What is children dentistry or pediatric dentistry?
By definition, pediatric dentistry is dentistry for anyone under the age of 13. We often think pediatrics means anyone under 18, but when you look at the physical development of teeth, a child is considered an adult, teeth-wise, once they reach around age 13. By then, all the permanent teeth have typically come in, and the roots are fully matured.
One of the most important reasons pediatric dentistry matters is because so many adults develop dental anxiety that began in childhood. Often, when I talk to patients, that anxiety started because they were either not exposed to dentistry early enough or had a bad dental experience as a child. Early exposure to dentistry is very important because it creates familiarity and allows us, as dentists, to care for children in a way that is comfortable and not traumatic.
If a child only goes to the dentist when something is wrong, they’re going to associate the dentist with something bad. That’s why regular routine care is so important when someone is young. It helps shape the future of their dental care and creates a level of comfort that can stay with them throughout life.
What’s unique about my practice is that the youngest patient I have seen to date is two weeks old, and my oldest patient is 103. That is a broad range of patients, and it’s why I’m talking about children’s dentistry today. I see many adults whose dental problems first started when they were children, and I would much rather help prevent those problems early.
What should a child’s dental routine at home consist of?
Very simply, the top two things are brushing and flossing. If those things are in place, we can eliminate a lot of problems. Brushing should be done twice a day for two minutes each time, and the best type of toothbrush to use is an electric toothbrush. Children are still learning how to brush properly, and there is a technique to it, so an electric toothbrush is usually more efficient and effective at cleaning.
I always recommend that when a child is under about age 10, a parent should supervise brushing. Let the child do the brushing, but always review afterward to make sure everything was taken care of. Often, I see kids who brush two or even three times a day, but because it’s done too quickly or without the proper technique, they still end up with problems.
The second most important thing for anyone to do, especially children, is flossing. Creating that habit early is important. Flossing can be more challenging for kids because they may not yet have the dexterity to use floss properly. Floss picks can make it a little easier, but flossing is usually best done by the parent. It should be done at least once a day.
Diet also matters. We’ve all heard that sugar is bad for our teeth. Sugar is harmful because it feeds the bacteria that cause tooth decay. Limiting sugar, or making sure children brush after sugary beverages, snacks, or candy, can help reduce the risk.
The final thing I would say is to make sure kids are not going to bed with sweets or drinks. Often, children are put to bed with milk. Milk does contain sugar. It may be healthy for the body, but it can still contribute to tooth decay. Water should be the only thing given prior to bedtime and at bedtime so the teeth stay rinsed and clean. These are some of the most important habits for maintaining good oral hygiene.
When should a child have their first dental appointment?
I always tell parents that the beginning of a child’s dental journey should start when they first show signs of teething. That doesn’t mean the child has to already have teeth, but when you notice early signs of teething—such as chewing on things or increased drooling—that’s when you want to bring them in. There’s a lot of education I like to go through with parents at that stage so they are prepared for when the teeth do start to come in.
That first visit is usually within the first couple of months of life, around four to six months old. This allows us to see your child at every developmental stage. As your child develops, the instructions for care will change, so it’s important to begin early and create a path for how we’re going to care for your child.
What should a child's dental visit look like?
What is especially important for a child’s early development and dental experience is how the office handles those first visits. At Inspire Dental, we take a no-pressure approach. We call it practicing without pressure, and we want your child’s visit to be the happiest experience possible.
In our waiting room, we have a private little room with toys and a bubble wall to make things fun while they wait. When you come back into the clinical area, it’s still all about fun. We have toys, stuffed animals, prizes, and even puppets with teeth so children can practice brushing and explore the experience in a playful way.
These first visits are all about exploration. We introduce children to new things, and we want them to feel free to explore. We do this without restraint whenever possible. Sometimes, some form of gentle restraint may be needed just to see inside the baby’s or child’s mouth, but that is always partnered with the parent. There is no one your child trusts more than you, so we invite the parent to be involved in the visit. We’re simply trying to get a view of how development is progressing, how many teeth are present, and whether there are any early signs of problems.
