Prevention is a vital part of your child's dental care. The dentist
will provide instructions and tips on home dental care, such as
brushing techniques. The dentist may also provide a list of foods
and habits that should be avoided.
Children generally need x-rays more often than adults since their
mouths grow and change rapidly. They are also more susceptible to
tooth decay. Pediatric dentists can use x-rays to survey erupting
teeth, diagnose bone diseases, analyze the extent of an oral injury,
or plan orthodontic treatment. Pediatric x-rays allow the dentist to
diagnose and treat conditions that cannot be visually detected
during an oral examination. If dental problems are identified and
treated early, dental care will be less invasive and affordable.
Pediatric dentists are careful to minimize the exposure of your
child to radiation. Lead body aprons and shields help protect the
child's body, and modern dental equipment is designed to focus the
x-ray beam only where needed and filter out unnecessary x-rays. Use
of high-speed film and digital x-rays help minimize radiation
For children with a high risk of tooth decay, the American Academy
of Pediatric Dentistry recommends x-ray examinations every six
months to detect cavities developing between the teeth. Children
with a low risk of tooth decay require x-rays less frequently.
Panoramic x-rays may sometimes be necessary to view the child's
entire mouth and jaws. It shows any permanent teeth that are
missing, abnormal growth, extra teeth or other oral issues. A
panoramic is typically scheduled when a child's 6th year molars
erupt and then once every 3-5 years after that. Sometimes a
panoramic may be recommended if there has been physical trauma to
Pediatric dentists use sealants to help prevent tooth decay.
Sealants are made of clear plastic and are applied to the chewing
surface area of the tooth. Some teeth tend to have depressions and
grooves which are difficult for the child to clean. Sealants are
used to fill these depressions to deter tooth decay. Application of
the sealant is quick, painless, and can be effective for many years
if your child practices good oral hygiene and avoids biting hard
Tooth Colored Filings:
Tooth colored porcelain fillings are usually used to enhance the
front teeth where appearance is the most important. They are also
used to also repair chipped or decayed teeth anywhere in the mouth.
The benefit of tooth colored fillings is that they are hard to
distinguish from the natural teeth color.
Baby teeth hold the spacing for the permanent teeth and help guide
the permanent teeth into position. Baby teeth allow for normal
development of the child's jawbone and muscles. When baby teeth
fracture due to decay or trauma and a filling is required on more
than one surface of the tooth, the pediatric dentist may recommend
the placement of a crown over the baby tooth instead of a filling.
The filling may decay again, break or wear out, and the tooth will
then require another restoration. A crown is more durable than a
filling, and should last until the child's adult teeth come in. In
many cases the crown results in less expense to the parent and less
trauma to the child.
Stainless Steel Crowns:
Stainless steel crowns are silver colored caps that cover the whole
tooth. Pediatric dentists favor stainless steel crowns for restoring
back teeth with extensive decay or decay in between the teeth.
Stainless steel crowns are is the most durable, and last until the
baby tooth falls out around the age of 12.
This is a stainless steel crown with a tooth colored coating the
front. This option is ideal for restoring baby teeth in the front
where parents are concerned with cosmetic appearance of their child.
Hard foods must be avoided since the tooth colored coating can chip
This type of crown is created using a clear shell that is filled
with tooth colored filling material and fitted over the tooth. A
light is applied to cure the material, then the outer clear shell is
removed, leaving the tooth colored material. Although this
restoration is the most cosmetically pleasing option, it is also the
most fragile. Strip crowns are only feasible if there is enough
natural tooth structure left once all decay has been removed and
prepped for crown placement.
This restoration is white plastic shell that is filled with tooth
colored filling material and fitted over the tooth. A curing light
is then applied to the restoration. Unlike a strip crown, this shell
is left in place.
Endodontic or root canal treatment focuses on the pulp of the tooth.
