthguard to protect his or her smile. Nightguards If your child often wakes up with jaw pain, earaches, or headaches, or if you see your child clenching or grinding his or her teeth, your child may have a common condition called “bruxism”. Many people do not even know that they grind their teeth, as it often occurs when one is sleeping. If not corrected, bruxism can lead to broken teeth, cracked teeth, or even tooth loss.

If your child is self-conscious about smiling, having braces can greatly improve the way he or she looks and feels. While we do not offer comprehensive orthodontic treatment, we will happily refer you to a trusted orthodontist for all of your child's orthodontic needs. When treatment is complete, your child will have an amazing, healthy smile, as well as the confidence to show it off! How Orthodontic Treatment Works Orthodontic appliances are made of metal, ceramic, or plastic. They may be removable or they may be brackets bonded to the teeth. By placing a constant, gentle force in a carefully controlled direction, braces slowly move teeth to the proper position. Gone are the days when a metal band with a bracket was placed around each tooth. Orthodontic patients can now choose brackets that are clear or metallic, and in some cases, customize the color of the appliance. Wires are far less noticeable, and the latest materials are designed to move teeth faster with more comfort. Duration of Treatment Depending on several factors, including age, treatment method, and how minor or severe your child’s case is, treatment time varies and can last between one and three years. Receiving interceptive, or early treatment, can also help provide a quicker treatment time later on in life. Another big factor to a successful treatment is your child’s cooperation. The more involved and diligent your child is, the quicker and more efficient treatment will be. As pediatric dentists we do limited orthodontics such as correction of a single tooth cross bite or palatal expansion for posterior cross bites. If your child is in need of comprehensive orthodontics he or she will be referred to an orthodontist. Types of Braces Traditional Metal Braces Traditional metal braces are the most common type of braces and are more comfortable today than ever before. Made of high-grade stainless steel, metal braces straighten teeth by using metal brackets and archwires. With metal braces, there is the option of adding colored elastics (rubber bands) for a more unique and colorful smile. Self-Ligating Braces Self-ligating braces are made from the same materials as traditional braces; however, self-ligating braces do not require the use of elastics, meaning fewer appointments and less friction being placed on the tooth. Self-ligating braces come with traditional metal, ceramic, or clear brackets. They are the same size as metal braces, but they use a specialized clip in place of elastics to help the archwire guide teeth into place. The clip helps reduce the amount of pressure being placed on the tooth and requires fewer adjustments because there are no elastics to replace. Clear (Ceramic) Braces Ceramic braces are made of clear materials and are therefore less visible on the teeth than metal braces. For this reason, ceramic braces are used mainly on older teenagers who have cosmetic concerns. While they are visually less prominent, they do require more attention to oral hygiene, as ceramic braces are larger and more brittle than their metal counterparts. For these reasons, ceramic braces tend to be used more on upper front teeth rather than on lower teeth. Clear Aligners Clear aligners are a series of invisible, removable, and comfortable acrylic trays that straighten the teeth like braces. Not only are the aligners invisible, they are also removable, allowing your child to eat and drink without concern while in treatment. Plus, this helps to make brushing and flossing less of a hassle. The aligners are comfortable and have no metal to cause mouth abrasions during treatment. Gold Braces Gold braces are similar to traditional metal braces. Like traditional metal braces, gold braces are made of stainless steel; however, they are coated in gold. The gold coating may be considered a more cosmetic option than traditional metal braces. And, the cost of gold braces is surprisingly comparable to most clear braces. Lingual Braces Lingual braces are hidden behind the teeth and are therefore “invisible” when your child smiles. Lingual braces are 100% customized to match the shape of the teeth. Lingual braces are a very reasonable option for athletes, models, actors/actresses, and musicians who play wind instruments.

