Pediatric Concerns

"Here we will answer frequently asked questions by parents & guardians concerning infants and children in a dental office.  In all cases, ask your dentist for more information regarding your specific issue."  
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When should I take my child to the dentist for the first time?
In order to prevent dental problems, the Canadian Dental Association recommends starting early for your child's first visit and this can also help familiarize them with the routine of seeing a dentist regularly.   Once you decide on a dentist, or pediatric specialist, it is recommended to have your infant assessed within 6 months of the eruption of their first tooth.   Parents should be aware of changes to their child's oral cavity and make an appointment if they have any concerns with what they see.  Some examples include infections, swelling, spots, tooth decay or abnormalities of the teeth or jaws.

Is it important to take care of my baby's teeth?
Yes! Baby (primary) teeth are the first of two sets of teeth your infant is expected to have in their lifetime.  Primary teeth are important for helping children eat and speak naturally, while also helping in maintaining space for permanent teeth to follow when they are ready to erupt.  Cavities formed in baby teeth can lead to dental infections and even affect the erupting permanent teeth.

How can I take care of my baby's teeth?
Try a soft-bristled toothbrush for infants with a small head can safely clean plaque and bacteria that can cause tooth decay.  The toothbrush should be used at least once a day, preferably before bedtime.  Since there is less salivation to buffer acidity when your child sleeps it can be detrimental for food/drinks to be present on their teeth during the hours they sleep.   When the teeth are erupting through the gums and causing sensitivity, a soft washcloth for babies can be used to clean the teeth and gums.  

My baby is teething! Is there something I can do to help with the process?
Signs of teething can be different depending on the individual and they include:

  • Drooling excessively
  • Runny nose
  • Rosy cheeks
  • Gnawing/Chewing on objects regularly
  • Loss of appetite
  • Reluctant to chew food
  • Irritability

Some ways to alleviate the discomfort of teething include using a chilled ring teether or washcloth.


When do habits like thumb & pacifier sucking become a problem for a child?
Thumb sucking and pacifiers may become a problem if the child maintains the habit over a long period of time past 3 years of age. Many children will stop the habit on their own; however, a mouth appliance may be recommended by the dentist to discourage the habit and help prevent malpositioning of teeth.

What should I do to avoid tooth decay caused by nursing my child?
There are a few ways to prevent cavities related to nursing and these include avoiding drinks other than water in their baby bottle at bedtime.  Avoid nursing your child to sleep as brushing and flossing their teeth is still very important. Have your child evaluated by a dentist regularly.

How often should my child visit the dentist?
Every six months is recommended for a checkup in order to prevent cavities and other issues. However, your dentist may individualize how often your child should visit depending on their personal oral health and we encourage frequent visits if you wish to have your child seen more frequently.  

When is the best time to start brushing my child's teeth?
Even before teeth appear, you can clean your child’s gums using a soft-bristled toothbrush or cloth with water. As the teeth start to erupt, brush them twice daily using non-fluoridated toothpaste and a soft, age-appropriate sized toothbrush. Use a "smear" of toothpaste to brush the teeth of a child less than 2 years of age. For the 2-5 year old, dispense a "pea-size" amount of toothpaste and perform or assist your child’s tooth brushing. Remember that young children do not have the ability to brush their teeth effectively. Children who can effectively spit out excess toothpaste may advance to fluoridated toothpaste.

What is important in terms of their diet and the effects of diet on teeth?
It is important to limit the intake of simple sugars and starches and the amount of time those sugary food items remain on their teeth before being brushed.  Limit sweets that slowly dissolve or that stick to teeth easily.  Avoid sugary foods & drinks at bedtime as teeth are more vulnerable to sugars and acidity while children sleep.  Maintain a well-balanced diet and include appropriate servings of fruits & vegetables, bread, dairy, cereals, fish, meat and eggs.

How can I protect my child's teeth when he plays sports?
Mouthguards are essential to protect a child from sports related dental injuries.  Mouthguards are often required for most sports (not limited to hockey, football, basketball, baseball, lacrosse, soccer etc.) and a custom-fitted mouthguard fabricated by a dentist can even provide protection from trauma to the head.  A professionally created mouth guard can even be used on an individual with braces.  Over-the-counter (boil & bite) sportsguards may also prevent damage to teeth; however, they are not designed to protect the tissues that support teeth such as the gums and underlying bone.

Why does my child have two rows of teeth?  If your child has a row of teeth, or single tooth, growing behind another row of teeth it can appear as if they have "shark teeth."  There is no need to panic  as this is a common occurrence.    Between the ages of 5-7 children will begin to lose their baby teeth and sometimes the permanent teeth will erupt out of the gums while the baby teeth are still present, creating a row behind or in front of the other.  Depending on how loose the baby teeth are, treatment may be indicated and it is important for your dentist to evaluate for crowding as an orthodontic consultation may be needed. 

Are dental x-rays safe for my children?
Dental x-rays are safe for use in children for diagnostic purposes and to rule out pathology.  The ordering of x-rays is dependent on their individual needs and dentists are especially careful to limit the amount of radiation exposure. Lead aprons, thyroid collars and high-speed film are used to ensure safety and minimize radiation.

How can parents help to prevent tooth decay?
Parents should take their children to the dentist or pediatric specialist regularly so that the dentist can recommend a personalized program of oral hygiene, including proper brushing, flossing, and other methods of prevention.  Regular home care techniques in combination with dental visits and healthy diet will contribute to a lifetime of general and oral health.  

What are "sealants" and how do they work? A sealant is a material that can be used to fill cavity-prone chewing surfaces, such as deep grooves on molars, and prevent food particles from getting stuck in these grooves.  Sealants are an effective method of preventing cavities on teeth in children and can be placed comfortably without local anesthetic.

What happens if my child has one or multiple cavities?
There are many ways to address a child’s need for restorative work (fillings, extractions, baby root canals, etc). Depending on a child’s age, level of maturity and ability to listen carefully and follow instructions, treatment may be completed in the regular dental environment; it may be completed with the help of mild sedation, or may require the need for referral to a pediatric dentist – specialized in dealing with the specific needs of challenging circumstances. All this can be discussed with the dentist and a decision will be made as to what is best suited for your child’s individual needs.

When will my child's adult teeth come in?

Permanent tooth eruption varies among individuals; however, dentists can monitor for the presence or absence of permanent teeth, proper eruption patterns and for misalignment of teeth at an early stage.  The dentist can help parents understand the best way to ensure your child's oral health for the future and have your child evaluated for early orthodontic treatment if indicated.