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Frequently Asked Questions

Pediatric Dental Health
As a parent, what can I do to help my child with preventive dentistry?

Parents play a major role in preventive dentistry for their children by guiding them into an excellent oral hygiene routine, providing a healthy diet and scheduling their regular dental check-ups. At our practice, we like to teach preventive dentistry to all of our patients and their families. Our preventive methods include:

  • Brushing
  • Flossing
  • Fluoride Treatments
  • Dietary Counseling
  • Dental Sealants
  • Sports Safety
My child looks like a shark with two rows of teeth, what should I do?

Over-retention of primary lower teeth is due to the delayed resorption of the roots due to lingual positioning of the permanent teeth, crowding of the permanent teeth, root canal obliteration (from trauma), or failure of endodontic obturation material to resorb. The timing of treatment is dependent on which arch is involved.

Lower Arch:
In the lower arch, if the primary tooth is mobile, we will usually monitor and allow the tooth to exfoliate on its own. We encourage "wiggling" the teeth with clean fingers for 1-3 months; most of the time, the teeth will exfoliate & no treatment is necessary. However if the tooth is not mobile and not exfoliated by age 8 or three quarters of the root of the permanent tooth is formed (from looking at the x-ray), the primary tooth should be extracted. Once the primary tooth is no longer present the permanent will migrate forward spontaneously.

Upper Arch:
In the upper arch, even if the primary teeth are mobile, they should be extracted to prevent the permanent tooth from erupting in cross-bite with the mandibular incisor. If the permanent tooth erupts in cross-bite, orthodontic intervention will be necessary to move the tooth into its proper position, as interference by the lower incisor will prevent spontaneous labial/forward migration.

If the permanent tooth is erupting labially, extraction of the primary tooth is not urgent.

My child grinds their teeth, what can I do?

Most people probably grind and clench their teeth from time to time. Occasional teeth grinding, also called bruxism, does not usually cause harm. However, when severe teeth grinding occurs on a regular basis the teeth can be damaged and other oral health complications can arise.

Bruxism is defined as habitual grinding of the teeth. It most often occurs at night but can occur when awake or asleep. The etiology of bruxism includes habit, emotional stress (eg response to anxiety, tension, anger, or pain), parasomnias, neurologic abnormalities, tooth malocclusion, and, rarely, a medication side-effect. Most often, however, the etiology of bruxism is unknown.

Bruxism is very common in young children. In fact, approximately 30% of children develop bruxism during the early-school years. Bruxism usually decreases by 7 to 8 years of age and stops before age 12, after eruption of all the permanent teeth.

For children younger than 10-12 years, treatment is usually not required. For older children, a dentist may recommend a mouth guard be worn at night.

Are thumb sucking and pacifier use harmful for my child's teeth?

Oral sucking habits are normal for babies and young children. Most children stop sucking on thumbs, fingers, and pacifiers on their own between two and four years of age. Usually, no harm is done to their teeth or jaws. In children who continue to suck on thumbs, fingers, and pacifiers, changes may be noted in tooth position and supporting bone structure.

At Park Smile, we recommend that children stop oral habits well before the eruption of their first permanent tooth, usually by the age of five. In children who continue with sucking habits, we recommend the use of positive reinforcement for motivation. The use of an oral appliance may be necessary if the habit persists.

What can I do to protect my child's teeth during sporting events?

A mouth guard should be a top priority on your child’s list of sports equipment. Athletic mouth protectors, or mouth guards, are made of soft plastic and fit comfortably to the shape of the upper teeth. They protect a child’s teeth, lips, cheeks and gums from sports-related injuries. Any mouth guard works better than no mouth guard, but a custom-fitted mouth guard fitted by one of our doctors is your child’s best protection against sports-related injuries.

What kind of diet is best for my child's dental health?

A well-balanced diet is one of the most important elements in achieving healthy teeth and gums. We recommend one serving each of: fruits and vegetables, breads and cereals, milk and dairy products, and meat, fish and eggs. You should limit the amount of sugars and starches in order to prevent harmful tooth decay and cavities.

When should my child consult an orthodontist?

One of the benefits of Park Smile is our team of specialists that allows for timely expert input and seamless transition across treatment. Following the American Association of Orthodontics guidelines, we will arrange for your child to have a preliminary orthodontic screening around age 7 with our orthodontist. Approximately 20% of children can benefit from early orthodontic treatment to create a healthy, functional bite (occlusion) while the face and jaw are still growing. Otherwise, our orthodontic team will check your child’s growth and development periodically. If and when the time is right for your child, orthodontic treatment can begin.

