Care For Your Baby

Q: When should my child first see a dentist?

A: "First visit by first birthday" sums it up. Your child should visit a pediatric dentist when the first tooth comes in, usually between six and twelve months of age. Early examination and preventive care will protect your child's smile now and in the future.

Q: Why so early? What dental problems could a baby have?

A: The most important reason is a practical prevention program. Dental problems can begin early. A big concern is nursing or baby bottle tooth decay. Your baby risks severe decay when he or she nurses continuously from the breast or from a bottle of milk, formula, or juice during naps or at night.

Another concern is gum disease. Recent studies show nearly half of all children ages two and three have at least mild inflammation of gum tissues. The earlier the dental visit, the better the chance of preventing dental problems. Children with healthy teeth chew food easily, learn to speak clearly, and smile with confidence. Start your child now on a lifetime of good dental habits.

Q: How can I prevent tooth decay from nursing or a bottle?

A: Don't nurse your child to sleep or put your baby to bed with a bottle of milk, formula, juice, or sweetened liquid. Use only water in the bottle, or give your baby a pacifier. Check with your pediatric dentist to make sure your child is getting enough fluoride for decay protection. Lastly, learn how to brush and floss your child's teeth.

Q: When should bottle or breast feeding be stopped?

A: To assure good dental health, infants should be weaned from a bottle or nursing at one year of age.

Q: Should I worry about thumb or finger sucking?

A: Thumbsucking is perfectly normal for infants: most stop by age two. If your child doesn't, discourage it after age four. Prolonged thumbsucking can create crowded, crooked teeth or bite problems. Your pediatric dentist will be glad to suggest ways to address a prolonged thumbsucking habit.

Q: When should I start cleaning my baby's teeth?

A: The sooner the better! Starting at birth, clean your baby's gums with a clean damp wash cloth. Use a tiny dab of fluoride toothpaste if your pediatric dentist advises fluoride protection. Later, brush your child's teeth with fluoride toothpaste and small, soft-bristled toothbrush. Remember that most small children do not have the dexterity to brush their teeth effectively.

Q: Any advice on teething?

A: From six months to age three, your child may have sore gums when teeth erupt. Many babies like a clean teething ring, cool spoon or cold wet wash cloth. Some parents swear by a chilled teething ring: others simply rub the baby's gums with a clean finger.

Dental Checklist

Birth to 6 Months

____ Clean mouth with gauze after feedings and at bedtime.

____ Ask your pediatrician or pediatric dentist about fluoride supplements.

____ Regulate feeding habits.

6 to 12 Months

____ First tooth should appear; time to see the pediatric dentist for an exam.

____ Begin to brush teeth after each feeding and at bedtime with small, soft-bristled brush.

____ Baby begins to walk; be alert to dental injuries.

____ Wean from breast or bottle by first birthday.

12 to 24 Months

____ Discontinue bottle use (especially at night) in consultation with your doctor.

____ First visit to dentist.

____ Follow schedule of exams and cleanings recommended by pediatric dentist.

____ Start using pea-sized portions of fluoridated toothpaste when child is able to rinse.

____ Most primary teeth have erupted.

____ Diet counseling - hygiene instruction.

3 to 4 Years

____ Evaluate primary molars for enamel sealant.

____ Verify change in fluoride dosage.

5 to 6 Years

____ Seal permanent first molars.

7 to 8 Years

____ Ask for orthodontic evaluation.

10 to 11 Years

____ Seal all premolars.

____ Evaluate appearance of teeth.

____ Confirm orthodontic evaluation.

12 Years

____ Seal permanent second molars.

12 - 16 Years

____ Continue check-up visits every six months.

17 Years

____ Discontinue fluoride treatment.

The above procedures are in addition to periodic check-up exams every six months.

Regular Dental Visits

Q: How often should a child see the dentist?

A: The American Academy of Pediatric Dentistry recommends a dental check-up at least twice a year for most children. Some children need more frequent dental visits because of increased risk of tooth decay, unusual growth patterns or poor oral hygiene. Your pediatric dentist will let you know the best appointment schedule for your child.

Q: What happens in a dental check-up?

A: The pediatric dentist will review your child's medical and dental history. He or she will gently examine your child's teeth, oral tissues, and jaws. The teeth will be cleaned and polished, followed by the application of a fluoride solution.

Your pediatric dentist won't talk just to you about dental health, he or she will talk to your child with easily understandable words, pictures, and ideas. Your child will be motivated to take responsibility for a healthy smile.

Nitrous Oxide Sedation

Many children are calm, comfortable, and confident in a pediatric dental office. Because pediatric dentists specialize in treating children, they make children feel special. The office is especially designed for children. Staff members choose to work in a pediatric dental office because they like kids.

Sometimes, however, a child feels anxious during treatment. Your child may need more support than a gentle, caring manner to feel comfortable. Nitrous oxide/oxygen is a safe, effective technique to calm a child's fear of the dental visit.

Q: What is nitrous oxide/oxygen?

