Pediatric Dentist

Pediatric Dentist - Dr. Toni Chen's officeDental Topics

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Your Child’s First Visit

According to the American Academy of Pediatric Dentistry, the first dental visit should be 6 months after the eruption of the first tooth, or by the time the child is 1 year old. Although the idea of an early dental visit is still surprising to many parents, the infant visit is endorsed by leading national public health groups.

The first dental visit is focused on learning about your child’s oral health and how to best care for your child’s unique needs. It is about establishing a relationship with your pediatric dentist and having your questions answered. We cover many subjects during your child’s first dental visit, including:

More than 1 out of 4 children in the United States have cavities by the age of 4 years old, sometimes as early as age 2. One of our major initiatives is to educate parents about early childhood cavities and help prevent them. In order to achieve this goal, we strongly believe in parent education during your child’s first dental visit. We discuss your child’s risk of developing cavities and we also educate parents about diet, oral hygiene and the use of fluoride to prevent problems.

The Oral Examination

Your child’s first visit will include an oral examination and a toothbrush demonstration. Some children fuss during this part of the visit, but most infants are very quiet and enjoy the attention and novelty of the first visit.

During the oral examination, Dr. Toni will examine your child’s mouth, in a way that is most comfortable for you and your child. Our staff will demonstrate how to clean your child’s teeth and give you a chance to practice (or this may be done on a dental model if your child is apprehensive).

Teeth Cleaning and Fluoride Treatment

We may also clean your child’s teeth, particularly if your child’s teeth have a stain that commonly occurs in infants. If your child has a higher risk of developing cavities, our doctor or dental assistant may also apply a topical fluoride preparation. This will help inhibit the development of caries (cavities).

Before leaving the office, you should have a clear idea about your child’s development, appropriate home care and your responsibilities. You should also have all your questions answered and have a clear idea about what you and Dr. Toni can do collaboratively to ensure your child has excellent oral health.

Preparing for the First Dental Visit

The best way to prepare for your child’s first dental visit is to consider what you want and need to know, and to think about all your questions beforehand. If possible, ask another adult to come with you to the visit. You want to be free to talk comfortably with Dr. Toni and staff.

In order to focus attention on your child, it is best to not bring other children along for the first visit. You might also bring along a favorite toy, blanket or other familiar object that helps your child know that the dental office is a comfortable and safe place.

To save time and make the first visit easier, our office would be happy to mail you all the office forms you will need. The forms may offer the chance to list questions or concerns you may want to discuss at the visit.

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Behavioral Guidance

We invite parents to stay with their children during the initial examination, as well as any future visits. We look at this as a team approach in overcoming apprehension, gaining your child’s confidence, and providing the safest environment. We find that once we establish a certain comfort level, many children feel comfortable in coming to the treatment area by themselves. We also find on occasion that children do better by themselves if they require treatment. You know your child best, and this may be something to consider. It is our goal to make this a great experience. For the safety and privacy of all patients, other children who are not being treated should remain in the reception room with a supervising adult.

Our dental staff tailors behavior guidance and management techniques based on your child’s level of comfort with us. We use various these techniques to establish positive communication and ensure a happy and comfortable environment.

  1. Tell-show-do: A verbal explanation of the dental procedure on an age appropriate level, followed by a demonstration, after which the procedure is completed.
  2. Nonverbal communication: Reinforcement and guidance of behavior through appropriate physical contact, posture, facial expressions and body language.
  3. Positive reinforcement: Awarding good behavior with verbal praise and rewards.
  4. Distraction: A technique that diverts the child’s attention from what he/she may perceive as unpleasant. It can involve taking breaks throughout a procedure if needed.
  5. Voice control: Moderation of the voice to help direct your child and reinforce appropriate behavior.

Dental Checkups and Cleanings

Dental checkups and cleanings are an essential part of a complete oral health regimen and should be done every 6 months. This includes taking x-rays periodically for diagnostic purposes and a prophy (teeth cleaning) to remove plaque and tartar from the teeth. During this appointment, you can expect Dr. Toni and staff to:

Home Care Recommendations

During the dental cleaning and checkup, we will make specific recommendations about home care. This includes oral hygiene, diet and the use of fluoride toothpaste. Oral health education is also important so that we may discuss specific milestones to expect as your child grows and develops.