Additionally, when your child has their full adult dentition in their late teen years, they will be introduced to Dr. Sonali Chhabra, who specializes in adult dentistry.

How often does my child need to visit the pediatric dentist?

We recommend that your child come for a check-up every 6 months. However, this may vary depending on the oral health and individual needs of each patient.

What is the difference between pediatric dentistry and family dentistry?

Pediatric dentistry is a dental specialty that specifically focuses on the oral health of young people from infants to adolescents. Following dental school, a pediatric dentist goes through two to three years of additional specialty training focusing solely on the special needs of children.

What type of toothpaste should my child use, and how much?

Your child should use a toothpaste with fluoride with the first eruption. Brushing twice a day offers more benefits than just once a day. Parents should dispense the toothpaste to prevent excessive use. For those under 2, use a smear. For those aged 2 to 5 years, a pea-sized amount is recommended.

To maximize the beneficial effect of fluoride in the toothpaste, rinsing after brushing should be kept to a minimum or eliminated altogether.

But I don't give my child soda, I only give him/her juice. How come it looks like he/she is getting cavities?

The frequency of drinking the juice is key as well as the length of time juice is being drunk. There are 39 grams of sugar in a 12 oz. can of soda. In a 6 oz. glass of juice, there are between 25 and 29 grams - more than soda! In fact, the American Academy of Pediatrics recommends no more than 6 ounces of juice per child per day because it is "empty calories.”

When should I start brushing my child's teeth, and what about using toothpaste?

Starting at birth, the American Academy of Pediatric Dentistry suggests cleaning your child’s gums with a soft infant toothbrush or cloth and water at least once a day at bedtime. When the first teeth begin to appear, start brushing twice a day using a soft-bristled toothbrush.

Use a smear of fluoridated toothpaste for children less than three years of age. A pea-size amount of fluoridated toothpaste is appropriate for children aged three to six.

I thought cavities are going away. How come you need to see children so young?

Cavities are on the rise again. There is a delicate interplay taking place in getting cavities; it is not just eating sugar or candy. In fact, it is a combination of what you eat, how frequently you eat, your genetic ability to fight decay through tooth hardness and saliva, and your use of preventative measures such as brushing, flossing, and toothpaste with fluoride.

What age should I bring my child to the dentist?

The American Academy of Pediatric Dentistry recommends establishing a dental home by the age of 1 or no later than 6 months from when the first tooth erupts.

Office Visits & Treatment
My child has cavities. What will you do?

Every child is different and we tailor the treatment plan for them. In some cases, it is preventative intervention known as anticipatory guidance. It might involve a fluoride varnish, or it might involve a filling. If a tooth is near being lost, it may include just waiting. This is all part of your child's "Cavities Risk Assessment.”

Do you use silver amalgam fillings?

Our office uses bonded composite resin fillings which are aesthetically pleasing, durable, and long lasting. They are more difficult to place and technique sensitive than the silver amalgam fillings, but we have found parents like them more. In some cases, we need to use stainless steel crowns in the back of the mouth for extremely damaged teeth.

Will I be allowed in the room during exam and treatment?

We have an open door policy. Parents are invited in if they wish. Some children do better with parents present, some without. It is unique for each child. We can help you make the decision.

If my child is too afraid or has very sensitive cavities, what will you do?

We use many forms of behavioral training to help a child get through a visit. Some children require the use of sedating medicines or general anesthesia to complete their treatment.

What Is Nitrous Oxide?

Oral Conscious Sedation: Nitrous Oxide/Oxygen
It is important that children remain calm during dental treatment to prevent injury to themselves and to allow them to receive proper dental care. The American Academy of Pediatric Dentistry recognizes nitrous oxide/oxygen inhalation as a safe technique to reduce anxiety and enhance effective communication. Indications for its use include: 1) a fearful and anxious patient, 2) certain patients with special health-care needs, 3) a patient whose gag reflex interferes with dental care, and 4) a cooperative child undergoing a lengthy procedure.

Understanding safe sedation

  • Nitrous oxide is a colorless and virtually odorless gas with effective anxiety-reducing effect. It is absorbed rapidly, allowing for both quick onset and recovery (2-3 minutes)
  • Commonly known as “laughing gas” because some patients become so comfortable and relaxed that they laugh
  • Child will be alert, responsive and will breathe on his/her own. Some children may take a nap, since they are relaxed; nitrous itself does not make a person sleepy.

