Dental FAQ's Pediatric FAQ's

Children 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 20 primary teeth usually appear by age 3, the pace and order of their eruption varies.

Oral care should begin soon after the baby birth. Gums should be cleaned after each feeding. You can begin brushing your child teeth as soon as they appear. 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). Always clean your infants gums after feedings. Wipe the gums with a clean, damp cloth or gauze pad. Parents should brush children teeth daily with a soft wet toothbrush and a pea-sized amount of fluoride toothpaste. Schedule a dental visit between 6-12 months of age. Supervise your child brushing to ensure proper brushing habits. To prevent nursing bottle mouth, if you must give your baby a bottle at nap or bed time, fill it with plain water -- not milk, formula or juice.

We may recommend regular fluoride treatments to strengthen enamel and resist decay. Whenever possible, drink fluoridated water and always use a fluoridated toothpaste. Dental sealants can provide a further layer of protection against cavities. The plastic coating is painted on the grooved chewing surfaces of the back teeth.

It is important to get an early start on dental care, so that your child will learn that visiting the dentist is a regular part of health care. The first step is to choose a dentist for your child. It may be your own dentist or one who specializes in treating children (called a pediatric dentist). Once you have selected a dentist, call the office to find out at what age he or she prefers to see child patients for the first time. Dentists encourage the assessment of infants, by a dentist, within 6 months of the eruption of the first tooth or by one year of age. It is important to make the first visit a positive experience for your child - one reason why it is best to visit before a problem develops. If you think there is a problem, however, take your child to the dentist right away, no matter what age. If you are a nervous dental patient, ask your spouse or another family member to take the child for the appointment. If your child senses that you are nervous, he or she may feel nervous too. When you talk to your child about going to the dentist, explain what will happen without adding things like "it wont hurt" or "dont be scared." Be sure to get an early start on regular dental care at home. Start cleaning your child mouth with a soft damp cloth before teeth come in and continue with a soft toothbrush once he or she has a first tooth. Limit the number of sugary treats you give your child, and focus on healthy food choices from the very beginning.

Teething is a phase in early childhood during which the milk teeth emerge into the mouth cutting through the gums. Children experience discomfort during this phase and may have disturbed sleep, eating problems and may be restless and cranky.

Teething is often blamed for systemic conditions like diarrhea, vomiting and fever. The possible explanation for this is that during teething the child has a tendency to chew objects for relief, which at times may not be clean and may be a source of microbes.

The discomfort associated with teething can be relieved to a certain extent by using teething gels, which are basically anti-inflammatory analgesics. These gels are massaged over the gums. Teethers of different types are available which the child can chew on for relief.

Infants teeth can be cleaned with a soft cloth wrapped around the index finger. Wet the cloth and rub gently over the teeth to clean them. Small soft brushes that can be inserted over your fingers are available that can be used to clean the teeth.

You can introduce a baby- size tooth brush at around 12 months of age encouraging the child to use the brush himself. Though the child may play with it rather than brush his teeth, it will ensure good lifelong habits in your child. This should be followed by the parent properly brushing the child teeth for him.

Initially for a toddler, a wetted toothbrush is sufficient to brush the teeth. Once the child has learnt to rinse his mouth and spit, you can start using a pea-sized helping of fluoride toothpaste. Most dentists advise using fluoride tooth pastes around three years of age. If you think your child may swallow the toothpaste, you can use a non-fluoridated one till he learns to spit it out. Visit Pediatric Treatment Section for further details

It is a good habit to brush the teeth both mornings soon after getting up and just before going to bed at night. Children should also be told to gargle every time after something is eaten.

Fluorides used in toothpastes have the ability to get incorporated into the tooth structure and make the teeth more resistant to dental decay. The use of fluorides may even arrest progression of caries which are in the initial stages

Sticky and sweet foodstuffs promote plaque and growth of caries causing microorganisms. This predisposes to dental caries.

In addition to using fluoride toothpastes, some other form of fluoride supplement may also be required to protect your child teeth. As this may differ from case to case, it is advisable to consult your dentist for more information.

Yes, studies have shown that fluorides can prevent decay by up to 50% if they are supplemented and monitored in water, food and tooth paste. In addition the patient should maintain good oral hygiene.

