Enchanted Forest Pediatric Dentistry

One of the questions that parents ask during their visits to Enchanted Forest has to do with the use of fluoride toothpaste.  Ingestion of toothpaste with fluoride in small children increases the risk of enamel fluorosis.  Don’t panic, enamel fluorosis in only a cosmetic problem which causes discoloration of permanent teeth once they come in (see photo).

Here is some general guidance to minimize fluoride ingestion:

•  Limit the amount of toothpaste placed on the brush and observe the child as they brush.

• The American Academy of Pediatric Dentistry recommends a “pea-sized” amount for children ages 2 to 5.

• • When deciding whether to use fluoridated toothpaste on children younger than 2 years of age, consider these factors.

–   The child’s risk of dental caries
–   The child’s risk of dental fluorosis
–   The benefit of the topical fluoride exposure via use of fluoridated toothpaste

• A 2007 Maternal and Child Health Bureau expert panel recommended that all children at high risk for dental caries should use fluoride toothpaste.

Please remember this is general, if you have additional or more in depth questions about topic please call Dr. Rojas or ask her during your child’s next appointment.

Many people require regular X-rays to keep track of their oral health. How often should X-rays be done on my child?

The answer depends on your child’s medical and dental history and the current condition of his/her mouth.  Some kids may need X-rays as often as every six months while others who visit the dentist regularly and have excellent oral health may need them less often.
The American Dental Association and the U.S. Food and Drug Administration suggest that children and teens who have a history of many cavities may need X-rays every six months or every year, depending on age.  So may those who have a high risk of decay for other reasons.  X-rays also help to keep track of tooth development.

Enchanted Forest Pediatric Dentistry utilizes the latest X-Ray equipment that minimizes radiation and thus any potential issues.   As a comparison, 4-bitewing X-Rays (usual number taken) has an equivalent amount of radiation to 0.6 days of natural background radiation (Radiation from our environment including outer space, the ground, building materials, air, and water) while a panoramic X-Ray image is equivalent to 3 days of natural background radiation.

Dental appliances have a strange name but they serve very important roles in your a child’s dental health: to prevent or to treat.

Some examples include:
–  Space Maintainers (both fixed and removable)
–  Thumb Sucking Appliances
–  Expansion Appliances

Pediatric dental appliances can also prevent injury to the teeth and may also reduce (or even eliminate) the need for extensive treatment later in life.  Despite all the pluses, it can be extremely difficult to encourage young children to wear removable dental appliances regularly.

Sometimes the cement (glue) that keeps your little one’s appliance in place can wear off or get lose causing discomfort and potentially embed itself into the gum tissue.  One of the first signs of trouble with an appliance is the gum turning white in ares where the appliance is secured.  It is entirely common for this to occur, don’t get alarmed, it is an easy fix if done promptly by someone with experience.    Dr. Rojas is always available to discuss appliances or to get them re-cemented or fixed if necessary.

Bad breath is often something that adults are aware of, but did you know that children can have halitosis, too? We think of children as having sweet smelling breath, but sometimes even toddlers can have smelly breath.

The bacteria that causes halitosis lives on oral debris and the dental plaque on teeth. The bacteria feeds on sulfur-containing substrates, producing hydrogen sulfide in the process. It is this sulfide that gives off a rotten egg smell. The main odor causing sites in the mouth are the back of the tongue, the areas between the teeth and under the gum line.

The most common cause of halitosis in children is poor dental hygiene and plaque buildup. Missed brushings leave the mouth primed for bacteria in the mouth to multiply, thus causing oral odor.  Flavored floss and a rotary toothbrush can make brushing more fun and effective for kids.  Teach your child to brush their tongue as well as their teeth. Do not give young children mouthwash or fluoride toothpastes or rinses, which can be harmful when swallowed, and avoid breath mints which usually contain sugar and encourage bacterial growth.

Always keep in mind that it is possible for bad breath to be caused by an illness. If your child has an infection or congestion in the sinuses or nasal cavities, the post nasal drip can lead to bad breath.  If your child has stuck something up his nose, that can lead to an infection which causes bad breath as well as a smelly discharge and odor emanating from the nose. Tonsillitis can cause bad breath in children, especially if food gets caught in the crevices of the tonsils.

Don’t let bad breath go for more than a couple of weeks without knowing the cause. Visit your pediatric dentist to figure it out.

Don’t panic if your child opens his mouth and you see a second row of teeth!!  This happens when the lower baby teeth haven’t fallen out yet but the permanent teeth come out anyway. It not that uncommon for this to happen, it actually happened to my husband many, many years ago!!

Typically,  erupting permanent teeth (one or several) push against the roots of a baby teeth and displace them, eventually forcing them to become loose and fall out. However, sometimes things don’t go as planned and the baby teeth don’t want to leave so the adult teeth continue to push up through the gums and try to assume their place behind the baby teeth.

