Kids Dentistry
Below are answers to the questions parents ask us most often about their child's dental care. If you do not see your question here, give us a call at 904-992-8900. We are happy to talk through it. You can also visit our Pediatric Services and Children's Dental Habits pages for more in-depth detail.
From baby's first tooth to "shark teeth" around age seven — what's normal, what to watch for, and when to ask.
Baby bottle tooth decay (or baby bottle syndrome) is a form of tooth decay that can destroy the teeth of an infant. This decay may even enter the underlying bone structure, which can hamper development of the permanent teeth. The teeth most likely to be damaged are the upper teeth.
Baby bottle decay is caused by frequent and long exposure of a child's teeth to liquids containing sugar — such as milk, formula, fruit juices, soda, and other sweetened liquids. These liquids fuel the bacteria in a child's mouth, which produces acids that attack enamel.
Children continually get new teeth from age 3 months to age 6 years. Most children have a full set of 20 primary teeth by the time they are 3 years old. As a child nears age 6, the jaw grows, making room for the permanent teeth. At the same time, the roots of the baby teeth begin to be resorbed by the tissues around them, and the permanent teeth under them begin to erupt.
Primary teeth are just as important as permanent teeth — for chewing, speaking, and appearance. They also serve as placeholders for the permanent teeth and provide structure to help shape the child's face.
Childhood cavities — now also known as Early Childhood Caries — are an aggressive form of caries that occur in infants and very young children. They are typically associated with prolonged consumption of liquids containing sugar and affect the top front teeth first, later spreading to other baby teeth. Because of the aggressive nature of this disease, early intervention is necessary.
The American Academy of Pediatric Dentistry (AAPD) and the American Academy of Pediatrics (AAP) recommend that all children should see a dentist before age one.
Yes — it is normal and even ideal for baby teeth to have spacing between each other.
Keep in mind that when permanent teeth erupt, their size will be considerably larger than baby teeth. As the baby teeth are lost, the erupting permanent tooth will quickly take advantage of this excess space.
Children who do not have spacing in their primary dentition can have a higher incidence of crowding (crooked teeth) in the permanent dentition.
By swallowing too much fluoride for the child's size and weight during the years of tooth development, a child can develop enamel fluorosis. This can happen in several ways:
One of our most common consults occurs when children around age seven begin to lose their lower front teeth. Many parents become overly worried about this phenomenon. It is VERY NORMAL for permanent lower incisors (front teeth) to erupt behind their predecessors (baby teeth).
However, if a baby tooth is not loose by the time half of the permanent incisor has erupted, it may be necessary to pull it. If you're unsure, bring your child in for a quick look and we'll let you know whether to wait or act.
There is no such thing as a single "best" toothpaste. We recommend only products that have been ADA (American Dental Association) accepted or approved.
The selection is usually made on a case-by-case basis. The main consideration when selecting toothpaste is your child's age — because of the risk of fluorosis in younger children who swallow toothpaste during regular brushing. A child may face the condition called enamel fluorosis if they get too much fluoride during the years of tooth development. Too much fluoride can result in defects in tooth enamel.
When your child needs work done, here's how we keep them safe and comfortable.
Conscious oral sedation is a procedure in which a child is given an oral medication that causes a depressed level of consciousness. The American Academy of Pediatric Dentistry (AAPD) has clearly defined the indications for this procedure:
As with any procedure in which a child's conscious state is altered, there are some risks involved. The main risks (serious complications) associated with conscious sedation include, but are not limited to: aspiration, respiratory arrest, cardiac arrest, and death. Because your child will be partially awake, local dental anesthesia (a lidocaine shot) is still needed, and this may limit the extent of work that we can provide.
Sedation dentistry is also an option in cases of accidents or trauma; but in these situations, the decision to administer the medication must take into consideration the risk of aspiration (breathing vomit into the lungs) and any head trauma that may have occurred. If your child is a candidate for conscious sedation, please make sure you follow the instructions provided by your pediatric dentist.
This is one of the most commonly asked questions we get from parents. We try to minimize the discomfort of the injection by placing a gel that works as a local anesthetic to numb the tissue where the injection will be administered.
Profound local anesthesia is usually obtained five to ten minutes after the injection, depending on the area of the mouth where the anesthetic was placed. We always check to confirm that the area is numb before we begin to work.
In cases of localized infection or trauma (like broken teeth), it is very difficult to obtain profound anesthesia. However, we have other means of supplementing the anesthetic — like the conjoined use of nitrous-oxide gas, medications, or conscious sedation.
Younger children, particularly preschoolers, may interpret the feeling of numbness as pain and therefore cry. Please follow the post-operative instructions we give you, in order to minimize complications such as lip biting.
In cases with extensive decay, we are limited by the maximum dosage of local anesthetic that we can use. As a rule, we also consider your child's comfort after they leave the clinic in order to determine how much local anesthetic we can use.
Very young children are at high risk of biting their lips or chewing on the inside of their cheeks after they receive local anesthetic (a lidocaine shot). This usually happens because of their natural curiosity — they try to feel the area or areas that are numb.
For these and other reasons, it is unlikely that we could work on all of your child's teeth at once. An exception to this rule would be a child who is taken to the operating room.
Why we recommend them, how often, and the steps we take to keep exposure low.
In general, children need x-rays more often than adults. Their mouths grow and change rapidly, and they are more susceptible to tooth decay than adults.
The American Academy of Pediatric Dentistry recommends x-ray examinations every six months for children with a high risk of tooth decay. Children with a low risk of tooth decay require x-rays less frequently.
X-rays allow us to diagnose and treat health conditions that cannot be detected during a clinical examination. If dental problems are found and treated early, dental care is more comfortable and more affordable.
X-ray films detect:
Particular care is applied to minimize the exposure of young patients to radiation. With contemporary safeguards, the amount of radiation received in a dental x-ray examination is extremely small. The risk is negligible — in fact, dental x-rays represent a far smaller risk than an undetected and untreated dental problem.
Call us at 904-992-8900, or request an appointment and we will talk through it in person.
The best answers to your questions come from a chairside conversation. Request an appointment online or give us a call.
