Frequently Asked Questions
Regular Dental Visits
A Pediatric Dentist has to be trained for two additional years after the initial four years of dental school. This training prepares the pediatric dentist to meet the needs of infants, children, and adolescents including children with special health care needs. Good oral health is an important part of your child’s overall health and well-being. Establishing us as your child’s Dental Home provides us the opportunity to help develop healthy dental habits and keep your child free from dental/oral disease. We focus on prevention, early cavity detection, and treatment of dental disease. Regular and pleasant visits to the dental office will make sure that your child is comfortable in a dental setting and will not be afraid of dentists as an adult.
The first dental visit should ideally be shortly after the first tooth erupts, but no later than the child’s first birthday. The earlier the dental visit, the better the chance of preventing dental disease and helping your child build a cavity-free smile.
The American Academy of Pediatric Dentistry recommends check-ups at least twice a year for most children. Some children may need to be seen more often due to elevated risk of tooth decay.
Since every child is unique, the need for dental x-rays varies from child to child. In general, children need x-rays taken more often than adults because their mouths grow and change rapidly, which makes them more susceptible to tooth decay than adults. For children with a high risk of tooth decay, we recommend x-rays be taken every 6 months to detect cavities developing between the teeth. Children with a lower risk will require x-rays less frequently.
We are careful to minimize the exposure of radiation to our child patients. With the contemporary current safeguards, the amount of radiation received by patients in dental x-ray examinations is extremely low small. We use lead aprons and shields to protect your child, and today’s our top-of-the-line equipment filters unnecessary x-rays. Digital x-rays with proper shielding make sure that your child receives a minimal radiation exposure.
Fluoride is a compound commonly used by dentists that contains fluorine. Using small amount of fluoride regularly can help prevent cavities. It is commonly added to tap water and may help to decrease cavities by 50%. It is also is present in toothpaste, mouth wash, and fluoride varnish.
Fluoride helps prevent the tooth enamel from mineral loss and helps remineralize the tooth. It also affects the bacteria that cause cavities by decreasing acid attack.
Fluoride use helps prevent and slow down decay while being safe and effective. However, fluoride containing products should be kept out of reach of children. Additionally, excessive use of fluoride can cause white spots on the teeth, and in very high doses, it can be toxic, just like any other medication.
Your child should use a fluoride toothpaste and brush twice daily, once after breakfast and once before bedtime.
For children under 3 years old, a smear the size of a grain of rice of the fluoride toothpaste should be used. For children 3-6 years old, a pea sized amount is recommended.
Topical fluoride is applied to tooth enamel and helps to prevent tooth decay. We use the fluoride varnish which is painted on the enamel. Children who benefit the most from fluoride are those at highest risk for decay. Risk factors include previous history of cavities, a high sugar diet, braces, or certain medical conditions such as dry mouth. Dry mouth can be caused by certain medications too.
Diet & snacking
A healthy diet is a balanced diet that includes fruits, vegetables, grains, meat and beans, and milk.
Children need a balanced diet for their teeth to develop properly and to maintain healthy gums. A diet high in sugar and starches makes your child more prone to cavities.
Be sure your child has a balanced diet. Sugary foods like cookies, candy, fruit snacks, and granola bars should be eaten sparingly. Additionally, soda, juice, and other sweetened beverages should be consumed infrequently. Sticky foods such as dried fruits or toffee are not easily washed away from the teeth by saliva, water, or milk, which puts individuals at higher risk for cavities. “Grazing” or frequent snacking also increases the acid attack on your teeth, which dissolves enamel and increases risk of tooth decay.
A dental sealant is a thin plastic coating on the chewing surfaces of the back teeth. The sealant material flows into the pits and grooves on the tooth. This prevents food particles or bacteria from getting stuck on the tooth, which in turn helps prevent cavities. Sealants are safe and effective. According to the CDC, children ages 6-11 without sealants have almost 3 times more cavities compared to kids with sealants. Sealants on permanent teeth reduce the risk of cavities by 80%. The application is usually fast and comfortable and can effectively protect teeth for many years.
Cavities, or tooth decay, is the destruction of your tooth enamel, the hard, outer layer of your teeth. It can be a problem for children, teens and adults. Plaque, a sticky film of bacteria, constantly forms on your teeth. When you eat or drink foods containing sugars, the bacteria in plaque produce acids that attack tooth enamel. The stickiness of the plaque keeps these acids in contact with your teeth and over time the enamel can break down. This is when cavities can form. A cavity is a little hole in your tooth. Cavities can be prevented by brushing twice a day with a fluoride toothpaste, use of fluoridated water, limiting sugar in the diet, and placement of sealants on the chewing surfaces of teeth, along with regular dental visits.
Cavities on children’s teeth can grow very fast and cause pain and infection. The factors that started the cavities in the first place can cause decay in other teeth, and as cavities get larger, the nerve of the tooth can become infected and lead to serious infections in the body.
Baby teeth hold space from the proper placing of permanent teeth. If a baby tooth is lost too early, it may mean a crooked smile in the child’s future.
Silver Diamine Fluoride
SDF is a colorless liquid made up of fluoride and silver ions. It kills bacteria that causes cavities.