Most of he time, an ectopic eruption will resolve on its own. The baby teeth will eventually fall out and the tongue will push the permanent teeth into proper position.

Dr. Rojas encourages children with loose teeth that are not causing discomfort to have the satisfaction of wiggling them out on their own.  If the baby teeth are held in solidly, or causing discomfort or it has been longer than a couple of weeks without change, I recommend helping those teeth come out.

Dr. Rojas suggests flossing as soon as any two of your child’s teeth touch each other.  Once a child’s teeth start to fit closely together, usually between the ages of two and six, parents should start to get their children in the habit of flossing daily.  As they develop dexterity, you can help them learn to floss.  Dr. Rojas suggests that you allow your child to floss his/her own teeth when their handwriting is clear and legible (watch out for those doctors to be!!).

Flossing removes food from between the teeth where a toothbrush can’t reach.  To stress the importance of flossing, do it for them regularly until they’re able to do it themselves.  This will help them develop a good habit of flossing while they still have their baby teeth so that when their permanent teeth come in, they already have flossing worked into their daily oral routine.

Use floss that is soft and flexible so that it doesn’t hurt their teeth and is comfortable on their gums. Dr. Rojas  is OK with children using floss holders but only for their front teeth.

Parents should continue to help the child floss his/her molars as the the string in floss holders is usually thicker and harder to use which could discourage the child from continued flossing.

A water flosser (e.i., Waterpik^®) for kids may also be used but only after age 6.  These water-based flossers are perfect for any kid who has braces or has trouble flossing.

Don’t worry if your child’s gums bleed at first—this is quite common.  After a few days of flossing, the bleeding should stop as their gums become healthier. But if the bleeding persists, consult your dentist.

The end of February is almost here and you have not made an appointment to visit us at Enchanted Forest Pediatric Dentistry?

Don’t worry, it is not the end of the world!! The goal of National Children’s Dental Health Month is to help kids develop good dental hygiene habits at an early age…. we always do that during your child’s regular dental visits.

If the reason for not coming to visit us (in February or ever) is because your child is scared, that is totally normal. Visiting the dentist, specially one that is not used to children, can be scary.

To keep your children from getting anxious, remember these tips:

• Visit a pediatric dentist (pedodontist)  like Dr. Rojas. These specialists have had extra training to work with children.

• Don’t show your anxiety if you’re scared of the dentist yourself. Children will pick up on it and copy your behavior.

• Take them to the dentist regularly – once every 6 months. Children who only go to the dentist when there’s a problem will quickly start to associate being there with getting bad news about their teeth. Plus, frequent check-ups are the best way to catch problems before they become painful or need further treatment.

• Talk to your children. Once you know where the fears lie,they can be easier to deal with.

• You already know that a tired child can be a difficult child. See if you can schedule an appointment for the morning. 

Sugar has long been identified by oral health experts as a major cause of tooth decay and cavities in children. Parents might be surprised to learn that when it comes to causing cavities, not all candy is created equal.

“Cavities and tooth decay are caused by prolonged exposure to sugar, among other fators” says Dr. Rojas.
“Parents can help their kids fight cavities by decreasing the amount of time sugar comes in contact with their teeth, as well as limiting the amount of candy they consume.”

The way it works is simple, naturally occurring bacteria in the mouth feed on sugar in candy and other foods and turn it into acid. This acid attacks tooth enamel and causes decay.

Sticky or chewy candies result in sugar being in contact with teeth for longer periods of time. When children chew sticky candies such as caramels or taffy, candy gets stuck on the surface and in between crevices. The longer the sugar is stuck to the teeth, the more time the bacteria have to feed on the candy and produce acid.  The more acid is produced and the longer the amount of time the teeth are exposed to it, the more chance your child has of developing cavities.

Valentine’s Day is a great time for parents to think about their children’s teeth, but oral health should be a year-round concern. Regularly encourage good oral health habits with your children, including flossing daily, brushing at least twice a day and visiting the dentist regularly.

Following the following tips by the American Dental Association will help your children grow up to have strong, healthy teeth:

• Begin cleaning your baby’s mouth during the first few days after birth. Wipe the baby’s gums after every feeding with a damp washcloth or gauze pad to remove plaque.
• Never allow an infant to nurse continuously from a bottle of milk, formula, sugar water or fruit juice during naps or at night.
• Allow your child to chew only sugarless gum.  Avoid lollipops and other sticky candy.
• Parents need to brush and floss their child’s teeth as soon as they come in. Children can learn to do this for themselves at about age 7.
• Never dip a child’s pacifier in any sweet liquids.
• If your local water supply does not contain fluoride, ask your dentist how your child should get it.

Dental health is everyone’s job!!   Remember, an ounce of prevention is worth a pound of cure or as Dr. Rojas would say “mas vale prevenir que lamentar”
Dr. Rojas and her awesome staff are always available to answer any questions.