Spencer & Spencer Pediatric Dentistry

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Dental Topics

General Topics

What is a Pediatric Dentist?

A Pediatric Dentist completes two additional years of training after completing dental school. These years are spent in a post-doctoral graduate residency program learning how to address and manage the unique challenges associated with treating infants, children, and adolescents. Some of which include early childhood development, child psychology, growth and development, and behavioral management.

Why Are The Primary Teeth Important?

Baby teeth are temporary; however, if a baby tooth is lost too soon (either from an accident or decay), it can lead to other teeth crowding the vacant spot. This can cause alignment issues when the permanent tooth begins to emerge and could cause crooked teeth and biting problems. Baby teeth are important to help with chewing and eating leading to proper nutrition. Finally, teeth play an important role in developing self-confidence and self-esteem, even in young children.

Eruption Of Your Child's Teeth

Your child’s first tooth will typically erupt between 6 and 12 months, although it is common to occur earlier. Usually, the two bottom front teeth – the central incisors – erupt first, followed by four upper front teeth – called the central and lateral incisors. Your child should have their first full set of teeth by their third birthday.

Permanent teeth start to  appear around age 6, beginning with the first molars and lower central incisors. The age of 8, is generally when the bottom 4 primary teeth (the lower central and lateral incisors) and the top 4 primary teeth (the upper central and lateral incisors) begin to fall out  and permanent teeth take their place. The rest of the permanent teeth will start to come in around age 10. Permanent teeth can continue to erupt until approximately age 21. Adults have 32 permanent teeth including the third molars (called wisdom teeth). 

children dental chart

Dental Emergencies

Toothache: If your child has a toothache, then have them rinse their mouth with warm water to ease the pain. If the pain persists for more than 24 hours, contact your pediatric dentist. Persistent toothaches can indicate more serious problems that need to be observed by a dental professional.

Cut or Bitten Tongue, Lip or Cheek:

If your child experiences a cut on their tongue, cheek, or lip, bleeding can usually be stopped by applying clean gauze to the affected area. You can also apply ice to the area to help stop the bleeding. If you cannot stop the bleeding, call your pediatric dentist or visit the emergency room. If your child has an open oral wound, for a long period they can be susceptible to infection.

Knocked Out Permanent Tooth: If your child fractures a tooth, then gather any fragments you can find and store them in a clean container of milk, or saliva of the child that lost the tooth. Never use water to transport a broken or knocked-out tooth. You must visit the dentist immediately to prevent infection and other complications that are brought on by chipped or knocked-out teeth. If the tooth is knocked out, only touch the crown of the tooth and not the root. Your pediatric dentist will be able to repair your child’s tooth or fix it with a crown.

Dental Radiographs (X-Rays)

X-rays are valuable aids to help dentists diagnose and treat conditions that cannot be visibly seen. X-Rays can detect much more than cavities. X-Rays can show erupting teeth, diagnose bone diseases, measure the damage of an injury, or help with the planning of pediatric treatment. If dental problems are found and treated early, dental care is more comfortable for your child and more affordable for you.


Dental X-Rays are very safe and the amount of radiation from dental X-Rays is very small. Today’s equipment filters out unnecessary X-rays and restricts the X-ray beam to the area of interest. Dental X-Rays are designed to limit the body’s exposure. Pediatric dentists are very careful to minimize the exposure of their patients to radiation. In fact, dental radiographs represent a far smaller risk than an undetected and untreated dental problem.

What's The Best Toothpaste For My Child?

Once your child has a few more baby teeth – usually between 8 and 12 months – then you can graduate from a washcloth to a toothbrush designed for toddlers. There are a lot of toothbrushes designed for babies and toddlers from which to choose. Generally speaking, toothbrushes designed for babies have much softer bristles and a smaller head than those meant for older children.

Use only a smear of toothpaste – about the size of a grain of rice – to brush their teeth. When they’ve gotten older and have more teeth, use a pea-sized amount of toothpaste. Always be sure to rinse their mouth out with cool water after you’re done brushing, and try to keep them from swallowing any toothpaste. 

