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Frequently Asked Questions
We make every effort to ensure that you and your child have a good experience in our office. We work hard so that the care provided is not only of the highest quality, but is also provided in a safe and efficient manner. Every effort is made so that your child leaves our office with a positive view of dentistry and is excited to return.
Despite best efforts to prevent decay, some very young children present to our office with cavities. At other times, older children present with a large amount of dental treatment that is required. Our goal is that every child will eventually be able to be treated in the office setting. However, a child may be unable to cooperate for the extensive treatment because of young age, or a child may not be able to cooperate if multiple appointments of treatment are required, especially if freezing is needed.
In cases such as these, it is appropriate to choose for the patient to undergo the dental treatment under general anesthesia. General anesthesia is VERY SAFE, and is provided at our own surgical facility beside our office, by medical anesthesiologists and nurses from Alberta Children’s Hospital. The advantage is that all treatment required can be accomplished at one time and the treatment provided is of the highest quality. Your child would be spared the trauma that may negatively affect their view of dentistry for the rest of their life. Once treatment is accomplished, with a fresh start, we can work together towards lifelong oral health.
A stainless steel crown is the standard tooth restoration done by a Pediatric Dentist. If your child presents with a large cavity, or many teeth with cavities, it is much smarter to restore the cavities with stainless steel crowns, as opposed to white fillings.
White fillings in back baby teeth, on average, only last between 3 and 5 years. That means that if your child has cavities at a young age, chances are that white fillings will not last until your child would lose those teeth naturally, between the ages of 10 and 12. So, your child’s cavities will likely have to be retreated multiple times before the teeth switch over to permanent teeth. It is both unfair to your child and inefficient to do a lot of unnecessary treatment. Therefore, it is the best choice to restore the back baby teeth with stainless steel crowns, that we know will last over time.
Stainless steel crowns are so great because they cover the teeth on all surfaces, and act like a suit of armor for the tooth. It is impossible to get a new cavity on a tooth that has been covered with a stainless steel crown. Bacteria cannot get in and further damage the tooth. Stainless steel crowns also avoid the issue of new decay that can develop under white fillings.White fillings are most often done for teeth at the front of the mouth, where looks can be an issue.
A pulpotomy, or pulp therapy, is required for a tooth when deep decay exists, extending into the pulp chamber of the tooth. The pulp chamber of the tooth houses the tooth’s nerves and blood vessels. If a cavity is touching the nerves and blood vessels, it is safe to assume that bacteria has entered the tooth, and pain and infection can develop if the tooth is left untreated.
When we do a pulpotomy, we remove the nerves, blood vessels and bacteria, so the tooth is essentially dead, but it remains in your child’s mouth and your child can continue to function with it. After a pulpotomy, or baby root canal, as it is sometimes called, the tooth must be sealed with a stainless steel crown.
A sealant is a plastic coating that is applied to the grooves and valleys of the biting surface of a tooth. The sealant serves to “seal out” any food and bacteria that might rest in those grooves and valleys which are very prone to cavities. Sealants should be placed on newly-erupted permanent molars, as soon as possible.
An infant’s first examination is too early to predict whether they will ultimately benefit from braces. A favorable factor at an early age is EXCESS SPACE. If your child has a shortage of space, or crowding, they are more likely to require some sort of intervention in the future.
Soothers, thumbs and fingers can change the shape of the jaws and the position of the teeth. At each successive recall examination, new measurements are taken to screen for potential orthodontic issues, and options for intervention are presented, when appropriate. Early orthodontic intervention makes treatment later on easier and shorter.
Frequent snacking can lead to cavities. The more often your child’s teeth are exposed to foods containing sugar, the risk of cavities goes up. Eating sweeter things is okay once in a while. BUT, it is better to consume a larger quantity of treats at one sitting, at a meal preferably, rather than spreading them throughout the course of the day.
Remember: SUGAR IS THE ENEMY! Your child’s teeth are exposed to sugar when they are eating, but the sugar damages the teeth for several hours after eating, as well.