SDF stops cavities from growing. The treatment is quick, comfortable, and affordable. Because SDF keeps decay from getting worse, fixing the teeth can be put off until a child is older or has an easier time sitting through treatment. Sometimes SDF is the only treatment needed if the cavities in the teeth are very small.
SDF is painted on a cavity with a small brush. Treating a cavity this way takes about two minutes. Best of all, the application does not hurt and requires no drilling or injection of anesthetic. The treatment has a metallic taste. It can sometimes cause mild irritation to the gums that will heal by itself in a couple of days.
It is very safe and has been used in countries around the world for over 40 years. It can postpone or even prevent the need for sedation or general anesthesia, especially for very young patients.
Space maintainers are appliances made of metal or plastic that are custom fit to your child’s mouth. A baby tooth helps hold a spot for the permanent tooth underneath it. Sometimes children lose a baby tooth too early due to trauma or needing to be extracted due to an abscess or large cavity. When this happens the teeth adjacent to it tilt into that space or move forward, and the teeth in the opposite jaw move towards that space too. Due to this, there is not enough space for the permanent tooth to come in. The teeth are then crowded or blocked off and will need orthodontic treatment to fix it.
When your child has space maintainers, avoid sticky sweets, do not tug or push the space maintainer with your fingers or tongue, and keep it clean by brushing it. Continue with regular dental visits. If it comes off, do not throw it away. Hang on to it and call us so that we can reseat it.
Thumb finger and Pacifier Habits
This type of sucking is completely normal for babies and young children. It provides security. For young babies, it is a way to make contact with and learn about the world. Some babies suck on their fingers or thumb before they are even born. Depending on the intensity and duration, this habit can affect the bite and growth of the jaw and bones that support the teeth. This may require orthodontic correction later. Most children stop their habit on their own. We recommend that the child stop use of pacifiers between eighteen months to two years of age. We also recommend that thumb or finger sucking is stopped when the child is old enough to understand possible effects of the habit and is old enough to be motivated to stop. As they grow older, sucking on fingers/pacifiers should be limited to bedtime or naptime only, till they are able to stop.
Sometimes your child may be anxious before or during treatment. Nitrous oxide/oxygen is a safe and effective sedative agent used to calm a child’s fear of the dental visit and enhance effective communication. It works well with children who have a strong gag reflex. It is a blend of 2 gases administered through a mask placed over the nose that helps calm them as they breathe the air. At the end of the treatment, it is eliminated after 5 minutes of breathing oxygen and has no lingering effect.
Your child will smell the gas and think it is stinky but then experience a of sense of relaxation.
It may help them feel happy and is often called laughing gas or happy air. It raises the pain threshold and makes the time appear to pass quickly, which makes the dental appointment easier.
It is very safe and well tolerated. Your child remains fully conscious and keeps all their natural reflexes while being mildly sedated.
Your child should have lighter meal about 2 hours before the appointment, as they occasionally can feel nauseous on a full stomach.
General anesthesia is when your child is given sleeping gas or medicine so that they are unconscious. It is used so they can undergo dental treatment without any discomfort. A physician or dentist with specialized training can use various medications to provide general anesthesia for patients receiving dental care.
General anesthesia is suggested for children with extensive dental needs who are extremely uncooperative, fearful, or anxious or for the very young who do not understand how to cope in a cooperative fashion. General anesthesia also can be helpful for children requiring significant surgical procedures or patients with special health care needs.
Although there is some risk associated with general anesthesia, it can be administered safely and effectively by an appropriately trained individual in a well-equipped facility. We take our patients to Children’s Hospital & Medical Center in Omaha, where they are given general anesthesia by trained pediatric anesthesiologists.
A physical is required prior to general anesthesia. The physical helps to ensure the safety of your child during the general anesthesia procedure. You need to make an appointment with your pediatrician or primary care doctor 7-10 days prior to your surgery date.
It is very important to follow instructions regarding the fasting from fluids and food prior to the appointment.
Your child will be discharged when they are stable and alert. Patients often are tired after general anesthesia, and your child will need to rest at home with minimal activity until the next day. Start your child with clear liquids and move to soft foods on the day of surgery and go back to normal diet the next day.
What is a No Drilling Filling?
Tooth decay often starts in between teeth, as these areas are difficult to reach with toothbrushes. Once the cavity reaches a certain stage or size, drilling is needed, and healthy tooth substance is always destroyed in the process.
If the cavities in between the teeth are detected early, Icon proximal can be the less invasive solution. It allows these lesions to be treated early and microinvasively and the tooth can be treated with no drilling
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Early tooth decay on the smooth surface of a tooth is usually detected visually. It often appears as a chalky white spot(s) that can alter the appearance of your teeth. These white spots also commonly appear on teeth after orthodontic treatment. Icon provides a fast and easy cosmetic treatment for these types of spots. The affected tooth is first prepared with a gel and then filled with a highly fluid liquid resin. Once treated, it takes on the appearance of the surrounding healthy enamel, restoring the tooth’s natural look. No drilling or anesthesia is needed to cosmetically remove white spots with Icon.
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