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Children's Dentistry Children's Dentistry

The first dental visit should occur when your child’s first tooth erupts or by age 1. At this visit, we will examine your child's teeth and gums. Depending on age and cooperation, x-rays may be taken to reveal decay and to check on the progress of your child's permanent teeth under the gums. We may clean your child's teeth and apply topical fluoride to help protect the teeth against decay. We will make sure that your child is receiving adequate fluoride at home. Most importantly, we will review with you how to clean and care for your child's teeth.


Children's Dentistry Children's Dentistry

Children's hands and mouths are different than adults. They need to use toothbrushes designed for children. Both adults and children should use brushes with soft, rounded bristles for gentle cleaning. It's advisable to use a new toothbrush about every three months.

Wipe infant's teeth and gums gently with a moist, soft cloth or gauze square. As babies grow, use a child's toothbrush with a small, pea-sized dab of fluoride-free toothpaste. By age 2 or 3 begin to teach your child to brush. You will still need to brush their teeth after they are finished. Dentists and hygienists often advise children to use a gentle, short, back and forth motion to remove plaque. When children are older they can switch to this method below:

Children's Dentistry

To increase acceptance, it is important to begin cleaning your child’s gums at an early age.   Even before your child’s teeth erupt, begin cleaning the mouth with a washcloth or gauze square after feedings.  As your child teeth erupt, you can begin to use a soft child's toothbrush. You should use just a pea-size amount of non-fluoride toothpaste (like Baby Orajel) until your child is able to spit the toothpaste out.   At this stage, which is usually around age 3, have your child brush with fluoride toothpaste.  Because children don’t have the dexterity to brush their teeth effectively until they are older (approximately age 7), the caregiver should brush the child’s teeth a second time.

For most toddlers, getting them to brush their teeth can be quite a challenge. 

To help your child understand the importance of brushing, it can be sometimes fun and helpful to let him or her eat or drink something that will 'stain' the teeth temporarily, and then let him or her brush them clean.

It can also be a good idea to create a "tooth brushing routine."

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  • Let him brush your teeth at the same time.
  • Let him pick out a few toothbrushes with his favorite characters and give him a choice of which one he wants to use each time (this will give him some feeling of control over the situation).
  • Let her brush her own teeth first (you will likely have to "help out").
  • Read some children's books about tooth brushing.
  • Have everyone brush their teeth at the same time.

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Sucking the thumb/finger(s) or the pacifier is a normal habit of many children.  Due to factors like frequency, duration, intensity and position, such a habit can adversely affect the position of the jaws and cause a malformed palate.  As the child ages, the jaw bones continue to grow and make changes. If the child continues the habit as he/she approaches age 4, such undesirable changes start to become permanent.  Therefore, it is important to break the habit by age four.  See your child’s dentist for further information.

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  • Wait until the time is right (low stress).
  • Motivate your child (show examples of what could happen to their teeth, and fingers/thumbs).
  • Use a reward system (small incentives encouraging your child to stick with it!)
  • Read a book about thumb sucking.

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The first baby teeth that erupt are the two bottom front teeth (incisors).  The upper front incisors erupt next, followed by more incisors, canines, and molars.  By 3 years of age, most children have 20 baby teeth. Between the ages of 5 and 6 the first permanent teeth will begin to erupt. Some of the permanent teeth replace baby teeth and some don't.  By age 14, most children have 28 teeth.  The wisdom teeth may or may not erupt by age 18.  This usually depends on the amount of space available.

Remember that because all children are different, exact eruption times will vary.


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  • If necessary, put your child to bed with a bottle of plain water, not milk or juice.
  • Stop nursing when your child is asleep.
  • Try not to let your child walk around using a bottle of milk or juice as a pacifier.
  • Start to teach your child to drink from a cup at about 6 months of age. Plan to stop using a bottle by 12 to 14 months at the latest.
  • Don't dip your child's pacifier in honey or sugar.
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Several specific types of bacteria that live in the mouth cause decay.  Such bacteria use sugar to manufacture acids that dissolve the teeth and cause an infection in the tooth. This infection is called decay.