A: Nitrous oxide/oxygen is a blend of two gases, oxygen and nitrous oxide. When inhaled, it is absorbed by the body and has a calming effect. Normal breathing eliminates nitrous oxide/oxygen from the body.

Q: How will my child feel when breathing nitrous oxide/oxygen?

A: Your child will smell a sweet, pleasant aroma and experience a sense of well-being and relaxation. If your child is worried by the sights, sounds, or sensations of dental treatment, he or she may respond more positively with the use of nitrous oxide/oxygen.

Conscious Sedation

Q: What is conscious sedation?

A: Conscious sedation is a way of using medication to relax a child without the loss of consciousness.

Q: Who should be sedated?

A: Children with severe anxiety and/or the inability to relax are candidates for sedation. Usually these children are young or have trouble managing their anxiety.

Hospital Dentistry

Q: What is general anesthesia?

A: General anesthesia provides a way of effectively completing dental care while a child is unconscious.

Q. Who should receive dental care with general anesthesia?

A: Children with severe anxiety and/or the inability to relax are candidates for general anesthesia. Usually these children are young or have compromised health and helping them control their anxiety is not possible using other methods.

Q: Is general anesthesia safe?

A: An experienced health care provider, specifically trained in delivering general anesthesia, is responsible for the general anesthesia delivery, monitoring and medical care of the child. Many precautions are taken to provide safety for the child during general anesthesia care. Patients are monitored closely during the general anesthesia procedure by anesthesia personnel who are trained to manage complications. Your pediatric dentist will discuss the benefits and risks involved in general anesthesia and why it is recommended for your child's treatment.

Preventive Dentistry

Q: What is preventive dentistry?

A: Preventive dentistry for children includes:

• brushing
• dental development
• flossing
• fluorides
• oral habits
• orthodontics
• parent involvement
• proper diet
• sealants
• sports safety

Your pediatric dentist practices preventive dentistry.

Q: Why is preventive dentistry important?

A: Preventive dentistry means a healthy smile for your child. Children with healthy mouths chew more easily and gain more nutrients from the foods they eat. They learn to speak more quickly and clearly. They have a better chance of general health, because disease in the mouth can endanger the rest of the body. A healthy mouth is more attractive, giving children confidence in their appearance. Finally, preventive dentistry means less extensive, and less expensive, treatment for your child.

Q: When should preventive dentistry start?

A: Preventive dentistry begins with the first tooth. Visit your pediatric dentist when the first tooth comes in. You will learn how to protect your infant's dental health. The earlier the dental visit, the better the chance of preventing dental disease and helping your child belong to the cavity-free generation.

Q: What role do parents play in prevention?

A: After evaluating your child's dental health, your pediatric dentist will design a personalized program of home care for your child. This program will include brushing and flossing instructions, diet counseling, and if necessary, fluoride recommendations. By following these directions, you can help give your child a lifetime of healthy habits.

Q: How do pediatric dentists help prevent dental problems?

A: Tooth cleaning and polishing and fluoride treatments are all part of your child's prevention program. But there's much more. For example, your pediatric dentist can apply sealants to protect your child from tooth decay, help you select a mouth guard to prevent sports injuries to the face and teeth, and provide early diagnosis and care of orthodontic problems. Your pediatric dentist is uniquely trained to develop a combination of office and home preventive care to insure your child a happy smile.

Space Maintenance

Q: Why do children lose their baby teeth?

A: A baby tooth usually stays in until a permanent tooth underneath pushes it out and takes its place. Unfortunately, some children lose a baby tooth too soon. A tooth might be knocked out accidentally or removed because of dental disease. When a tooth is lost too early, your pediatric dentist may recommend a space maintainer to prevent future space loss and dental problems.

Q: Why all the fuss? Baby teeth fall out eventually on their own!

A: Baby teeth are important to your child's present and future dental health. They encourage normal development of the jaw bones and muscles. They save space for the permanent teeth and guide them into position. Remember: Some baby teeth are not replaced until a child is 12 or 14 years old.

Patients With Special Needs

Q: Do special children have special dental needs?

A: Most do. Some special children are very susceptible to tooth decay, gum disease or oral trauma. Others require medication or diet detrimental to dental health. Still other children have physical difficulty with effective dental habits at home. The good news is, dental disease is preventable. If dental care is started early and followed conscientiously, every child can enjoy a healthy smile.

Q: How can I prevent dental problems for my special child?

A: A first dental visit by the first birthday will start your child on a lifetime of good dental health. The pediatric dentist will take a full medical history, gently examine your child's teeth and gums, then plan preventive care designed for your child's needs.


Q: How often should a child have dental X-ray films?

A: Since every child is unique, the need for dental X-ray films varies from child to child. Films are taken only after a complete review of your child's health, and only when they are likely to yield information that a visual exam cannot.

In general, children need X-rays more often than adults. Their mouths grow and change rapidly. 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.

Q: Why should X-ray films be taken if my child has never had a cavity?

A: X-ray films detect much more than cavities. For example, X-rays may be needed to survey erupting teeth, diagnose bone diseases, evaluate the results of an injury, or plan orthodontic treatment. X-rays allow dentists 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 affordable.