Fluorides have the ability to get incorporated into the tooth structure and make the teeth more resistant to dental decay. The use of fluorides may even arrest progression of caries which are in the initial stages. Fluoride when consumed during formation of teeth gets incorporated in the tooth structure and makes the enamel stronger. It also has an anti -bacterial effect on several germs that cause decay and makes dental plaque difficult to attach to the tooth.

Fluoride when added in drinking water (in one part per million parts of water) helps prevent caries in the entire population of a particular region. This has been tried in many cities around the world with great success. Fluorides are also available in tablet form, varnishes, filling materials, food products like salt and toothpastes. However, except tooth pastes all other forms need to be consulted and monitored by the dentist before consumption.

It can be considered quite normal for children to suck their finger up to a certain age. Continued finger sucking beyond 3 years of age may cause serious defects in the developing oral and facial structures

Many children develop the habit of sucking the thumb or other fingers. A number of possible causes exist for finger sucking. These include: 1. Lack of adequate nursing or feeding. 2. Feeling of insecurity due to inadequate parental care, love and affection. 3. Sudden change in domestic or work atmosphere which the child cannot cope with. 4. Stress related to school, friends etc.

Finger sucking may not cause irreversible harm in children less than 3 years of age. However much depends on factors such as duration, intensity and frequency of the sucking habit. Continuation of the habit beyond 3 years may pose problem for the developing facial and dental structures. The teeth can come forwards and open bite can occur.

Many children stop sucking the thumb when the causative factor is identified and eliminated. Timely nursing, feeding, and increasing the time you spend with the child may to some extent decrease his insecurity. Slightly older children can be reasoned out of the habit by explaining the bad effects of the habit. The dentist may sometimes advice the use of finger bandaging or the use of bitter medicine to make the habit less pleasurable. When these simple steps fail the dentist may advice a habit breaker, which is placed behind the front teeth, and prevents the child from sucking the thumb.

Thumb sucking can cause problems if allowed to persist beyond 3 years of age. Some of the effects include the front teeth being pushed too far forward, spacing of the teeth and therefore poor facial appearance. Continued indulgence in the habit may cause defects in the developing jaw and facial bones.

Habits like biting nails, pencils, etc besides causing wear of the teeth can cause injury to the gums and supporting structures around the teeth. In addition the pressures they exert on the teeth may force them into abnormal positions which may necessitate orthodontic treatment.

No, infact the sugar content of milk will promote decay. These children develop a rampant form of dental caries involving several teeth in the mouth. This form of caries is called nursing bottle caries. Nursing bottle caries is usually associated with prolonged bottle feeding of sugar containing drinks such as milk and juices. They may occur due to bottle-feeding at bedtime or during sleep and lack of cleansing of the teeth thereafter. Nursing caries can also occur due to prolonged on demand breast feeding at night due to lactose sugar present in the milk. This form of dental decay affects many teeth and may be seen as marked discoloration of the teeth. In later stages the teeth may fracture. The child often experiences pain on brushing and eating cold or hot food substances

Tongue thrusting is a habit wherein the person forces the tongue against the back surface of the front teeth while swallowing. This habit can produce Proclination of the front teeth and spaces between them. The dentist may have to train the patient on the correct swallowing method by some exercises and use of habit breaking devices.

Clefts of the lip and palate are a very common occurrence. They are congenital deformities meaning defective developments seen at the time of birth. Cleft lip is seen as a clefting of the lip - usually the upper. This produces bad facial appearance. Cleft palate is seen as a cleft or furrow in the palate producing sometimes a communication between the nose and the mouth. This causes difficulty in nursing the child and may later pose problems of speech.

The clefts of the lip and palate occur due to a variety of reasons, the most important being genetic. The other causes include the intake of certain teratogenic drugs or chemicals during pregnancy, which cause a defect in the development.

Clefts pose numerous problems. They are treated by a multidisciplinary approach by involvement of the pediatrician, orthodontist, pediatric dentist, plastic surgeon, Prosthodontist etc.

It sounds like a very normal situation and nothing to be concerned about. When the teeth are forming in the jaws, they are surrounded by a soft tissue membrane called Nasmyth Membrane (named after Alexander Nasmyth, a Scottish dental surgeon in London who died in 1847). As the teeth erupt, remnants of this membrane remain on the surface of the enamel. The fibrous nature of the membrane readily picks up coloration from food. In most cases normal chewing and brushing will remove the remnants with time. If they don not come off, they can be removed by having a professional cleaning. Other causes for staining of teeth include high fevers during infancy, too much fluoride in drinking water and certain medications if taken while the teeth are still forming.

