If your child has had a dental trauma, please contact our office. It is always best to have a dentist look to ensure a proper diagnosis. We use the following dental trauma guidelines for determining the best course of treatment for your child’s dental trauma:

dental trauma guide button

Anesthetic: Your child…

• May drink right away; however, wait until the “sleepy” area wakes up to eat/chew
• May not bite, pinch, chew, suck or rub the “sleepy” area.
• May have Motrin as needed
• Will experience an unsightly, ulcerated area if cheek, lip or tongue is bitten. It may look infected, but it is normal for the mouth to look this way when damaged. Do not apply numbing medication because it will allow your child to bite/reinjure the area.

Extraction: Your child…

• Will likely experience some bleeding. This is to be expected. If persistent bleeding occurs, place gauze over the area and bite down firmly for 10-15 minutes. Repeat as needed.
• May not use a straw or drink “fizzy” carbonated drinks today.
• Should not rinse/swish mouth with water or mouth rinse for 24 hours.
• Should have a soft food diet for 24 hours.
• May have swelling. If this occurs, consult with the dentist and apply ice to the area.
• May take Ibuprofen for discomfort.

White/Silver Filling: Your child…

• Should have a soft food diet for 24 hours.
• Should avoid flossing for 24 hours.
• Must avoid sticky/chewy foods.
• May take Motrin for discomfort, especially if anesthetic was used.

Sealants: You child…

• Should avoid gum/sticky candy, especially for the first 24 hours.
• May feel like he/she has something on the tooth for a few days before getting used to the feeling.
• May eat and drink right away if other procedures were not done (like fillings, fluoride, etc)

Crowns: Your child…

• Will have this crown until the baby tooth falls out. If it is a permanent tooth, we will discuss other options.
• May not have gum/sticky candy while the crown is in the mouth.
• May experience bleeding at the gumline for a few days, but will heal.
• May take Motrin for discomfort.
• Must practice good oral hygiene around the crown (brushing and flossing).

Space Maintainers: Your child…

• May not have gum/sticky candy as long as the appliance is in the mouth.
• Must brush well around the bands.
• Should be seen if it becomes loose or falls out. If it is loose, push the band back around the tooth and call the office. If it comes out, save it and call the office to have it recemented.

If any unusual symptoms occur, please contact the office.
Arlington Pediatric Dentistry
817.465.0044

Q. When should my child first see a dentist?
“First visit by first birthday” sums it up. Your child should visit a pediatric dentist when the first tooth comes in, usually between 6 and 12 months of age. This visit will establish a dental home for your child. Early examination and preventive care will protect your child’s smile now and in the future.

Q. Why so early? What dental problems could a baby have?
The most important reason is to begin a thorough prevention program. Dental problems can begin early. A big concern is Early Childhood Caries (formerly known as baby bottle tooth decay or nursing caries). Once a child’s diet includes anything besides breast-milk, erupted teeth are at risk for decay. The earlier the dental visit, the better the chance of preventing dental problems. Children with healthy teeth chew food easily and smile with confidence. Start your child now on a lifetime of good dental habits.

Q. How can I prevent tooth decay from nursing or using a bottle?
At-will breast-feeding should be avoided after the first primary (baby) teeth begin to erupt and other sources of nutrition have been introduced. Children should not fall asleep with a bottle containing anything other than water. Drinking juice from a bottle should be avoided. Fruit juice should only be offered in a cup with meals or at snack time.

Q. When should bottle-feeding be stopped?
Children should be weaned from the bottle at 12-14 months of age.

Q. Should I worry about thumb and finger sucking?
Thumb sucking is perfectly normal for infants; many stop by age 2. Prolonged thumb sucking can create crooked teeth or bite problems. If the habit continues beyond age 3, a professional evaluation is recommended. Your pediatric dentist will be glad to suggest ways to address a prolonged thumb sucking habit.

Q. When should I start cleaning my baby’s teeth?
The sooner the better! Starting at birth, clean your child’s gums with a soft infant toothbrush or cloth and water. As soon as the teeth begin to appear, start brushing twice daily using 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 toothbrushing. Remember that young children do not have the ability to brush their teeth effectively.

toothbrush

Q. Any advice on teething?
From six months to age 3, your child may have tender gums when teeth erupt. Many children like a clean teething ring, cool spoon or cold wet washcloth. Some parents swear by a chilled ring; others simply rub the baby’s gums with a clean finger.

