For years many thought that teething caused fever and general sickness. Teething has been blamed for many things! Research into the problems of teething has shown that some children become irritable, have increased drooling and sometimes a facial rash. However, for most children the effect of teething is teeth! It is a normal part of development. If your child has a high temperature that worries you, it is unlikely to be caused by teething and you should consult your physician.
Many children have unfortunate accidents and can damage their mouths and teeth. A wide range of injuries can occur. Sometimes the damage to the baby teeth are of little concern and sometime they are severe and teeth can be moved about or knocked out. The more serious injuries can cause damage to the second teeth that are still forming in the jaws. The amount and type of damage depends on the age of the child as this reflects the stage of development of the underlying second tooth. The amount of injury will not be seen until the second tooth comes into the mouth.
Fluoride supplementation is determined by the history of each child’s fluoride intake. A child, who drinks plenty of water in an optimally “Fluoridated Community” or Fluoridated bottled water, may not need a fluoride supplement. If you use a water filtration system or are considering the purchase of one, check to see if it filters out fluoride (i.e., reverse osmosis). If it does filter out fluoride your child may need a fluoride supplement. Fluoride assessments can be done by your child’s paediatrician or paediatric dentist.
Avoid nursing children to sleep or putting anything other than water in their bed-time bottle. Also, learn the proper way to brush and floss your child’s teeth. Take your child to a paediatric dentist regularly to have his/her teeth and gums checked. The first dental visit should be scheduled by your child’s first birthday.
Have your paediatric dentist evaluate the fluoride level of your child’s primary source of drinking water. If your child is not getting enough fluoride internally through water (especially if the fluoride level is deficient or if your child drinks bottled water without fluoride), then your paediatric dentist may prescribe fluoride supplements.
Parents should take their children to the dentist regularly, beginning with the eruption of the first tooth. Then, the dentist can recommend a specific program of brushing, flossing, and other treatments for parents to supervise and teach to their children. These home treatments, when added to regular dental visits and a balanced diet, will help give your child a lifetime of healthy habits.
Sucking is normal for babies and young children. Thumbsucking habits are usually established by three months of age. Some children have the need to “suckle” more than others. Frequent use of a pacifier or thumb can create a number of problems such as an anterior open bite (front teeth do not meet), palatal changes and tongue protrusive posturing (tongue thrusting). Although these conditions can be corrected through orthodontics and/or surgical procedures in the future, early intervention is recommended. Pacifiers should be discontinued by 2-3 years of age. If your child has a thumbsucking habit, begin to encourage discontinuation at 4-6 years of age. Your paediatric dentist will work with you and your child to develop a positive reinforcement reward system to help them quit.
Make sure your child has a balanced diet, including one serving each of: fruits and vegetables, breads and cereals, milk and dairy products, and meat fish and eggs. Limiting the servings of sugars and starches will also aid in protecting your child’s teeth from decay. You can also ask your paediatric dentist to help you select foods that protect your children’s teeth. See also ADA Snack Attack You are what you eat leaflet.
A check-up every six months is recommended in order prevent cavities and other dental problems. However, your paediatric dentist can tell you when and how often your child should visit based on their personal oral health.
There is very little risk in dental X-rays. Paediatric dentists are especially careful to limit the amount of radiation to which children are exposed. Lead aprons and high-speed film are used to ensure safety and minimize the amount of radiation.
A fluoride varnish is a concentrated fluoride substance that is “painted” on a tooth to re-mineralize (repair) enamel on baby or permanent teeth.
A toothache that is severe and continuous and results in gnawing or throbbing pain or sharp or shooting pain are common symptoms of an abscessed tooth. Other symptoms may include: Fever, pain when chewing, sensitivity of the teeth to hot or cold, bitter taste in the mouth, foul smell to the breath (Halitosis), swollen neck glands, general discomfort, uneasiness, or ill feeling, redness and swelling of the gums (Gingivitis, Periodontitis), swollen area of the upper or lower jaw and an open, draining sore on the side of the gum.
Bruxism is the action of involuntarily grinding your teeth. Usually “grinding” occurs during the night while sleeping. If your child does this and there is a lot of wear on his/her teeth, your dentist may recommend a night guard. A night guard is a customized splint made out of hard or soft plastic. It is to be worn during the night to help protect the enamel from being damaged. The wearing of a night guard induces relaxation of the muscles used during grinding. Instead of the teeth making contact with the opposing teeth, they come in contact with the splint.
