Children

Why are baby teeth important? They just fall out anyway.

Baby teeth are important and it is important to look after them for several reasons. Firstly and most importantly baby teeth with cavities can develop into abscessed teeth. This is extremely painful and can cause systemic infection and sepsis. A child in agony is a pitiful sight and infection and swelling in the head and neck area can be life threatening. Secondly, the front teeth are important for proper speech development and the development of self esteem. Thirdly, the baby teeth hold space for the permanent teeth. When there is decay the back teeth shift into the space lost and decrease the total arch length. This causes crowding of the permanent teeth and increases the need for orthodontics, increases the length of orthodontic treatment needed, and therefore increases the cost of orthodontic treatment. Fourthly, the cost of neglect is high. To put it bluntly, floss and toothpaste are cheap. Sugary treats and beverages are unnecessary and should not be a regular part of the diet. Fillings, extractions, root canals, general anesthesia, and hospitalization are very expensive and entirely preventable.

When should young children come to the dentist?

In the past few years there has been a huge increase in dental decay in very young children. Treatment of decay in young children is now the most common reason for day surgery in that age group. There are about 19,000 dental surgeries performed on children in hospitals per year in Canada. This is excluding Quebec and excluding surgeries in private clinics. Since most children are treated in private clinics, the number is actually quite a bit higher. For this reason, CHEO and Sick Kids in Toronto are recommending that young children have their first visit 6 months after the eruption of the first tooth. Thereafter we would see the child once a year until they are 4 years old when we do a formal complete examination and begin introducing procedures like polishing, scaling, radiographs and fluoride treatments.

Why do you take x-rays on children and when?

The contacts between baby teeth are particularly broad and decay can’t be felt with a dental explorer. By the time the cavity can be felt with an explorer on a baby tooth, the decay will likely be very extensive. Bitewing radiographs (x-rays) are the best way to see decay in children. We take bitewing radiographs once the baby molars are touching, if the child is able to cooperate. I try not to take them on the first visit if the child is very young unless there is obvious large decay, as I don’t want to overwhelm the child by doing too much the first time.

How can I prevent decay in my children?

It is simple. Brush your children’s teeth for them, morning and night until Grade 2. In Grade 2 they can take over the mornings, in Grade 3 they can brush on their own. Floss your children’s teeth as soon as they touch, until they are 10. At 10 they can learn to do it. Do not be tempted to let them do it on their own early. They won’t have enough dexterity to do a proper job. Have them drink fluoridated tap water always. Start using fluoride toothpaste at age 6. Restrict access to sticky sweets. Remember that drive fruit is very high in sugar and is sticky!

How should I prepare my child for their dental appointment?

Please eliminate all negative speech when referring to the whole dental experience. This does not help children to cope. Treat going to the dentist like going to the grocery store. You would never say, “Now here is the cart and I’m going to put you in the card and don’t worry the cart won’t hurt you.” You are much more likely to just pick your child up and put them in the cart. You aren’t nervous about grocery store carts and you child picks up on that “vibe”. So before you come to the office, never say things like “It will be OK. The dentist won’t hurt you.” Or, “I want you to be brave”, “I hope you don’t have any cavities because then you would have to get a filling and a needle”.

So what should you say?.. “Well Brenda, we’re off to the dentist for a check up (or a cleaning or a filling)”. Say it with positivity. Don’t add a lot of extraneous detail. If you are nervous, either do your best to not let your nervousness show or get a non-nervous spouse, grandparent or friend to bring the child.

What is the best time of day for a child to have treatment?

Children under 10 and nervous or timid children are best seen early in the day, after having had a good night sleep and a good breakfast. If you child is sick cancel the appointment. We won’t charge you. Once kids are over 10 or have had previous work done without nervousness then they can be appointed at any time.

If you have a nervous child with younger siblings.

Don’t bring the younger siblings with the older nervous sibling if at all possible. They will model on the older nervous sibling and the cycle will repeat itself. You may also want to talk to the older nervous child and ask them not to talk about their fears to the younger child.

What about Sedation?

For nervous children who need treatment there are options. If they need extensive treatment for their age and capability or are very nervous a referral will be made to a pediatric dentist who can provide moderate sedation or general anesthetic (with pediatric anesthesiologist). For children with mild anxiety and a few cavities we have the option of nitrous oxide/oxygen mild sedation here in the office. We also have an ipod and we can download music your child likes to they can listen to music while we work.