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Click on a topic of interest for more information. What is a Pediatric Dentist? For information on special oral health care needs, we've provided links to the following sites:
American
Academy of Pediatric Dentistry
Your Child’s First Dental Visit
It is best if you refrain from using words around your child that might cause unnecessary fear, such as needle, pull, drill or hurt. Pediatric dental offices make a practice of using words that convey the same message, but are pleasant and non-frightening to the child. The American
Academy of Pediatric Dentistry and the American Dental Association recommend
having your child seen on or before age one. As a service to our
patients, we offer a complimentary
Well-Baby Check-up to infants up to 18
months of age. Why Are The Primary Teeth So Important? It is very important to maintain the health of the primary teeth.
Neglected cavities can and frequently do lead to problems which affect developing
permanent teeth. Primary teeth, or baby teeth are important for (1) proper chewing and
eating, (2) providing space for the permanent teeth and guiding them into the correct
position, and (3) permitting normal development of the jaw bones and muscles. Primary
teeth also affect the development of speech and add to an attractive appearance. While the
front 4 teeth last until 6-7 years of age, the back teeth (cuspids and molars) aren’t
replaced until age 10-13. Radiographs (X-Rays) are a vital and necessary part of your child’s dental diagnostic process. Without them, certain dental conditions can and will be missed. X-Ray’s detect much more than cavities. For example, X-Rays may be needed to survey erupting teeth, diagnose bone diseases, evaluate the results of an injury, or plan orthodontic treatment. X-Rays allow dentists to diagnose and treat health conditions that cannot be detected during a clinical examination. If dental problems are found and treated early, dental care is more comfortable for your child and more affordable for you. The American Academy of Pediatric Dentistry recommends X-rays and examinations every six months for children with a high risk of tooth decay. On average, most pediatric dentists request radiographs approximately once a year. It is in your child's best interest to have a complete set of radiographs taken, either a panoramic and bitewings or periapicals and bitewings. Pediatric dentists are particularly careful to minimize the exposure of
their patients to radiation. With contemporary safeguards, the amount of
radiation received in a dental X-ray examination is extremely small. The
risk is negligible. In fact, the dental X-rays represent a far smaller risk
than an undetected and untreated dental problem. Lead body aprons and
shields will protect your child. Today’s equipment filters out unnecessary
X-rays and restricts the X-ray beam to the area of interest. High-speed film
and proper shielding assure that your child receives a minimal amount of
radiation exposure. Begin daily brushing as soon as the child’s first tooth erupts. A pea-size amount of fluoride toothpaste can be used after the child is old enough not to swallow it. Your dentist can help you determine whether the child has the skill level to brush properly. Usually, children require parental brushing and flossing help until approximately age 9. Proper brushing removes plaque from the inner, outer and chewing surfaces. When teaching children to brush, place toothbrush at a 45 degree angle; start along gum line with a soft bristle brush in a gentle circular motion. Brush the outer surfaces of each tooth, upper and lower. Repeat the same method on the inside surfaces and chewing surfaces of all the teeth. Finish by brushing the tongue to help freshen breath and remove bacteria. Flossing removes plaque between the teeth where a toothbrush
can’t reach. Flossing should begin when any two teeth touch. Use about 18 inches of floss,
winding most of it around the middle fingers of both hands. Hold the floss lightly between
the thumbs and forefingers. Use a gentle, back-and-forth motion to guide the floss between
the teeth. Curve the floss into a C-shape and slide it into the space between the gum and
tooth until you feel resistance. Gently scrape the floss against the side of the tooth.
Repeat this procedure on each tooth. Don’t forget the backs of the last four teeth.
Flossing aids and instructions in their use are available from our office
staff. Healthy eating habits lead to healthy teeth. Like the rest of the
body, the teeth, bones and the soft tissues of the mouth need a well-balanced diet.