Avoid nursing children to sleep or putting anything other than water in their bed-time bottle. Also, learn the proper way to brush and floss your child’s teeth. Take your child to a paediatric dentist regularly to have his/her teeth and gums checked. The first dental visit should be scheduled by your child’s first birthday.
Many remedies have been suggested over the years. There are non medical things that can help. Teething rings have been found to be helpful for some babies. The biting pressure seems to relieve some discomfort especially if the teething ring is chilled. We generally do not recommend pain relief tablets. The treatment can be managed by local measures. For example, special local anaesthetic medicines are available to be placed on sore gum areas. Only use medicines intended for this purpose should be used.
Paediatric dentists are dental professional dedicated to the oral health of children from infancy through the teen years. They have the experience and qualifications to care for a child’s teeth, gums, and mouth throughout the various stages of childhood. In Australia you require at least 10 years to be ready to become a recognised Paediatric dentist including your Bachelor of Dental Science and three years of residency training in dentistry for infants, children, teens, and children with special needs.
The dental assistant is a valuable part of any successful dentist office. The assistant provides support to both the dentist and the dental hygienist. Generally, the dental assistant is charged with responsibilities that may be considered small but are in fact very necessary to the function of the practice. Essentially, the dental assistant handles a number of little details, thus freeing the dental operators in the office to focus on direct patient care. Here are a few examples of the type of support offered by dental assistants. One of the more common tasks associated with the dental assistant is the preparation of the patient care areas of the office. The assistant will make sure that all instruments are kept in proper working order, are kept sterilized, and are laid out properly for use by the dentist or dental hygienist. In addition, the assistant will also make sure that medication, bibs, and other essentials intended to make the patient more comfortable are prepared and ready for use. Our Dental Assistants do also assist in Sedations and General Anaesthesias.
During a dental appointment, a hygienist typically removes soft and hard deposits from your child’s teeth; examines the gums and teeth to discern the presence of disease or oral abnormality; and strips the teeth of stains and plaque. A dental hygienist takes x-rays and applies cavity-deterring agents (fluoride or sealants). A dental hygienist takes on a somewhat academic role as well: he or she educates dental patients on how to establish and maintain suitable oral hygiene, often with the aid of teeth models to give the parent and child a visual sense. The hygienist should leave the patient with a good understanding of proper brushing habits and the relationship between diet and oral health.
Early Childhood Caries (a.k.a. “nursing bottle caries”) is the most common preventable form of tooth decay. Other commonly used terms for this condition are “bottle rot, or baby bottle tooth decay”. This condition can occur when a child, who has the cavity causing bacteria in his saliva, is allowed to nurse continually from the breast and/or from a bottle with milk, formula, juice or other sugary substances during the night and even during naptime. As you begin to fall asleep your saliva glands slow down. Saliva helps fight the acid and toxins created by specific bacteria that cause tooth decay. Thus by allowing these liquids to pool around your child’s teeth during sleeping periods, the bacteria can attack healthy enamel which can result in serious dental decay such as early childhood caries. As soon as the first tooth erupts and every tooth thereafter the level of decay causing bacteria will increases if present. If your child must have a bottle at naptime or bedtime, it is recommended to prevent decay that it contains 100% water.
For years many thought that teething caused fever and general sickness. Teething has been blamed for many things! Research into the problems of teething has shown that some children become irritable, have increased drooling and sometimes a facial rash. However, for most children the effect of teething is teeth! Teething is a normal part of development. If your child has a high temperature that worries you, it is unlikely to be caused by teething and you should consult your physician. Many remedies have been suggested over the years. There are non medical things that can help. Teething rings have been found to be helpful for some babies. The biting pressure seems to relieve some discomfort especially if the teething ring is chilled. We generally do not recommend pain relief tablets. The treatment can be managed by local measures. For example, special local anaesthetic medicines are available to be placed on sore gum areas. Only use medicines intended for this purpose should be used.
Different methods have been recommended. The popular technique nowadays is to use a clean, small gauze pad. If non-sterile ones are purchased they are much less expensive. Alternately, a clean dry wash cloth can be used. The teeth and gums are firmly wiped to remove liquid and food debris. This is done before bedtime. Once the child has back teeth, a small, soft toothbrush can be used to clean the grooves on the chewing surfaces of the molars.
