Pediatric FAQs

Until what age should I brush my child’s teeth? When can they start brushing on their own?

Parents should start brushing their child’s teeth from the first tooth until they have developed the necessary dexterity, typically around the age of 9, to brush effectively on their own. However, even when children start brushing independently, it is important for parents to supervise and ensure proper brushing techniques are being followed until they demonstrate consistent proficiency. If a child must be forced to brush their teeth at night, it is recommended that an adult still brush for the patient regardless of age. Just like adults, when we are forced to do something we don’t want to do, we typically don’t do a great job. Nighttime is the most important time to brush.

At what age can I start flossing my child’s teeth?

You can start flossing your child’s teeth as soon as two adjacent teeth touch each other, which usually occurs around the age of 2 to 3 years old (sometimes earlier is the front teeth touch). It’s important to use child-friendly flossing tools and techniques to ensure gentle and effective cleaning between their teeth. These tools and techniques can be further explained during your dental exam with the Pediatric Dentist.

When will my child start losing baby teeth? When will they start getting adult teeth?

Children typically start losing their baby teeth around the age of 6 or 7, but the timing can vary for each child. The order in which baby teeth are lost also varies, but it generally follows a pattern starting with the front teeth. The process of losing baby teeth and getting adult teeth continues until around the age of 12 or 13 when most of the permanent teeth have erupted. However, the eruption of adult teeth can vary from child to child, and it is not uncommon for the process to continue into the teenage years.

Is sugar-free juice better than regular fruit juice? What is the best drink for children?

Sugar-free juice is generally preferable to regular fruit juice as it contains fewer added sugars, but it is still important to consume it in moderation due to its high acidity and potential to contribute to tooth decay. Milk is a healthier choice than juice as it provides essential nutrients like calcium and protein, supporting bone and overall growth. Milk still has sugars that facilitate tooth decay despite its nutritional qualities. The best drink for children is water, as it hydrates without adding sugars or acids that can harm teeth, but if your child is involved in sports and engaged in intense physical activity, an electrolyte drink can be suitable to replenish lost fluids and electrolytes, provided it is consumed in moderation and not excessively sugary. When the game is done, the drink is done (no sipping afterward). Frequency is key—the easiest way to do this is to limit non-pure water drinks to mealtime and/or snack time.

When do children get panoramic radiographs? When are these generally taken? How often are these taken? What is the radiation exposure?

Panoramic radiographs are typically taken for children when there is a need for a comprehensive view of the entire oral and maxillofacial region, such as assessing dental development, eruption patterns, evaluating impacted teeth, or planning orthodontic treatment. The timing of panoramic radiographs varies based on the child’s specific dental needs and growth stage. The first panoramic radiograph is taken between the age of 5-8 depending on the eruption of the incisors (front teeth) and permanent first molars (also called the six-year molars). The radiation exposure from a panoramic radiograph is higher compared to an intraoral radiograph, but modern digital equipment and techniques minimize radiation doses, and lead aprons are used to shield the body from unnecessary exposure. These specific radiographs are recommended every 3-5 years, depending on the dental findings/presentation.

Do all children need CBCT radiographs?

No, not all children need CBCT (cone-beam computed tomography) radiographs. CBCT scans provide three-dimensional images of the oral and maxillofacial structures and are typically used for specific diagnostic purposes, such as evaluating complex dental or skeletal issues, assessing impacted teeth, or planning orthodontic or surgical treatments. The decision to use CBCT radiographs in children is made by the dentist or specialist based on the individual’s unique needs and the specific diagnostic requirements of the case.

What are dental sealants? What are the benefits and risks?

Dental sealants are thin plastic coatings applied to the chewing surfaces of the back teeth (molars and premolars) to protect them from cavities. The benefits of dental sealants include sealing the deep grooves and pits of the teeth, preventing bacteria and food particles from getting trapped, and reducing the risk of tooth decay. If any concerns arise, please be sure to discuss them with your dentist.

What makes incipient/small cavities different from cavities that need treatment?