If your child’s tooth has come out too soon because of decay or an accident, it is important to maintain the space to prevent future space loss and dental problems when permanent teeth begin to come in. Without the use of a space maintainer, the teeth that surround the open space can shift, impeding the permanent tooth’s eruption. When that happens, the need for orthodontic treatment may become greater. Types of Space Maintainers Space maintainers can be made of stainless steel and/or plastic, and can be removable or fixed (cemented to the teeth). Removable A removable space maintainer looks much like a retainer with plastic blocks to fill in where the tooth is missing. If your child is older and can reliably follow directions, a removable space maintainer can be a good option. Fixed Fixed space maintainers come in many designs. A band-and-loop maintainer is made of stainless steel wire and held in place by a crown or band on the tooth adjacent to the empty space. The wire is attached to the crown or loop and rests against the side of the tooth on the other end of the space. A lingual arch is used on the lower teeth when the back teeth on both sides of the jaw are lost. A wire is placed on the lingual (tongue) side of the arch and is attached to the tooth in back of the open space on both sides. This prevents the back teeth from shifting forward into the gap. In the case of a lost second primary molar prior to the eruption of the first permanent molar, a distal shoe may be recommended. Because the first permanent molar has not come in yet, there is no tooth to hold a band-and-loop space maintainer in place. A distal shoe appliance has a metal wire that is inserted slightly under the gum and will prevent the space from closing. Caring for Your Child’s Space Maintainer There are four general rules for taking care of your child’s appliance. Your child should avoid sticky foods, including candy and chewing gum. Encourage your child not to push or tug on the space maintainer with the fingers or tongue. Keep your child’s space maintainer clean through effective brushing and flossing. Your child should continue to see the pediatric dentist for regular dental visits.

There are times when it is necessary to remove a tooth. Sometimes, a baby tooth has misshapen or long roots that prevent it from falling out as it should, and the tooth must be removed to make way for the permanent tooth to erupt. Other times, a tooth may have so much decay that it puts the surrounding teeth and jaw at risk. Infection, orthodontic correction, or problems with a wisdom tooth can also require removal of a tooth. If it is determined that your child’s tooth needs to be removed, your pediatric dentist may extract the tooth during a regular checkup or may schedule another visit for this procedure. The root of each tooth is encased within the jawbone in a “tooth socket,” and the tooth is held in that socket by a ligament. In order to extract a tooth, the dentist must expand the socket and separate the tooth from the ligament holding it in place. While this procedure is typically very quick, it is important to share with your dentist any concerns or preferences for sedation; we want to make sure your child is as comfortable as possible. The day after your child’s extraction: No drinking with straws No vigorous rinsing and spitting No swimming A soft diet is recommended; no eating of popcorn, pretzels, pizza, crackers, or any food with sharp edges If your child has any discomfort, give a children’s dose of Advil® or Tylenol® If your child experiences swelling, apply a cold cloth or an ice bag and call our office

If your child’s primary tooth has extensive decay, or has been damaged by trauma, action may be needed to restore the integrity of the tooth and prevent infection from spreading to surrounding teeth. After a set of X-rays are taken, your dentist will be able to assess the extent of the infection and recommend one of two options, a pulpotomy or a pulpectomy. Pulpotomy If the decay or trauma is confined to the crown of the tooth, a pulpotomy may be recommended. When a cavity gets really deep, close to the pulp of a tooth, or even into the pulp, the pulpal tissue becomes irritated and inflamed. A pulpotomy is when the inflamed pulp chamber, usually on a baby molar, is removed. The dentist will remove all the infected material in the pulp of the crown only, leaving the living tooth root intact. After a pulpotomy on a baby molar, the empty space will be filled with dental cement and a stainless steel crown will be placed to restore the tooth. Pulpectomy If the infection involves tissue in both the tooth crown and the tooth root, a pulpectomy may be the best option. In a pulpectomy, the entire pulp material is removed from both the crown and the roots. After numbing your child’s tooth, the dentist will remove the pulp and nerve tissue from the crown and from the canals of the roots. Then, the pulp chamber and root canals will be thoroughly cleaned and disinfected. Next, the dentist will fill the tooth and tooth roots with a dental cement, and finish with a stainless steel crown. Crowns Crowns are “cemented” onto an existing tooth and fully cover the portion of the tooth above the gum line. In effect, the crown becomes the tooth’s new outer surface. Stainless steel dental crowns are considered a good temporary restoration to save a primary tooth until the permanent tooth can erupt and take its place. Keeping the primary tooth if at all possible is very important. A primary tooth can be restored with a stainless steel crown during one appointment. A crowned tooth must be brushed and flossed just like other teeth.

Nitrous oxide, or laughing gas, is the most frequently used method for easing mild to moderate anxiety in children. Administered through a small mask that fits over your child’s nose, it is an effective way to calm anxiety. Your child will be asked to breathe through his or her nose and not through their mouth. As the gas begins to work, your child will become calm, although he or she will still be awake and able to talk with the dentist. At the end of your child’s appointment, he or she will resume breathing regular oxygen, and all the effects of nitrous oxide will disappear. As your child gets older and becomes more comfortable during dental visits, nitrous oxide may not be necessary.