Children’s Dentistry FAQ

Here are some of the most frequently asked questions our parents ask about children’s dentistry.

Why are the primary teeth important?

Baby teeth are important to the future dental health of your child for the following reasons:

  1. If your child has poor dental health, they will chew their food improperly, resulting in a poorer diet, poorer general health and poorer school participation.
  1. Healthy teeth and smiles build confidence for our children. When children see that they have cavities in their teeth, they tend to shy away from their friends and become more reserved. Healthy primary teeth help your child feel comfortable about the way they look and will encourage normal development of the jaw bones and muscles.
  1. If your child loses their primary front teeth early, they will struggle to say certain words until their permanent teeth erupt into the mouth. The primary teeth allow good pronunciation and speech habits.
  1. The baby teeth guide the permanent teeth to erupt into the correct position in the dental arch, since the permanent teeth grow under the baby teeth. This way, they are ensuring there is enough room for permanent teeth to erupt. The permanent teeth may be unable to come into the right position if the primary teeth are lost prematurely. The second primary molar is not lost until 12 or 13 years of age.

When should my child be seen by a dentist?

The American Academy of Pediatric Dentistry recommends a child’s first check-up at six months old, or after the eruption of the first tooth. But at Arlington Smile Center, we feel the earlier the better. We encourage you to bring your baby to our office for well-baby checks during the first few weeks of life to learn about correct oral habits, teething problems, feedings habits, and in general, how to prevent cavities and orthodontic issues. It is proven that one out of five children are tongue-tied. If found early, treatment can make a dramatic difference. When we catch the tongue-tie early, among other benefits for the mother and child, treatment eliminates painful latching experiences and unproductive nursing or bottle-feeding schedules for the baby. By beginning as early as possible with early dental visits, we can minimize your child’s dental problems. Also, introducing your child to the dentist when little or no work is needed leads to a much more positive attitude about dentistry for the entire family.

How can I help prevent cavities in my child’s teeth?

First, help your child brush their teeth thoroughly every day, at least twice a day, even if they fight you or resist. The bacteria that grow on the teeth forms a white, creamy material called plaque. Your child may be brushing, but not necessarily be removing the plaque from their teeth. Bacteria use the food on the teeth, especially sugars, to generate acid. This eventually causes a hole or cavity in the tooth, and these cavities generally start between the teeth where you can’t see them until it is too late. You can also prevent dental decay by limiting sweet foods with a meal. The tooth can be made less susceptible to decay through the use of fluoride, which makes the tooth more resistant to decay. In addition, at Arlington Smile Center, we use top-of-the-line fluoride called varnish that has been found to protect the teeth for months past their check-up. Sealants bonded to the chewing surfaces of the back teeth can also prevent decay in these susceptible areas.

My child does not like milk. Will this make their teeth weaker?

No. Calcium is one of the things needed to form good tooth structure. Your child can receive calcium from many other foods such as cheese, almonds and eggs. Milk does have sugar in it. If allowed to remain on the teeth, as in a night bottle, it will act like sugar and cause cavities.

Why does my child need radiographs (X-rays)?

It is our obligation as pediatric dentists to give your child the very best in dental care. In order to accomplish this, we must use X-rays. Most offices today, including ours, utilize digital X-rays, which reduce radiation and eliminate chemical developing. The images allow us to see the condition, size, and eruption path of the permanent teeth under the primary teeth.

When do I begin brushing my child’s teeth, and how much toothpaste can I use?

Begin brushing your child’s teeth at the age of 1 year old. It has been proven that if tooth-brushing begins at this age, the child will suffer less from dental decay. This happens because early tooth-brushing habits can diminish the number of bacteria from the very first stages of development and maintain a low concentration throughout life.