*Courtesy of the American Academy of Pediatric Dentistry

Q: What is a healthy diet for my child?
A: A healthy diet is a balanced diet that naturally supplies all the nutrients your child needs to grow. A balanced diet is one that includes the following major food groups: Fruits Vegetables Grains Meat & Beans Milk These are the key groups according to the food pyramid.

Q: How does my child’s diet affect his/her dental health?
A: Children must have a balanced diet for their teeth to develop properly. They also need a balanced diet for healthy gum tissue around the teeth. Equally important, a diet high in certain kinds of carbohydrates, such as sugar and starches, may place your child at extra risk for tooth decay.

Q: How do I make my child’s diet safe for his/her teeth?
A: First, be sure they have a balanced diet. Then, check how frequently they eat foods with sugar or starch in them. Foods with starch include breads, crackers, pasta and snacks, such as pretzels and potato chips. When checking for sugar, look beyond the sugar bowl and candy dish. A variety of foods contain one or more types of sugar, and all types of sugars can promote dental decay. Fruits, a few vegetables, and most milk products have at least one type of sugar.

Sugar can be found in many processed foods, even some of which do not taste sweet. For example, a peanut butter and jelly sandwich not only has sugar in the jelly, but may have sugar added to the peanut butter. Sugar is also added to such condiments as catsup and salad dressings.

Q: Should my child give up all foods with sugar or starch?
A: Certainly not! Many provide nutrients your child needs. You simply need to select and serve them wisely. A food with sugar or starch is safer for teeth if it is eaten with a meal, not as a snack. Sticky foods, such as dried fruit or toffee, are not easily washed away from the teeth by saliva, water or milk. Therefore, they have more cavity-causing potential than foods more rapidly cleared from the teeth. Talk to your pediatric dentist about selecting and serving foods that protect your child’s dental health.

Q: Does a balanced diet assure that my child is getting enough fluoride?
A: No. A balanced diet does not guarantee the proper amount of fluoride for the development and maintenance of your child’s teeth. If you do not live in a fluoridated community or have an ideal amount of naturally occurring fluoride in your well water, your child may need a fluoride supplement during the years of tooth development. Your pediatric dentist can help assess how much supplemental fluoride your child needs, based upon the amount of fluoride in your drinking water and other potential sources of fluoride.

Q: My youngest isn’t on solid foods yet. Do you have suggestions for him?
A: Do not nurse a young child to sleep or put him to bed with a bottle of milk, formula, juice or sweetened liquid. While a child sleeps, any unswallowed liquid in the mouth feeds bacteria that produce acids and attack the teeth. Protect your child from severe tooth decay by putting him to bed with nothing more than a pacifier or bottle of water.

Q: Any final advice?
A: Yes. Here are tips for your child’s diet and dental health.
1. Ask your pediatric dentist to help you assess your child’s diet.
2. Shop smart! Do not routinely stock your pantry with sugary or starchy snacks. Buy “fun foods” just for special times.
3. Limit the number of snack times; choose nutritious snacks.
4. Provide a balanced diet, and save foods with sugar or starch for mealtimes.
5. Don’t put your young child to bed with a bottle of milk, formula, or juice.
6. If your child chews gum or sips soda, choose those without sugar.

*Courtesy of the American Academy of Pediatric Dentistry

Most children are calm, comfortable and confident in a pediatric dental office. The office is designed for young people, and pediatric dentists have additional training in caring for infants, children and adolescents. Staff members choose to work in a pediatric dental office because they like children and want to cater to their special needs. These elements combine to make your child feel relaxed and special.

Sometimes, however, a child may feel anxious before or during treatment. Your child may need more support than a gentle, caring manner to feel comfortable. Nitrous oxide/oxygen is a safe, effective sedative agent used to calm a child’s fear of the dental visit and enhance effective communication. Additionally, it works well for children whose gag reflex interferes with dental treatment.

