Pediatric Dentistry Q & A

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How old should my child be for their first dental visit? The American Academy of Pediatric Dentistry recommends that every child should have a dental home by 12 months. At that age we will discuss proper brushing and dietary habits for your child. This includes the proper care of your child’s teeth if they are still nursing or using a bottle. We typically start dental cleanings in our office at around 2-3 years old.

Why should I care about my child brushing if all of the baby teeth eventually fall out? Primary teeth or “baby teeth” have nerves and blood vessels just like the permanent teeth. If a cavity forms, it could lead to discomfort, pain, and infections. I have seen many children who present to my office with half of their face swollen, all because of a cavity on a baby tooth. Teaching the importance of proper brushing at a young age will hopefully set the stage for a lifetime of good dental habits and health.

My two year old refuses to brush his teeth. I have tried everything from singing, brushing songs, to buying the latest toothbrush with flashing lights. Nothing works and I don’t want to “traumatize” my child. What should I do? It is time for some tough love. When you are crossing a street and your child does not want to hold your hand, what do you do? Of course you grasp their hand even if they are kicking and screaming. Your child’s teeth need to be brushed twice a day no matter what it takes! Sometimes two adults are needed to help hold a resistant child and brush their teeth. As long as you are consistent and positive, they will eventually open wide and allow you to help with the brushing.

How can I prepare my three year old for his first dental cleaning? Explain to him that we are going to visit a dentist who is going to help you brush your teeth. It is important to only talk positive about the experience and to never use any negative words. If you tell him that he is going to have a fun time, chances are he probably will. If you tell him that the dentist cleaning “won’t hurt” you have already introduced a possible negative experience into his mind. Keep your descriptions of what will happen simple and positive.

My six year old grinds her teeth at night while sleeping. It is so loud that I can hear her across the house. What can be done to stop the grinding?
I am asked this question at least once a day. Teeth grinding in young children is very common. We do not know what causes the clenching or grinding, however, we do know that it usually stops when the baby teeth start to fall out. If your child continues to grind their teeth after all the permanent teeth have erupted, a night guard may be indicated at that time.

How do you feel about battery operated toothbrushes for children? After years of practicing dentistry for children I have observed that the quality of brushing is usually worse for the children that use an electric brush compared to the ones that use a manual brush. Perhaps some children feel that an electric brush is a shortcut to brushing and don’t spend an adequate amount of time brushing. If your child really wants to use an electric brush, make sure to monitor and assist them with the proper technique.

What age should my child stop with the pacifier? It is best to wean them off the pacifier by about age 2-3 years old. Prolonged pacifier use can result in a narrow palate as well as an open bite (where the teeth don’t overlap each other in the front of the mouth). If the pacifier habit is broken at a young age, these effects often reverse on their own.

How about thumb sucking? How and when should I attempt to help my child end this habit? This is a more sensitive and complicated issue than the pacifier. A pacifier habit is usually easier to deal with since you can simply give them all away one day to the “Pacifier Fairy”. Similar to the pacifier habit, it is best to break the thumb habit by about 2-3 years of age. It is important to have an open dialogue with your child regarding why you want them to stop the thumb habit. A thumb sucking habit also results in a narrow palate as well as an open bite in the front of the mouth. These effects usually reverse themselves when the thumb habit is broken at a young age. If your child is still sucking their thumb at around age 5, it is important to explain to them how this is the time when baby teeth begin to fall out and permanent teeth start to erupt. Make sure they understand that their thumb is preventing the big teeth from growing in properly.  If the habit persists, it is time to consult with your child’s dentist.

What can I do to prevent tooth decay from nursing or using a bottle? Once the first tooth erupts, babies should not be nursed or bottle fed to sleep with milk. If your baby falls asleep while drinking milk, it is important to still brush their teeth. Children should not fall asleep with anything besides water. It is important to remember that a prolonged and repeated exposure to milk can cause tooth decay.

The dental information on this Web site is provided for educational purposes only. The information provided in this site, or through linkages to other sites, is not a substitute for dental or professional care, and you should not use the information in place of a visit, call consultation or the advice of your dentist or other healthcare provider. If you believe you have a dental emergency you should call your dentist immediately. If you have any questions regarding your health or a medical condition, you should promptly consult your physician.

Darrin J. Hirt, D.D.S., M.S.