Pediatric dentistry is the branch of dentistry that specializes in the care of children, technically up to the age of 18-21. While much of dentistry in children can be done in a general dentist’s office, sometimes due to the special needs of particular pediatric patients, or their age, specialialist care is needed. In our general dental office in Spring, TX, we care for a lot of children and below we outline some of the more common questions and concerns in children dental care.
How old should a child be to start seeing a dentist?
We recommend a child to start seeking a dental home starting around 6 months of age. At this age, the primary or “baby” teeth are just starting to emerge so monitoring can be started. Also, by exposing children to dental care early, they can become accustomed to dentists and very likely experience less anxiety later on in life, not to mention a greatly reduced likelihood of dental problems!
What is the most dangerous cause of decay in baby teeth?
Aside from consuming too much sugar-containing foods, one of the most common and dangerous causes of decay in children is excessive use of baby bottles. In these scenarios, parents often leave baby bottles filled with milk in the toddlers’ mouths and let them fall to sleep. However, because milk also contains ample amounts of sugar, this leaves the baby teeth very vulnerable to decay in a phenomenon called “baby bottle caries,” characterized by severe decay especially in the top front teeth. Therefore, we always recommend parents to take particular caution to avoid having the child use baby bottles during sleep.
My child has decay in his/her baby teeth.
Is fixing them necessary or should I just wait for them to fall out?
In general, decay in teeth should always be addressed. However, in the case of baby teeth, if the teeth are very loose and on the verge of falling out, letting them fall out on their own without treatment might be an option as well. However, in this scenario, two prerequisites must be met: 1) The teeth are very loose and of virtual certainty to fall out, and 2) No acute infection or pain present. Otherwise, we always recommend addressing decay to avoid having the child suffer potential pain/infection from decay.
OK, so my child has decay that needs to be addressed.
How is this done in children and what options are there?
Dentistry in principle is virtually the same in children as in adults. For small cavities, we remove the decay and fill the voids with either silver (amalgam) or tooth-colored (composite) fillings. For decay that is too deep or has already compromised the nerves, we would remove the infected nerves and place a steel crown on the tooth. For teeth that are damaged beyond restoration, we simply take them out. Treatment is done under local anesthesia so no pain would be experienced by the patient.
What if my child can’t sit through the treatment? He/she is very anxious and cries during treatment.
Generally, it has been our experience that for kids over the age of 5, the majority of them are able to sit through basic dental treatment through a combination of reasoning, tell-show-do, positive encouragment, and perhaps parental supervision. For those that are younger or for those with high anxiety, we would recommend them for specialist care with a pediatric dentist where sedation would be used. In our office, we do not sedate children as we do adults since we believe that children sedation requires more care and precaution, as their bodies are still developing and any drug allergies unknown. In cases where specialist care is needed, we highly recommend those using sedation and not the papoose board, as the latter tends to psychologically traumatize children and make it difficult for them to trust dentists as adults.
Is pediatric sedation safe?
I have heard of cases where children fatalities or injuries in recent years from this.
Yes, pediatric sedation is safe, provided that a pediatric dentist does it under an approved setting, preferably in a hospital. Doses must be given properly, and monitoring is mandatory as well. Our office works with a pediatric dentist who has hospital privileges in the Texas Children’s Hospital so that care done there is top-notch, safe, and monitored.
My child’s teeth are coming in crooked.
Should I be worried about how his/her permanent teeth will look?
We recommend not to worry about crooked baby teeth, as it is unknown how their permanent teeth will look given uncertainly in growth and maturation. How teeth come out and how they are aligned is a balance between the amount of space available (arch growth), size of teeth coming in, and perhaps daily habits as well. In cases where crowding does take place or teeth are impacted, they can be easily rectified with modern dental technology from orthodontics, minor surgery, and time.
I think my child needs braces. When can I take him/her to get it done?
In general, we recommend waiting until all baby teeth are properly exfoliated before getting braces. However, in cases where skeletal disharmony is present or if certain baby teeth are not being lost properly, earlier intervention might be necessary through the use of headgears or other devices. Our office recommends having braces done during puberty to take advantage of the growth spurt so that any skeletal disharmony, if present, can be most easily corrected.