Q: What is nitrous oxide/oxygen?
Nitrous oxide/oxygen (N2O-O2) is a blend of two gases — oxygen and nitrous oxide. A fitted mask is placed over the nose and, as the patient breathes normally, uptake occurs through the lungs. At the end of treatment, it is eliminated after a short period of breathing oxygen and has no lingering effects.

Q: How will my child feel when breathing nitrous oxide/oxygen?
Your child will smell a faint, sweet aroma and experience a sense of well-being and relaxation. Since it may produce a feeling of giddiness or euphoria, it is often called “laughing gas.” Children sometimes report dreaming and their arms and legs may feel “tingly.” It raises the pain threshold and may even make the time appear to pass quickly. If your child is worried by the sights, sounds or sensations of dental treatment, he or she may respond more positively with the use of nitrous oxide/oxygen.

Q: How safe is nitrous oxide/oxygen?
Very safe. Nitrous oxide/oxygen is perhaps the safest sedative in dentistry. It is well tolerated. It has a rapid onset, is reversible, can be adjusted in various concentrations and is non-allergenic. Your child remains fully conscious — keeps all natural reflexes — when breathing nitrous oxide/oxygen. He/she will be capable of responding to a question or request. Nitrous oxide/oxygen may also be used in combination with other sedative agents.

Q: Are there any special instructions for nitrous oxide/oxygen?
First, give your child little or no food in the two hours preceding the dental visit (occasionally, nausea or vomiting occurs when a child has a full stomach). Second, tell your pediatric dentist about any respiratory condition that makes breathing through the nose difficult for your child, as it may limit the effectiveness of nitrous oxide/oxygen. Third, tell your pediatric dentist if your child is taking any medication on the day of the appointment.

Q: Will nitrous oxide/oxygen work for all children?
Pediatric dentists know that all children are not alike. Every service is tailored to your child as an individual. Nitrous oxide/oxygen may not be effective for some children, especially those who have severe anxiety, nasal congestion, or discomfort wearing a nasal mask. Your pediatric dentist will review your child’s medical history, level of anxiety, and dental treatment needs and inform you if nitrous oxide/oxygen is recommended for your child. Pediatric dentists have comprehensive specialty training and can offer other sedation methods that are right for your child.

*courtesy of the AAPD (American Academy of Pediatric Dentistry)

What is fluoride?
Fluoride is a compound that contains fluorine, a natural element. Using small amounts of fluoride on a routine basis can help prevent tooth decay. In areas where fluoride does not occur naturally, it may be added to community water supplies. Research shows that community water fluoridation has lowered decay rates by over 50 percent, which means that fewer children grow up with cavities. Fluoride can be found as an active ingredient in many dental products such as toothpaste, mouth rinses, gels and varnish.

How does fluoride prevent cavities?
Fluoride inhibits loss of minerals from tooth enamel and encourages remineralization (strengthening areas that are weakened and beginning to develop cavities). Fluoride also affects bacteria that cause cavities, discouraging acid attacks that break down the tooth. Risk for decay is reduced even more when fluoride is combined with a healthy diet and good oral hygiene.

Will my child need fluoride supplements?
The pediatric dentist considers many factors before recommending a fluoride supplement. Your child’s age, risk of developing dental decay and dietary sources of fluoride are important considerations. Infant formulas contain different amounts of fluoride. Bottled, filtered and well waters also vary in the amount of fluoride they contain. Your pediatric dentist can help determine if your child is receiving — and not exceeding — the recommended amount.

How safe is fluoride?
Using fluoride for the prevention and control of decay is proven to be both safe and effective. Nevertheless, products containing fluoride should be stored out of the reach of young children. Too much fluoride could cause fluorosis of developing permanent teeth. Fluorosis usually is mild, with tiny white specks or streaks that often are unnoticeable. In severe cases of fluorosis, the enamel may be pitted with brown discoloration. Development of fluorosis depends on the amount, duration and timing of excessive fluoride intake. The appearance of teeth affected by fluorosis can be greatly improved by a variety of treatments in esthetic dentistry.

What type of toothpaste should my child use?
Your child should use toothpaste with fluoride and the American Dental Association Seal of Acceptance. Brushing twice a day (after breakfast and before bedtime) provides greater benefits than brushing once daily. Parents should dispense toothpaste to prevent their young children from swallowing too much.