The most important thing to do is to remain calm. Then find the tooth. Hold it by the crown rather than the root and try to reinsert it in the socket. If that is not possible, put the tooth in a glass of milk and take your child and the glass immediately to the paediatric dentist.
First, rinse the irritated area with warm salt water and place a cold compress on the face if it is swollen. Give the child acetaminophen for any pain, rather than placing aspirin on the teeth or gums. Finally, see a dentist as soon as possible.
Paediatric dentists are the paediatricians of dentistry. A paediatric dentist has two to three years specialty training following dental school and limits his/her practice to treating children only. Paediatric dentists are primary and specialty oral care providers for infants and children through adolescence, including those with special health needs.
The first tooth usually comes in around 6 months of age. Most often it is a lower front tooth. Our experience, however, is that the tooth eruption timing of primary teeth is more variable than for permanent teeth. The front 8 teeth (4 on top and 4 on bottom) usually have come in by 9 months of age. Ideally we like to see children have their first dental check up by their first birthday. Why? Seeing the child early gives the dentist the opportunity to examine the mouth and confirm normal oral development. Most importantly, the teeth can be examined for cleanliness. It gives the dentist the opportunity to provide advice on prevention and make the best care plan for your child. It also gives parents the chance to discuss feeding practices, teething and mouth habits.
For those babies not being breast fed, there is general agreement that around one year of age is a good time to wean baby from the bottle. Paediatric dentists like to see children give up bottles as soon as possible. That is because they see an alarming number of toddlers with Nursing Bottle Decay. This type of decay, which begins on the front teeth, is only seen in toddlers. It results from prolonged use of a milk or sweetened liquid bottle that is put into bed with the baby. Weaning from the bottle seems to follow two paths. The first is stopping the bottle suddenly. It is a “cold turkey” approach. The second method is a gradual reduction in the usage of the bottle. Reduction usually begins during the day when baby is able to drink from a cup. The last and most difficult bottle to be discontinued is the bottle before bedtime.
As soon as your child’s first tooth appears, begin using a soft-bristled toothbrush once in the morning after breakfast, before naps and most importantly at night before your child goes to bed. Use only a tiny bit of toothpaste, a pea-sized amount is sufficient and will not be harmful if swallowed. Do not be discouraged if your child refuses or becomes fussy during the brushing of his/her teeth. Children do very well with routines. As this is done on a “routine” basis your child will become desensitized to brushing. If your child doesn’t seem to like the taste of toothpaste, just use water. Toothpaste is not a necessity for most infants under 24-36 months of age. The simple answer is that teeth should be cleaned as soon as they first appear. Parents should not limit the cleaning only to teeth. The gums also need to be cleaned.
Flossing should be introduced when primary (“baby”) teeth have come into the mouth, usually by age 3 and if there is contact with other teeth.
Is your child active in sports? If your child is involved in athletic activities such as football, baseball, basketball, soccer, hockey, skateboarding, gymnastics or any other activity where there is a risk of falls or head contact with other team players or equipment, you should consider having your dentist make your child a custom mouthguard. Mouth guards are the number one priority when it comes to sports equipment. You can get preformed mouth guards at your local sports store. However, customized mouth guards made by your paediatric dentist are more effective in preventing injuries and are more comfortable for your child. It does cost a bit more, but the protection it offers to their permanent teeth is priceless.
The sooner the better! Starting at birth, clean your child’s gums with a soft infant toothbrush or cloth and water. As soon as the teeth begin to appear, start brushing twice daily using fluoridated toothpaste and a soft, age-appropriate sized toothbrush. Use a “smear” of toothpaste to brush the teeth of a child less than 2 years of age. For the 2-5 year old, dispense a “pea-size” amount of toothpaste and perform or assist your child’s toothbrushing. Remember that young children do not have the ability to brush their teeth effectively. Children should spit out and not swallow excess toothpaste after brushing.
Early examination procedures have been recommended strongly in the past decade to help reduce the number of infants and children who suffer from preventable tooth decay. Ideally we like to see children have their first dental check up by their first birthday. Why? Seeing the child early gives the dentist the opportunity to examine the mouth and confirm normal oral development. Most importantly, the teeth can be examined for cleanliness. It gives the dentist the opportunity to provide advice on prevention and make the best care plan for your child. It also gives parents the chance to discuss feeding practices, teething and mouth habits.
