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Q & A with Pediatric Dentists

Local dentists weigh in on the issues affecting your child's dental health

Pediatric Dentists
February 2013

What's new in the field of pediatric dentistry?

Most if not all contemporarily trained pediatric dentists now practice what is referred to as "the patient and experience based approach". It is no longer acceptable to simply get the work completed. We know that early dental experiences shape attitudes and willingness to seek dental care throughout adulthood. It is all about the pediatric patient. Pediatric dentists receive additional training to provide exceptional service and experiences to infants, children, adolescents and patients with special needs. Some patients may benefit from laughing gas, oral sedation, or comprehensive care in the operating room under general anesthesia.

Anticipatory guidance is another tool utilized by pediatric dentists. Simply stated it is an individualized comprehensive plan that looks at the parents' experience with cavities (which can indicate the child's susceptibility for developing cavities), diet analysis, adequate fluoride intake, application of sealants, how often x-rays should be taken and timing of orthodontic treatment, if necessary.

Dental materials continue to be improved. Many parents have expressed concern over Bisphenol A (BPA). BPA is an organic compound that is found in various plastic products and can cause endocrine and metabolism problems. Sealants and resins (white fillings) are now BPA free. It is a great time to be a kid!

Submitted by Kevin Beadle D.D.S. of Carmel Pediatric Dentistry

Should wisdom teeth be removed in young children to avoid potentially bigger problems with extraction in the future?

It is my opinion that wisdom teeth should not be removed in young children to avoid potentially bigger problems with extraction or crowding in the future. The optimal time to remove wisdom teeth is roughly between the ages of 17 and 25, depending on the dental age of your child. During the late teens and early adult years, it is easier for dentists and more tolerable for patients in this age group because of root and bone development as well as healing potential. Wisdom teeth can be seen on panoramic radiographs to see the direction in which the teeth will erupt or possible impaction. Start talking to your dentist about the position and Health of your child's wisdom teeth as early as age 13.

Submitted by Michelle H. Edwards, DDS, MSD from Children's Dental Center in Fishers

What misconceptions or misinformation do parents often have when caring for their children's teeth?

Often parents are overwhelmed with information about how to best care for their children's teeth. One area of common misconception and confusion is how fruit flavored drinks and snacks affect our children's teeth and overall oral health.

Some parents do not realize that most juice or fruit drinks are high in sugar content and are harmful to the health of their child's teeth. Often, even juices marketed as "100% real fruit" contain many grams of sugar and should be avoided. As children get older, they are often interested in soda, sports and energy drinks. These also have high sugar content, often along with high acidity which is also harmful to the enamel of your child's teeth. Search for sugar-free alternatives for your children to drink. And remember, the most tooth-friendly drink is water!

Fruit snacks, dried fruit and other "sticky" foods and candies are another area of concern to the health of your child's teeth. Parents often think of these foods as good for their children because they state they are made with fruit. However, fruit snacks and other "sticky" foods are often very high in sugar content and stick to your child's teeth for an extended period of time putting his or her teeth at a high risk for dental decay.

If you have concerns or questions about which foods and drinks are the healthiest for your child's teeth, visit your local dentist or www.aapd.org for guidance.

Submitted by Dr. Kira Stockton and Dr. Erin Phillips of Indianapolis Pediatric Dentistry

What are the benefits of dental sealants and when should children have them done?

According to the American Academy of Pediatric Dentistry, in school-aged children 90% of tooth decay occurs in the pits and grooves, even with the best effort in brushing! To reduce this risk and avoid invasive dental treatment, we recommend sealants on healthy teeth that are most susceptible to dental decay. A sealant is a plastic resin applied to the chewing surface of back teeth to help create a smooth surface. This prevents bacteria from harboring where your toothbrush can't reach, making brushing easier and more effective against tooth decay. It is most common to 'seal' the grooves of permanent molars as soon as they erupt, around the age of 6 and 12. Along with proper diet, good home care and regular dental visits, sealants are an effective measure to keeping your child cavity free! This will help ensure more positive dental experiences long term. 

Submitted by Dr. Ana Vazquez, DMD CEO of Fishers Pediatric Dentistry

How do you help a young child who is really frightened to be at the dentist?

At Children's Dentistry of Indianapolis, we understand that it is quite common for young children to be frightened about the dental environment. We encourage many proactive measures to assist with the building of our relationships with patients. Often it is helpful for patients to have a tour of our office prior to their actual appointment. This allows them to experience some of the experience in a low stress manner. We encourage parents to set appointment times when their child is likely to have their best experience. Traditionally, young children are most alert and cooperative earlier in the morning. Parents are encouraged to discuss the dental visit with their child prior to the actual appointment in an easy, simple manner; explaining we are helping to keep their smiles healthy. It helps to avoid terms like "pain" and "shot". We suggest parents accompany their child throughout the entire first visit, rather than remain in the reception room.

Also, it often helps a frightened child to bring a favorite small toy or personal article along for comfort and support. We have catered our entire office to infants, children, adolescents and those with special health care needs. Our office is bright and cheerful, includes televisions, video games and stuffed animals and is staffed with specially trained members to maximize comfort and minimize anxiety.

Submitted by Sam Bullard, DDS, MSD and Swati Singh, DDS of Children's Dentistry of Indianapolis

What should you do if a child knocks out a tooth?

Find the tooth! In many cases a permanent tooth that is knocked out (avulsed) can be replanted back in the same space. In many cases where parents think a tooth has been knocked out, it was actually pushed up or intruded into gums. Ideally, gently rinse the debris off the tooth and try to put the tooth back in the space. Have your child gently bite down on a cloth to help it stay in place.

If that is not an option, store the tooth in some type of solution. Milk is the best alternative, however if that is not available, saliva or water will also work. It is important to keep the tooth moist and tissue fibers in place, so no washing, scrubbing or drying the tooth. Call your dentist—this is a true dental emergency!

Time is of the essence and the quicker the tooth can be replanted, the greater the chances are for success in maintaining the tooth. The best chance for success is if the tooth is replanted within 60 minutes.

If the knocked-out tooth is a primary tooth DO NOT try to put the tooth back into the space. Call your dentist and take the tooth to the appointment. The actual tooth gives us good information about the injury. It can tell us if the entire tooth came out or if some of the root is still in the space. If bone fragments are attached to the tooth, there may be more fractured bone around the adjacent teeth. The permanent teeth are growing and developing right above the roots of the baby teeth. So trying to put the tooth back in the space can damage or move the permanent tooth bud. A "kiddy denture", like the ones seen in child pageants on television, can be safely worn until the permanent tooth comes in.

Submitted by Dr. Jennifer Satterfield-Siegel of Special Smiles Pediatric Dentistry

Tags: Health, In This Issue

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