Recall/Follow-up Visits

After your child’s first visit, Dr. Toni will suggest a schedule of follow-up visits. In general, pediatric dentists typically recommended follow-up visits every six months. In our office, we recognize that each patient is different and will tailor your child’s recall and x-ray schedule according to his/her individual needs and risks. Depending on your child’s caries risk, he/she may not need x-rays every 6 months.

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Restorative decisions for primary (baby) teeth are driven by different goals and expectations than permanent teeth. The primary teeth are a temporary dentition with known life expectancies for each tooth. By matching the “right” restoration with the expected lifespan of each tooth, we succeed in providing a permanent restoration that will never have to be replaced. We use only the best dental products and restoration materials, to ensure that your child’s restorations will last. For this reason, we offer tooth-colored fillings (composite fillings) that are free of mercury.

White Fillings

There are several different types of dental materials available for use in dental offices today. With the advent of newer and better dental materials, we are fortunate to be able to provide tooth-colored or white fillings as an alternative to amalgam (silver) fillings. White fillings are composed of a material called composite that bond to the tooth, making it stronger and less likely to fracture.

Amalgam Fillings (Silver Fillings)

Amalgam fillings have a long history of use in dentistry for restorative purposes. Amalgam is a mercury and silver alloy, which is a mixture of different metals, with mercury comprising a small percentage of the material.

Amalgam Fillings and Aesthetics
One of the drawbacks to amalgam fillings is aesthetics. Cosmetically, amalgam can be unsightly, especially when placed on teeth near the front part of the mouth. The inherent property of the material also requires the dentist to remove more healthy tooth structure in order to hold the filling in place.

Mercury Toxicity Concern
There is the ongoing concern about the mercury in amalgam and exposure to the material for dentists, patients and it’s impact to the environment. Current scientific information continues to support the use of amalgam as a restorative material; however, due to the reasons listed above, our office has chosen to use only tooth-colored or white fillings. Please do not hesitate to ask us about the inherent differences between composite or amalgam fillings, or the restorative properties of either material.

Stainless Steel Crowns

Stainless steel crowns are the most common crowns used by pediatric dentists to restore primary (baby) teeth. They are customized to fit your child’s tooth and are extremely durable and easy to place. Your child may need a stainless steel crown if:

Pulp Therapy

The pulp of a tooth is the inner, central core of the tooth. The pulp contains nerves, blood vessels, connective tissue and reparative cells. The purpose of pulp therapy in pediatric dentistry is to save a decayed or infected tooth that might otherwise need to be extracted. Dental caries (cavities) and traumatic injury are the main reasons for a tooth to require pulp therapy. Pulp therapy is often referred to as a nerve treatment, a “baby” root canal, or pulpotomy.

Baby Root Canals and Stainless Steel Crowns
After pulp therapy, the baby tooth will still be functional, but weak and prone to fractures. To protect it from further injury, the tooth will require a full coverage stainless steel crown for maximum protection. The restored tooth along with the stainless steel crown will eventually be replaced by the permanent tooth.


Pediatric dentists perform extractions for numerous reasons, including:

If your child needs an extraction, we take great care to make the appointment as painless as possible. We use topical anesthetic cream and then numb the area with The Wand™ anesthetic machine. During the extraction, your child should feel a little bit of pressure as the tooth is gently lifted out of the socket. It is normal to experience a small amount of bleeding afterward, and biting down firmly on a square gauze usually stops the bleeding. Rest assured that our staff members will go over post-care instructions in detail. For apprehensive children who require extensive treatment, we offer Nitrous Oxide, Oral Sedation and IV Sedation.

Space Maintainers

Space maintainer - Dr. Toni ChenSpacers or space maintainers are either removable or fixed passive appliances meant to maintain the space of a primary or baby tooth. There are occasions when primary teeth are lost prematurely, before the permanent tooth can emerge. Reasons include overcrowding, decay, an abscess, infection or physical trauma. In these instances, a spacer is put in place to prevent the drifting or shifting of teeth.

