Pediatric Dental Problems - In Your Local Los Angeles, CA Area

A Kid's Dentist Explains Dental Visits

Parents often feel helpless when a son or daughter is fearful or apprehensive regarding a trip to the pediatric dentist. Talk with your dentist about your concerns. A partnership must exist between the parent and the dentist. Your own attitudes and understanding of what will occur during each visit will greatly influence the outcome of your child's visit. The following information will assist you in helping your child toward a comfortable and successful visit to the dentist.

Schedule a morning appointment. Children are more rested in the morning, and morning appointments usually have less waiting time. If your child is in school, he or she may worry all day about the appointment and will be tired after school.

Do not promise an expensive present if your child is well-behaved. Your little one may assume that he is about to do something very difficult. A surprise waiting to be given just after the visit may be more appropriate. Do not tell your child to be brave or that nothing will hurt. The idea that seeing the dentist requires being brave or that something might hurt may have never occurred to the child.

During any waiting time, sit close beside your child and read him a story. This not only provides distraction, but also places a child in a more relaxed frame of mind. Free play should be avoided.

If your child is scheduled for restorations (fillings), say as little as possible regarding the events of the visit. Your tone of voice and body language could accidentally create a sense of fear or apprehension in an unsuspecting child. The parent who is more comfortable with dental treatment should do the talking. Allow your dentist to use his or her experience to determine how much your child should be told just prior to the procedure.

If local anesthesia (a shot to numb the teeth) is to be used, do not discuss this issue with your child before the visit. The most feared part of the visit is usually the injection. In some cases, the use of local anesthesia may not be necessary. Do not attempt to predict what your dentist will do. If your child asks about the need for a shot, answer saying that you do not know. Most injections are performed painlessly with the child unaware of the occurrence. A child who comes to the office already intensely worried about the shot is much more difficult to calm.

Your expectations of your child's ability to cooperate for a dental procedure must be age-appropriate. By four years of age, an emotionally and physically healthy child should be able to separate from his parent for an examination and possibly treatment. Dentists have varying opinions as to whether or not a parent should be present for treatment. Some parents are reluctant to separate from the child, and others prefer not to accompany the child for treatment. Parents should agree with the philosophy of their kid's dentist.

Only one parent should accompany the child for the visit. The parent who is more comfortable with dental visits should be the choice. Consistency is very important. The dentist, child, and parent function as a team. The rules must stay the same. If the visit went well with Dad, he should be the parent who accompanies the child for every visit. Apprehensive or fearful children generally do better with Dad. Mom may be a little more emotional and more anxious regarding the treatment. However, this is not always the case. You are the expert for your child's emotional well-being. You should decide who would be the better choice for this particular experience.

If you are present for treatment, you should be the kid's dentist silent partner. You may pat your child or offer some words of support or praise, but remain calm and quiet. Do not repeat the dentist's requests of your child and do not raise your voice at any time. The dentist will manage the behavior. The dentist's attention should not be divided between you and your child, and your child's attention should not be divided between you and the dentist. A minor operation is being performed. The kid's dentist must concentrate not only on the procedure but also on managing your child's behavior. Try not to distract him or her.

Some children will attempt to manipulate their parents during treatment. If your child is crying, listen to the sound of the crying. Compensatory crying often occurs. The child is not in discomfort, but is just coping by crying. Parents may become the court of appeals. The child constantly attempts to delay treatment by reaching out for a hug. If both you and your dentist believe your child is capable of undergoing treatment, you must provide tough love at this time. If your child will not cooperate with you present, your dentist may ask you to leave the treatment room. Leave your car keys with your little one, so he knows you are not leaving the office. Assure him that you will be close by.

If you do not plan to be present during treatment, separate from your child in the reception room and not after she is seated in the dental chair.

Parental love must permit children to move toward independence. A parent's permitting his or her child, age four or older, to undergo treatment without the parent present sends two messages. First, "It is ok. I really do not need to be right beside you for this." Secondly, "You can do it! I have confidence in you." This child has been given a sense of empowerment.

The limitations and strengths of each child must be recognized. By sharing with your dentist in the proper preparation and guidance, both you and your child can begin to look forward to that next dental visit!

By Jane A. Soxman, DDS

Pediatric Dentist and Tooth Decay FAQs

Q. Should you give a baby a fluoride supplement?

A. Babies living in areas where the water supply is fluoridated do not need fluoride supplements. If the water supply is not fluoridated, or if the baby is breastfed, the physician or pediatric dentist may recommend supplements starting at the age of six months.

Besides tap water, and often bottled water as well, fluoride also is found in juices (especially cranberry juice) and baby foods (especially chicken). These sources may provide enough fluoride without the need for supplements, so discuss the need for fluoride supplements with your child's physician and/or pediatric dentist

Q. What causes "baby bottle tooth decay"?

A. Frequent, long-term exposure of a child's teeth to sugary liquids (including breast milk, formula, and milk) causes baby bottle tooth decay. The sugars in these liquids pool around the teeth and feed the bacteria in plaque.

