Pediatric dentistry (formerly Pedodontics/Paedodontics) primarily focuses on children from birth through adolescence. The American Dental Association (ADA), recognizes pediatric dentistry as a specialty, and therefore requires dentists to undertake two or three years of additional training after completing a general dentistry degree. At the end of this training, the American Board of Pediatric Dentistry issues a unique diploma (Diplomate ABPD). Some pediatric dentists (pedodontists) opt to specialize in oral care for children with special needs, specifically children with autism, varying levels of mental retardation, or cerebral palsy.
One of the most important components of pediatric dentistry is child psychology. Pediatric dentists are trained to create a friendly, fun, social atmosphere for visiting children, and always avoid threatening words like “drill,” “needle,” and “injection.” Dental phobias beginning in childhood often continue into adulthood, so it is of paramount importance that children have positive experiences and find their “dental home” as early as possible.
How can I prepare for my child’s first dental visit?
Pediatric dentists are required to undergo extensive training in child psychology. Their dental offices are generally colorful, child-friendly, and boast a selection of games, toys, and educational tools. Pediatric dentists (and all dental staff) aim to make the child feel as welcome as possible during all visits.
There are several things parents can do to make the first visit enjoyable. Some helpful tips are listed below:
Take another adult along for the visit – Sometimes infants become fussy when having their mouths examined. Having another adult along to soothe the infant allows the parent to ask questions and to attend to any advice the dentist may have.
Leave other children at home – Other children can distract the parent and cause the infant to fuss. Leaving other children at home (when possible) makes the first visit less stressful for all concerned.
Avoid threatening language – Pediatric dentists and staff are trained to avoid the use of threatening language like “drills,” “needles,” “injections,” and “bleeding.” It is imperative for parents to use positive language when speaking about dental treatment with their child.
Provide positive explanations – It is important to explain the purposes of the dental visit in a positive way. Explaining that the dentist “helps keep teeth healthy” is far better than explaining that the dentist “is checking for tooth decay and might have to drill the tooth if decay is found.”
Explain what will happen – Anxiety can be vastly reduced if the child knows what to expect. Age-appropriate books about visiting the dentist can be very helpful in making the visit seem fun. Here is a list of parent and dentist-approved books:
- The Berenstain Bears Visit the Dentist – by Stan and Jan Berenstain.
- Show Me Your Smile: A Visit to the Dentist – Part of the “Dora the Explorer” Series.
- Going to the Dentist – by Anne Civardi.
- Elmo Visits the Dentist – Part of the “Sesame Street” Series.
What will happen during the first visit?
There are several goals for the first dental visit. First, the pediatric dentist and the child need to get properly acquainted. Second, the dentist needs to monitor tooth and jaw development to get an idea of the child’s overall health history. Third, the dentist needs to evaluate the health of the existing teeth and gums. Finally, the dentist aims to answer questions and advise parents on how to implement a good oral care regimen.
The following sequence of events is typical of an initial “well baby checkup”:
- Dental staff will greet the child and parents.
- The infant/family health history will be reviewed (this may include questionnaires).
- The pediatric dentist will address parental questions and concerns.
- More questions will be asked, generally pertaining to the child’s oral habits, pacifier use, general development, tooth alignment, tooth development, and diet.
- The dentist will provide advice on good oral care, how to prevent oral injury, fluoride intake, and sippy cup use.
- The infant’s teeth will be examined. Generally, the dentist and parent sit facing each other. The infant is positioned so that his or her head is cradled in the dentist’s lap. This position allows the infant to look at the parent during the examination.
- Good brushing and flossing demonstrations will be provided.
- The state of the child’s oral health will be described in detail, and specific recommendations will be made. Recommendations usually relate to oral habits, appropriate toothpastes and toothbrushes for the child, orthodontically correct pacifiers, and diet.
- The dentist will detail which teeth may appear in the following months.
- The dentist will outline an appointment schedule and describe what will happen during the next appointment.
What Does a Pediatric Dentist Do?
Pediatric dentists fulfill many important functions pertaining to the child’s overall oral health and hygiene. They place particular emphasis on the proper maintenance and care of deciduous (baby) teeth, which are instrumental in facilitating good chewing habits, proper speech production, and also hold space for permanent teeth.
Other important functions include:
Education – Pediatric dentists educate the child using models, computer technology, and child-friendly terminology, thus emphasizing the importance of keeping teeth strong and healthy. In addition, they advise parents on disease prevention, trauma prevention, good eating habits, and other aspects of the home hygiene routine.