If your child loses a tooth prematurely or needs an extraction due to overcrowding, Dr. Toni will go over optimal treatment for your child and create a tailored treatment plan. This may or may not include a space maintainer or a referral to an Orthodontist. Below are some examples of space maintainers and what they look like:

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Sedation Dentistry and Behavioral Management

Providing a safe and enjoyable environment for both you and your child is our utmost concern. For this reason, we offer sedation dentistry as a helpful service to children and young adults that have a high level of anxiety during dental procedures. Sedation medication increases patient cooperation and allows dental treatment to be completed.

Your child is carefully monitored and we use only the minimum amount of sedation medication to safely complete dental care. Sedation medication may be taken orally (Oral Sedation), inhaled through the nose and mouth (Nitrous Oxide) or delivered intravenously (IV Sedation). Our office offers several options for sedation, which may vary according to your child’s age, anxiety level and dental work required. These options can be thoroughly explored during your child’s first visit, or any subsequent appointment.

Nitrous Oxide

Nitrous Oxide is a very safe and effective way to reduce your child’s mild anxiety and establish good communication. Inhalation sedation is actually a combination of nitrous oxide and oxygen. The onset is rapid, reaching the brain in 20 seconds; the relaxing effects are felt within a few minutes. (Read More) The amount of sedation can be adjusted throughout the procedure to customize the experience for every child through the nitrous mask, which is often scented with flavors like vanilla or cherry. Nitrous oxide is especially useful in cases where a child has a sensitive gag reflex. The most common adverse effects are nausea and vomiting, which occur when the nitrous level is too high. We carefully monitor nitrous oxide levels, and lift the mask when necessary to immediately stop the intake of gas.

Oral Sedation

Oral sedation is reserved for children that cannot have dental work completed in a more traditional method and do not require a great deal of treatment. Our office uses oral sedation fairly sparingly as there are more restrictions with oral sedation. The goals of oral sedation are to control behavior and movement, minimize discomfort and psychological trauma, while maximizing the amnesia effect.

Treatment with oral sedation usually is in the form of a liquid or may be a combination of medication. It is typically taken before the dental appointment (at the office), and the effects may last for several hours. Oral sedation is oftentimes called ‘conscious sedation’ because your child will be awake and conscious, but also relaxed and drowsy. Please ask our office about any special instructions before sedation, such as no drinks or food prior to treatment.

IV Sedation

First and foremost, our primary goal is to maintain your child’s safety at all times. IV sedation is administered by a highly trained and certified dentist anesthesiologist whose sole responsibility is to ensure the safety of your child during the dental procedure. Sedation medications administered by intravenous route (IV) travel directly into the bloodstream and take effect within minutes. We use a medical monitoring device to monitor respiration, blood pressure and heart rate.

IV sedation produces a feeling of peace and well being, eliminates anxiety and apprehension, while encouraging a gentle amnesia. Children and young adults oftentimes benefit from this type of sedation. Common situations include:

Protective Stabilization

Protective stabilization in used cases where it is necessary to protect the child, parent, family member, staff or dental practitioner from injury during a dental appointment. In the event of an unexpected reaction to dental treatment, protective stabilization can:

  1. Restrict or eliminate physical movement
  2. Protect patient and others from harm
  3. Enable the staff to perform necessary dental treatments

Stabilization units are routinely used in emergency rooms and we offer this option to parents with a signed informed consent and an explanation to the child regarding the need for restraint. We also encourage parents to consider all options for an uncooperative child, including sedation, behavior guidance techniques and lifestyle changes (nutrition, exercise and sleep patterns).

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Pediatric Dental Emergencies

Our office provides emergency dental care for all of our patients during regular business hours (8am – 5pm). We also provide after hour services via a paging system for our patients 24 hours a day, 7 days a week.

If your child suffers a dental emergency during normal business hours, please immediately contact our office. After Dr. Toni examines your child, we will either provide specific recommendations or schedule an appointment, depending upon the nature of the emergency. We strive to offer timely appointments for every patient, including dental emergencies, and appreciate your understanding and flexibility with scheduling.