How much toothpaste should my child use?
For children under 2-years-old, use a smear of fluoridated toothpaste. For those aged 2 to 5 years, a pea-sized amount is recommended.

What is topical fluoride?
Topical fluoride is a preventive agent applied to tooth enamel. It comes in a number of different forms. A dental professional places gels or foams in trays that are held against the teeth for up to four minutes. Fluoride varnish is brushed or “painted” on the enamel. Varnish is especially useful for young patients and those with special needs who may not tolerate fluoride trays. Children who benefit the most from fluoride are those at highest risk for decay. Risk factors include a history of previous cavities, a diet high in sugar or carbohydrates, orthodontic appliances, and certain medical conditions such as dry mouth.

*Courtesy of the American Academy of Pediatric Dentistry

Dental Sealants Example

Q: What are sealants?
Sealants protect the grooved and pitted surfaces of the teeth, especially the chewing surfaces of back teeth where most cavities in children are found. Made of clear or shaded plastic, sealants are applied to the teeth to help keep them cavity-free.

Q: How do sealants work?
Even if your child brushes and flosses carefully, it is difficult—sometimes impossible—to clean the tiny grooves and pits on certain teeth. Food and bacteria build up in these crevices, placing your child in danger of tooth decay. Sealants “seal out” food and plaque, thus reducing the risk of decay.

Q: How long do sealants last?
Research shows that sealants can last for many years if properly cared for. Therefore, your child will be protected throughout the most cavity-prone years. If your child has good oral hygiene and avoids biting hard objects, sealants will last longer. Your pediatric dentist will check the sealants during routine dental visits and recommend re-application or repair when necessary.

Q: What is the treatment like?
The application of a sealant is quick and comfortable. It takes only one visit. The tooth is first cleaned. It is then conditioned and dried. The sealant is then flowed onto the grooves of the tooth and allowed to harden or hardened with a special light. Your child will be able to eat right after the appointment.

Q: How much does it cost?
The treatment is very affordable, especially in view of the valuable decay protection it offers your child. Most dental insurance companies cover sealants. Some companies, however, have age and specific tooth limitations. Check with your benefits provider about your child’s coverage and talk to your pediatric dentist about the exact cost of sealants for your child.

Q: Which teeth should be sealed?
The natural flow of saliva usually keeps the smooth surfaces of teeth clean but does not wash out the grooves and fissures. So the teeth most at risk of decay—and therefore, most in need of sealants— are the six-year and twelve-year molars. Many times the permanent premolars and primary molars will also benefit from sealant coverage. Any tooth, however, with grooves or pits may benefit from the protection of sealants. Talk to your pediatric dentist, as each child’s situation is unique.

Q: If my child has sealants, are brushing and flossing still important?
Absolutely! Sealants are only one step in the plan to keep your child cavity-free for a lifetime. Brushing, flossing, balanced nutrition, limited snacking, and regular dental visits are still essential to a bright, healthy smile.

Q: How often should a child have dental X-ray films?
Since every child is unique, the need for dental X-ray films varies from child to child. Films are taken only after reviewing your child’s medical and dental histories and performing a clinical examination, and only when they are likely to yield information that a visual examination cannot.

In general, children need X-rays more often than adults. Their mouths grow and change rapidly. They are more susceptible than adults to tooth decay. For children with a high risk of tooth decay, the American Academy of Pediatric Dentistry recommends X-ray examinations every six months to detect cavities developing between the teeth. Children with a low risk of tooth decay require X-rays less frequently.

Q: Why should X-ray films be taken if my child has never had a cavity?
X-ray films detect much more than cavities. For example, X-rays may be needed to survey erupting teeth, diagnose bone diseases, evaluate the results of an injury, or plan orthodontic treatment. X-rays allow dentists to diagnose and treat conditions that cannot be detected during a clinical examination. If dental problems are found and treated early, dental care is more comfortable and affordable.

Q: Will X-ray films be taken routinely?
No. X-ray films are recommended only when necessary to evaluate and monitor your child’s oral health. The frequency of X-ray films is determined by your child’s individual needs. If your child’s previous dentist obtained X-ray films, request copies to be sent to your new pediatric dentist to help reduce radiation exposure.

