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Pediatric dentists are the pediatricians of dentistry. Pediatric dentists are primary and specialty oral care providers for infants and children through adolescence. A pediatric dentist has two to three years of specialty training following dental school and limits his or her practice to treating children. This specialty training involves child psychology and development, behavior guidance techniques, treating patients with complex medical histories, and treating patients under sedation and general anesthesia. Pediatric dentists often work closely with other health care providers to ensure oral health care needs are aligned with a child’s general health care.
The American Academy of Pediatric Dentistry, as well as the American Academy of Pediatrics, recommend that children see a dentist by their first birthday or within six months of their first tooth coming in (whichever comes first).
Children under the age of three are usually more comfortable in their parent’s lap than in the dental chair. Dr. Stephanie and Dr. Katie encourage parents to place the child in their lap to offer comfort during their first few visits. We will perform a “knee-to-knee” exam, where the teeth and gums are examined to evaluate growth and development. During the cleaning, a topical fluoride will be applied and any dietary or hygiene recommendations will be made. Older children will be encouraged to sit in the dental chair and their first visit will involve a full exam, cleaning, X-rays (as needed) and a fluoride treatment.
Primary teeth, often called “baby teeth,” are important for a child’s growth and development. Not only do they help children speak clearly and chew naturally, but they also aid in forming a path that permanent teeth can follow when they are ready to erupt. These teeth should be maintained until they are ready to wiggle out as they help the formation of the upper and lower jaw. When primary teeth are affected by the bacteria that causes tooth decay, it can affect the child’s overall health. If these teeth are removed prematurely without proper space maintenance, children may experience difficulty speaking and eating—and permanent teeth can become delayed in their eruption. Permanent teeth may not have enough space to erupt, leading to problems with permanent dentition, jaw alignment and development.
Tooth decay or dental caries is caused by bacteria called strep mutans. This type of bacteria is infectious and contagious. In fact, dental caries is the most common chronic and infectious disease today in children. It is also preventable! The strep mutans which cause tooth decay feed on the food that we eat and produce acid, which in turn begins to eat away at the tooth. These bacteria require simple sugars to live, which come from food in our diet that either contains sugars (processed candy, snacks, soda or juices) or is broken down into sugars (bread, crackers, pasta, rice, cereal). In addition to feeding on simple sugars, strep mutans thrive when they are in contact with acid. Juice is the largest source of acid in most children’s diets, but other beverages such as Gatorade, sodas (diet soda included) and even some bottled waters are acidic. Parents should limit the amount of juice, and other sweetened or acidic beverages their child drinks and ensure it is given with a meal. The American Academy of Pediatrics recommends:
At Pediatric Dental Specialists of West Michigan, we recommend stopping thumb and pacifier habits between 18 months and two years of age. Excessive sucking on a finger or pacifier can alter the shape of the upper jaw and affect how it forms. Thumb and pacifier sucking habits will generally only become a problem if they go on for a very long period of time. Most children stop these habits on their own, but if they are still sucking thumbs or fingers when the permanent teeth arrive, a mouth appliance may be recommended by your pediatric dentist. Research has shown that if these habits do not stop before age three, there may be lasting effects to the formation of the jaw.
Kids need a variety of vitamins and minerals to grow up strong and healthy. Gummy vitamins have recently become popular but they do come with hidden dangers. The added sugar and sticky texture create a perfect storm for the formation of a cavity. These vitamins, like any other gooey treats, can get stuck in the grooves of teeth for hours, and as the saliva slowly dissolves them, they form a pool of “goo” deep in the pits and fissures. It only takes about 20 minutes for cavity-forming bacteria to start forming destructive acids from these sugars. Not only that, but these vitamins often taste like candy so children can easily overdose on them. Acute vitamin toxicity can be prevented by keeping these vitamins out of reach, and by talking to your child’s pediatrician about whether or not they need to take a daily vitamin. Most children can get their nutritional requirements from natural dietary sources.
