Hello and welcome to the latest blog post installment! The topic today is on pediatric/children’s dentistry. I cannot begin to explain the variety of questions I receive on this topic. Most are very well informed questions, and some, frankly, are quite off the wall. Yet, at the end of the day, they all come from parents that are concerned about the health and well-being of their children. In this post I will answer some of the most frequent questions that I receive on an almost daily basis and hopefully answer questions that some you may have as well!
Question 1: When should I bring my child for their first dental visit?
This questions always raises the most eyebrows when I answer, because most people tend to assume the answer to be,” sometime after the age of 3.” I still do not have the slightest idea where this notion came from, but I also cannot fault anyone for assuming this is the standard age. After all, by the age of 3 most children have a full set of baby teeth. However, current recommendations from the American Academy of Pediatric Dentistry suggest that a child have their first visit by either the age of 1, or at the sign of the first tooth, whichever comes first. The reasons for this early visit are numerous. Once a tooth erupts, the risk for developing cavities begins. While it’s not terribly likely to find a cavity in an infant, they are exposed to higher levels of sugars in juices, placing them at risk for a condition called “nursing bottle caries” or “baby bottle rot” as it is sometimes referred. These early dental visits also allow your dentist to identify any potential tooth or gum tissue developmental issues that may need to be addressed early. Lastly, these early dental visits (referred to as “Happy Visits” in our Elgin office) set the child down a path of trust and confidence with their dentist and dental hygienist.
Question 2: What is the best way to brush my child’s teeth?
The first key to this question is simple: patience. As a dentist, and a father of three young children, even I struggle with children who fuss, cry and run every time you tell them it is time to brush and floss. Fortunately, children can be easily distracted. There are apps on smartphones and tablets that allow children to follow along with their favorite song or cartoon character. A really fun device that I recently noted is from a company called Playbrush.
There are a variety of techniques that can be employed to brush your child’s teeth. Most commonly recommended is the small circle method. However, the most effective means of plaque removal come from a technique called the Modified Bass (no, not the fish). The technique is simply to angle the toothbrush underneath the gumline and move the brush back and forth to “sweep under the gums.” Electric toothbrushes are a particularly wonderful tool to make this even more effective. The most common brands are from Oral B and Sonicare. These are great investments in your child’s oral health.
Question 3: Where are my child’s teeth? Shouldn’t they be in by now?
This question is typically accompanied by the highest level of panic and concern for most parents, and for good reason. You care about your child and yet, they hit the age of 1 (sometimes older) and they still have that beautiful gummy smile! Fear not nervous parents, this is not unusual. On average, a child will start to erupt their first teeth around 6 months of age. Notice what I said there; AVERAGE. Some babies are born with teeth in their mouth and some children sprout teeth well after 1 year of age. Each child is different and will grow and develop at their own rate. The teeth are no exception. Just be patient and you’ll be experiencing the joy of a teething baby in no time!
Question 4: When does my child need to see the orthodontist?
This question is undoubtedly the hardest to answer as almost every orthodontist has a different philosophy on treatment. I have seen children in braces as early as 5 years old. In my opinion, anything before the age of 8 is too premature, but many orthodontists these days are placing children in what is known as “phase 1 orthodontics.” This usually involves placing brackets and spacers in an attempt to create space for teeth to come in as normally as possible. The goal is to attempt to avoid children becoming what have been historically called “extraction cases.” Orthodontics is all about space availability. If the teeth are larger than the space allows, it has historically been common to selectively remove bicuspid teeth (teeth between the front teeth and the molars) in order to create enough space to line up the rest. Phase 1 orthodontics attempts to avoid such treatments. The inevitable follow up question is, “Doc, if it was your kid which would you prefer?” I always tell parents I cannot answer that question because I do not know which way my children will develop over the next few years. However, I will never discourage a parent from seeking consultation with an orthodontist. It never hurts to have a conversation and have your child monitored by an orthodontist. The best course of treatment for your child is one that gives you the most comfort. Trust is paramount. If you do not trust your healthcare provider or those providing care for your child, a second opinion is always available. Do what you feel is right and if you still have doubts, your family dentist should be able to steer you in the right direction.
Question 5: Does my child really need that filling? Won’t the tooth just fall out anyway?
This question is always the most interesting to me because, in essence, it is very logical thought. If something is temporary, and it’s broken, why bother doing anything, right? I’ll admit, in some cases I will tell a parent that if their child has a cavity and it is close to coming out, I will simply let it nature take its course. However, this is more the exception than the rule. The reasons for this are numerous. Let’s look at a few of them. First, tooth decay spreads through baby teeth much faster than adult teeth. The enamel is thinner and the nerves of the teeth are more easily exposed to the cavity. Next, baby teeth serve an importance beyond that of just chewing food. They serve as the protectors of the permanent teeth. If the tooth becomes infected, this can alter the development of the adult tooth which will need to be addressed once the adult tooth erupts. This is not only more invasive, it is almost certainly more expensive. A third important aspect is one of space maintenance. The baby teeth hold the space for the adult teeth to erupt. If a cavity spreads and the tooth needs to be removed prematurely, the remaining teeth may shift and drift. This can drastically reduce the spacing available for the adult teeth and almost assures that your child will need braces.
Hope this helps!
Let’s keep our kids healthy, happy and smiling!
Until next time,
Dr. Bryan Blazer