Elevated Pediatric Dentistry

Dental FAQ

Why is it important to choose a Pediatric Dentist?

Pediatric dentists care for children of all ages. From first tooth to adolescence, they help your child develop a healthy smile until they’re ready to move on to a general dentist. Pediatric dentists have had 2-3 years of special training to care for young children and adolescents.

Should I Visit the Dentist During Pregnancy?
Research has shown that mothers with poor oral health may be at a greater risk of passing cavity-causing bacteria to their children, and periodontal disease can increase the risk of preterm birth and low birth weight. The American Academy of Pediatric Dentistry (AAPD) recommends that all pregnant women continue to visit the dentist for checkups during pregnancy.

To decrease the risk of spreading the bacteria, mothers should visit their dentist regularly, brush and floss on a daily basis, and maintain a healthy diet full of natural fiber, and reduce sugary foods. Additionally, increasing water intake and using fluoridated toothpaste helps prevent cavities and improves oral health.
When will my child begin to get teeth?
Your child’s first tooth will typically erupt between 6 and 12 months, although it can occur earlier or later. Usually, the two bottom front teeth erupt first, followed by two top front teeth. Your child should have all 20 baby teeth by their third birthday.

Permanent teeth start to appear around age 6, beginning with the first molars and lower central incisors. Kids lose all their baby front teeth (incisors) between 6 and 8 years old, and they lose the remainder of baby teeth between 10 and 12.

Permanent teeth can continue to erupt until approximately age 21. Adults have 32 permanent teeth including the third molars (called wisdom teeth).
Why do I need to take care of baby (primary) teeth?

Although all baby teeth will eventually fall out, it is important to maintain the health of these teeth until they fall out naturally. Untreated cavities on baby teeth can cause pain, infection and can also spread decay to permanent teeth. Losing baby teeth too soon can also cause crowding of the permanent teeth as they begin to emerge. Baby teeth are important to allow for normal chewing and eating leading to proper nutrition, and to keep an overall high quality of life during childhood. 

What is Baby Bottle Tooth Decay?
One of the most common forms of early childhood caries is “baby bottle tooth decay,” which is caused by the continuous exposure of a baby’s teeth to sugary drinks. Nighttime bottle feeding or nursing beyond 18 months can cause cavities on primary teeth, especially when combined with other carbohydrates. Baby bottle tooth decay primarily affects the upper front teeth, but other teeth may also be affected.

Early symptoms of baby bottle tooth decay are white spots on the surface of teeth or on the gum line, and tooth sensitivity. More severe symptoms can appear in advanced stages of baby bottle tooth decay. There may be brown or black spots on teeth, bleeding or swollen gums, fever, and bad breath. If your child shows any of these symptoms, please see your pediatric dentist immediately to prevent more complicated problems from occurring.
Tips to Prevent Baby Bottle Tooth Decay
Once your baby has teeth, don’t send them to bed with a bottle of anything except water. This is understandably difficult, but research studies are clear that baby bottle use beyond 12-18 months will rapidly cause tooth decay. Starting the weaning process before then greatly reduces the likelihood of them getting a cavity early on.

As your baby’s teeth start to emerge, start brushing the teeth twice per day with a soft bristled toothbrush and a thin smear of fluoridated toothpaste.

Try to limit sugary drinks and food when possible. Frequent snacking on sugar can provide a steady reservoir for the bacteria in your baby’s mouth to create a cavity. Juice, soft drinks, sports drinks, milk, and sweetened tea can all cause cavities and do so at even higher rates when they are delivered slowly over time through a sippy cup.

Find a pediatric dental home by age 1 at the latest. Regular dental checkups every 6 months will lower your child’s overall cavity risk.
What if my Child Fractures or knocks out a Tooth?

If your child fractures a tooth, then gather any fragments you can find and store them in a clean container of milk, or saliva of the child that lost the tooth. Never use water to transport a broken or knocked out tooth. It is important that you visit the dentist immediately to prevent infection and other complications that are brought on by chipped or knocked out teeth. If the tooth is knocked out, only touch the crown of the tooth and not the root. Your pediatric dentist will be able to repair your child’s tooth or fix it with a crown.