During procedure

  • A small mask is placed over the nose so the child can breathe the nitrous oxide/oxygen comfortably.
  • Time seems to pass faster, which makes the child more relaxed and comfortable
  • A local anesthetic may also be given to numb the area to be treated
  • At the end of treatment, the nitrous oxide is turned off and only oxygen flows through the mask to flush out the nitrous oxide from the child’s system
    Before treatment
  • A very light meal may be given 2 hours before the appointment; though adverse effects of nitrous oxide are rare, nausea and vomiting occur in a very small percentage of patients (0.5%)

After treatment

  • Child will be alert and ready to go home
  • If local anesthetic is used, child will feel numbness in the treated area for about 2-3 hours afterwards; carefully watch for lip/cheek biting
Are dental X-rays safe for children?

With contemporary safeguards, such as lead aprons and high-speed film, the amount of radiation received in a dental X-ray examination is extremely small. Even though there is very little risk, pediatric dentists are particularly careful to minimize the exposure of child patients to radiation. In fact, dental X-rays represent a far smaller risk than an undetected and untreated dental problem.

What is fluoride?

Fluoride is a compound that contains fluorine, a natural element. Using a small amount of fluoride on a regular basis can prevent tooth decay. Studies show that cavities are reduced by 15 to 30% in kids who use fluoride toothpaste. Research shows that community water fluoridation has lowered decay rates over 50%. For nearly 70 years, studies have consistently shown that fluoridation of community water supplies is safe and effective in preventing dental decay in both children and adults.

How does fluoride prevent tooth decay?

Fluoride inhibits loss of minerals from tooth enamel and encourages remineralization, strengthening areas that are weakened/beginning to develop cavities. Fluoride also affects bacteria that cause cavities, discouraging acid attacks that break down teeth. Fluoride binds with natural tooth minerals of calcium and phosphate, resulting in tooth structures that are more acid-resistant. Thus fluoride helps fight decay in people of all ages. Risk for decay is reduced even more when combined with a healthy diet and good oral hygiene.

How safe is fluoride?

Use of fluorides for the prevention and control of cavities is documented to be both safe and highly effective. However, too much fluoride can cause fluorosis of the developing permanent dentition. Fluorosis is generally mild, with tiny white specks that are often unnoticeable. In severe cases, the enamel may be pitted with brown discoloration. Development of fluorosis depends on the amount, the duration and timing of excessive fluoride. Numerous studies and years of clinical experience shows that in-office application of fluoride are beneficial to dental health.

What are dental sealants?

Our teeth are covered with a sticky film of bacteria, called plaque. When we eat or drink anything that contains sugar, bacteria turn the sugar into acids that can attack tooth enamel . Over time, these attacks can cause decay, or cavities. The good news is that there is a way to protect teeth and prevent decay: dental sealants.

A dental sealant is a plastic resin material applied to the chewing surfaces of the back teeth. The sealant material flows into the pits and grooves in the teeth. The sealant acts as a barrier, protecting enamel by sealing out plaque, bacteria, and food.

Which teeth are suitable for sealants?

Permanent molars are the most likely to benefit from sealants. The first molars usually come into the mouth when a child is about 6 years old. Second molars appear at about age 12. It is best if the sealant is applied soon after the teeth have erupted, before they have a chance to decay.

How are sealants applied?

Applying sealants does not require drilling or removing tooth structure. The process is short. After the tooth is cleaned, a special gel is placed on the chewing surface for a few seconds. The tooth is then washed off and dried. Then, the sealant is painted on the tooth. The dentist then shine a light on the tooth to help harden the sealant. It takes about a minute for the sealant to form a protective shield.

Are sealants visible?

Sealants can only be seen up close. Sealants can be clear, white, or slightly tinted.

Will sealants make teeth feel different?

As with anything new that is placed in the mouth, a child may feel the sealant with the tongue. Sealants, however, are very thin and only fill the pits and grooves of molar teeth.

How long will sealants last?

A sealant can last for as long as 5 to 10 years. Sealants should be checked at your regular dental appointment and can be reapplied if they are no longer in place.

Will sealants replace fluoride for cavity protection?

No. Fluorides, such as those used in toothpaste, mouth rinse, and community water supplies also help to prevent decay, but in a different way. Sealants keep germs and food particles out of the grooves by covering them with a safe coating. Sealants and fluorides work together to prevent tooth decay.

How do sealants fit into a preventive dentistry program?

Sealants are one part of a child's total preventive dental care. A complete dental program also includes fluoride, twice-daily brushing, wise food choices, and regular dental care.

Why is sealing a tooth better than waiting for decay and filling the cavity?

Decay damages teeth permanently. Sealants protect them. Sealants can save time, money, and the discomfort sometimes associated with dental fillings. Fillings are not permanent. Each time a tooth is filled, more drilling is done and the tooth becomes a little weaker.