FAQ
General Questions:
Q: What is a pediatric dentist?
A: Pediatric dentistry is a specialty of dentistry that focuses on the oral health and unique needs of young people. After completing a four-year dental school curriculum, two additional years of rigorous training are required to become a pediatric dentist. These years of training focus on the dental and emotional needs of infants, children, adolescents and persons with special health care needs.
Q: When should I bring my child for the first dental visit?
A: We start seeing children as young as 6 months in our office. The Academy of Pediatric Dentist recommends that a child be seen for his/her first dental check-up by his/her first birthday! We review oral hygiene and lots and lots of prevention with mom and dad. Your child will also receive his/her first fluoride treatment. Our office team tries hard to prevent cavities. As you can imagine, it is easier to prevent than to treat in our office.
Q: Why are baby teeth important?
A: Strong healthy primary (baby) teeth help your child chew food, speak clearly, give his/her face proper shape and guide the proper eruption of permanent teeth. The Center for Disease Control reports that caries (cavities) are the most prevalent infectious disease in children. Dental caries are 5 times more common that asthma. Decay of primary teeth can affect growth, lead to malocclusions and cause pain, infection, and/or damage to the underlying tooth. It is important that these teeth stay healthy and present until naturally lost.
Q: At what age do teeth usually erupt and fall out?
A: Throughout your life, you will have two sets of teeth: primary (baby) teeth and secondary (permanent) teeth. At age 6-8 months, the primary teeth appear; all 20 are in place by age 3. Permanent teeth will begin to grow around age 6, and except for wisdom teeth, are all present between ages 12 and 14. The next teeth to grow in are the 12-year molars and finally the wisdom teeth. Wisdom teeth typically begin breaking through from age 17 and on. The total number of permanent teeth is 32, though few people have room for all 32 teeth. This is why wisdom teeth are usually removed.
Q: What do I do if I have a dental emergency?
A: Dental emergencies and tooth injuries are a common occurrence of childhood. Knowing how to handle a dental emergency can mean the difference between saving or losing your child’s tooth. Here are some tips that can help you cope with a dental emergency quickly and calmly!
- Toothache – Clean the area around the sore tooth thoroughly. Rinse the mouth vigorously with warm salt water or use dental floss to dislodge trapped food or debris. DO NOT place aspirin on the gum or on the aching tooth. Take acetaminophen (Tylenol).
- Broken tooth – Rinse dirt from injured area with warm water. Place cold compresses over the face in the area of the injury. Locate and save any broken tooth fragments. Place any fragments in milk or water if milk is not available. Call our office as soon as possible.
- Cut or bitten tongue, lip or cheek – Apply ice to bruised area. If there is bleeding, apply firm but gentle pressure with a clean gauze or cloth. If bleeding does not stop after 15 minutes or cannot be controlled by simple pressure, take the child to a hospital emergency room.
- Knocked-out permanent tooth - Find the tooth! Handle the tooth by the top (crown), not by the root portion. You may rinse the tooth, but DO NOT clean or handle the tooth unnecessarily. Try to reinsert it in its socket. Have the child hold the tooth in place by biting on a clean gauze or cloth. If you cannot reinsert the tooth, transport the tooth in a cup containing milk. See Dr. Ochoa or Dr. Gonzales IMMEDIATELY! Time is a critical factor in saving the tooth.
- Possible broken jaw – If a fractured jaw is suspected, try to keep the jaws from moving using a towel, tie or handkerchief. Then take the child to the nearest hospital emergency room.
- Bleeding after a baby tooth falls out – Fold and pack a clean gauze or cloth over the bleeding area. Have the child bite on the gauze with pressure for 15 minutes. This may be repeated once; if bleeding persists, call our office.
- Cold/Canker sores - Many children occasionally suffer from “cold” or “canker” sores. Usually over-the-counter preparations give relief. If sores are frequent, then Dr. Ochoa / Dr. Gonzales can prescribe a steroid cream to aid in healing.
Q: Does your child grind his teeth at night? (bruxism)
A: AHHHH! This is such a common problem with no real great solution.
- 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 but very, very rarely. The negatives to a mouth guard are the possibility of choking if the appliance becomes dislodged during sleep and it may interfere with growth of the jaws. The positive is obvious by preventing wear to the primary dentition.
- You may be advised by one of our assistants to “wear out” your child’s grinding muscles right before bedtime by having them vigorously chew sugar-free gum during your nighttime routine. This sometimes works but not consistently.
- The good news is most children outgrow bruxism. The grinding decreases between the ages 6-9 and children tend to stop grinding between ages 9-12.
Q: What is the best time for orthodontic treatment (braces)?
A: Developing malocclusions, or bad bites, can be recognized as early as 2-3 years of age. Often, early steps can be taken to reduce the need for major orthodontic treatment at a later age. Dr. Ochoa / Dr. Gonzales will evaluate the need for braces at each appointment. Our office does not do braces, but we have plenty of friends who do a wonderful job. We will refer your child when the time comes.
- Stage I – Early Treatment: This period of treatment encompasses ages 2 to 6 years. At this young age, we are concerned with underdeveloped dental arches, the premature loss of primary teeth, and harmful habits such as finger or thumb sucking. Treatment initiated in this stage of development is often very successful and many times, though not always, can eliminate the need for future orthodontic/orthopedic treatment.