What if my child has a Tongue, Cheek or Lip Injury with Excessive Bleeding?

If you child experiences a cut on their tongue, cheek or lip, bleeding can usually be stopped by applying clean gauze to the affected area. You can also apply ice to the area to help stop the bleed. If you cannot stop the bleeding, call your pediatric dentist or visit the emergency room. . If your child has an open oral wound, for a long period of time they can be susceptible to infection.

What do I do for a Persistent Toothache?

If your child has a toothache, then have them rinse their mouth with warm water to ease the pain. If the pain persists for more than 24 hours, contact your pediatric dentist. Persistent toothaches can indicate more serious problems that need to be observed by a dental professional.

Why are Dental Radiographs (X-Rays) Important?
X-rays are valuable aids to help dentists diagnose and treat conditions that cannot be visibly seen. X-Rays can detect much more than cavities. X-Rays can show erupting teeth, diagnose bone diseases, measure the damage of an injury, or help with planning of orthodontic treatment. If dental problems are found and treated early, dental care is more comfortable for your child and more affordable for you.

Dental X-Rays are very safe and the amount of radiation from dental X-Rays is very small. Today’s equipment filters out unnecessary x-rays and restricts the x-ray beam to the area of interest. Dental X-Rays are designed to limit the body’s exposure. Pediatric dentists are very careful to minimize the exposure of their patients to radiation. In fact, dental radiographs represent a far smaller risk than an undetected and untreated dental problem.
When Is The Best Time For Orthodontic Treatment?
Orthodontic Treatment can be recognized as early as 2-3 years of age. Often, preventative steps can be taken to help reduce the need for major orthodontic treatment later on.

From ages 2 to 6, the main concern would be habits such as finger or thumb sucking. underdeveloped dental arches, and early loss of primary teeth.

From ages 6 to 12, treatment options deal with jaw and dental alignment problems. This is a great time to start treatment, as your child’s hard and soft tissues are usually very responsive to orthodontic or orthopedic forces.
What are Shark Teeth?

When adult teeth come in behind the baby teeth can be called “Shark Teeth” It is common, and occurs as the result of a lower baby tooth not falling out when the permanent tooth is arriving. In most cases, the baby tooth will fall out on its own within a couple months. If it doesn’t fall out on its own contact your pediatric dentist.

My child snores and often seems to stop breathing during sleep. What could cause this?
If your shows signs of disturbed sleep including long pauses in breathing, tossing and turning in the bed, chronic mouth breathing during sleep, night sweats (owing to increased effort to breathe) this may be an indication of sleep apnea. This is far more common than parents realize and is most seen in children between 2 and 8 years old, although it can present itself at any age.

If your child is suffering from these symptoms, we can help determine underlying causes and may refer your child to an Ear, Nose and Throat (ENT) doctor for further evaluation. While there is a possibility that affected children will “grow out of” their sleep disorders, the evidence is steadily growing that untreated pediatric sleep apnea can affect attention-deficit hyperactivity disorder, bed-wetting, sleep-walking, and even failure to thrive.
Do you offer pediatric sedation?
Elevated Pediatric Dentistry Specialists is proud to offer several options for safe and effective sedation.

We use Nitrous oxide, sometimes called “laughing gas,” to help children become more comfortable during certain procedures. Nitrous oxide as a safe and effective sedative agent that is mixed with oxygen and inhaled through a small mask that fits over your nose to help you relax. It is not intended to put them sleep but instead is designed to help them feel calm and comfortable. The effects of nitrous oxide are temporary and wear off soon after the mask is removed.

For treatments that may last longer or cause more discomfort, we will often recommend a mild oral sedative that your child can take prior to treatment. Every effort is made to ensure proper dosage and limit mild side effects, if any.

More complex treatments may require deeper sedation to relieve both pain and anxiety. On occasion, general anesthesia through an IV may be used to cause a temporary loss of consciousness. Your child’s comfort and safety are very important to us.
Do you use Silver diamine fluoride (SDF)?

Yes. Silver diamine fluoride (SDF) is a liquid substance used to help prevent tooth cavities (or caries) from forming, growing, or spreading to other teeth. It can also help to arrest the cavities in young kids to hold on treatment until treatment can be done.