If your child suffers a dental emergency after normal business hours, the doctor or another staff member is on call 24 hours a day. In the event of an emergency, please call our office and leave a detailed message with our voice messaging system. This should trigger our office’s emergency paging system, and a staff member will contact you promptly. Please have the telephone number of your local pharmacy handy, in case our office prescribes medication.

Common Dental Emergencies

  1. Toothache: Rinse the mouth thoroughly with warm water and brush the area surrounding the tooth to decrease irritation from plaque build-up. If pain persists or swelling is evident, apply cold compresses and contact our office immediately.
  2. Cut on the Tongue, Lip or Cheek: Apply ice to injured areas to help control the swelling. If there is bleeding, apply firm but gentle pressure with a gauze or cloth. If bleeding cannot be controlled by simple pressure or if you have concerns about the laceration, visit the hospital emergency room.
  3. Chipped or Fractured Tooth: Contact us during business hours for a chipped or fractured baby tooth. Depending on the extent of trauma, the patient may or may not need to be seen the same day. For a permanent tooth, rinse the mouth with water and apply cold compresses to reduce swelling. If possible, locate and save any broken tooth fragments and then call our office. Wrap the fragments in a moistened paper towel and bring them with you so that we can decide if they can be reattached. For more serious injuries such as avulsed (knocked out) permanent teeth, please contact our office (626) 656-8680 immediately for treatment recommendations. Do not handle the permanent avulsed tooth by the root if possible.

Preventing Dental Emergencies

It is difficult to prevent injuries with children, but there are a few things that you can do to help reduce the risks:

Post-Operative Care

Care of the Mouth After Local Anesthetic

Care of the Mouth After Trauma

Care of the Mouth After Extractions

Bleeding – Some bleeding is to be expected. If unusual or sustained bleeding occurs, place cotton gauze firmly over the extraction area and bite down or hold in place for fifteen minutes. This can also be accomplished with a tea bag. Repeat if necessary.

Pain – For discomfort use Children’s Tylenol, Advil, or Motrin as directed for the age of the child. If a medication was prescribed, then follow the directions on the bottle.

Care of Sealants

By applying a thin covering over the pits and fissures, sealants keep out plaque and food, thus decreasing the risk of decay. Since, the covering is only over the biting surface of the tooth, areas on the side and between teeth cannot be coated with the sealant. Good oral hygiene and nutrition are still very important in preventing decay next to these sealants or in areas unable to be covered.

Your child should refrain from eating ice or hard candy, which tend to fracture the sealant. Regular dental appointments are recommended in order for your child’s dentist to be certain the sealants remain in place.

The American Dental Association recognizes that sealants can play an important role in the prevention of tooth decay. When properly applied and maintained, they can successfully protect the chewing surfaces of your child’s teeth. A total prevention program includes regular visits to the dentist, the use of fluoride, daily brushing and flossing, and limiting the number of times sugar-rich foods are eaten. If these measures are followed and sealants are used on the child’s teeth, the risk of decay can be reduced or may even be eliminated!

Oral Discomfort After a Cleaning

A thorough cleaning unavoidably produces some bleeding and swelling and may cause some tenderness or discomfort. This is not due to a “rough cleaning” but, to tender and inflamed gums from insufficient oral hygiene. We recommend the following for 2-3 days after cleaning was performed:

  1. A warm salt water rinse 2-3 times per day. (1 teaspoon of salt in 1 cup of warm water)
  2. For discomfort use Children’s Tylenol, Advil or Motrin as directed by the age of the child.

Please do not hesitate to contact the office if the discomfort persists for more than 7 days or if there are any questions.

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Common Problems

Baby Bottle Caries

Baby bottle or early childhood caries is a serious form of decay among young children. This condition is caused by prolonged contact between teeth and liquids containing high amounts of sugar. These include breast milk, cow’s milk, soy milk, rice milk, formula, fruit juice and other sweetened drinks. The sugar in these liquids feeds bacteria in the mouth, producing acids that attack tooth enamel. Feeding a child a bottle at night gives bacteria ample time to produce acids, leading to rampant tooth decay.