- celery, carrots and fresh vegetables
- apples, oranges, plums, peaches, pears, pineapple, strawberries, melon, grapes and grapefruit
- plain popcorn
- natural yogurt
- anything sticky
- toffees, fruit roll-ups, raisins, dried fruit
- cookies and cakes
- sweetened and/or carbonated drinks
Mouth injuries often happen when babies start to stand up, walk and climb…beware of SLIPPERY bathtubs!
In the event of the injury, a dentist should assess your child within 24-48 hours of the accident. It is essential to take x-rays at the time of the injury and thereafter, to establish a baseline and to monitor changes over time. Appropriate follow-up is also essential, otherwise treatment options are limited.
Once children start playing sports, CUSTOM mouth guards made by a dentist are important to protect the teeth, jaws, joints and brain from injuries.
Although fluoride is no longer added to the water supply, there is a naturally occurring level of fluoride in the drinking water in Calgary. Unfortunately, the naturally-occurring level of fluoride is not high enough to prevent tooth decay.
However, if you provide your child with fluoride supplements, in combination with the naturally-occurring level of fluoride, your child would be exposed to TOO MUCH FLUORIDE. Therefore, fluoride supplements are NOT NECESSARY in Calgary. But, daily, low-dose TOPICAL fluoride in the form of toothpaste is critical and effective to prevent dental decay in children of all ages.
Fluoride is a naturally-occurring mineral. It is overwhelmingly SAFE to consume. When teeth are exposed to fluoride, the mineral is incorporated into the tooth structure and the tooth becomes stronger and more resistant to developing cavities. In some cases, fluoride can stop a cavity that already exists from progressing and needing treatment.
The most effective methods of exposing your child’s teeth to fluoride is through fluoridated drinking water and fluoridated toothpaste. Unfortunately, fluoride is no longer added to the drinking water in Calgary. Now, more so than ever before, it is important to expose your child’s teeth to fluoride via fluoridated toothpaste.
Therefore, AT ALL AGES, you should brush your child’s teeth with a fluoridated toothpaste. From the age of 0-2 years, use a “smear” or “grain-of-rice-sized” amount of fluoridated toothpaste. Over the age of 3, you should use a “pea-sized” amount of toothpaste.
Once you have brushed your child’s teeth, encourage them to spit out the excess toothpaste, but DO NOT RINSE it out. Allow the toothpaste to sit on your child’s teeth overnight. That way you can maximize the benefits of the fluoride being in contact with the teeth.
It is impossible to see what is going on between the teeth if they are touching (that’s why we take x-rays). It is also impossible to clean between the teeth with a brush. If there is no space between the teeth, it is essential to floss. You will not necessarily be pulling out debris; the purpose of flossing is to disturb the bacteria that are living between the teeth, so that they can be washed away. You really want to avoid decay between the teeth, because it is the most difficult to treat.
Floss with the fluoride toothpaste remaining in the mouth. That way you will pull the fluoride down in between the teeth and it will help to harden up some areas that may otherwise develop into cavities.
Why not start flossing early? Flossing is something that you should be doing daily for the rest of your life anyway. You should get your child into the habit early. The sooner you start, the easier it will be!
In a perfect world, you would brush your child’s teeth twice a day, every day. In the real world, you must, AT THE VERY LEAST, brush your child’s teeth WELL, once a day, at night, WITH FLUORIDE TOOTHPASTE and nothing except water should be consumed afterward.
You, yes, YOU, must brush your child’s teeth. They cannot do it well on their own; no matter how gifted they may be in all other areas!
RULE OF THUMB: Unless your child can tie their own shoes or cut their own meat, you should assume they won’t be doing a good job at brushing their teeth, and even if they can, you should supervise their brushing.
“BUT HE WON’T LET ME BRUSH HIS TEETH!”
Well, let us ask you this: If you think it is difficult to brush their teeth, imagine how difficult it would be to do a filling? So help us out here, please! To be honest, its not easy…it may be a two person job!