The pulp contains nerves and blood vessels that supply nutrients and
oxygen to the tooth. Endodontic treatment is performed in order to
save the tooth when the pulp gets infected or injured. During
treatment, the hollow area inside the tooth is cleaned, disinfected
When the pulp has been injured by trauma, decay or other causes,
endodontic treatment is usually the best way to try to save the
tooth. Unless a child's tooth is about to fall out, a dentist may
recommend endodontic treatment on a child's primary (baby) tooth.
Without treatment, the child will experience pain or discomfort, and
infection may result. Early extraction of the primary tooth is
usually not advisable because primary teeth are necessary for
chewing and for learning proper pronunciation during language
development. Also if a baby tooth is extracted too early,
neighboring teeth can shift and occupy some of the vacant space
making it difficult for the permanent tooth to grow in properly.
Symptoms that indicate a need for endodontic treatment can include
toothache, sensitivity to hot and cold, or if the pulp has been
exposed from fracture and the child is experiencing sensitivity. The
type of endodontic treatment that may be recommended depends on how
seriously the pulp is affected, an evaluation of the tooth and the
results of an X-ray.
Primary teeth or "baby teeth" play an important role in a child's
life for proper chewing, speaking and speech development. Primary
teeth also maintain proper spacing for the permanent teeth and help
guide the permanent teeth when they finally cut through the gums. So
whenever possible, dentists try to preserve the natural baby tooth
when treating for decay or damage. However, there are times when it
is necessary to remove a baby tooth. Extraction of a tooth may be
necessary in the following situations:
• The tooth is too damaged or
decayed to be restored
• The tooth fails to loosen and
fall out on its own and blocks the adult tooth from emerging
• Teeth need to be removed due to
crowding or for orthodontic purposes
• Impacted or un-erupted wisdom
Once a tooth has been removed, neighboring teeth may start to shift,
resulting in problems with spacing and growth and development. To
avoid these problems, the dentist may place a space maintainer.
Space maintainers are necessary when a primary tooth (baby tooth)
has been lost prematurely. A space maintainer holds open the gap
where the permanent tooth will come in, and avoids shifting of the
neighboring teeth. Space maintainers can be fixed or removable, and
they can be unilateral (fixed to one side of the mouth) or
bilateral(fixed to both sides of the mouth). For younger patients,
fixed space maintainers are usually recommended.
Also known as laughing gas, nitrous oxide is a type of sedation that
can be administered when a child is scared and not able to relax. It
is also used with patients who have sensitive gag reflexes.
Conscious sedation medications are available for children who need
help relaxing at the dental office. Conscious sedation is sometimes
needed for those children who are anxious during appointments.
Conscious sedation helps increase cooperation and reduces anxiety
and discomfort during dental procedures.
Baby Bottle Tooth
Baby bottle tooth decay, sometimes called nursing bottle syndrome,
is when your babys teeth begin to decay, or form cavities. This
happens when well-meaning moms and dads put their children to bed
with a bottle of formula, milk or juice to help soothe them to
sleep. The sugars from these liquids remain on the teeth, and
combine with bacteria which are normally found on the teeth. This
produces acids, which causes the decay. Not only is this unsightly,
but it affects your child's current and future dental health as
Here are some tips to prevent baby bottle tooth decay:
Start at an early age to help your child fall asleep without a
After the final feeding, use a soft piece of sterile gauze, or a
soft baby fingertip toothbrush to wipe their teeth and gums. Since
most babies like putting things in their mouths anyway, this is
usually easy, and helps introduce tooth brushing at an early age. If
you must give them a bottle to sleep, make it plain water rather
than formula, milk or juice.
the baby falls asleep while drinking, remove the bottle or breast,
and gently wipe their teeth and gums as described above.
Never dip a pacifier in honey or sugar.
Start offering your child a sippy cup at six months of age. Plan to
be rid of the bottle by twelve to fourteen months. By this time, you
can be brushing their teeth with water at bedtime.