Pediatric Dentistry:

Frequently Asked Questions

Dentists can seem scary to kids, and even some parents. Below are some commonly asked questions that can help prepare you and your child for their visit.

Why do I need an x-ray?

X-Rays are a vital and necessary part of your child’s dental diagnostic process. Without them, certain dental conditions cannot be identified or treated.

X-rays 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-ray and examinations every six months for children with a high risk of tooth decay. This includes children who consume a substantial amount of sugar or snack foods. On average, most pediatric dentists request x-rays approximately once a year. Approximately every 3 years, it is a good idea to obtain a complete set of x-rays, either a panoramic and bitewings or periapicals and bitewings.

Pediatric dentists are particularly careful to minimize the exposure of their patients to radiation. Lead body aprons and shields will protect your child. With contemporary safeguards, the amount of radiation received during a dental X-ray examination is extremely small; the risk is negligible. In fact, dental x-rays represent a far smaller risk than an undetected and untreated dental problem. 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.

What’s the best toothpaste for my child?

Tooth brushing is one of the most important tasks for good oral health. Many toothpastes, and/or tooth polishes 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 as shown on the box and tube. These toothpastes have undergone testing to ensure they are safe to use.

Use only a smear of toothpaste (the size of a grain of rice) to brush the teeth of a child less than 3 years old. For children 3—6 years old, use 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 on their own. Children should spit out and not swallow excess toothpaste after brushing.

What if my child grinds his/her teeth at night?

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 shape and order of their teeth. 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 that 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 prescribed. The negatives to a mouth guard are the possibility of choking if the appliance becomes dislodged during sleep and it may interfere with growth of the jaws. The positive outcome is the prevention of wear to the teeth.

The good news is that most children outgrow bruxism. The grinding decreases between the ages 6 and 9 and children tend to stop grinding between ages 9 and 12. If you suspect bruxism, discuss this with your pediatrician or pediatric dentist.

What are the effects of thumb sucking?

Sucking is a natural reflex and infants and young children may suck thumbs, fingers, pacifiers and other objects. It may make them feel secure and happy, or provide a sense of security during 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 2 and 4. 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 a 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:

  • Children often suck their thumbs when feeling insecure. Focus on correcting the cause of anxiety, instead of the thumb sucking.
  • Children who are sucking for comfort will feel less of a need when their parents provide comfort.
  • Reward children when they refrain from sucking during difficult periods, such as when being separated from their parents.
  • Your pediatric dentist can encourage children to stop sucking and explain what could happen if they continue.
  • If these approaches don’t work, remind the children of their habit by bandaging the thumb or putting a sock on the hand at night. Your pediatric dentist may recommend the use of a mouth appliance.

What is pulp therapy?

The pulp of a tooth is the inner, central core of the tooth. The pulp contains nerves, blood vessels, connective tissue and reparative cells. The purpose of pulp therapy in pediatric dentistry is to maintain the vitality of the affected tooth (so the tooth is not lost).

Dental caries (cavities) and traumatic injury are the main reasons for a tooth to require pulp therapy. Pulp therapy is often referred to as a “nerve treatment”, “children’s root canal”, “pulpectomy” or “pulpotomy”. The two common forms of pulp therapy in children’s teeth are the pulpotomy and pulpectomy.

A pulpotomy removes the diseased pulp tissue within the crown portion of the tooth. Next, an agent is placed to prevent bacterial growth and to calm the remaining nerve tissue. This is followed by a final restoration (usually a stainless steel crown).

A pulpectomy is required when the entire pulp is involved (into the root canal(s) of the tooth). During this treatment, the diseased pulp tissue is completely removed from both the crown and root. The canals are cleansed, disinfected, and in the case of primary teeth, filled with a resorbable material. Then, a final restoration is placed. A permanent tooth would be filled with a non-resorbing material.

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 2–6 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 6–12 years, with the eruption of the permanent incisor (front) teeth and six-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.

What if the adult teeth are coming in behind the baby teeth?

This is a very common occurrence with children, usually the result of a lower, primary (baby) tooth not falling out when the permanent tooth is coming in.  In most cases, if the child starts wiggling the baby tooth, it will fall out on its own within two months. If it doesn’t, then contact your pediatric dentist, where they can easily remove the tooth.  The permanent tooth should then slide into the proper place.

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Fireweed Building Dental
4341 Tudor Centre Drive, Suite 100
Anchorage, AK 99508

Phone
(907) 729-2000

ANMC Dental
4315 Diplomacy Drive
Anchorage, AK 99508

Phone
(907) 729-2000

Hours
7:30 a.m.-6 p.m.
Monday – Friday

VNPCC Dental
1001 Knik-Goose Bay Road
Wasilla, AK 99654

Phone
(907) 631-7690

Hours
7:30 a.m.-6 p.m.
Tuesday- Friday