What is Bruxism (Teeth Grinding)?
Bruxism is more commonly known as teeth-grinding, and a surprising number of children suffer from it – around 3 in 10. Teeth-grinding usually occurs while children are asleep, and it can become a dental problem if left unchecked. Regular teeth-grinding can wear down tooth enamel, reinforce improper bite patterns, and leave teeth more susceptible to cavities and decay.

Bruxism can cause headaches, earaches, facial pain and bite and jaw problems.

If your child’s teeth-grinding is ongoing, then their dentist may prescribe a night guard to protect their teeth and mouth. A night guard helps ease the pain of tooth grinding, and protects tooth enamel from being worn away.
How do I Stop My Child from Thumb Sucking or Pacifier Use?
Thumb sucking, finger sucking and pacifier use are habits common in many children. In fact, nearly one third of all children suck on their thumbs, fingers or pacifiers in their first year of life. Thumb sucking, finger sucking and pacifier use can lead to many oral developmental issues that negatively affect the development of the mouth. These habits can cause problems with the proper alignment of teeth and can even affect the roof of the mouth.

Boredom, anxiety, anger, hunger, or even sadness can all cause children to suck on their fingers for comfort. Children mostly suck on their fingers for comfort from an uncomfortable emotional state or stressful situation.

If your child hasn’t stopped sucking their fingers by age 5, then you must wean them from the habit so that they can develop a healthy young smile. By 5 years of age, your child’s mouth will be rapidly developing and thumb sucking, finger sucking or pacifier use can interfere with that process.
I have noticed that my child breathes through his/her mouth frequently. Is this a problem?
While it can be common for children to breathe through their mouths on occasion (when they are congested, have a cold or are involved in strenuous activity) breathing through the mouth all the time, including when you’re sleeping, can lead to problems.

If your child is suffering from these symptoms, we can help determine underlying causes and may refer your child to an Ear, Nose and Throat (ENT) doctor for further evaluation. Mouth breathing in children can cause bad breath, crooked teeth, jaw alignment issues, and other orthodontic problems.
How Can I Help Prevent Cavities for My Children?

To prevent cavities, we suggest enjoying a mouth-healthy diet, full of fibrous fruits and vegetables. Drink more water, which prevents dry mouth and naturally cleans teeth. Brush twice a day for two minutes at a time, and floss daily. Visit your dentist every six months for routine checkups and preventative care.

How Do I Care for My Child’s Teeth?

It’s never too early to begin a healthy oral care routine. In fact, you should begin caring for your child’s gums long before their first tooth emerges, which is usually around the six-month mark of their life. Healthy gums are an important predicator of healthy teeth, and maintaining clean gums will help ensure that your child has healthy, cavity-free baby teeth.

You can clean your infant’s gums – or their first teeth – by simply using a cold, clean washcloth. Simply rinse a clean, soft washcloth with cool water and wring it out. After your child has finished eating, or drinking a sugary drink, use the damp washcloth to gently wipe out their mouth. This will remove any sugar or acid that’s left by their food, and help prevent early cavities.

Once your child has a few more baby teeth – usually between 8 and 12 months – then you can graduate from a washcloth to a toothbrush designed for toddlers. There are a lot of toothbrushes designed for babies and toddlers from which to choose. Generally speaking, toothbrushes designed for babies have much softer bristles and a smaller head than those meant for older children.

Use only a smear of toothpaste – about the size of a grain of rice – to brush their teeth. Children 3 and older can safely use a pea size amount of toothpaste. It is safe for young children to swallow a small amount of toothpaste during brushing, but it is important to keep the toothpaste tube away from your child to avoid them swallowing the whole tube.

Flossing is also important for baby teeth. Flossing helps remove the plaque and food that can become lodged between teeth. Be sure to floss your child’s teeth daily.

Can my Child’s Diet affect their Teeth?

Children should eat a variety of foods including grains, fruits, protein, vegetables, and low-fat dairy, raw vegetables like carrots, celery and bell pepper are excellent snacking alternatives to unhealthy chips and crackers. Starchy carbs like potato chips and crackers can stick to teeth and cause unhealthy buildup, which can lead to cavities. Fibrous vegetables like celery can actually clean your teeth as you eat them! That is also true of fibrous fruits like apples, strawberries and kiwi.