If you must feed your child a bottle at night, it should ideally contain only water. All other feeding times should end with a gentle wiping of your baby’s gums. If teeth are present, they should be brushed with a soft bristle toothbrush. The easiest way to do this is to sit down, place the child’s head in your lap or lay the child on a dressing table or the floor. Whatever position you use, be sure you can see into the child’s mouth easily.

Mothers and Early Childhood Caries
Mothers with untreated dental disease can pass it along to their children. Modifying the mother’s oral hygiene at the time the infant is most susceptible (6-30 months) can have a major impact on the child’s dental decay rate. Improving home care, diet, and including the use of topical fluoride are good ways to decrease the risk of passing the bacteria to your infant.

Sippy Cups
Sippy cups should be used as a training tool from the bottle to a cup and should be discontinued by the first birthday. If your child uses a sippy cup throughout the day, fill the sippy cup with water only (except at mealtimes). By filling the sippy cup with liquids that contain sugar (including milk, fruit juice, sports drinks, etc.) and allowing a child to drink from it throughout the day, it soaks the child’s teeth in a sugary solution that promotes early chilhood decay.


Thumb or Finger Sucking
Sucking is a natural reflex for infants and young children. The action is soothing and relaxing, inducing feelings of happiness and security. Usually, children stop the habit between the ages of two and four, often due to peer pressure at school.

Children should cease thumb sucking by the time their permanent front teeth are ready to erupt because it can cause problems with tooth alignment and development.

To help children get through thumb sucking, try to praise them when they are not doing it instead of scolding when they are. Children often suck their thumbs when feeling insecure, so focus on correcting the cause of anxiety instead of the thumb sucking.

Pacifiers can affect the teeth essentially the same way as sucking a thumb or finger, but a pacifier habit can be controlled and modified more easily than the thumb or finger habit. When using a pacifier:

If you have concerns about thumb sucking or use of a pacifier, please ask Dr. Toni.

Parents are often concerned about the nocturnal grinding of teeth (bruxism). The first indication is usually noise from grinding the teeth together during sleep. Psychological factors such as stress due to a new environment, or changes at school can influence your child to start the habit. Most children outgrow bruxism naturally; grinding decreases between the ages of 6 and 9 and tends to stop before the age of 12. If you suspect your child has a bruxism habit, please discuss this with us during your next dental visit.

Treatment for Bruxism
The majority of cases of pediatric bruxism do not require any treatment. If excessive wear of the teeth (attrition) is present, we may prescribe a mouth guard or night guard to protect permanent teeth.

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Pediatric Dentistry

Why should my child see a pediatric dentist instead of a general dentist?

Upon graduation from dental school, dentists have some experience working with children, but general dentists are less familiar treating infants and toddlers. A Pediatric dentist has had additional training in the field of pediatric dentistry and has acquired extensive knowledge in child growth and development, child psychology, and pharmacological and behavioral management techniques.

For younger children, behavioral management techniques are critical in overcoming the fear of seeing a dentist. For older children and teens, the pediatric dentist identifies early signs of teeth crowding and monitors facial growth. A children’s dentist also screens for anomalies in dental development such as missing or extra teeth, and identifies predisposing factors to common problems like TMJ. It may appear that a simple dental exam is the same for all dental practitioners, but the pediatric dentist evaluates specific details far beyond simply checking for cavities.

Development and Growth

When do my child’s teeth start to form?

Children’s teeth begin forming before birth. Halfway through pregnancy, cells begin to form the hard structures of primary teeth. As early as 3 months, the first primary (baby) teeth begin to erupt through the gums. The lower central incisors usually come in first, followed closely by the upper central incisors. Although all 20 primary teeth usually appear by age 3, the pace and order of eruption varies.

Permanent teeth begin appearing around age 6, starting with the first molars and lower central incisors. This process continues until approximately age 21 for the third molars or wisdom teeth. Adults have 28 permanent teeth, or up to 32 including the wisdom teeth.

When will my baby start getting teeth?

Teething, the process of baby (primary) teeth coming through the gums into the mouth, is variable among individual babies. Some babies get their teeth early and some get them late. In general, the first baby teeth to appear are usually the lower front (anterior) teeth and they usually begin erupting between the age of 6-8 months.

See “Eruption of Your Child’s Teeth” for more details.

