Parent Resources & FAQs

Find answers to pediatric dental questions and common service concerns.


General Questions

why see a pediatric dentist?

Pediatric dentistry is a distinct field that focuses on the oral health and unique needs of infants, children, adolescents, and children with special health care needs.  Pediatric dentists complete a standard four-year degree in dentistry followed by an additional two years of rigorous, specialized training in pediatric dentistry.  This specialized program of study and hands-on experience prepares pediatric dentists to treat their patients and start them on a path to a life of healthy teeth and happy smiles.

when should my child see a pediatric dentist?

Getting an early start on dental care is a critical step on the road to teaching your child lifelong healthy habits.  Pleasant visits early on establish trust and confidence in dentists that your child will have for the rest of their life.

Our office, as well as the American Academy of Pediatric Dentistry, the American Dental Association, the American Academy of Pediatrics, and the American Association of Public Health Dentistry all recommend that your child establish a dental home by his or her first birthday.  Our goal is to help all children feel good about visiting the dentist and teach them and you to how to care for their teeth and gums. 

what should I expect at my child’s first visit?

Each exam is personal and unique. The exam with Dr. Marcie will include a visual examination of your child’s teeth and mouth, “counting” and “exploring” your child’s teeth and talking to your child about their teeth and hygiene. We will discuss brushing techniques, flossing, fluoride and alternative treatments, and healthy eating habits tailored to your child’s specific needs.

Your child’s teeth will be polished and scaled to remove the plaque and tartar from the tooth surfaces and under the gum line. Children will get to choose a fun toothpaste flavor before sitting back to watch a kid-friendly movie while their teeth are cleaned.

If your child has decay or other problems requiring treatment, Dr. Marcie will discuss them with you and a treatment, Dr. Marcie will discuss with you the most appropriate treatment plan options, designed with you and your child in mind.

what if my child needs X-rays?

Dental X-rays will be taken only as needed during routine cleaning appointments to check for cavities in between teeth, survey erupting teeth, diagnose bone disease, evaluate the results of an injury, or to plan orthodontic treatment. We will always minimize your child’s radiation exposure by providing 100% digital equipment that uses 90% less radiation than traditional dental X-rays and prescribing X-rays on an individual basis. Your child will wear a lead body apron with a thyroid collar during each X-ray process. If you have any concerns about X-rays for your child, please discuss them with us!

what if my child grinds their teeth?

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. 

The majority of cases of pediatric bruxism do not require any treatment. 

The good news is most children outgrow bruxism. The grinding decreases between the ages of 6-9 and children tend to stop grinding by age 12. If you suspect bruxism, discuss this with us at your next appointment.

 

does my child need braces?

Most children do not need orthodontics until their permanent teeth are in, around age 12. However, there are a few orthodontic problems that may need to be corrected in the primary or early mixed dentition, and regular visits will allow a pediatric dentist to offer advice and guidance regarding the appropriate age for your child to begin orthodontic treatment.

what if my child can’t cooperate for dental treatment?

Our goal is for your child to have a positive experience at the dentist and grow up without dental fears that many people have today.  Luckily, pediatric dentistry has come a long way!  There are more non-invasive ways to treat cavities, and for small lesions, this works well.  If your child has cavities that need treatment, nitrous oxide (i.e. "laughing gas") can be very effective. If a child is especially fearful or suffers from extreme situational anxiety, we also have sedation or general anesthesia available  in order to ensure the safest delivery of the best possible treatment for your child in a more controlled environment.  We believe sedation is our last option, and only if it is absolutely needed.

Early Infant Care

when does my baby’s first tooth erupt?

Some babies are born with teeth!  Most babys first tooth appears around 6 months of age…but as late as 3 years! Don’t be alarmed if your child has a different timeline or eruption pattern; sometimes habits can influence their teeth. Here are some guidelines:

teeth chart.png


why are primary teeth 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 proper chewing and eating, providing space for the permanent teeth and guiding them into the correct position, and permitting normal development of the jaw bones and muscles. 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.

 

when should I start cleaning my baby’s teeth?

Our rule is, the sooner, the better! Starting at birth, clean your child's gums with an infant toothbrush and water. Children up to age seven do not have the dexterity to brush their teeth effectively, so remember that it is the parent’s job and it should be done at least once a day at bedtime. Unless otherwise advised, do not use fluoridated toothpaste until age 2-3, after your child has learned to effectively spit out excess toothpaste.

 

prevention of Early Childhood Caries

One serious form of decay among young children is baby bottle tooth decay, or Early Childhood Caries. This condition is caused by frequent and long exposures of an infant’s teeth to liquids that contain sugar, including milk (also 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 your baby a bottle as a comforter at bedtime, it should contain only water.

Encourage your child to drink from a cup as they approach their first birthday. Children should not fall asleep with a bottle. Breast feeding is the best thing you can do for your baby, but the frequency of at-will nighttime breast-feeding should be avoided after the first primary (baby) teeth begin to erupt. Drinking juice from a bottle should be avoided; it should be in a cup, and they should drink no more than 4oz per day. Children should be weaned from the bottle at 12-14 months of age.