Children should eat a variety of foods from the five major food groups. Most snacks that
children eat can lead to cavity formation. The more frequently a child snacks, the greater
the chance for tooth decay. How long food remains in the mouth also plays a role. For
example, hard candy and breath mints stay in the mouth a long time, which cause longer
acid attacks on tooth enamel. If your child must snack, choose nutritious foods such as
vegetables, low-fat yogurt, and low-fat cheese which are healthier and better for
children’s teeth. Good oral hygiene removes bacteria and the left over food particles that combine to create cavities. For infants, use a wet gauze or clean washcloth to wipe the plaque from teeth and gums. Avoid putting your child to bed with a bottle filled with anything other than water. See "Baby Bottle Tooth Decay" for more information. For older children, brush their teeth at least twice a day. Also, watch the frequency and number of snacks containing sugar that you give your children. The American Academy of Pediatric Dentistry recommends six month visits to the pediatric dentist beginning at your child’s first birthday. Routine visits will start your child on a lifetime of good dental health. Your pediatric dentist may also recommend protective sealants or home
fluoride treatments for your child. Sealants can be applied to your child’s
permanent molars to prevent decay on deeply grooved surfaces. A sealant is a clear or shaded plastic material that is applied to
the chewing surfaces (grooves) of the back molars, where many cavities in children are found. This sealant acts as a barrier to food, plaque and
acid, thus protecting the decay-prone areas of the teeth. Baby Bottle Tooth Decay (Early Childhood Caries) One serious form of decay among young children is baby bottle tooth decay. This condition is caused by frequent and long exposures of an infant’s teeth to liquids that contain sugar. Among these liquids are milk (including breast milk), formula, fruit juice and other sweetened drinks. Putting a baby to bed for a nap or at night with a bottle other than water can cause serious and rapid tooth decay. Sweet liquid pools around the child’s teeth giving plaque bacteria an opportunity to produce acids that attack tooth enamel. If you must give the baby a bottle as a comforter at bedtime, it should contain only water. If your child won't fall asleep without the bottle and its usual beverage, gradually dilute the bottle's contents with water over a period of two to three weeks. After each feeding, wipe the baby’s gums and teeth with a damp
washcloth or gauze pad to remove plaque. The easiest way to do this is to sit down, place
the child’s head in your lap or lay the child on a dressing table or the floor.
Whatever position you use, be sure you can see into the child’s mouth easily. Teething, the process of baby (primary) teeth coming through the gums
into the mouth, is variable among individual babies. Some babies get their
teeth early and some get them late. In general the first baby teeth are
usually the lower front (anterior) teeth and usually begin erupting between
the age of 6-8 months. See "Eruption
of Your Child’s Teeth" for
more details. Eruption Of Your Child’s Teeth Children’s teeth begin forming before birth. As early as 4 months, the first primary (or baby) teeth to erupt through the gums are the lower central incisors, followed closely by the upper central incisors. Although all 20 primary teeth usually appear by age 3, the pace and order of their eruption varies. It is not uncommon to have a permanent tooth erupt while the primary tooth is still present. Permanent teeth begin appearing around age 6, starting with the first molars and lower central incisors. This process continues until approximately age 21. Adults have 28 permanent teeth, or up to 32 including the third molars (or wisdom teeth). TOOTH DEVELOPMENT
Toothache: Clean the area of the affected tooth thoroughly. Rinse the mouth vigorously with warm water or use dental floss to dislodge impacted food or debris. DO NOT place aspirin on the gum or on the aching tooth. If face is swollen apply cold compresses. Take the child to a dentist. Cut or Bitten Tongue, Lip or Cheek: Apply ice to bruised areas. If there is bleeding, apply firm but gentle pressure with a gauze or cloth. If bleeding does not stop after 15 minutes or it cannot be controlled by simple pressure, take child to hospital emergency room. Knocked Out Permanent Tooth: Find the tooth. Handle the tooth
by the crown, not the root portion. You may rinse the tooth but DO NOT clean or handle the
tooth unnecessarily. Inspect the tooth for fractures. If it is sound, try to reinsert it
in the socket. Have the patient hold the tooth in place by biting on a gauze. If you
cannot reinsert the tooth, transport the tooth in a cup containing the patient’s
saliva or milk. The tooth may also be carried in the patient’s mouth. The patient
must see a dentist IMMEDIATELY! Time is a critical factor in saving the tooth. Fluoride is an element, which has been shown to be beneficial to teeth by strengthening the enamel, thus, reducing dental decay. Children who receive fluoride can have up to 40% fewer cavities than those who do not. It is very important to provide the optimal level of fluoride for your child. We do this by considering the age of the child and the amount of fluoride occurring naturally in your drinking water. It is imperative that you obtain fluoride level test results for your drinking water before giving fluoride supplements to your child. Your local water utilities or health department can help you access this information. While
drinking water fluoridates the teeth from within, topical fluoride applied
at six month recall visits protect the outer enamel of the teeth.