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“Baby-bottle” tooth decay (now called “early childhood caries”), is related to several factors, such as sugar (carbohydrates), frequency of sugar exposure, and bacteria. Children who go to bed with a bottle of milk, formula or juice are more likely to get tooth decay because the teeth are constantly in contact with sugar.  For the same reason, children who are breastfed “on-demand” are at a higher risk of developing decay.  Frequent snacking during the day also increases the risk of decay.


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Fluoride helps make teeth strong and prevents tooth decay. If the water where you live does not have enough fluoride, your doctor may prescribe fluoride supplements (fluoride drops or pills). Your child would take these pills or drops every night, starting when your child is about 6 months old. Only give the prescribed amount of fluoride to your child, because too much fluoride can cause spots to develop on your child's permanent teeth. Children should take these drops or pills until they are 14 to 16 years old (or until you move to an area with fluoride in the water).


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A. If you do not reside in a community that has fluoridated water or has the appropriate amount of natural fluoride in the well water, your child will need some sort of supplement in their diet. We can help you determine how much of a supplement your child needs based upon their weight, age, current water fluoride levels and brand of toothpaste.  Currently, Northern Nevada does not have fluoride in the water.

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A. It is important that your child receives a naturally balanced diet that includes the important nutrients your child needs in order to grow. A daily diet should include the major food groups:  Meat, Fish and Eggs; Vegetables and Fruits; Breads and Cereals; and Milk and Other Dairy Products.

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A. Absolutely. It is important that you initiate a balanced diet for your child so that their teeth and gums develop appropriately. Please note that a diet high in sugar and other forms of carbohydrates may increase the probability of tooth decay.

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A. As we stated earlier, it is important to initiate a balanced diet. Analyze the frequency in which starch based foods are eaten.  Remember that sugar is found in foods other than candy. These types of foods include breads, pasta, potato chips, etc.  All types of sugars can promote tooth decay. For example, most milk-based products contain sugar. A peanut butter and jelly sandwich is a favorite for bag lunches. Unfortunately, it includes sugar that is not only in the jelly, but also in the peanut butter. For less sugar and more flavor and nutrients, try replacing jelly with fresh fruit slices (apples, pears, or bananas) or chopped dried fruit. Go easy on the peanut butter—it’s high in fat. Choose the “no-salt-added” type for less sodium.

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A. Of course not. Many of these foods are incredibly important to your child’s health. However it’s best to incorporate such foods during mealtimes because decay is related to frequency of snacking. Foods that stick to the teeth are also more difficult to remove with water, saliva or toothbrushing. It is important to talk to our staff about your child’s diet and maintaining proper dental care.

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A. It’s important not to nurse your children to sleep or put them to bed with a bottle of milk, juice or formula. When a child is sleeping, any liquid that remains in the mouth can support the bacteria that produce harmful acid. A simple pacifier or bottle of water is fine.


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In most cases, cavities are due to a diet high in sugary foods and a lack of brushing.  Thus, limiting sugar intake and brushing regularly can help prevent tooth decay.  It’s also important to receive a professional cleaning twice a year.

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  • Limit the frequency of meals and snacks.
  • Encourage brushing, flossing and rinsing.
  • Watch what your child drinks.
  • Avoid sticky foods.
  • Make treats a part of meals.
  • Choose nutritious snacks.
  • See your child’s dentist every 6 months.

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A. Contact our office as soon as possible.  However, we do not recommend re-implanting the avulsed tooth.

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A. Contact our office ASAP!  Time is of the essence! Rinse the knocked out tooth in cool water. Do not scrub the tooth. If possible, replace the tooth in the socket and hold it there with clean gauze. If you can’t put the tooth back into the socket, place the tooth in a container of egg whites or milk (water if milk is not available.) Come to our office immediately. Feel free to call our emergency number if it is after hours. The tooth has a better chance of being saved if you act within the first 30 minutes.

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A. Contact our office as soon as possible. Our goal is to save the tooth and prevent infection. Rinse the mouth out with water, and apply a cold compress to reduce swelling. If possible, bring the broken tooth fragment to our office.

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A. Call our office immediately to schedule an appointment.

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A. Sport related dental injuries can be reduced or prevented by wearing a mouth guard. Child proofing your home can help reduce injuries. Regular dental check ups will also contribute to preventative care.