How can I make teething more comfortable for my baby?

Tooth eruption or “teething” starts at any time between the age of 4 months up to 36 months, and can be painful at times for your infant. To make your child more comfortable during teething:

Why are baby teeth important?

It is very important to maintain the health of primary or baby teeth. Untreated decay can lead to pain, abscess, infection, facial swelling and may cause problems for permanent teeth. Primary teeth are important for:

Many parents are under the misconception that dental care for baby teeth are less important because they will eventually be replaced by permanent teeth. While the front 4 baby teeth are typically replaced by the age of 6 or 7, the back teeth (cuspids and molars) are not typically replaced until ages 10-13. This is why our office places such a strong emphasis on preventative care. For the reasons listed above, children need healthy baby teeth for optimal dental development.

Will my child need fillings even though the cavities are on baby teeth?

This is one of the most common questions asked, and the answer depends on the tooth in question and how much longer we expect your child to have that tooth. If your child is 12 years old and we expect that particular tooth to fall out within 6 months, then restoring that particular baby tooth may not be necessary. However, if the cavity is if found on a tooth that normally will not exfoliate (fall out) until age 12, and your child is currently 3 years old, then restoring the tooth would be the treatment of choice. Without the proper dental treatment, the cavity may cause pain, infection, facial swelling, bone loss, disturbance to the development of the permanent tooth, and eventual loss of the baby tooth. Please consult your dental professional in regard to the specific dental treatment that is necessary for your child. The answer above should not be used as a substitution for seeking dental care.

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Oral Hygiene and Dental Care

When should I start to brush my child’s teeth?

Tooth brushing should begin as soon as the primary (baby) teeth erupt in the mouth. Dental wipes maybe helpful, but the bristles from the toothbrush will help you clean crevices and grooves that a dental wipe will not be able to reach. Try finding a soft bristled toothbrush that has a long handle so it is easier for the parents to hold.

Care Of Your Child’s Teeth

How often should my child brush his/her teeth?

Brushing should be done twice a day: once in the morning and once in the evening right before bed. If the patient drinks anything other than water before going to bed, then you must brush and floss your child’s teeth again!

What is the best toothpaste for children?

Tooth brushing is one of the most important aspects of good oral health. Many toothpastes, and/or tooth polishes, however, can damage young smiles. They contain harsh abrasives, which can wear away young tooth enamel. When looking for toothpaste for your child, pick one that is recommended by the American Dental Association, as shown on the box. These toothpastes have undergone testing to ensure they are safe for children of all ages.

What if my child swallows toothpaste?

Children should spit out toothpaste after brushing to avoid ingesting excess amounts of fluoride. If too much fluoride is ingested, a condition known as fluorosis can occur. Fluorosis causes discoloration ranging from white specks or streaks to mottled brown stains. The discoloration will not be visible until the permanent teeth erupt.

If your child is under the age of 2, consider buying a fluoride-free brand. There may be some situations where a form of fluoride should be introduced before age 2, usually in children at high risk for caries (decay). This something that should be discussed with Dr. Toni.

Cavity Formation and Prevention

How do cavities (caries) form?

Cavities are caused by bacteria in the mouth. These bacteria are living organisms that use sugars (glucose, sucrose, fructose, lactose, or cooked starches) as a food source. The digestion of these sugars creates acids that cause the breakdown of tooth enamel and dentin. This is a gradual process that can be avoided with good oral hygiene, regular dental visits and proper homecare.

How does diet affect cavity formation?

Sugar produces a marked increase in caries activity. By avoiding sticky foods such as gummy candy, fruit roll-ups, and dried fruit, you can decrease your child’s likelihood of developing cavities on the chewing surface. Sugary drinks such as Gatorade, soda and even natural organic juices can cause cavities in between the teeth. In fact, the American Academy of Pediatrics recommends only 4-6 oz of fruit juice a day for your child.

My child does not eat a lot of candy or sweets, do I still have to worry about cavities?

Anything we eat or drink can cause cavities if the teeth are not cleaned and cared for properly, with the exception of pure water. Refined carbohydrates such as bread, pasta and crackers are all broken down into simple sugars that can be metabolized by bacteria.

