Dental Topics

Children’s teeth begin forming before birth. As early as 4 months, the first primary teeth begin to erupt through the gums. Although all 20 primary teeth usually appear by age 3, the pace and order of their eruption varies.

Permanent teeth begin appearing around age 6, starting with the first molars and lower central incisors. At the age of 8, you can generally expect 4 primary teeth on the bottom (lower central and lateral incisors) and 4 primary teeth on the top (upper central and lateral incisors) to be replaced by permanent teeth. Around ages 10-12, another wave of permanent teeth begin to make their appearance. This process continues until approximately age 21. By the time children reach adulthood, they typically have 28 permanent teeth, or up to 32 including the third molars (or wisdom teeth).

During the transition from primary to permanent teeth, many parents have concerns about the possibility of adult teeth coming in behind the primary teeth, failing to push these first teeth out in the process. This is a very common occurrence and, in most cases, the primary tooth will fall out within two months if the child starts wiggling it. If not, your pediatric dentist can easily remove the tooth, allowing the permanent tooth to slide into the proper place.

We offer state-of-the-art digital x-rays to provide your child with the least amount of radiation possible in the field of dentistry. X-Rays are a vital and necessary part of your child’s dental diagnostic process. Without them, certain conditions can be missed.

While x-rays are used to detect cavities, they are also serve many other important functions. For example, radiographs may be needed to survey erupting teeth, diagnose bone diseases, evaluate the results of an injury, or plan orthodontic treatment. They allow dentists to diagnose and treat health conditions that cannot be detected during a clinical examination. If these issues are found and treated early, more extensive dental issues can be avoided and dental care will be more comfortable for your child and more affordable for you.

On average, most pediatric dentists request basic radiographs once a year and a complete set every 3 years. For children with a high risk of tooth decay, the American Academy of Pediatric Dentistry recommends x-rays and examinations every six months.

Pediatric dentists are particularly careful to minimize their patients’ exposure to radiation. With modern safeguards, including protective body shields, precision x-ray machines and high-speed filming, the amount of radiation received in a dental x-ray is extremely small and the risk negligible. In fact, these x-rays present a far smaller risk to children’s health than undetected and untreated dental problems. It is of upmost importance to us to protect your children as if they were our own!

Toothbrushing is one of the most important tasks to maintain good oral health. However, many toothpastes and polishes contain harsh abrasives and can damage young tooth enamel. When looking for a toothpaste for your child, make sure to pick one that has the American Dental Association recommendation displayed, as these products have undergone testing to ensure safety. Make sure to carefully follow the instructions listed on the tube for age-specific usage guidelines.

The AAPD recommends using no more than a smear or rice-size amount of fluoridated toothpaste for children less than three years of age and using no more than a pea-size amount of fluoridated toothpaste is appropriate for childrenaged three to six. To maximize the beneficial effect of fluoride in the toothpaste, teeth should be brushed twice a day, and rinsing after brushing should be kept to a minimum or eliminated altogether.

Parents are often concerned about children grinding their teeth (bruxism) while asleep. This condition is usually discovered by the noise it creates or by noticeable signs of wear on the teeth.

If excessive wear of the teeth (attrition) is present, then a mouth guard may be used. While this prevents damage to the teeth, it may interfere with jaw growth and increases the risk of choking. The good news is that most children outgrow pediatric bruxism by 9-12 years of age without intervention. If you suspect this condition, discuss your concerns with your pediatrician or pediatric dentist.

The pulp of a tooth is the inner, central core. It contains nerves, blood vessels, connective tissue and reparative cells. The purpose of pulp therapy in pediatric dentistry is to maintain the vitality of a tooth affected by decay or injury in attempts to save it from being lost. Pulp therapy is often referred to as a “nerve treatment” or “children’s root canal” and the two most common forms of this pediatric treatment are the pulpotomy and pulpectomy.

A pulpotomy removes the diseased pulp tissue within the crown portion of the tooth. Next, an agent is placed to prevent bacterial growth and to calm the remaining nerve tissue. This is followed by a final restoration (usually a stainless steel crown).

A pulpectomy is required when all of the pulp is affected, extending into the root canal(s) of the tooth. The diseased pulp tissue is completely removed from both the crown and root and the canals are cleansed and disinfected. If the area affected is a primary tooth, it will then be filled with a resorbable material. If the tooth is permanent, a non-resorbable material will be used. Lastly, a final restoration is placed.

Developing malocclusions, or bad bites, can be recognized as early as 2-3 years of age. Often, early steps can be taken to reduce the need for major orthodontic treatment later in life.

Early Treatment: This period refers to the treatment of children aged 2 to 6 years. At this young age, we are concerned with underdeveloped dental arches, the premature loss of primary teeth, and harmful habits such as finger or thumb sucking. Treatment initiated in this stage of development is often very successful and many times, though not always, can sometimes eliminate the need for future orthodontic/orthopedic treatment.

Mixed Dentition: This period refers to the treatment of children aged 6 to 12 years, with the eruption of the permanent incisor (front) teeth and 6 year molars. Treatment concerns deal with jaw relationships and dental alignment problems. Because the hard and soft tissues are usually very responsive to orthodontic and orthopedic forces during this time, when treatments are needed, they are very effective.

Adolescent with Permanent Dentition: This stage deals with the permanent teeth and the development of the final bite relationship.