Posts for tag: pediatric dentistry

By Edward Joseph, D.D.S.
June 25, 2020
Category: Oral Health
FAQsAboutChildrensDentalDevelopment

Watching your newborn develop into a toddler, then an elementary schooler, a teenager, and finally an adult is one of the most exciting and rewarding experiences there is. Throughout the years, you’ll note the passing of many physical milestones — including changes that involve the coming and going of primary and permanent teeth. Here are some answers to frequently asked questions about children’s dental development.

When will I see my baby’s first tooth come in?
The two lower front teeth usually erupt (emerge from the gums) together, between the ages of 6 and 10 months. But your baby’s teeth may come earlier or later. Some babies are even born with teeth! You will know the first tooth is about to come in if you see signs of teething, such as irritability and a lot of drooling. The last of the 20 baby teeth to come in are the 2-year molars, so named for the age at which they erupt.

When do kids start to lose their baby teeth?
Baby teeth are generally lost in the same order in which they appeared, starting with the lower front teeth around age 6. Children will continue to lose their primary teeth until around age 12.

What makes baby teeth fall out?
Pressure from the emerging permanent tooth below the gum will cause the roots of the baby tooth to break down or “resorb” little by little. As more of the root structure disappears, the primary tooth loses its anchorage in the jawbone and falls out.

When will I know if my child needs braces?
Bite problems (malocclusions) usually become apparent when a child has a mixture of primary and permanent teeth, around age 6-8. Certain malocclusions are easier to treat while a child’s jaw is still growing, before puberty is reached. Using appliances designed for this purpose, orthodontists can actually influence the growth and development of a child’s jaw — to make more room for crowded teeth, for example. We can discuss interceptive orthodontics more fully with you at your child’s next appointment.

When do wisdom teeth come in and why do they cause problems?
Wisdom teeth (also called third molars) usually come in between the ages of 17 and 25. By that time, there may not be enough room in the jaw to accommodate them — or they may be positioned to come in at an angle instead of vertically. Either of these situations can cause them to push against the roots of a neighboring tooth and become trapped beneath the gum, which is known as impaction. An impacted wisdom tooth may lead to an infection or damage to adjacent healthy teeth. That it is why it is important for developing wisdom teeth to be monitored regularly at the dental office.

If you have additional questions about your child’s dental development, please contact us or schedule a consultation. You can also learn more by reading the Dear Doctor magazine articles “Losing a Baby Tooth” and “The Importance of Baby Teeth.”

ReducingYourChildsDentalAnxietyNowCouldBenefitThemforaLifetime

If you're a parent, raising kids can be a great adventure. It can also rev up your stress meter in a heartbeat. One area in particular can give you heartburn: your child's lack of enthusiasm for visiting the dentist.

Dental anxiety in varying degrees in children isn't uncommon. At times, it can be difficult for everyone involved for a child to receive the dental care they need if they're in an upset or agitated state. Fortunately, though, there are things you can do to minimize your child's dental anxiety.

First, start regular dental visits as early as possible, usually around their first birthday. Children who begin seeing the dentist earlier rather than later are more apt to find the sights, sounds and other experiences of a dental office a routine part of life.

You might also consider using a pediatric dentist for your child. Pediatric dentists specialize in child dental care, and have specific training and experience interacting with children. Pediatric dental offices are also usually “kid friendly” with toys, videos, books and interior decorations that children find appealing.

Your attitude and demeanor during a dental visit can also have an effect on your child. Children in general take their cues for how to feel from their caregivers. If you're nervous and tense while with them at the dentist, they may take that as a sign they should feel the same way. In contrast, if you're calm and relaxed, it may help them to be calm and relaxed.

Along the same lines, your attitude and level of commitment to dental care, both at home and at the dentist, will rub off on them. The best way to do that is by setting the example: not only as you brush and floss every day, but during your own dental visits. Take them with you: If they see you're not anxious about your care, it may improve their own feelings about their care.

The main goal is to try to make your child's overall dental experience as positive and pleasant as possible. The benefits of this can extend far beyond the present moment into their adult lives.

If you would like more information on your child's dental care, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Taking the Stress Out of Dentistry for Kids.”

SedationCanHelpaChildReceiveNeededDentalCareNowandintheFuture

You have a wonderful pediatric dentist who's great with kids. Their dental office is a children's wonderland with cheerful colors, toys and a staff that tries to make things fun. But no matter what you do—including rewards and positive praise—it's not enough to calm your child's anxiety during dental visits.

Even with the most conducive clinical environment and parental efforts, some children still have an inordinate fear of seeing the dentist. Their anxiety could be a roadblock to getting the treatment they need to maintain good oral health and development. And if that fear carries over into adulthood, they may get into the habit of postponing needed care.

But dentists have an important tool they can use to help children relax: conscious sedation therapy. Using proven sedation medication, dentists can place patients in varying degrees of suppressed consciousness.

Although often used in conjunction, sedation is not the same as anesthesia. The latter is used to eliminate pain during dental procedures. Sedation, on the other hand, aims to calm the negative emotions generated by dental anxiety. A child under sedation can still breathe normally without assistance and respond to physical stimulation or verbal commands.