Q: How safe are dental X-rays?
Pediatric dentists are particularly careful to minimize the exposure of child patients to radiation. With contemporary safeguards, the amount of radiation received in a dental X-ray examination is extremely small. In fact, dental X-rays represent a far smaller risk than undetected and untreated dental problems.

Q: What safeguards are used to protect my child from X-ray exposure?
Lead body aprons and shields help protect your child. Today’s equipment filters out unnecessary X-rays and restricts the X-ray beam to the area of interest. High-speed film, digital X-rays, and proper shielding assure that your child receives a minimal amount of radiation exposure.

Arlington Pediatric Dentistry employs all-digital x-ray technology.

*Courtesy of the American Academy of Pediatric Dentistry

Q: Why do children suck on fingers, pacifiers or other objects?
A: This type of sucking is completely normal for babies and young children. It provides security. For young babies, it is a way to make contact with and learn about the world. In fact, babies begin to suck on their fingers or thumbs even before they are born.

Q: Are these habits bad for the teeth and jaws?
A: Most children stop sucking on thumbs, pacifiers or other objects on their own between 2 and 4 years of age. However, some children continue these habits over long periods of time. In these children, the upper front teeth may tip toward the lip or not come in properly. Frequent or intense habits over a prolonged period of time can affect the way the child’s teeth bite together, as well as the growth of the jaws and bones that support the teeth.

Q: When should I worry about a sucking habit?
A: Your pediatric dentist will carefully watch the way your child’s teeth erupt and jaws develop, keeping the sucking habit in mind at all times. Because persistent habits may cause long term problems, intervention may be recommended for children beyond 3 years of age.

Q: What can I do to stop my child’s habit?
A: Most children stop sucking habits on their own, but some children need the help of their parents and their pediatric dentist. When your child is old enough to understand the possible results of a sucking habit, your pediatric dentist can encourage your child to stop, as well as talk about what happens to the teeth and jaws if your child does not stop. This advice, coupled with support from parents, helps most children quit. If this approach does not work, your pediatric dentist may recommend ways to change the behavior, including a mouth appliance that interferes with sucking habits.

Q: Are pacifiers a safer habit for the teeth than thumbs or fingers?
A: Thumb, finger and pacifier sucking affect the teeth and jaws in essentially the same way. However, a pacifier habit often is easier to break.

*Courtesy of the American Academy of Pediatric Dentistry

Q: What are space maintainers?
A: Space maintainers are appliances made of metal or plastic that are custom fit to your child’s mouth. They are small and unobtrusive in appearance. Most children easily adjust to them after the first few days.

Q: Why do children lose their baby teeth?
A: A baby tooth usually stays in place until a permanent tooth underneath pushes it out and takes its place. Unfortunately, some children lose a baby tooth too soon. A tooth might be knocked out accidentally or removed because of dental disease. When a tooth is lost too early, your pediatric dentist may recommend a space maintainer to prevent future space loss and dental problems.

Q: Why all the fuss? Baby teeth fall out eventually on their own!
A: Baby teeth are important to your child’s present and future dental health. They encourage normal development of the jaw bones and muscles. They save space for the permanent teeth and guide them into position. Remember: Some baby teeth are not replaced until a child is 12 or 14 years old.

Q: How does a lost baby tooth cause problems for permanent teeth?
A: If a baby tooth is lost too soon, the teeth beside it may tilt or drift into the empty space. Teeth in the other jaw may move up or down to fill the gap. When adjacent teeth shift into the empty space, they create a lack of space in the jaw for the permanent teeth. Therefore, permanent teeth are crowded and come in crooked. If left untreated, the condition may require extensive orthodontic treatment.

Q: What are space maintainers?
A: Space maintainers are appliances made of metal or plastic that are custom fit to your child’s mouth. They are small and unobtrusive in appearance. Most children easily adjust to them after the first few days.

Q: How does a space maintainer help?
A: Space maintainers hold open the empty space left by a lost tooth. They steady the remaining teeth, preventing movement until the permanent tooth takes its natural position in the jaw. It is more affordable — and easier on your child — to keep teeth in normal positions with a space maintainer than to move them back in place with orthodontic treatment.