Does Your Child Grind His Teeth At Night? (Bruxism)

Bruxism is more commonly known as teeth-grinding, and a surprising number of children suffer from it – around 3 in 10. Teeth-grinding usually occurs while children are asleep, and it can become a dental problem if left unchecked. Regular teeth-grinding can wear down tooth enamel, reinforce improper bite patterns, and leave teeth more susceptible to cavities and decay.

Bruxism can cause headaches, earaches, facial pain and bite and jaw problems.

If your child’s teeth-grinding is ongoing, then their dentist may prescribe a night guard to protect their teeth and mouth. A night guard helps ease the pain of tooth grinding, and protects tooth enamel from being worn away.

Thumb Sucking

Thumb sucking, finger sucking, and pacifier use are habits common in many children. In fact, nearly one-third of all children suck on their thumbs, fingers, or pacifiers in their first year of life. Thumb sucking, finger sucking, and pacifier use can lead to many oral developmental issues that negatively affect the development of the mouth. These habits can cause problems with the proper alignment of teeth and can even affect the roof of the mouth.

Boredom, anxiety, anger, hunger, or even sadness can all cause children to suck on their fingers for comfort. Children mostly suck on their fingers for comfort from an uncomfortable emotional state or stressful situation.

If your child hasn’t stopped sucking their fingers by age 5, then you must wean them from the habit so that they can develop a healthy young smile. By 5 years of age, your child’s mouth will be rapidly developing and thumb sucking, finger sucking or pacifier use can interfere with that process.

What Is Pulp Therapy?

The inside core of a tooth, known as the pulp, holds vital tissues such as nerves, blood vessels, connective tissue, and cells that aid in repair. The goal of pulp therapy in pediatric dentistry is to preserve the health of the impacted tooth and prevent its loss.

Cavities and traumatic injury are the leading causes for the need of pulp therapy, which is sometimes referred to as “nerve treatment,” “children’s root canal,” “pulpectomy,” or “pulpotomy.” There are two common forms of pulp therapy for children’s teeth: pulpotomy and pulpectomy.

A pulpotomy involves removing the damaged pulp tissue within the crown of the tooth, followed by the application of an agent to stop bacterial growth and ease the remaining nerves. This is then capped off with a final restoration, typically a stainless steel crown.

In contrast, a pulpectomy is necessary when the entire pulp, including the root canal, is affected. During the procedure, all diseased pulp tissue is removed from both the crown and root, after which the canals are cleaned, disinfected, and filled. For primary teeth, a resorbable material is used, while permanent teeth are filled with a non-resorbing substance. Finally, a final restoration is placed to complete the treatment.

What Is The Best Time For Orthodontic Treatment?

Orthodontic Treatment can be recognized as early as 2-3 years of age. Often, preventative steps can be taken to help reduce the need for major orthodontic treatment later on.

From ages 2 to 6, the main concern would be habits such as finger or thumb sucking, underdeveloped dental arches, and early loss of primary teeth.

From  ages 6 to 12, treatment options deal with jaw and dental alignment problems. This is a great time  to start treatment, as your child’s hard and soft tissues are usually very responsive to orthodontic or orthopedic forces.

Adult Teeth Coming in Behind Baby Teeth

When adult teeth come in behind the baby teeth can be called “Shark Teeth” It is common, and occurs as the result of a lower baby tooth not falling out when the permanent tooth is arriving. In most cases, the baby tooth will fall out on its own within a couple months. If it doesn’t fall out on its own contact your pediatric dentist.

Early Infant Oral Care

Perinatal & Infant Oral Health

Research has shown that mothers with poor oral health may be at a greater risk of passing cavity-causing bacteria to their children, and periodontal disease can increase the risk of preterm birth and low birth weight. The American Academy of Pediatric Dentistry (AAPD) recommends that all pregnant women continue to visit the dentist for checkups. during pregnancy.

To decrease the risk of spreading the bacteria, mothers should visit their dentist regularly, brush and floss on a daily basis, and maintain a healthy diet full of natural fiber, and reduce sugary foods. Additionally, increasing water intake and using fluoridated toothpaste helps prevent cavities and improves oral health. 