So choose raw fruits and vegetables instead of chips, they are better for your overall health, and they won’t stick to your teeth like starchy carbs and sugars.

What are Dental Sealants?

Dental sealants work to prevent cavities by sealing pits and fissures that naturally occur in molars. Sealants “seal off” the pit and fissure of your molars to prevent food and plaque from collecting and forming cavities.

What is Fluoride and Why Do My Children Need It?
Fluoride is considered to be nature’s own cavity fighter. Fluoride is naturally found in all sources of water such as lakes, rivers and even the ocean. Fluoride is added to most public water supplies, so the tap water in your home has fluoride added to it. Fluoride helps build tooth enamel which helps protect your teeth from tooth decay.

For more than half a century, the ADA has recommended using toothpaste containing fluoride to prevent cavities. Fluoridated toothpaste does an excellent job of cleaning teeth, but make sure that your child spits all of it out and rinses their mouth thoroughly after brushing since ingesting excessive fluoride can lead to a condition called fluorosis. Fluorosis is faint white lines on the teeth.
Xylitol – A Healthier Sugar for Teeth?
Xylitol has the sweet benefits of traditional sugar, but it doesn’t have the negative effects on teeth like sugar. The natural sugar alcohol, Xylitol, actually helps prevent cavities by inhibiting the growth of bacteria that causes cavities. You can find natural xylitol in some fruits and berries. Xylitol can most often be found in gums and mints.

The American Academy of Pediatric Dentistry (AAPD) recognizes the benefits of xylitol for the oral health of infants, children, adolescents, and persons with special health care needs.
Are Sports Drinks Bad for Your Teeth?

Did you know that sports drinks can contain more sugar than leading cola beverages, with as much as 19 grams of sugar per serving? The sugars increase the acidity in your mouth which attracts tooth enamel destroying bacteria. Sugar increases the acidity in your mouth which helps give bad oral bacteria the fuel it needs to create cavities.

Why Does my Child Need a Mouthguard?

Mouth guards – sometimes called mouth protectors – work by helping cushion a blow to the face, and minimizing the risk of broken teeth, or lacerating a lip, tongue or cheek. Did you know that the CDC estimates that more than 3 million teeth are knocked out at youth sporting events? Mouth guards work to prevent tooth loss and other facial injuries. Mouth guards come in a variety of shapes, sizes, and are designed for multiple sports.<br>
Contact us about custom mouth protectors.

What is a Frenectomy?

A frenectomy is the removal of connective tissue (called the frenum) from under the tongue (Lingual Frenectomy) or the upper gums (Maxillary Frenectomy). If your baby is having trouble with breastfeeding and “latching on” or your older child is experiencing certain speech, eating, or orthodontic problems, we may recommend frenectomy as an option. New technologies have made frenectomies a safe and convenient option for even very young children.

Babies who have difficulty achieving or maintaining proper latching with their mother’s breast, may have a condition called Ankyloglossia, sometimes referred to as tongue-tie. Tongue-tie is usually related to a short, thick frenum, which limits the tongue’s capacity to move. Symptoms of a possible tongue-tie or lip-tie in a newborn are: prolonged breastfeeding, difficulty latching onto the breast (causing sore nipples on the mother), and excessive gassiness. Many mothers are opting for a safe, fast-healing frenectomy to help their babies establish a good seal while eating. Apart from breastfeeding difficulty, tongue ties can also impact speech and eating in children and adults. Patients often try to compensate for the lack of tongue mobility by changing their jaw position – resulting in other orthodontic issues.

What are the orthodontic reasons for a Frenectomy?

Frenectomies can be an important part of orthodontic treatment when a long or short frenum is causing tooth or jaw displacement. In the case of a short lingual frenum, patients may push out the lower jaw to make eating or speaking easier – causing pain in the jaw or an underbite. In this case, a lingual frenectomy may be recommended to help ensure the success of orthodontic treatment. When treating a patient with a gap between their front teeth, the orthodontist may recommend a maxillary frenectomy after braces to prevent the teeth from spreading apart after treatment.