Acidic foods such as lemons, pickles, ketchup, sour candies, sodas, etc. can also demineralize your child’s teeth and wear away the enamel.

How do I prevent cavity formation?

Intelligent snacking, brushing teeth after meals, and flossing daily can decrease the likelihood of developing cavities. Intelligent snacking is about knowing which foods to eat, and which to avoid.

Snack foods to avoid:

Safe snack foods that do not promote decay:

How do sealants help in preventing cavities?

A sealant is a protective coating that is applied to the chewing surfaces (grooves) of the back teeth (premolars and molars), where four out of five cavities in children are found. This sealant acts as a barrier to food, plaque and acid, thus protecting the decay-prone areas of the teeth.

Before Sealant Applied

After Sealant Applied

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How does fluoride help my child's teeth?

Fluoride is a mineral that is found naturally in drinking water and some foods. It has long been known to combat tooth decay through the remineralization of tooth enamel. Tooth enamel incorporates fluoride while teeth are forming and after they have erupted, making teeth less susceptible to decay. The most natural way to add fluoride to a diet is to simply drink water with the correct fluoride content.

Does my child need Fluoride Treatment?

If your child is not receiving enough fluoride, Dr. Toni can make the appropriate recommendations. Bottled water containing fluoride is an option, as are fluoride rinses and fluoride toothpastes, provided your child is over the age of 6 and can fully expectorate when asked to do so.

Teens & Preteens

Does my teen or preteen still need to see a pediatric dentist?

Pediatric dentists are trained to evaluate and diagnose skeletal and dental problems that may arise during mixed dentition years, when your child has both primary and permanent teeth. Typical problems may include jaw protrusion or deficiency, spacing or crowding issues, impacted teeth and supernumerary (extra) or missing teeth. Monitoring these changes is an important part of pediatric dentistry, which is why children often continue to come to our office through adolescence.

When is the best time for orthodontic treatment?

Pediatric dentists can recognize malocclusions as early as 2-3 years of age. We believe in taking early steps to reduce the need for major orthodontic treatment at a later age. By recognizing and diagnosing dental problems early on, Dr. Toni can make the appropriate referral to an orthodontist.

Stage I – Early Treatment: during the early years 2-6, we are concerned with underdeveloped dental arches, the premature loss of primary teeth, and harmful habits such as finger or thumb sucking.

Stage II – Mixed Dentition: from ages 6 to 12, treatment concerns deal with jaw and dental realignment problems. This is an excellent stage to start treatment, beginning with the eruption of the permanent incisor (front) teeth and 6 year molars. Early referral to an orthodontist may be appropriate, as hard and soft tissues are very responsive to orthodontic or orthopedic forces during this phase.

Stage III – Adolescent Dentition: this stage deals with the permanent teeth and the development of the final bite and jaw alignment.

Tongue piercing and is it really cool?

You might not be surprised anymore to see people with pierced tongues,lips or cheeks, but you might be surprised to know just how dangerous these piercings can be.

There are many risks involved with oral piercings, including chipped or cracked teeth, blood clots, blood poisoning, heart infections, brain abscess, nerve disorders (trigeminal neuralgia), receding gums or scar tissue. Your mouth contains millions of bacteria, and infection is a common complication of oral piercing. When infected, your tongue could swell large enough to close off your airway!

Common symptoms after piercing include pain, swelling,infection, an increased flow of saliva and injuries to gum tissue. Difficult-to-control bleeding or nerve damage can result if a blood vessel or nerve bundle is in the path of the needle.

So follow the advice of the American Dental Association and give your mouth a break – skip the mouth jewelry.

Does my child need a mouthguard?

When a child begins to participate in recreational activities and organized sports, injuries can occur. A properly fitted mouth guard, or mouth protector, is an important piece of athletic gear that can help protect your child’s smile, and should be used during any activity that could result in a blow to the face or mouth.

Mouthguards help prevent broken teeth, and injuries to the lips, tongue, face or jaw. A properly fitted mouth guard will stay in place while your child is wearing it, making it easy for them to talk and breathe.

Ask your pediatric dentist about custom and store-bought mouth protectors.

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