Twice a year applications keep this at an optimal level. Tooth brushing is one of the most important tasks for good oral health. Many toothpastes, and/or tooth polishes, however, can damage young smiles. They contain harsh abrasives which can wear away young tooth enamel. When looking for a toothpaste for your child make sure to pick one that is recommended by the American Dental Association. These toothpastes have undergone testing to insure they are safe to use. Remember, children should spit out toothpaste after brushing. If your child is too young or unable to spit out toothpaste, consider providing them with a fluoride free toothpaste, using no toothpaste, or using only a "pea size" amount of toothpaste. For children prone to high
rates of decay or children in orthodontics, we may advise a fluoride home
gel or rinse. Does Your Child Grind His Teeth At Night? (Bruxism) Parents are often concerned about the nocturnal grinding of teeth (bruxism). Often, the first indication is the noise created by the child grinding on their teeth during sleep. Or, the parent may notice wear (teeth getting shorter) to the dentition. One theory as to the cause involves a psychological component. Stress due to a new environment, divorce, changes at school; etc. can influence a child to grind their teeth. Another theory relates to pressure in the inner ear at night. If there are pressure changes (like in an airplane during take-off and landing when people are chewing gum, etc. to equalize pressure) the child will grind by moving his jaw to relieve this pressure. The majority of cases of pediatric bruxism do not require any treatment. If excessive wear of the teeth (attrition) is present, then a mouth guard (night guard) may be indicated. The good news is most children outgrow bruxism. The grinding gets
less between the ages 6-9 and children tend to stop grinding between ages 9-12. If you
suspect bruxism, discuss this with your pediatric dentist. Sucking is a natural reflex and infants and young children may use thumbs, fingers, pacifiers and other objects on which to suck. It may make them feel secure and happy or provide a sense of security at difficult periods. Since thumb sucking is relaxing, it may induce sleep. Thumb sucking that persists beyond the eruption of the permanent teeth can cause problems with the proper growth of the mouth and tooth alignment. How intensely a child sucks on fingers or thumbs will determine whether or not dental problems may result. Children who rest their thumbs passively in their mouths are less likely to have difficulty than those who vigorously suck their thumbs. Children should cease thumb sucking by the time their permanent front teeth are ready to erupt. Usually, children stop between the ages of two and four. Peer pressure causes many school-aged children to stop. Pacifiers are no substitute for thumb sucking. They can affect the teeth essentially the same way as sucking fingers and thumbs. However, use of the pacifier can be controlled and modified more easily than the thumb or finger habit. If you have concerns about thumb sucking or use of a pacifier, consult your pediatric dentist. A few suggestions to help your child get through thumb sucking:
Tongue
Piercing – Is it Really Cool?
You might not be surprised anymore to see people with
pierced tongues, lips or cheeks, but you might be surprised to know just how
dangerous these piercings can be. There are many risks involved with oral piercings
including chipped or cracked teeth, blood clots, or blood poisoning. Your
mouth contains millions of bacteria, and infection is a common complication
of oral piercing. Your tongue could swell large enough to close off your
airway! Common symptoms after piercing include pain, swelling,
infection, an increased flow of saliva and injuries to gum tissue.
Difficult-to-control bleeding or nerve damage can result if a blood vessel
or nerve bundle is in the path of the needle. So follow the advice of the American Dental
Association and give your mouth a break – skip the mouth jewelry. Tobacco – Bad News in Any Form Tobacco in any form can jeopardize your child’s health and cause incurable damage. Teach your child about the dangers of tobacco. Smokeless tobacco, also called spit, chew or snuff, is often used by teens who believe that it is a safe alternative to smoking cigarettes. This is an unfortunate misconception. Studies show that spit tobacco may be more addictive than smoking cigarettes and may be more difficult to quit. Teens who use it may be interested to know that one can of snuff per day delivers as much nicotine as 60 cigarettes. In as little as three to four months, smokeless tobacco use can cause periodontal disease and produce pre-cancerous lesions called leukoplakias. If your child is a tobacco user you should watch for the following that could be early signs of oral cancer:
Because the early signs of oral cancer usually are not painful, people often ignore them. If it’s not caught in the early stages, oral cancer can require extensive, sometimes disfiguring, surgery. Even worse, it can kill. Help your child avoid tobacco in any form. By doing
so, they will avoid bringing cancer-causing chemicals in direct contact with
their tongue, gums and cheek. What is the Best Time for Orthodontic Treatment? 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 at a later age. Stage I – Early Treatment: This period of treatment encompasses ages 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 eliminate the need for future orthodontic/orthopedic treatment. Stage II – Mixed Dentition: This period covers the ages of 6 to 12 years, with the eruption of the permanent incisor (front) teeth and 6 year molars. Treatment concerns deal with jaw malrelationships and dental realignment problems. This is an excellent stage to start treatment, when indicated, as your child’s hard and soft tissues are usually very responsive to orthodontic or orthopedic forces. Stage III – Adolescent Dentition: This stage deals with the permanent teeth and the development of the final bite relationship. For more