Monitoring growth – By continuously tracking growth and development, pediatric dentists are able to anticipate dental issues and quickly intervene before they worsen. Also, working towards earlier corrective treatment preserves the child’s self-esteem and fosters a more positive self-image.
Prevention – Helping parents and children establish sound eating and oral care habits reduces the chances of later tooth decay. In addition to providing check ups and dental cleanings, pediatric dentists are also able to apply dental sealants and topical fluoride to young teeth, advise parents on thumb- sucking/pacifier/smoking cessation, and provide good demonstrations of brushing and flossing.
Intervention – In some cases, pediatric dentists may discuss the possibility of early oral treatments with parents. In the case of oral injury, malocclusion (bad bite), or bruxism (grinding), space maintainers may be fitted, a nighttime mouth guard may be recommended, or reconstructive surgery may be scheduled.
How Can a Pediatric Dentist Care For My Child’s Teeth?
The pediatric dentist examines the teeth for signs of early decay, monitors orthodontic concerns, tracks jaw and tooth development, and provides a good resource for parents. In addition, the pediatric dentist has several tools at hand to further reduce the child’s risk for dental problems, such as topical fluoride and dental sealants.
During a routine visit to the dentist: the child’s mouth will be fully examined; the teeth will be professionally cleaned; topical fluoride might be coated onto the teeth to protect tooth enamel, and any parental concerns can be addressed. The pediatric dentist can demonstrate good brushing and flossing techniques, advise parents on dietary issues, provide strategies for thumb sucking and pacifier cessation, and communicate with the child on his or her level.
When molars emerge (usually between the ages of two and three), the pediatric dentist may coat them with dental sealant. This sealant covers the hard-to-reach fissures on the molars, sealing out bacteria, food particles, and acid. Dental sealant may last for many months or many years, depending on the oral habits of the child. Dental sealant is an important tool in the fight against tooth decay.
How Can I Help At Home?
Though most parents primarily think of brushing and flossing when they hear the words “oral care,” good preventative care includes many more factors, such as:
- Diet – Parents should provide children with a nourishing, well-balanced diet. Very sugary diets should be modified and continuous snacking should be discouraged. Oral bacteria ingest leftover sugar particles in the child’s mouth after each helping of food, emitting harmful acids that erode tooth enamel, gum tissue, and bone. Space out snacks when possible, and provide the child with non-sugary alternatives like celery sticks, carrot sticks, and low-fat yogurt.
- Oral Habits – Though pacifier use and thumb sucking generally cease over time, both can cause the teeth to misalign. If the child must use a pacifier, choose an “orthodontically” correct model. This will minimize the risk of developmental problems like narrow roof arches and crowding. The pediatric dentist can suggest a strategy (or provide a dental appliance) for thumb sucking cessation.
- General Oral Hygiene – Sometimes, parents clean pacifiers and teething toys by sucking on them. Parents may also share eating utensils with the child. By performing these acts, parents transfer harmful oral bacteria to their children, increasing the risk of early cavities and tooth decay. Instead, rinse toys and pacifiers with warm water, and avoid spoon-sharing whenever possible.
- Sippy Cup Use – Sippy cups are an excellent transitional aid when transferring from a baby bottle to an adult drinking glass. However, sippy cups filled with milk, breast milk, soda, juice, and sweetened water cause small amounts of sugary fluid to continually swill around young teeth – meaning acid continually attacks tooth enamel. Sippy cup use should be terminated between the ages of twelve and fourteen months or as soon as the child has the motor skills to hold a drinking glass.
- Brushing – Children’s teeth should be brushed a minimum of two times per day using a soft-bristled brush and a pea-sized amount of toothpaste. Parents should help with the brushing process until the child reaches the age of seven and is capable of reaching all areas of the mouth. Parents should always opt for ADA-approved toothpaste (non-fluoridated before the age of two, and fluoridated thereafter). For babies, parents should rub the gum area with a clean cloth after each feeding.
- Flossing – Cavities and tooth decay form more easily between teeth. Therefore, the child is at risk for between-teeth cavities wherever two teeth grow adjacent to each other. The pediatric dentist can help demonstrate correct head positioning during the flossing process and suggest tips for making flossing more fun!
- Fluoride – Fluoride helps prevent mineral loss and simultaneously promotes the remineralization of tooth enamel. Too much fluoride can result in fluorosis, a condition where white specks appear on the permanent teeth, and too little can result in tooth decay. It is important to get the fluoride balance correct. The pediatric dentist can evaluate how much the child is currently receiving and prescribe supplements if necessary.
If you have questions or concerns about pediatric dentistry, please contact our office.
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