Q. When should an infant's oral hygiene begin?

A. Even without teeth, oral hygiene should begin soon after birth. After each feeding, wipe your baby's gums, inside the cheeks, tongue, and roof of the mouth with a clean, damp washcloth or wet gauze pad. This removes plaque, the sticky film containing decay-causing bacteria.

Q. What are the white patches sometimes found in a newborn's mouth?

A. Yeast infections in the mouth occur frequently in newborns. White patches can spot the tongue, cheeks, gums, or roof of the mouth. If they are removed, some bleeding will occur. Treatment is usually unnecessary; however, your doctor should be notified of this condition.

Q. What is the condition known as "tongue-tie"?

A. A piece of tissue connects the tongue to the bottom of the mouth, and if it's too short, a condition known as ankyloglossia results. This is common in newborns and usually resolves itself over time. The only reason to have the tissue cut is if the infant cannot nurse.

Q. When do babies start getting primary teeth?

A. The average age for the first primary tooth is five to six months; however, there is great variation.

Q. What are the signs of teething?

A. Fussiness, excessive drooling, rash, diarrhea, changes in sleep and feeding patterns, and fever can signal a baby's discomfort. However, don't assume that a fever or these changes are caused just from teething. They also can be symptoms of other health conditions. Check with your doctor to ensure your baby receives proper medical care.

Q. What remedies are recommended for teething pain?

A. Your children's dentist or pediatrician may recommend a pacifier, teething ring, or a special numbing ointment for the gums. Some teething rings and pacifiers can be chilled to extend their numbing effect. Older children will enjoy the soothing relief that popsicles provide.

Q. How can you help your child's teething pain?

A. To help your child's teeth pain, gently massage the infant's gums with a clean, wet finger, a small, cool spoon, or a clean, wet gauze pad. This often soothes the child's teeth pain and irritation. A cold rubber teething ring also helps.

Q. Can decay-causing bacteria be passed to an infant?

A. Yes, babies are exposed to bacteria from a variety of sources, such as a caregiver blowing on food to cool it, tasting food, sharing utensils, kissing the infant on the mouth, sharing a cup, or sucking on the baby's fingers. Care should be taken not to expose the infant to bacterial exposure from these sources.

Q. How should you care for a child's primary teeth?

A. As soon as the first tooth erupts, with a clean, wet washcloth or wet gauze. The gums also should be gently wiped. If a toothbrush is used, it should be an appropriate size.

Q. When should you start caring for your child's teeth?

A. As soon as primary teeth appear, they are at risk for decay and need to be brushed twice daily with a soft-bristled brush. Do not use toothpaste until your child is two years old.

Q. How can you prevent baby bottle tooth decay?

A. You can prevent baby bottle tooth decay by wiping the child's teeth and gums with a clean, moist washcloth after each feeding to remove plaque. You should never let your child go to sleep with a bottle containing a sweetened liquid. Among these are milk (including breast milk), formula, fruit juice, and other sweetened liquids. Constant use of a sipping cup containing sweetened liquids also can cause baby bottle tooth decay.

Q. Why is it important to care for primary (baby) teeth, since they will fall out anyway?

A. Primary teeth serve as the foundation for a healthy mouth, including the gums and the proper positioning of permanent teeth. They serve as natural space maintainers, holding the space open until the permanent teeth are ready to take their place.

If primary teeth become broken or decayed and are not properly treated, problems can occur with permanent teeth, which may contribute to other health problems. The result can be costly orthodontics and other pediatric dentistry treatments.

Q. Can juices hurt your child's teeth?

A. Because of the sugar content, juice and juice products have much greater potential to cause decay. Apple juice may cause staining of the teeth and should be diluted with water. Any beverage other than water has the potential to cause tooth decay, especially if the child drinks it frequently.

Q. What problems occur from baby bottle tooth decay?

A. To repair the decay, extensive treatment or extraction of the teeth may be required. Because the children are usually around 18 months to 2 years of age, hospitalization with general anesthesia is often required to perform these procedures.

Q. Is sucking harmful for teeth?

A. While sucking is a natural reflex, sucking on thumbs and pacifiers can cause problems after the permanent teeth erupt. Continued sucking after this time affects the proper growth of the mouth, alignment of teeth, and the development of the roof of the mouth that can result in the need for orthodontic treatment and other pediatric dentistry treatments in the future.

Q. How can parents encourage a child to stop thumb sucking?

A. Set a positive tone and praise the child when they're not sucking. Thumb sucking is a stress-reliever and offers comfort. Look for any factor that might be causing discomfort or anxiety and seek solutions to correcting them, rather than focusing on sucking as the issue.

Reward the child when he or she doesn't fall back into the habit, especially during stressful situations. Schedule an appointment with the child's pediatric dentist to talk about what is likely to happen if the habit continues.

Q. What can parents do if a child has difficulty breaking a thumb sucking habit?

A. Finding ways to take away the pleasure of thumb sucking reduces or eliminates the satisfaction gained from it. Bandage the thumb or put a sock over the hand at night. A pediatric dentist or pediatrician can prescribe a bitter-tasting medication to coat the thumb. A mouth appliance can be used to block the ability to suck.