Your Child's First Dental Visit-Establishing A "Dental Home"

American Academy of Pediatric Dentistry recommends taking your child to the dentist when their first tooth appears or by 12 months of age at the very latest. It is important to establish a “Dental Home” for your child. 

Your “Dental Home” is a continuous relationship between your child and their dentist. 

We will walk you and your child through your first visit and make it a positive and enjoyable experience. We invite them to come back on their own so we can devote full attention to them during their appointment. 

When Will My Baby Start Getting Teeth?

Your child’s first tooth will typically erupt between 6 and 12 months, although it is common to occur earlier. Usually, the two bottom front teeth – the central incisors – erupt first, followed by four upper front teeth – called the central and lateral incisors. Your child should have their first full set of teeth by their third birthday.

Permanent teeth start to  appear around age 6, beginning with the first molars and lower central incisors. The age of 8, is generally when the bottom 4 primary teeth (the lower central and lateral incisors) and the top 4 primary teeth (the upper central and lateral incisors) begin to fall out  and permanent teeth take their place. The rest of the permanent teeth will start to come in around age 10. Permanent teeth can continue to erupt until approximately age 21. Adults have 32 permanent teeth including the third molars (called wisdom teeth).

Baby Bottle Tooth Decay (Early Childhood Caries)

One of the most common forms of early childhood caries is “baby bottle tooth decay,” which is caused by the continuous exposure of a baby’s teeth to sugary drinks. Baby bottle tooth decay primarily affects the upper front teeth, but other teeth may also be affected.

Early symptoms of baby bottle tooth decay are white spots on the surface of teeth or the gum line, and tooth sensitivity. More severe symptoms can appear in advanced stages of baby bottle tooth decay and include brown or black spots on teeth, bleeding or swollen gums, fever, and bad breath. If your child shows any of these symptoms, you need to see your pediatric dentist immediately to prevent further, more complicated problems from occurring.

Sippy Cups

Sippy cups serve as a transitional tool from bottles to regular cups, and it’s recommended to phase them out by the time a child reaches their first birthday. If your child uses a sippy cup frequently, it’s best to only fill it with water (excluding meal times). Continuous sipping on sugary liquids such as milk, fruit juice, sports drinks, etc., from a sippy cup throughout the day can increase the risk of cavities by exposing a child’s teeth to bacteria that cause decay.

Prevention

Care Of Your Child's Teeth

How Do I Care for My Child’s Teeth?

It’s never too early to begin a healthy oral care routine. In fact, you should begin caring for your child’s gums long before their first tooth emerges, which is usually around the six-month mark of their life. Healthy gums are an important predictor of healthy teeth, and maintaining clean gums will help ensure that your child has healthy, cavity-free baby teeth.
You can clean your infant’s gums – or their first teeth – by simply using a cold, clean washcloth. Simply rinse a clean, soft washcloth with cool water and wring it out. After your child has finished eating or drinking a sugary drink, use the damp washcloth to gently wipe out their mouth. This will remove any sugar or acid that’s left by their food, and help prevent early cavities.

Once your child has a few more baby teeth – usually between 8 and 12 months – then you can graduate from a washcloth to a toothbrush designed for toddlers. There are a lot of toothbrushes designed for babies and toddlers from which to choose. Generally speaking, toothbrushes designed for babies have much softer bristles and a smaller head than those meant for older children.

Use only a smear of toothpaste – about the size of a grain of rice – to brush their teeth. When they’ve gotten older and have more teeth, use a pea-sized amount of toothpaste. Always be sure to rinse their mouth out with cool water after you’re done brushing, and try to keep them from swallowing any toothpaste. 

Flossing is also important for baby teeth. Flossing helps remove the plaque and food that can become lodged between teeth. Be sure to floss your child’s teeth daily

Can my Child’s Diet affect their Teeth?

Children should eat a variety of foods including grains, fruits, protein, vegetables, and low-fat dairy.raw vegetables like carrots, celery, and bell pepper are excellent snacking alternatives to unhealthy chips and crackers. Starchy carbs like potato chips and crackers can stick to teeth and cause unhealthy buildup, which can lead to cavities. Fibrous vegetables like celery can clean your teeth as you eat them! That is also true of fibrous fruits like apples, strawberries, and kiwi.
So choose raw fruits and vegetables instead of chips, they are better for your overall health, and they won’t stick to your teeth like starchy carbs and sugars.