Sedation medications can be administered orally, usually in syrup form, or with an intravenous (IV) drip. Two of the more popular drugs are Midazolam and Hydroxyzine, both of which act fast and then leave the body quickly after the procedure. These types of sedation drugs have a very low risk of side effects compared to general anesthesia.

While under sedation, the child's vital signs (heart rate, respiration, blood pressure, etc.) are continuously monitored. Afterward, they'll wait in recovery until their vital signs are back to their pre-sedation levels. They can then go home to rest for the remainder of the day, and then usually return to school or other normal activities the following day.

Besides making it easier for a child to receive needed dental care, conscious sedation can also make the overall visit more pleasant, and lead to more positive memories of the experience. This may indeed help them later in life to overcome any lingering anxiety and continue regular dental care throughout adulthood.

If you would like more information on reducing your child's dental visit anxiety, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Sedation Dentistry for Kids.”

By Edward Joseph, D.D.S.
February 11, 2020
Category: Oral Health
4ThingstoDotoKeepYourChildsDentalDevelopmentonTrack

When you’re expecting a new baby, there’s a lot to prepare: outfitting the nursery, stocking up on diapers or choosing a pediatrician. It’s also not too early to consider how to protect your new child’s dental development.

From birth through adolescence, a child’s mouth goes through a whirlwind of growth. Hopefully, it all follows a normal track, but detours can arise like tooth decay or bite problems.

Here are 4 things you can do to keep your child’s dental development on track.

Start oral hygiene before teeth. Daily oral hygiene is essential toward helping your child avoid tooth decay. And don’t wait for teeth to come in—begin wiping their gums with a clean, damp cloth right after nursing. When teeth do appear, switch to brushing with just a smear of toothpaste and then add flossing as more teeth come in.

Begin regular dental visits. The American Dental Association recommends pediatric dental visits around the first birthday. The possibility of tooth decay becomes a concern around this time as the primary teeth are steadily erupting. Starting earlier rather than later may also help your child adjust to the routine of dental visits that they’ll most likely carry on as they get older.

Control their sugar consumption. Because sugar is a prime food source for disease-causing bacteria, you should keep your child’s sugar consumption as controlled as possible. For example, don’t put a baby to bed with a bottle filled with a sugary liquid (including juice and breast milk)—the constant presence of the liquid during nap time encourages bacterial growth and acid production.

Get an orthodontic evaluation. While we often associate orthodontic treatment with the teen years, it may be possible to head off bite problems earlier. So, see an orthodontist for a bite evaluation when your child is around age 6. If there are signs of a developing problem, certain techniques could help stop or slow them from getting worse, helping you avoid extensive and expensive treatment later.

With a newborn coming, you and your family have a lot on your plate. Be sure, though, not to forget making plans for keeping their teeth and gums healthy.

If you would like more information on dental care for your child, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Age One Dental Visit.”

GiveYourChildAddedProtectionAgainstCavitiesWithTopicalFluoride

Keeping your child’s teeth and gums healthy may sometimes seem like “one step forward, two steps back.” You do all the right things like daily brushing and flossing, and keeping sugar consumption to a minimum. But they’re still getting too many cavities.

We can add something else to what you’re already doing to decrease their cavity rate: apply a concentrated fluoride mixture (stronger than what’s found in toothpaste or drinking water) directly to their teeth. Studies have shown that topical fluoride is effective at reducing the risk of new cavities in children at high risk for decay, and may even reverse early decay.

Topical fluoride can be applied as a gel, foam or varnish. The particular method used depends on factors like the child’s age or the preference of the dentist. But any of the three methods can deliver a short-term, high dose of fluoride to the teeth.

As a result, the burst of fluoride strengthens tooth enamel against decay, with plenty of evidence of its effectiveness. As such, the American Dental Association recommends periodic topical fluoride applications for children older than 6, and especially those that appear to be at higher risk for decay.

You might, however, be concerned about the long-term health effects of these stronger concentrations of fluoride. Again, research indicates that the only long-term hazard associated with too much fluoride is a condition called fluorosis, which produces heavy tooth staining. Fluorosis, though, is more of an appearance issue and doesn’t harm the tooth itself. And it can be avoided in the case of topical fluoride by performing the procedure correctly and conservatively.

There’s also a short-term risk of a reaction to the fluoride mixture if the child swallows too much during the procedure, which could cause stomach upset and pain, vomiting or headaches. We can avoid this by using precautions like dental dams and other isolation methods to prevent the child from ingesting it.

Using proper precautions and procedures, topical fluoride is a safe and effective way to give your child added protection against decay. Avoiding this destructive disease can help ensure they’ll enjoy good dental health for the rest of their lives.

If you would like more information on keeping your child’s teeth and gums healthy, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Fluoride Gels Reduce Decay.”



Burbank, CA Dentist
Edward C. Joseph, D.D.S.
2701 West Alameda Ave, Suite #403
Burbank, CA 91505
(818) 842-7628

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