Many parents have been led to believe that baby teeth don’t need to be restored if affected by decay. Yes, these teeth will eventually fall out. However, the average age for a child’s first primary tooth to fall out is 6-8 years of age and the last one between 11-13 years of age. If a primary tooth has been affected by decay and not treated properly it can result in the damage of a permanent tooth. Primary teeth play a vital role in your child’s growth and development. These teeth act as a guide for the permanent teeth to come into the mouth in the best possible position. If a tooth is prematurely lost before the permanent tooth is ready to come in, the nearby teeth can tip or move into the vacant space. When this happens, the permanent teeth may come in malpositioned.
At approximately 6 to 7 years of age, parents begin to notice the new permanent teeth are coming in darker than the baby teeth. Our permanent teeth have a greater amount of dentin, which is yellow in colour. Since the enamel is translucent, the colour of the dentin shows through. When all the permanent teeth have erupted the colour will blend and appear uniform.
Overcrowding may be caused by a small jaw, big teeth or a combination of both. This can result in a permanent tooth coming in behind the baby tooth in the lower jaw. In the upper jaw, a permanent tooth may arise in front of the baby tooth. If a child’s mouth is overcrowded, a permanent tooth may not be directly underneath the baby tooth, therefore allowing the permanent tooth to erupt out of its natural alignment. It is wise to have your child evaluated by a dentist to determine whether or not the baby tooth needs to be removed to allow the permanent tooth to erupt in the best possible position. If a baby tooth is over-retained on the upper front area, it must be evaluated for possible removal as soon as possible.
Many times, due to an injury, the nerve inside the tooth may be bruised or infected causing a grey discoloration. With time, usually within a month or so, the tooth may lighten up or may become darker. Anytime there is an injury to the mouth you need to have your child evaluated by a dentist so it can be determined whether the tooth may need to have a nerve treatment.
About 1 in 10 children experience tooth decay before they are two years old. The most common cause is when a baby is placed in the crib at night with a bottle of milk or sweetened liquid. The contents of the bottle cling to the teeth all night. Tooth decay begins! The same effect can occur with a sweetened pacifier. In rare circumstances, babies who are breast fed throughout the night over a long time are also at risk. The decay experienced by these toddlers has a typical pattern. It usually is evident near the gum line of the upper front teeth. Because of the age of these children, treatment becomes a major problem sometimes requiring general anaesthesia. Parents need to be alert and keep the teeth healthy. Occasionally when illness or some other disturbance affects growing teeth, the quality of the enamel is poor. These teeth can decay early and more easily. A dental examination around one year of age helps identify these problems.
Sealants work by filling in the crevasses on the chewing surfaces of the teeth. This shuts out food particles that could get caught in the teeth, causing cavities. The application is fast and comfortable and can effectively protect teeth for many years.
A sealant is a clear or opaque resin coating that is applied to the chewing surfaces of teeth. More commonly used on permanent teeth, they can be applied to baby teeth as needed. They have been shown to prevent cavities on the chewing surfaces of teeth. This procedure only takes a few minutes without any local anaesthetic. In order to maintain the sealants it is best to have your child avoid hard and sticky candies such as jawbreakers or caramels as well as chewing on ice. The longevity of a sealant depends on diet, hygiene and oral habits.
Paediatric dentists are dental specialists with additional years of training. Along with specialized technical skills, they also possess a thorough understanding of the needs and development of children. Paediatric dentists care for infants, children, adolescents and teenagers. They have also acquired specialized training in treating patients with special needs. Patient behaviour management is a large part of the dentist and his or her staff’s expertise. In fact, it is perhaps the most important part of paediatric dentistry. In addition, most paediatric dentist have received specialized training in the appropriate use of sedation techniques such as nitrous oxide and oral conscious sedation. In collaboration with an anaesthesiologist, paediatric dentist can provide dental treatment under intravenous anaesthesia and hospital general anaesthesia. With these treatment modalities, our practice is able to tailor your child’s treatment to his individual needs. This expertise allows your child to develop a positive outlook towards dentistry as well as form a bond of trust and acceptance with the doctor and his or her staff.
We recommend that children receives an orthodontic evaluation by age 7 because enough permanent teeth have come in and enough jaw growth has occurred that the dentist or orthodontist can identify current problems, anticipate future problems and alleviate parents’ concerns if all seems normal. The first permanent molars and incisors have usually come in by age 7, and crossbites, crowding and developing injury-prone dental protrusions can be evaluated. Any ongoing finger sucking or other oral habits can be assessed at this time also.