 

teething

From 6 months to age 3 years, your child may have sore gums as their teeth erupt. Many children like a clean teething ring, cool spoon or cold wet washcloth. Some parents swear by a chilled teething ring; others may simply rub the baby's gums with a clean finger.

 

preventing decay           

Developing healthy habits for life

Four things are necessary for cavities to form: 1) a tooth; 2) bacteria; 3) sugars or other carbohydrates; and 4) time. At Young Dentistry we will help you learn how to make teeth strong and keep bacteria from organizing into harmful colonies. It is important to develop healthy eating habits, and understand the role that time plays in developing cavities. Remember, dental decay is an infection of the tooth.

 

brushing

Use a toothbrush with soft bristles and a small strip of toothpaste. When brushing teeth, move the brush in small circular motions to reach food particles that may be under the gum line. Hold the toothbrush at an angle and brush slowly and carefully, covering all areas between teeth and the surface of each tooth. It will take several minutes to thoroughly brush the teeth. Brush the tongue and the roof of the mouth before rinsing.

Teeth should be brushed at least two times daily to avoid the accumulation of food particles and plaque. If time permits, brushing after the noon meal is certainly encouraged for our patients. As soon as the bristles start to wear down or fray, replace the toothbrush with a new one.

The following brushing schedule is optimal.

  • In the morning after breakfast

  • After lunch or right after school

  • At bedtime

 

flossing

Children should have big spaces between all of their teeth. However, if teeth are touching then a toothbrush can’t reach between the teeth, and dental floss must be used to remove food particles and plaque.

Whichever type of floss is easiest for you to use is ok with us. Floss all teeth that are touching, and remember to floss behind all back teeth as well. Floss at night to make sure the teeth are squeaky clean before going to bed. When first beginning to floss, the gums may bleed a little. If the bleeding does not go away after the first few times, let a staff member know at your next appointment.

diet

Children must have a balanced diet for their teeth and gum tissue around the teeth to develop properly. Equally important, a diet high in certain kinds of carbohydrates, such as sugar and starches, may place your child at an extra risk of tooth decay.

Check how often your child eats foods with sugar or starch in them. Foods with starch include breads, crackers, pasta and snacks such as pretzels and potato chips. When looking for sugar in your child's diet, look beyond the sugar bowl and candy dish. A variety of foods contain one or more types of sugar, and all types of sugars can promote dental decay. Sugar can be found in many processed foods, even some which do not taste sweet. Sticky foods, such as dried fruit or toffee, are not easily washed away from the teeth by saliva, water or milk. They have more cavity-causing potential than foods more rapidly cleared from the teeth. A food with sugar or starch is safer for teeth if it's eaten with a meal, not as a snack.

If your child is not yet on solid foods, avoid nursing your child to sleep or putting them to bed with a bottle of milk, formula, juice, or sweetened liquid. While your child sleeps, any unswallowed liquid in the mouth supports bacteria that produce acids and attack the teeth. Protect your child from severe tooth decay by putting them to bed with nothing more than a pacifier or bottle of water.

In summary, here are tips for your child's diet and dental health:

  • Shop smart! Do not stock your pantry with sugary or starchy snacks. Buy "fun foods" for special occasions only.

  • Limit the number of snack times and choose nutritious snacks.

  • Provide a balanced diet, and save food with sugar or starch for mealtimes.

  • Don't put your young child to bed with a bottle of milk, formula or juice.

  • If your child chews gum or sips soda, choose those items that are sugar-free.

 

fluoride and xylitol

Fluoride is a natural element that encourages remineralization (a strengthening of weak areas in the tooth).  Fluoride is sometimes added in water and in dental products such as toothpastes, mouthwashes, and other products.  You only need to use a small amounts of fluoride to get the maximum benefit.  Although fluoride is safe and effective if used in the recommended quantities, many parents are hesitant to give more fluoride to their children.  For this reason, we discuss all possible areas where the patient may be receiving fluoride and together we will come up with a preventive plan that you are comfortable with.  For prevention in the office, we use exclusively fluoride varnish.

The American Academy of Pediatric Dentistry recognizes the benefits of xylitol on oral health.  Studies using xylitol (4-40 grams per day, in 3-7 divided doses), as either a sugar substitute or a small dietary addition have demonstrated a dramatic reduction in new tooth decays.  To find gum or candy that contains xylitol, visit a local health food store or search the internet to find products containing 100% xylitol.

Adolescent Dentistry

lip and tongue piercing

There are many risks involved with oral piercing including chipped or cracked teeth, blood clots, or blood poisoning. The mouth contain millions of bacteria, and infection is a common complication of oral piercing. Tongues can swell large enough to close off an 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.