How Do I Prevent Cavities?

To prevent cavities, we suggest enjoying a mouth-healthy diet, full of fibrous fruits and vegetables. Drink more water, which prevents dry mouth and naturally cleans teeth. Brush twice a day for two minutes at a time, and floss daily. Visit your dentist every six months for routine checkups and preventative care.

What are Dental Sealants?

Dental sealants work to prevent cavities by sealing pits and fissures that naturally occur in molars. Sealants “seal off” the pit and fissure of your molars to prevent food and plaque from collecting and forming cavities.

Fluoride

Fluoride is considered to be nature’s own cavity fighter. Fluoride is naturally found in all sources of water such as lakes, rivers, and even the ocean. Fluoride is added to most public water supplies, so the tap water in your home has fluoride added to it. Fluoride helps build tooth enamel which helps protect your teeth from tooth decay.
For more than half a century, the ADA has recommended using toothpaste containing fluoride to prevent cavities. Fluoridated toothpaste does an excellent job of cleaning teeth, but make sure that your child spits all of it out and rinses their mouth thoroughly after brushing since ingesting excessive fluoride can lead to a condition called fluorosis. Fluorosis is faint white lines on the teeth.

Mouth Guards

Mouth guards – sometimes called mouth protectors – work by helping cushion a blow to the face, and minimizing the risk of broken teeth, or lacerating a lip, tongue, or cheek. Did you know that the CDC estimates that more than 3 million teeth are knocked out at youth sporting events? Mouth guards work to prevent tooth loss and other facial injuries. Mouthguards come in a variety of shapes, and sizes, and are designed for multiple sports.

Xylitol - Reducing Cavities

Xylitol has the sweet benefits of traditional sugar, but it doesn’t have negative effects on teeth like sugar. The natural sugar alcohol, Xylitol, actually helps prevent cavities by inhibiting the growth of bacteria that causes cavities. You can find natural xylitol in some fruits and berries. Xylitol can most often be found in gums and mints.
The American Academy of Pediatric Dentistry (AAPD) recognizes the benefits of xylitol for the oral health of infants, children, adolescents, and persons with special health care needs.

Beware of Sports Drinks

Did you know that sports drinks can contain more sugar than leading cola beverages, with as much as 19 grams of sugar per serving? The sugars increase the acidity in your mouth which attracts tooth enamel-destroying bacteria. Sugar increases the acidity in your mouth which helps give bad oral bacteria the fuel it needs to create cavities.

Adolescent Dentistry

What is Oral Cancer?

One of the issues your dentist is always on the lookout for is small oral spots or sores that you most likely aren’t aware of. These spots could be oral cancer.

 According to the ADA, oral cancer kills more US residents than either cervical or skin cancer (melanoma). As things stand now, only half of all people diagnosed with oral cancer survive more than five years.

 But if you visit your dentist on the recommended six-month schedule, you’d be likely to be in the half of oral cancer patients that go on to live long lives.

 In about 10% of patients, the dentist may notice a small red or white spot or sore. Most of these are harmless, but to be on the safe side, your dentist may do a biopsy.

 If the biopsy comes back positive, it’s not the end of the world. You can treat oral cancer at an early, nearly-always-curable stage.

Three-quarters of oral cancers are associated with tobacco usage. Smokeless tobacco can also lead to periodontal disease.

Why should I avoid Tobacco of any kind?

We’ve all heard that smoking can cause cancer, but smokeless tobacco (snuff) is also bad news. One can of snuff a day delivers as much nicotine as 60 cigarettes. At that rate, snuff usage can cause periodontal disease and pre-cancerous lesions in as little as 3-4 months.

What about electronic cigarettes? Since they’re so new, there’s not much evidence available on their ill effects. But the evidence there is isn’t encouraging. Vaping may be healthier than smoking, but you’re still inhaling addiction-causing nicotine and toxic chemicals, which contributes to cancer.