Prevention of tooth decay must begin immediately after your child’s first feeding. Cavity-causing bacteria can live in your child’s mouth even before teeth are present.
Use a moist washcloth to clean your child’s gum pads, ideally after every feeding, as milk residue can breed bacteria that will ultimately cause cavities.
Once teeth begin to erupt, you must start using a toothbrush with soft bristles AND toothpaste.
The more frequently your child’s teeth are exposed to sugar, the higher the risk of cavities. Sugar comes in many forms and all kinds of milk are considered sugar; that’s how they make a child grow.
Sugar is found in:
- Breast milk
- Cow’s, Goat, Soy, Almond, Hemp Milk
- Retentive carbohydrates (raisins, fruit leathers, sticky candy)
- Soft drinks
When a child is put to bed with a bottle containing milk, or anything other than water, or if the child is nursed to sleep, the liquid entering the mouth coats the teeth, pools and breeds bacteria that cause cavities. Cavities are likely to develop quickly and would be difficult to treat at an early age.
If a child drinks anything other than water from a bottle before bed, you should brush their teeth AFTERWARD. While working on cutting out the habit, at the very least, you should wipe the residue from the teeth with a wet washcloth. That’s not the best thing, but it is better than nothing!
When dentists look in your child’s mouth, we are able to detect any decay that exists on the biting surface and the sides of the teeth with our eyes and our instruments. However, we cannot see what is going on in between the teeth if they are touching, without x-rays. It is critical to take x-rays as soon as your child is able, to rule out any cavities and to diagnose any extra or missing teeth.
Dental x-rays are VERY safe. They are much safer than undetected and untreated dental problems. Pediatric 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.
Tooth decay is an infectious disease and it is dangerous. Untreated dental decay continues to affect more of the tooth and rapidly infects other teeth. A dentist should examine every child at least every 6 months; otherwise we cannot keep on top of a problem that can worsen very quickly, leading to pain and infection within days.
Nothing you read on the internet, no matter how many pictures you have seen, will replace a clinical examination done by an appropriately-trained professional; the dentist must actually LOOK in your child’s mouth.
- Knee-to-knee examination
We start by examining all aspects of the oral cavity, starting from the outside, then moving efficiently to the inside.
- Touch the neck and nodes
- Examine the lips, tongue, cheeks, palate, floor of the mouth, uvula, throat, and gums
- Finally, the teeth are counted and checked for cavities, and measurements are recorded
CRYING is expected, and actually makes the examination easier. CRYING is age-appropriate behavior and it won’t stop us from completing the examination.
The first primary teeth erupt into the baby’s mouth as early as 4 months of age. Usually the two lower front teeth are first, followed by the upper front teeth. All of the baby teeth are usually in place by 3 years of age, totaling 20 teeth.
The two lower front teeth are also the first to be lost, at about age 6. Around that time, the first permanent adult teeth, the first molars and lower central incisors, also erupt. All of the permanent teeth erupt and all of the baby teeth are lost by the age of 13, give or take a few years.
Baby teeth are critically important to your child’s development.
They serve many functions, including:
- Biting and chewing, required for good nutrition
- Supporting the lips to present a pleasant face structure and smile
- Providing the necessary tools for speech
- Guiding the permanent teeth into the best position
All of your child’s teeth will not have switched over to permanent, adult teeth until about the age of 13. Untreated cavities in the baby teeth can lead, not only to pain and infections, but problems with the adult teeth. Therefore, DECAYED BABY TEETH MUST BE REPAIRED!!!
A Pediatric Dentist is the Pediatrician of dentistry. A Pediatric Dentist has two to three additional years of specialty training following dental school and limits his/her practice to treating children only. A Pediatric Dentist is the primary and specialty oral care provider for infants and children through adolescence, including those with special health needs.
Have we missed something?
Our team of highly trained staff of Pediatric Dental Specialists, hygienists, assistants and receptionists are ready to answer any additional questions you may have!