Follow the advice of the American Dental Association and give your mouth a break – skip the mouth jewelry.

tobacco use

Tobacco in any form can endanger your child’s health and cause incurable damage. Teach your child about the dangers of tobacco.

Smoking can have the following effects on your child's oral health:

  • Oral Cancer

  • Periodontal (gum) disease (a leading cause of tooth decay) loss and sensitivity

  • Delayed healing after a tooth extraction or other oral surgery

  • Fewer options for some kinds of dental care (smokers are often poor candidates for implants)

  • Bad breath

  • Stained teeth and gums

  • Diminished sense of taste and smell

Like cigarettes, smokeless tobacco products contain a variety of toxins associated with cancer. At least 28 cancer-causing chemicals have been identified in smokeless tobacco products. Smokeless tobacco is known to cause cancers of the mouth, lip, tongue, and pancreas. Users also may be at risk for cancer of the voice box, esophagus, colon and bladder because they swallow some of the toxins in the juice, which is created by mastication of the tobacco. Additionally, smokeless tobacco can irritate your gum tissue, causing periodontal disease. Sugar is often added to smokeless tobacco to enhance the flavor, increasing the risk for tooth decay. Smokeless tobacco also typically contains sand and grit, which often wears down the user's teeth.

If your child is a tobacco user you should watch for the following that could be early signs of oral cancer:

  • A sore that won’t heal

  • White or red leathery patches on the lips, and on or under the tongue

  • Pain, tenderness or numbness anywhere in the mouth or lips

  • Difficulty chewing, swallowing, speaking or moving the jaw or tongue; or a change in the way the teeth fit together

Because early signs of oral cancer are usually 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 cheeks. For further information and support pertaining to tobacco use, visit:http://tobaccofree.mt.gov/.

Post Operative Care

special instructions

These instructions are meant to serve as reminders for caring for your child following a specific procedure. If you have any questions remaining after reading through the instructions, don’t hesitate to call for further information.


care of the mouth after local anesthetic

If your child’s procedure was in the lower jaw, the tongue, teeth, lip, and surrounding tissue will be numb or asleep. If their procedure was in the upper jaw the teeth, lip and surrounding tissue will be numb or asleep.

Children frequently do not understand the effects of local anesthesia, and may chew, scratch, suck, or play with the numb lip, tongue, or cheek. These actions can cause minor irritations or they can be severe enough to cause swelling and abrasions to the tissue.

Please monitor your child closely for approximately two hours following the appointment. It is often wise to keep your child on a liquid or soft diet until the anesthetic has worn off.

care of the mouth after trauma

Please keep the traumatized area as clean as possible. A soft washcloth often works well during healing to aid the process. Watch for changes such as darkening of teeth, swelling of gum tissues, or spontaneous pain. Maintain a soft diet for two to three days, or until the child feels comfortable eating normally again. Avoid hard/sticky foods or foods that are extremely hot or cold. If antibiotics or pain medicines are prescribed, be sure to follow the prescription as directed.

 

care of the mouth after extractions

Your child should not scratch, chew, suck, or rub the lips, tongue or cheek while they feel numb or asleep. Your child should be watched closely so they don’t injure their lip, tongue or cheek before the anesthesia wears off.

  • Do not rinse the mouth for several hours

  • Do not spit excessively

  • Do not drink a carbonated beverage (Coke, Sprite, etc.) for the remainder of the day

  • Do not drink through a straw

  • Keep fingers and tongue away from the extraction area

  • Some bleeding is to be expected. If unusual or sustained bleeding occurs, place cotton gauze firmly over the extraction area and bite down or hold in place for fifteen minutes. Repeat if necessary.

  • Avoid strenuous exercise or physical activity for several hours after the extraction

  • For discomfort use Children’s Tylenol, Advil, or Motrin as directed for the age of the child. If a medicine was prescribed, then follow the directions on the bottle

 

caring for sealants

By forming a thin covering over the pits and fissures, sealants keep out plaque and food, thus decreasing the risk of decay. Good oral hygiene and nutrition are still very important in preventing decay next to these sealants or in areas unable to be covered.

Your child should refrain from eating ice or hard candy, which tend to fracture the sealant. When properly applied and maintained, they can successfully protect the chewing surfaces of your child's teeth. A total prevention program includes regular visits to the dentist, the use of fluoride, daily brushing and flossing, and limiting the amount of sugar-rich foods that are eaten. If these measures are followed and sealants are used on the child's teeth, the risk of decay can be reduced or may even be eliminated!

 

oral discomfort after a cleaning

A thorough cleaning unavoidably produces some bleeding and swelling and may cause some tenderness or discomfort. This is not due to a “rough cleaning,” but to tender and inflamed gums from insufficient oral hygiene. We recommend the following for 2-3 days after cleaning was performed:

  • A warm salt water rinse 2-3 times per day

  • For discomfort, use a children’s pain reliever as directed by the product

  • Please do not hesitate to contact the office if your child’s discomfort persists for more than 7 days or if there are any questions