Composite (white or tooth colored) and amalgam (silver) restorations are both reliable, strong choices to restore teeth. Composite is made from a mixture of glass or quartz filler in a resin medium that produces a tooth-colored filling. Composite is the material of choice for any restoration on a front tooth, and may be done on back teeth as well. For composite to be successful, it must be placed on a dry tooth to ensure proper adhesion to the tooth.
Fluoride benefits teeth in three ways. First, it can act in a topical way to remineralize teeth that are starting to weaken by decay, thus arresting or stopping the decay process. Second, it can strengthen teeth, making them less susceptible to decay. Third, it inhibits the bacteria that cause decay because it is antimicrobial.
The sooner the better! When the first teeth erupt, we recommend cleaning your child’s gums with a soft infant toothbrush twice a day. Flossing is encouraged as soon as your child’s teeth start to touch. For some children, this can happen early on. It will be important to start this habit right away to prevent food and plaque from being trapped between the teeth, which can lead to early tooth decay.
For children under three years old, use a smear of fluoridated toothpaste. And for children over three years old, use a pea-sized amount of fluoridated toothpaste. We recommend giving your child a turn to brush their teeth, but ensure that a parent or caregiver is always the primary toothbrusher. Remember, most children under age seven do not have the dexterity to brush their teeth effectively so work with your child to teach good brushing habits.
There is very little risk in dental X-rays. Pediatric dentists are especially careful to limit the amount of radiation exposure for children. Lead aprons and digital radiographs are used to ensure safety and minimize radiation. At PDS, we use digital radiography, which drastically limits the amount of radiation in comparison to traditional film X-rays. A child receives more radiation being outside on a sunny day for 15 minutes than he or she does from dental X-rays.
The best thing parents can do is to encourage healthy eating habits and routine brushing and flossing. Start by maintaining a regular brushing schedule of twice per day (i.e. after breakfast and before bed). Between-meal snacks should be limited so a child does not continuously snack throughout the day. Sticky foods, such as fruit snacks and gummy candies, should be avoided as they are not easily brushed out of teeth and lead to cavities. Snacks like string cheese, fresh fruits or vegetables should be encouraged. Juice and sweetened beverages should be limited to mealtimes in the amount recommended by the American Academy of Pediatrics. Many parents dilute juice or other beverages with water, but it is important to remember that diluted juice still contains sugar, and more importantly, still contains acid.
If your child participates in sports, especially high-impact athletics, we do recommend using a mouthguard. Properly designed and custom fabricated mouthguards are essential to prevent athletic injuries and reduce the incidence of concussions. They must be protective, comfortable, resilient, tear resistant, tasteless, and most importantly, have sufficient thickness in critical areas to absorb impact energy. Custom mouthguards are designed by the dentist and crafted by taking an impression of your child’s mouth. A stone cast of the teeth is made, then adapted with a thermoplastic material over the teeth. Finally, the cast is trimmed to ensure a correct and comfortable fit.
Tongue ties are quite common and can cause many problems, including difficulty when nursing, bottle feeding, eating, or speaking. Tongue ties have a significant effect on a child’s growth and development during the most formative time in their lives. To properly identify and diagnose tongue ties, pediatric dentists require special training. Many providers are not experienced in the diagnosis and treatment process. However, Dr. Katie and Dr. Stephanie have completed multiple continuing education courses to understand the diagnosis and treatment of tongue ties.
Our treatment involves a CO2 laser, which reduces healing time and post-operative pain. The tissue is vaporized by this type of laser, unlike other forms of treatment that may burn or cut the tissue. Dr. Katie and Dr. Stephanie are certified by the American Board of Laser Surgery for the treatment of tongue ties and other oral soft tissue problems. They encourage an interdisciplinary approach that includes working with lactation consultants, chiropractors, occupational therapists, and speech pathologists or therapists.