Age 1 to 3: Use a minimal amount of fluoridated toothpaste (the size of a grain of rice) on a children’s toothbrush once a day, during the bedtime brushing session. It doesn’t matter if your child swallows this bit of toothpaste if you have well water or your city does not have fluoride in the water. During the daytime brushing sessions, use non-fluoridated tooth and gum cleanser until your child learns to spit out the toothpaste. Remember not to use fluoridated toothpaste at this age if you live in a fluoridated area.

Age 3 to 6: When your child becomes 3 years old, use a pea-sized amount of toothpaste. For more effective brushing, have your child spit out the toothpaste, but do not make your child rinse his mouth, after brushing.

Age 6 and above: A normal amount of toothpaste should be used provided they can spit it out with ease. The use of toothpaste is necessary due to the beneficial effect of the fluoride on the enamel of the teeth. Before the age of 6 years, encourage your child to avoid rinsing out the remaining toothpaste since the beneficial effect of the toothpaste is increased if the child doesn’t rinse with water after brushing.

What can I do when my child won’t cooperate with tooth-brushing?

  1. Make tooth brushing a positive experience. Try to find ways to make it fun and enjoyable. Be patient and relaxed.
  2. Avoid brushing your child’s teeth when they are tired or hungry. It will be harder for them to cooperate.
  3. Be consistent. Routine is important. Some days will be easier than others, but your children need to know that they will have their teeth brushed every morning and night.
  4. Take turns brushing each other’s teeth. Use your own toothbrush!
  5. Make a game of it. Play “Guess what I see on your teeth!” Use a small hand mirror and a flashlight for fun.
  6. Be sure you can see into your child’s mouth as you brush. Support the chin and neck.
  7. Have your child sit or lie comfortably. Use your lap, the changing table, or wherever it is convenient.
  8. Brush teeth gently but with enough pressure to remove debris. Use a small, soft toothbrush.
  9. Try different flavors of fluoride toothpaste. Find one your child likes.
  10. Allow your child to swallow or spit often during brushing. Children need frequent swallowing breaks so they don’t feel like they are choking.
  11. Be a good role model. Let your child see you brush and floss your teeth daily.
  12. Brush your child’s teeth until they are at least 9 years old. Some researchers suggest until your child is 12 years old may be necessary, depending on his or her manual dexterity, fine motor skills or special needs.

Do you recommend children use electric toothbrushes?

A manual toothbrush is as good as an electric toothbrush when used properly. A nylon bristle toothbrush with a small head and bent handle is very good for your child. You need to change your brush frequently, usually every 3 to 4 months, due to the accumulation of bacteria and damage to the bristles. Do not keep using toothbrushes that are very worn since they do more harm than good (abrasions of the gums, attrition of the teeth, compromised cleaning). If you opt for using an electric brush, make sure it is held steady on each tooth one at a time where the tooth meets the gum.

Do my kids need to use dental floss?

Brushing alone is not enough to remove bacteria, as brushing cleans only three of the five surfaces of the tooth. Use dental floss every night before brushing. It may prevent dental decay between the teeth at the proximal surfaces (picture below). Also, flossing significantly decreases bad breath due to the reduction of bacteria that are trapped between the teeth or the fillings. Waxed dental floss is softer and usually more acceptable to children.

At what frequency do you give fluoride treatment at dental visits?

The frequency of fluoride treatment is usually twice a year, but patients in higher-risk categories may need fluoride treatments more frequently, up to four times a year. Also, orthodontic patients usually need more frequent cleanings and fluoride treatments due to the increased risk for decay or gingivitis during orthodontic treatment. However, if you prefer that your child does not receive fluoride, just let us know at the time of your visit.

What is a stainless-steel crown?

This is a tooth-shaped silver cap that protects a tooth that can no longer hold a typical filling. This crown is cemented into place and comes out when the primary tooth is ready to be lost. When the baby tooth is ready to fall out, the crown usually stays attached to the root of the tooth and all falls out in one piece. We can use tooth-colored material instead of stainless steel crowns, but they don’t seem to have the longevity of stainless steel crowns.

What do I do if a permanent tooth falls out?