Incipient or small cavities refer to early stages of tooth decay where the damage is limited to the outer layer of the tooth, known as enamel. At this stage, the decay may be reversible with proper oral hygiene and preventive measures. Cavities that require treatment, on the other hand, have progressed beyond the enamel and have affected the underlying layers of the tooth, such as dentin. These cavities typically require dental intervention, such as fillings, to remove the decayed portion and restore the tooth’s structure. Early detection of incipient cavities through regular dental check-ups enables timely intervention to prevent further progression and the need for more extensive treatment.

What is Silver Diamine Fluoride (SDF)? What are the indications for using SDF? Is it guaranteed to arrest decay? What are the risks?

Silver Diamine Fluoride (SDF) is a liquid solution containing silver particles and fluoride. It is used as a non-invasive treatment for dental caries (decay) management, particularly in cases where conventional treatment options may be challenging, such as young children or individuals with special needs. SDF can help arrest the progression of cavities and prevent further decay.

While SDF has shown high success rates in halting decay progression, it is not guaranteed to completely eliminate the need for additional treatment. SDF will stain the affected area of the tooth, turning it black or dark brown. Additionally, SDF may cause a temporary metallic taste or mild irritation to the gums or oral tissues, but serious adverse effects are rare.

The decision to use SDF is made by a dentist based on the specific indications and circumstances of each case, weighing the potential benefits against the risks and considering individual patient factors. It is important to consult with a dental professional to determine if SDF is an appropriate treatment option for your specific situation.

What are white fillings? What are the benefits and risks?

White fillings, also known as composite fillings or tooth-colored fillings, are dental restorations made of a mixture of plastic and glass materials. They are used to repair teeth affected by decay or minor damage and can be matched to the natural color of the tooth, providing an aesthetically pleasing result. The benefits of white fillings include their natural appearance, ability to bond directly to the tooth structure, and preservation of a more healthy tooth structure compared to amalgam (silver) fillings. Risks associated with white fillings are minimal and may include the potential for staining over time and a higher risk of fracture if there is extensive decay.

Are tooth-colored crowns or stainless steel crowns a better choice?

Tooth-colored crowns and stainless steel crowns serve different purposes and have different advantages. Tooth-colored crowns, typically made of zirconia or composite materials, provide a more natural appearance and are often used for visible front teeth. For back teeth, there is the option of tooth-colored or stainless steel crowns. Stainless steel crowns are highly durable and the gold standard for the restoration of baby molars with extensive decay. Tooth-colored crowns are an aesthetic alternative to stainless steel crowns, however, they require more tooth removal (higher risk of infection), are more technique sensitive, and not every patient is a candidate for tooth-colored crowns. If you want to know what full coverage restorations your child is a candidate for it is best to consult your local pediatric dentist.

Is a dental infection in a child less severe than a dental infection in an adult?

Dental infections in children can be equally as severe as dental infections in adults, and prompt treatment is essential regardless of age. In fact, dental infections in children can have additional implications on oral development and overall health, highlighting the importance of timely intervention and professional dental care.

My child’s baby teeth are crowded, is this normal? Will they need braces when they get older?

Crowding of the teeth can occur in children and is relatively common. It can be influenced by factors such as genetics, jaw size, and the eruption pattern of permanent teeth. While some cases of crowding may resolve as permanent teeth come in and the jaw grows, many children with crowding may benefit from orthodontic intervention, such as expansion appliances and braces to help with jaw development and proper alignment of teeth.

What age are kids referred to the orthodontist? Why are some referred earlier than others?

Children are typically referred to an orthodontist for an evaluation around the age of 7. This is because by this age, the permanent first molars and incisors have usually erupted, allowing the orthodontist to assess the child’s dental development and identify any potential issues. Some children may be referred earlier than others if they exhibit signs of severe crowding, crossbite, jaw misalignment, or tooth-size space discrepancy. The aforementioned are all orthodontic concerns that require early intervention to guide proper growth and development of the teeth and jaws. Early referral allows the orthodontist to monitor the child’s growth and initiate timely treatment if necessary.