The more often a child visits and the more positive the environment is, the less pressure and anxiety they will develop.
Lastly, a lot of that pressure can also start with the parent. The way you talk to your child about the dentist matters. Children do great when things are fun, but if dental care is presented through threats, that creates fear and anxiety. I’ve seen many situations where parents say things like, “If you don’t brush your teeth, you’re going to lose them,” and that creates a negative opinion of dentistry. We want it to be fun. We want it to feel like a game. We can also give you ideas on how to do that because we’re here to partner with you in caring for your child.
What are the most common dental issues in children?
Now that we’ve talked about routines and habits, let’s look at the most common dental issues in children. I would say the most common issue is trauma. As children develop, they go from lying on their back to rolling over, crawling, walking, and eventually running. As they learn to walk and run, they fall down a lot, and those falls can cause dental trauma.
When there is a traumatic event, it’s very important to know that if a child knocks out a baby tooth, we do not reimplant it. Many people have heard that if a tooth gets knocked out, you put it back in. That is true for an adult tooth, but not for a baby tooth. What most people don’t realize is that an adult tooth starts forming when a child is only a few months old. That development process is very slow, but if there is trauma and we try to put a baby tooth back into place, we can actually damage the developing permanent tooth underneath. We can afford to lose a baby tooth, but we never want to lose an adult tooth because there is no replacement.
The second most common issue would be cavities. Kids love sugar, and so do adults. That’s why proper hygiene techniques are so important. If we apply those habits consistently, then sugar won’t stay on the teeth long enough to cause damage. Trauma and cavities are the two most common issues we see in children.
What are dental treatment options for kids?
Occasionally, if a dental problem occurs—whether from trauma or cavities—we may need to go beyond just a filling. Some of the treatment options for kids include fillings, crowns, and even root canals.
I often get asked why a root canal would ever be needed in a child. The reason is that a child’s tooth still has a nerve in it. Even though it’s a baby tooth, it plays an important role. Baby teeth help guide the development and eruption of the adult teeth. If a baby tooth is lost too soon, it can create crowding issues, cause teeth to come in at odd angles, or even prevent the adult tooth from erupting properly.
That’s why it’s important to preserve baby teeth as much as we can. A baby root canal may be performed when we believe that tooth still needs to remain in the mouth for several years. Saving that tooth helps guide the eruption of the permanent adult tooth.
When should children start to lose their baby teeth and when should adult teeth start to come in?
This usually begins around age six. Every child develops differently, but there are averages. In general, age six is the most common time to start seeing baby teeth fall out and adult teeth come in. However, some children may begin at age five, while others may not start until age seven or even eight. It all depends on the child’s development.
What sedation options are available for children?
Even when we create the best possible experience for children, dental procedures can still be scary. There may be drills involved, and often we need to numb a tooth, which means a shot. Even that little poke can be frightening for a child. That’s why we offer sedation options to help make your child more comfortable and allow dentistry to be performed safely.
There are four levels of sedation in total, and in our practice, we offer every level. The lowest level is nitrous gas. Nitrous helps a child feel a little silly and more relaxed. However, if your child has a lot of anxiety, nitrous may not be enough. It also does not affect memory, so they will remember everything from the procedure.
The next level is minimal sedation, where we give medicine that the child swallows. This relaxes them more than nitrous, and it also affects memory. Even though they may seem awake, they often won’t remember the procedure afterward. That can be very helpful in creating a better long-term experience.
Oral sedation works when a child is still somewhat compliant. If a child’s anxiety is too severe and they are thrashing, kicking, or moving too much, then we may need the highest level, which is general anesthesia. Under general anesthesia, your child is completely asleep. That allows us to safely perform the dentistry more efficiently and comfortably. Our approach to sedation is always customized to each child’s needs.
How can I schedule an appointment with Inspire Dental?
At Inspire Dental, you come first. Whether you need dental care or simply have questions, call us at (210) 972-0768 or email [email protected] to schedule your visit. Our team is here to help you every step of the way.