You should talk about the upcoming visit in a positive, matter-of-fact way. A visit to the dentist can be a pleasant adventure for your child. Make the dental visit an enjoyable outing. Don not let the child know of your own anxiety or fears of dentistry if you have any. Don not use a dental visit as punishment or discuss the visit in terms of pain or other negative images. For example, don ont say, "This wont hurt," or "The dentist wonnt hurt you." Its ok to reward your child if he or she behaves well at the dental visit, but don not use bribery. Children generally believe bribes are related to negative experiences. Early dental visits can reinforce a positive experience for the child, leading to a lifetime of healthy teeth. At a first visit the teeth and gums will be examined for decay, proper alignment, and other problems. The teeth will be cleaned and fluoride applied. Home care skills will be discussed to help the teeth stay strong and healthy. The primary teeth (the first set) are very important for the future development of the permanent teeth. They maintain the space that is needed so that the permanent teeth can errupt in a normal alignment. Healthy primary teeth are also needed to chew food comfortably, speak clearly, and for an attractive smile. Some patients ask me if their child should visit during the parent dental visit. If the parent is a relaxed and confident patient, and if the treatment is simple and short, this may well be a good idea.

Following a few simple guidelines can help keep your child’s teeth strong and beautiful for life:

  • Start oral care early: Oral care should start soon after your child is born. After feeding, clean your child’s gums using gauze or a clean, damp cloth. As soon as your child’s teeth appear — as soon as four months after birth — they should be brushed. Each day, brush your child’s teeth with a soft, wet toothbrush and a pea-sized amount of fluoride toothpaste.
  • Prevent nursing-bottle mouth: Nursing-bottle mouth, also known as baby-bottle tooth decay or baby-bottle syndrome, can cause a baby’s front teeth to rapidly decay, which can lead to a lifetime of dental difficulties. Preventing nursing bottle mouth is easy: If you give your baby a bottle at nap or bed time, simply fill it with plain water rather than formula, milk, or juice—never let your child fall asleep with a bottle filled with a liquid other than water In addition, check your child for brown spots near the gums because they are a warning sign for tooth decay.
  • Take your child to the dentist: General, preventative dentistry should start early. A child’s first dental visit should take place at 6 to 12 months after birth. Regular fluoride treatments, administered by a dentist, are especially helpful in strengthening enamel and arresting tooth decay for children.
  • Take advantage of dental sealants: Dental sealants are a popular and effective way to protect your child’s teeth against cavities.

Dental sealants are a plastic coating painted on the grooved, hard-to-reach surfaces of the back teeth. Pits and fissures on these surfaces are particularly susceptible to tooth decay. Dental sealants can be used to seal out cavity-causing bacteria from damaging the teeth.

Dental sealants material bonds directly to the tooth and hardens with the aid of a special curing light. Dental sealants hold up well under the force of chewing, and they provide protection against cavities for about five years. During regular dental visits, the dentists can check the status of sealants and re-apply them if necessary.

Because fluoride is effective in preventing decay from forming on the smooth surfaces of teeth, and dental sealants protect the grooves of teeth, these treatments are best used in conjunction. Dental sealants are particularly effective for protecting children teeth. The first permanent molars emerge when a child is about 6. A dental sealant treatment performed shortly after these first permanent teeth emerge protects the teeth from developing cavities. Another good time for applying sealants occurs when a child is about 12, when the second permanent molars emerge. We may also recommend sealants for adults who are at a particularly high risk of tooth decay.

Sealants are excellent protection against cavities. In addition to brushing, flossing and fluoride, they protect teeth from the need for future restorations.

A variety of materials are available for restorations, including dental amalgam, stainless steel, gold, porcelain and resin. Most sealants and resins contain no (or very little) Bisphenol A and it does not release in the application. All materials have various pros and cons. You and your dentist should decide together which material is best for you or your child.

No, the amount of Bisphenol A that comes from dental sealants has always been extremely small and limited to a few specific products. As well, this very minimal exposure occurs within the first few hours/days after placement, and then quickly reduces to virtually nothing.