information concerning orthodontics, please click here. When a child begins to participate in recreational activities and organized sports, injuries can occur. A properly fitted mouth guard, or mouth protector, is an important piece of athletic gear that can help protect your child’s smile, and should be used during any activity that could result in a blow to the face or mouth. Mouth guards help prevent broken teeth, and injuries to the lips, tongue, face or jaw. A properly fitted mouth guard will stay in place while your child is wearing it, making it easy for them to talk and breathe. Ask your pediatric dentist about custom and
store-bought mouth protectors. Many of our patients age 12 and up, express interest in having whiter teeth. To help them achieve the results they desire, we offer Crest Professional Strength Whitening Strips or a whitening system using custom fit trays and gel. Both methods allow our teen-age patients the opportunity to enhance their smiles for prom, homecoming, senior pictures, and just everyday good looks. As
a service to our orthodontic patients, we provide a complimentary set of
whitening strips at the completion of treatment. Parent Advisory on Tooth Decay Our office emphasizes prevention as the best way to minimize dental expenses and optimize your child's dental health. This includes seeing our pediatric office twice a year for examinations, oral hygiene instructions and prophylaxis, and topical fluoride applications and periodic cavity detecting x-rays. Recently, we have seen a dramatic increase in the number of children experiencing interproximal caries (cavities that occur between teeth) that are diagnosed by bitewing x-rays (cavity detecting x-rays). What can you do? We are seeing a trend in our patients as to the amount and frequency of fruit drinks, sport drinks and 100% fruit juices (not just sodas) being consumed. When your child is thirsty, offer water. Water is preferred even over the 100% natural juices such as Juicy Juice because they contain considerable levels of natural sugar, and these sugars will produce cavities. Flossing cleans the area between teeth where your children could get cavities. We will show your children how, and if you monitor and assist them, you could decrease their decay rate. Snacks should be sugar-free between meals. If your children want candy or some special treat, offer it as dessert after the evening meal. In-between meal snacks should be sugar-free (for example, cheese goldfish crackers). Frequency of exposure to foods containing sugar correlates with the extent of decay children develop. Every time your child has a sip of soda, or a fruit drink, or candy, or a handful of raisins, he or she receives 20 minutes of lactic acid production that starts the process of demineralization and cavity production. That is why we emphasize sugar-free snacking. When children snack frequently, they are having their teeth bathed in sugar solutions for 3 to 5 hours per day. What about Fluoride treatments in our office? Some parents request fluoride once a year because their insurance company will pay for only one treatment a year. That is not in a child's best interests. Topical fluoride treatments in our office increase the outer enamel hardness of children's teeth up to 10,000 ppm (parts per million) of fluoride, and this helps to prevent decay from occurring. Over a six-month interval, this fluoride protection gradually leeches out, and your child needs to have fluoride applied again. Our office may also recommend home fluoride as a supplement to in-office fluoride treatments. Sealants protect the tops of your children's permanent molars, but not areas in between the teeth. Don't confuse the value of sealant protection (protection to the chewing surfaces where the grooves and fissures are deep) with protection to all surfaces of the teeth. Even with sealants, a child can get cavities, and lots of them, if care is not given to all areas of the teeth. All
of the above suggestions are made with your child's dental health in mind.
That is our primary focus and the reason for our existence. We treasure
children and want them healthy and happy, just as their parents do! We take every step to ensure that your child's visit for restorative care is comfortable. To this end we will usually use a local anesthetic to numb the teeth being restored, so there will be no feeling while your child is being treated. Giving painless anesthetics to children is what parents have come to expect from our doctors. For children in need of more relaxation, the use of nitrous oxide may be recommended. For further information on this, please click on the following link to visit the American Academy of Pediatric Dentistry. The doctors are on staff at several area hospitals for those patients who cannot be treated in the office due to age or mental /physical handicap. The
doctors are specially trained in treating patients with special needs.
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Copyright © 2003 Drs. Rollefson,
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The pediatric dentist has an extra two years of specialized training and is
dedicated to the oral health of children from infancy through the teenage
years. The very young, pre-teens, and teenagers all need different
approaches in dealing with their behavior, guiding their dental growth and
development, and helping them avoid future dental problems. The pediatric
dentist is best qualified to meet these needs and is also trained in the
treatment of special needs patients.
You can make your child's first visit to the dentist
enjoyable and positive. Your child should be informed of the visit and told
that the dentist and his staff will explain all procedures and answer any
questions. The less to-do concerning the visit, the better. 