The first thing to do would be to find the tooth and put it in milk. Bottled water would be a good second choice. We don’t want the tooth to dry out, so we need to keep it moist. Please DO NOT clean the tooth, just keep it in the milk or water until you can get to our office as soon as possible, ideally within two hours.

My child has one tooth that is turning gray. What does this mean and what do I do?

If you notice your child’s tooth turning gray, take the child to the dentist to check for an infection. Sometimes the tooth is just bruised when it looks gray or purple, and it goes back to normal with time. But often, children have an infected tooth and grayness is the only sign. If a pimple develops above the tooth, it is called a fistula and the child needs to get the baby tooth removed. It is very important to not let the infection remain or it can spread through the bloodstream and lead to a very sick child or even, in extreme cases, death.

What to do for the colicky baby who doesn’t sleep?

You got your tongue tie released and now what ? Your baby is better but it still challenging for them stay asleep and you are exhausted. Mom, I cannot stress this enough! Please make sure You take the time to get “moms” D3 blood levels checked. Dr. Roca would Be happy to give you Rx to check your blood levels and make sure your baby is getting the right amount of D through your breast milk.

You cannot give sufficient D to your baby in your breast milk unless your vitamin D level is over 60. Please go to Dr. Gominak’s website to find out about vitamin D dosing and how to use vitamin safely

Babies who sleep better wake up happy every morning. Babies with a normal vitamin D level sleep 12 to 14 hours. They wake up to nurse and then fall asleep again easily because vitamin D helps the immune system. Babies with normal D levels do not get infections, do not develop allergies or asthma and normally do not need tubes in their ears. A healthier baby is a happier baby.

BOTH mom and child need the vitamin D3 level to be between 60 and 80 to be healthy. Mom will know how baby is feeling by their sleep, reflux and colic symptoms.

BOTH mom and child need the vitamin D3 level to be between 60 and 80 to be healthy. Mom will know how baby is feeling by their sleep, reflux and colic symptoms.

It is truly life changing when you and your baby are sleeping well.

The primary source of the babies microbiome and vitamin D are coming from mom! You never need to use supplements for your baby without watching your babies response to them.

Please note:
For babies to sleep normally and be healthy, they do not need vitamin supplements and supplements can make your baby’s sleep worse.

If your baby does not sleep, has reflux or is colicky, it most likely means your vitamin D levels were low when your baby was born and now the baby does not have the right microbiome in the gut and therefore does not have high enough D blood levels. You can fix this by giving your baby multivitamin drops.

The American Academy of pediatrics recommends baby liquid vitamins for all breast-fed babies. Babies do not need probiotics. Instead, they need 400 IU of D3 plus all 8B vitamins (thiamine, riboflavin, niacin, folate, pyridoxine pantothenic acid, biotin and B12) in a multivitamin.

In addition, your baby will get vitamin D and B through your breastmilk from the multivitamin. Remember, if your D3 level was between 60-80 when your baby was born, the odds are that your baby has all he or she needs. But check your levels if your baby is fussy or not sleeping like other babies.

Again, please do not assume the baby or prenatal vitamins you take has all the 8B vitamins you need. Read the back of the bottle to know if all of the 8B vitamins are present. If you do not have all 8B vitamins, you will not get the right microbiome to grow in your gut or in your babies gut. Keep your eye on the labels since companies tend to change ingredients.
Michael’s Naturopathic Programs Pedialyte infant and toddler liquid multivitamin natural citrus flavor
Rainbow Light nutritional systems NutriStart multivitamin food-based essential infant and toddler nutrition

Trace minerals research children’s liquid multivitamin and mineral citrus plants
I am currently studying children’s airways and children’s sleep disorders with the ASAP Pathway study club and learning ways to do early intervention and prevention for sleep disorders in infants and children.

This is just a sampling of often-asked questions. Have one of your own? Don’t hesitate to give us a call at 703-237-7622 so we can assist you.