What Is A Pediatric Dentist?

The pediatric dentist has an extra two to three years of specialized training after dental school and is dedicated to the oral health of children from infancy through the teenage years. The very young, pre-teens, and teenagers all need different approaches in dealing with their behavior, guiding their dental growth and development, and helping them avoid future dental problems. The pediatric dentist is best qualified to meet these needs.

Why Are The Primary Teeth Important?

It is very important to maintain the health of the primary teeth. Neglected cavities can and frequently do lead to problems that affect the development of permanent teeth. Primary teeth, or baby teeth, are important for (1) proper chewing and eating, (2) providing space for the permanent teeth and guiding them into the correct position, and (3) permitting normal development of the jaw bones and muscles. Primary teeth also affect the development of speech and add to an attractive appearance. While the front four teeth last until six to seven years of age, the back teeth (cuspids and molars) aren’t replaced until age 10-13.

What Happens After the Eruption Of Baby Teeth?

Children’s teeth begin forming before birth. As early as four months, the first primary (or baby) teeth to erupt through the gums are the lower central incisors, followed closely by the upper central incisors. Although all 20 primary teeth usually appear by age three, the pace and order of their eruption varies.

Permanent teeth begin appearing around age six, starting with the first molars and lower central incisors. This process continues until approximately age 21. Adults have 28 permanent teeth, or up to 32, including the third molars (or wisdom teeth).

What's The Best Toothpaste For My Child?

Tooth brushing is one of the most important tasks for good oral health. Many toothpastes, and/or tooth polishes, however, can damage young smiles. They contain harsh abrasives, which can wear away young tooth enamel. When looking for a toothpaste for your child, make sure to pick one that is recommended by the American Dental Association as shown on the box and tube. These toothpastes have undergone testing to ensure they are safe to use.

Remember, children should spit out toothpaste after brushing to avoid getting too much fluoride. If too much fluoride is ingested, a condition known as fluorosis can occur. If your child is too young or unable to spit out toothpaste, consider providing them with a fluoride-free toothpaste, using no toothpaste, or using only a "pea size" amount of toothpaste.

Does Your Child Grind His Teeth At Night? 

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. One theory as to the cause involves a psychological component. Stress due to a new environment, divorce, changes at school; etc. can influence a child to grind their teeth. Another theory relates to pressure in the inner ear at night. If there are pressure changes (like in an airplane during take-off and landing, when people are chewing gum, etc. to equalize pressure) the child will grind by moving his jaw to relieve this pressure.

The majority of cases of pediatric bruxism do not require any treatment. If excessive wear of the teeth (attrition) is present, then a mouth guard (night guard) may be indicated. The negatives to a mouth guard are the possibility of choking if the appliance becomes dislodged during sleep and it may interfere with the growth of the jaws. The positive is obvious by preventing wear to the primary dentition.

The good news is most children outgrow bruxism. The grinding decreases between the ages of six and nine and children tend to stop grinding between ages nine to 12. If you suspect bruxism, discuss this with your pediatrician or pediatric dentist.

What Do I Need To Know About Thumb-Sucking?

Sucking is a natural reflex and infants and young children may use thumbs, fingers, pacifiers and other objects on which to suck. It may make them feel secure and happy, or provide a sense of security at difficult periods. Since thumb-sucking is relaxing, it may induce sleep.

Thumb-sucking that persists beyond the eruption of the permanent teeth can cause problems with the proper growth of the mouth and tooth alignment. How intensely a child sucks on fingers or thumbs will determine whether or not dental problems may result. Children who rest their thumbs passively in their mouths are less likely to have difficulty than those who vigorously suck their thumbs.

Children should cease thumb-sucking by the time their permanent front teeth are ready to erupt. Usually, children stop between the ages of two and four. Peer pressure causes many school-aged children to stop.

Pacifiers are no substitute for thumb-sucking. They can affect the teeth essentially the same way as sucking fingers and thumbs. However, the use of the pacifier can be controlled and modified more easily than the thumb or finger habit. If you have concerns about thumb sucking or the use of a pacifier, consult your pediatric dentist.

A few suggestions to help your child get through thumb-sucking:

  • Children often suck their thumbs when feeling insecure. Focus on correcting the cause of anxiety, instead of the thumb-sucking.
  • Children who are sucking for comfort will feel less of a need when their parents provide comfort.
  • Reward children when they refrain from sucking during difficult periods, such as when being separated from their parents.
  • Your pediatric dentist can encourage children to stop sucking and explain what could happen if they continue.
  • If these approaches don’t work, remind the children of their habit by bandaging the thumb or putting a sock on the hand at night. Your pediatric dentist may recommend the use of a mouth appliance.
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