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A. A sealant is a plastic type of material which is bonded into the grooves of the chewing surface of a tooth as a means of helping to prevent the formation of tooth decay.

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A. In many cases, it is near impossible for children to clean the tiny grooves in their teeth. When a sealant is applied, the surface of the tooth is somewhat flatter and smoother.  There are no longer any places on the chewing part of the tooth that the bristles of a toothbrush can't reach and clean.  Since plaque can be removed more easily and effectively, there is a lower risk of tooth decay.

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A. The longevity of sealants can vary.  Success depends on many factors, such as patient cooperation.  Sealants which have remained in place for three to five years are considered to be successful. Our office will check your child’s sealants during routine dental visits and will recommend repair or reapplication when necessary.

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A. The most common teeth for a dentist to seal are a child’s "back" teeth (molars and premolars). The recommendation for sealants should be considered on a case by case basis.

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A. Generally, the procedure takes just one visit.  The tooth is cleaned, conditioned and dried. The sealant is then placed into the grooves of the tooth and hardened with a special blue light. In some cases, the sealant is buffed down. All normal activities can occur directly after the appointment.

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A. It is just as important for your child to brush and floss their teeth. Sealants are not 100% protective against tooth decay.

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A. This treatment is quite affordable, especially when you consider the value of protection against tooth decay. Most dental insurance companies cover sealants. Check with your insurance company about your child’s coverage.


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A. Athletic mouth protectors are comprised of soft plastic. They come in a standard or custom fit to adapt comfortably to the upper teeth.

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A. Mouth guards protect the teeth from possible sport injuries. They also protect the lips, cheeks, tongue and jaw bones. Most injuries occur to the mouth and head area when a child is not wearing a mouth guard.

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A. Your child should wear a mouthguard while playing any sports based activity where there is a risk of head, face or neck injury. Such sports include hockey, soccer, karate, basketball, baseball, skating, skateboarding, as well as many other sports. Most oral injuries occur when children play basketball, baseball and soccer.

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A. Choose a mouth guard that is comfortable for your child. If a mouth guard feels bulky or interferes with speech, then it is probably not appropriate for your child.

There are many options when choosing a mouth guard. Usually found in athletic stores, mouth guards vary in comfort, protection, and cost. The least expensive tend to be the least effective in preventing oral injuries. Customized mouth guards can be provided through our practice.


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While many people believe that periodontal disease is an adult problem, studies indicate that gingivitis (the first stage of periodontal disease) is nearly a universal problem among children and adolescents. Advanced forms of periodontal disease are rare in children, but can occur.

Chronic gingivitis is common in children. It can cause gum tissue to swell, turn red and bleed easily. Gingivitis is preventable and treatable with a regular routine of brushing, flossing and professional dental care. If left untreated, it can eventually advance to more serious forms of periodontal disease.

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  • Type I diabetes
  • Dowm syndrome
  • Papillon-Lefevre syndrome

For example, in a survey of 263 Type I diabetics, 11 to 18 years of age, 10 percent had overt periodontitis.


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There is evidence that demonstrates how periodontal disease may increase during adolescence due to lack of motivation to practice oral hygiene. Children who maintain good oral health habits  are more likely to continue brushing and flossing than children who were not taught proper oral care.


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Early diagnosis is important for successful treatment of periodontal diseases. Therefore, it is important that children receive a periodontal examination as part of their routine dental visits. Be aware that if your child has an advanced form of periodontal disease, this may be an early sign of a systemic disease. A general medical evaluation should be considered for children who exhibit severe periodontitis, especially if it appears resistant to therapy.

An important step in the fight against periodontal disease is to establish good oral health habits with your child at an early age. When your child is 12 months old, you can begin using toothpaste when brushing his or her teeth. However, only use a pea-sized portion on the brush and press it into the bristles so your child won't eat it.  When the gaps between your child's teeth close, it's important to start flossing.

If your child currently exhibits poor oral hygiene, encourage your child to brush and floss. It's much easier to modify these habits in a child than in an adult. Since your child models behavior after you, it follows that you should serve as a positive role model in your oral hygiene habits. Remember that a healthy smile, good breath and strong teeth all contribute to a young person's sense of personal appearance, confidence and self-esteem.


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