Q: What special care do space maintainers need?
A: Pediatric dentists have four rules for space maintainer care. First, avoid sticky sweets or chewing gum. Second, do not tug or push on the space maintainer with your fingers or tongue. Third, keep it clean with conscientious brushing and flossing. Fourth, continue regular dental visits.

Ever hear a sound like a wild animal gnashing its teeth coming from your child’s bedroom in the middle of the night?

No worries. Turns out lots of our kids are those wild animals.

And while teeth grinding may not sound like the healthiest of noises to come out of your child’s mouth, there’s generally little to worry about, according to Rhea Haugseth, a pediatric dentist and president-elect of the American Academy of Pediatric Dentistry.

We asked her six questions about what turns out to be a common issue. Below are her responses:

1. Why do kids grind their teeth? Does the answer change depending on the age of the child?
Children exhibit teeth grinding very commonly. We see it in children younger than 7-8 years old often. A lot of children will stop grinding once their six-year permanent molars erupt. Their permanent teeth bite begins to establish itself once those molars erupt.

Prior to this, children’s bites are very flexible and subject to changes as they grow. Occasionally, children will exhibit an abnormal bite causing them to grind because of the placement of their teeth.

2. Could it be stress-related? Do children grind their teeth for some of the same reasons adults might grind their teeth?
More common is stress related grinding in students of middle school age and high school when (final exams and other) major testing occurs. This is the stress more common to this age group.

3. What should parents do if their child is grinding his or her teeth?
If the child is still very young with baby teeth still present, nothing needs to be done as we do not want to affect their growth. If the child is older, intervention may be necessary. The plan is to protect the permanent teeth while not negatively affecting their normal growth.

4. What should they look out for? When should parents worry?
Their dentist will notice and track wear patterns and recommend treatment when appropriate.

5. How common is teeth-grinding?
It is very common in children less than 7 years of age. There are adults that do this so not all children outgrow grinding. According to some studies, there is also a correlation between children grinding their teeth and those children that have sleeping disorders.

6. Any other tips for parents who are concerned about their children’s teeth-grinding issue?
Our major concern is that permanent teeth are not affected and normal growth is allowed to occur. Many children do this and this does not mean that they are stressed, rather sometimes this is a natural expression of frustration until their vocabulary increases and they can verbally express their frustrations. In most cases this is a subconscious response and will change with age and growth.

Emergency! What Do I Do?

Toothache
First, clean the area of the tooth and rinse thoroughly with warm water. Use floss or a toothbrush to get rid of any food particles in and around the area and apply something cold to the tooth and gums (nothing hot!). If pain persists, call our office to set up an appointment.

Knocked Out Baby Tooth
No need to worry. This is not usually an emergency, and in most cases, no treatment is necessary. Contact us if you have any questions or concerns.

Knocked Out Permanent Tooth
Find the tooth if possible! Handle it by the crown, not by the root, and rinse it with clean water – no soap or abrasives! You must act quickly in order to save the tooth.

You’ll need to see a dentist immediately, but you’ll need to secure the tooth for transport. If the tooth is still in tact and not fractured or cracked, you can try to insert it into the original cavity. Hold the tooth in place by biting on gauze.

If you can’t re-insert the tooth, place the tooth in a cup of cold milk or inside the cheek of the patient (if they’re old enough).

Bitten or Cut Lip, Tongue or Cheek
Place some ice on the cut to help control swelling. Apply gauze or something similar with some pressure if there’s bleeding. Call a doctor or visit your nearest ER if the bleeding can’t be contained.


Chipped or Fractured Permanent Tooth
Ouch! The risk here is infection and extensive dental treatment may be possible, but you can help minimize damage and often save the tooth.

Firstly, contact us or your dentist right away and set up a time to come in. Reduce swelling by rinsing the mouth out with water and applying cold compresses. Save any broken tooth fragments and bring them with you to your appointment.

Chipped or Fractured Baby Tooth
Contact us your pediatric dentist.

Head or Face Injury
Take your child to the nearest hospital emergency room immediately.

Possible Broken or Fractured Jaw
Keep the jaw from moving and take your child to the nearest hospital emergency room.



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