- Stage II – Mixed Dentition: This period covers the ages of 6 to 12 years, with the eruption of the permanent incisor (front) teeth and 6-year molars. Treatment concerns deal with jaw malrelationships and dental realignment problems. This is an excellent stage to start treatment, when indicated, as your child’s hard and soft tissues are usually very responsive to orthodontic or orthopedic forces.
- Stage III – Adolescent Dentition: This stage deals with the permanent teeth and the development of the final bite relationship.
Q: A word on thumb sucking
A: First off, I wish I had a magic wand to help my little patients to stop. This is a tough thing for some children!
- 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 2 and 4. 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, 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 use of a pacifier, consult your pediatric dentist.
- A few suggestions to help your child get through thumb sucking:
- Instead of scolding children for thumb sucking, praise them when they are not.
- 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.
- For children who are ready to stop but can’t control the nights, try a sock over the hand or a glove as a reminder in the middle of the night.
- Dr. Ochoa or Dr. Gonzales may recommend the use of a mouth appliance if permanent teeth are at risk of being affected.
- A positive approach that we recommend is called “calendar therapy”. For every day that your child does NOT use his/her thumb, a sicker can be placed on that day. Set mini goals with your child to reach 2 days; 4 days; 1 week; 2 weeks and eventually the whole month! Good luck and let our office know when the habit has stopped because we give gifts to our little folks who “kick the habit!
Q: Tongue Piercing – Is it really cool?
A: You might not be surprised anymore to see people with pierced tongues, lips or cheeks, but you might be surprised to know just how dangerous these piercings can be.
- There are many risks involved with oral piercings including chipped or cracked teeth, blood clots and blood poisoning. Your mouth contains millions of bacteria, and infection is a common complication of oral piercing. Your tongue could swell large enough to close off your 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.
- So follow the advice of the American Dental Association and give your mouth a break – skip the mouth jewelry.
Prevention Questions:
Q: How do I prevent cavities?
A: Good oral hygiene removes bacteria and the leftover food particles that combine to create cavities. For infants, use a wet gauze or clean washcloth to wipe the plaque from teeth and gums. Avoid putting your child to bed with a bottle filled with anything other than water.
- For older children, brush their teeth at least twice a day. Also, watch the number of snacks containing sugar that you give your children.
- Be mindful of what your child is drinking. A rule in our office is that you can have anything you’d like to drink with your meals, but in between meals – WATER or SUGAR-FREE drinks ONLY!
- The American Academy of Pediatric Dentistry recommends six-month visits to the pediatric dentist beginning at your child’s first birthday. Routine visits will start your child on a lifetime of good dental health.
- Your pediatric dentist may also recommend protective sealants or home fluoride treatments for your child. Sealants can be applied to your child’s molars to prevent decay on hard to clean surfaces
Q: What is a sealant?
A: A sealant is a clear or shaded plastic material that is applied to the chewing surfaces (grooves) of the back teeth (premolars and molars), where four out of five cavities in children are found. This sealant acts as a barrier to food, plaque and acid, thus protecting the decay-prone areas of the teeth. Sealants are quick and easy to apply and do not involve the use of anesthesia or drilling. It is recommended that sealants are placed as soon as permanent back teeth erupt. Once placed, sealants are checked at every six-month exam to ensure that they are intact. They usually last for several years before reapplication is needed. Children are asked to avoid sticky, chewy candy to prolong the life of the sealant.
Q: What is baby bottle tooth decay?
A: One serious form of decay among young children is baby bottle tooth decay. This condition is caused by frequent and long exposures of an infant’s teeth to liquids that contain sugar. Among these liquids are milk (including 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 the baby a bottle as a comforter at bedtime, it should contain only water.
- After each feeding, wipe the baby’s gums and teeth with a damp washcloth or gauze pad to remove plaque. The easiest way to do this is to sit down, place the child’s head in your lap or lay the child on a dressing table or the floor. Whatever position you use, be sure you can see into the child’s mouth easily.
Q: What’s the best toothpaste for my child?
A: 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 insure they are safe to use.
- 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.
Q: What is fluoride and how is it good for my child’s teeth?
A: Fluoride is a naturally occurring mineral in all water sources, including the oceans. Many years of research have shown that fluoride helps prevent tooth decay in children and adults and it also helps to repair weak tooth structure prior to the formation of a cavity. Fluoride is obtained in two forms: topical, which we get through toothpaste, and systemic, which is best obtained in drinking tap water. Our tap water here in San Antonio is fluoridated! Fluoride is safe to use and effective in the prevention of tooth decay, if used properly. We recommend that your child receive an in-office fluoride treatment two times a year.
Q: Healthy Diet, Healthy Teeth
A: The teeth, bones and soft tissue of the mouth require a healthy, well-balanced diet. A variety of foods from the five food groups helps minimize (and avoid) cavities and other dental problems. Minimize frequent snacking and snacks high in sugar, such as candy and fruit juice. We recommend that you encourage plenty of fruits, vegetables and water in your child’s diet.
Q: What is Xylitol and how does it help fight cavities?
A: Xylitol is a 5-carbon sugar alcohol found naturally in fruits, berries, mushrooms, lettuce, hardwoods and corn cobs.
- Studies have shown up to an 80 percent reduction in the bacteria which cause cavities with consistent xylitol use.
- Studies show that 4 to 12 grams of xylitol per day are very effective. What that means to you and me is that you would need to use a xylitol product 3-5 times a day to be most effective.
- Xylitol gum and candies are available online and at some health food stores. Xylitol must be the first ingredient in the gum to produce the desired clinical effect. Ice Breakers is one type that can be found at your local grocery store.
