Frequently Asked Questions(FAQ's)

General FAQ's

My son is over one year old and has no teeth. Should I worry?

Even though most children that age have a number of teeth, some children may have delayed tooth eruption. There is usually no cause for concern about this.

My child's permanent lower front tooth is coming in behind his baby tooth. What should I do?

If the baby teeth are moderately to very loose, there is no immediate treatment. Patience is recommended. This is a normal process. The tongue will push the permanent lower front tooth forward. If the teeth are not very loose, your child should be taken for a x-ray and the situation evaluated. The milk tooth may have to be extracted if your dentist feels it may not fall off on his own.

My son sucks his thumb or finger. What effect can it have on the bite, and when should I work on stopping the habit?

Most children stop sucking their fingers between the ages of three to five. If your child continues this habit past the time of the eruption of the first permanent tooth, then it can have a permanent effect on the adult bite. The habit should be stopped before these teeth come in. From a preventive point of view, infants should be given pacifiers, as they will do much less harm than finger habits, and most children will discontinue their use earlier. Read Thumb Sucking

I have heard that a nursing bottle can cause cavities on toddlers, at what age should I take my child off the bottle?

Your child should stop using a bottle when he is old enough to hold a cup. This usually occurs around one year of age. After this age a child should NEVER be placed to sleep with a bottle because this may cause dental decay, increase the incidence of ear infections, and prolong the use of the bottle. If your child is habituated to sleeping with a bottle, the best way to stop this habit is by placing only water in the bottle, or progressively diluting it until it is all water. Then be firm with the child, give juice or milk in a cup, which will not cause as severe a decay.

What are the signs of teething, and what can I do to make my child more comfortable?

The signs of teething are drooling, irritability, restlessness, and loss of appetite. Fever, illness, and diarrhea are not symptoms. If your child presents with the latter signs, they need to be evaluated by your doctor. The best solution to comfort the child is to have the child chew on a cold or frozen rubber teething ring. Topical anesthetics/ gels are NOT recommended.

Why are baby teeth important? Don't they fall out?

Baby teeth serve the important function of eating, speech, and esthetics (self-image). These teeth not only help form the developing jaws, but they hold space for the permanent teeth to make normal bite possible. The last baby tooth falls out at about twelve years of age. A decayed baby tooth can become so badly decayed that it can do damage to the permanent tooth. At times severe infections of the face, head, and neck can be caused by infected baby teeth, necessitating care of baby teeth knowing they will eventually fall off.

When should I expect my son to brush and floss on his own?

We recommend that parents brush their children’s teeth for the first five to seven years of life, since young children lack the manual dexterity of proper tooth brushing. The toothbrush should be a child’s size, with soft nylon rounded bristles. Toothpaste should not be used until the child is able to spit (three to four years of age) to avoid swallowing it. A pea-sized drop should be dispensed by the parent for young children. Flossing should be performed by the parent prior to brushing. Most children lack the proper manual dexterity to floss on their own until the age of ten and will need a parent’s help and supervision.

Infant Oral Health Care Information

Diet and Nutrition

Diet

Infants and toddlers often have a high carbohydrate diet. There are also lots of natural sugars in milk and fruit juices.

Chips and dry cereals are carbohydrates that form a pasty film that sticks firmly on teeth. These carbohydrates are then converted to sugars by the normal oral bacteria that promote tooth decay and gum problems. Be careful!

Oral Habits

Thumbs, fingers, and pacifiers can definitely cause or intensify orthodontic problems.

– However, it is normal for infants and children to have a strong sucking desire.
– Some disfigurement of the primary teeth will self-correct.
– Most children stop oral habits on their own.
– Oral habits should be stopped before the permanent teeth erupt (approx. 6 yrs. old).
– Grinding of teeth is normal and should not be an area of concern unless there is significant wear of the teeth.

Teething

– Symptoms include – sensitive and uncomfortable gum areas, drooling, irritability, possible low grade fever and diarrhea.
– Treatment can include – massaging sore gums with a finger or teething rings, placing ice or frozen rings on gum areas. The best remedy is your child’s pediatric dose of Tylenol or fever reducing medication for pain.

Brushing

-Plaque is the enemy.
-Brush 2 times per day (after breakfast and especially before bed.)
-Brush in a circular pattern, cleaning one area at a time.
-Toothpaste is not necessary. A wet brush will work fine to remove plaque and food.
-A washcloth or gauze will work well for the early primary dentition.
-Flossing is recommended for teeth that have tight contacts and trap food.
-Stains can occur from foods, vitamins, iron drops, and other medicines.
-We can easily clean these off if they occur.

Toothpaste has quite a bit of fluoride in it. If the child is allowed to swallow it, this can cause white or brown spots to occur on the developing permanent teeth. Use toothpaste sparingly with young children.

Fluoride

Too much fluoride can cause a discoloration of the permanent teeth called fluorosis.
Sources of fluoride include – fluoridated water, bottled juices (from concentrate), prescription vitamins, and toothpaste.
Know the fluoride level in your water.
If your water is not fluoridated, we can provide you with a prescription for fluoride drops.
Do not allow your child to eat or swallow toothpaste as fluorosis can easily occur.
Traumatic Injuries: We hope you never have to experience a dental injury but…

30% of children have dental injuries before the age of 5, with boys being twice as likely to experience an injury than girls.
If injuries occur, severe enough to cause bleeding or fractured teeth, the child should receive an evaluation.

Change of color of teeth or red swollen gums are not normal and can indicate a dental infection although the child is in no apparent discomfort. Primary teeth react differently to injuries than permanent teeth. Often only an x-ray can detect pathological changes in the traumatized primary teeth.

Everyone says don't give sweets to kids. What to give?

Minal has cooked up some suggestions for LOW-SUGAR SNACKS

1)Peanuts and raisins, mixed put mixture in a paper cup for kids to carry around when playing outside.
2)Carrot sticks used as dippers for health dip made from curds.
3)Fresh fruits – whole or cut & served attractively
4)Quarters of hard boiled eggs
5)Cubes / slices of cheese
6)Flavored yogurts – in moderation, sugar added
7)Panir sprinkled with salt & pepper.
8)Carrot coins – cut carrot into “coin” shaped slices – kids love to eat money
9)Fruit juices – a wide range of tetra packed juices available.
10)Milk shake – milk, 8oz. – banana or other fruit, 1 egg, 1 tsp. honey + 2 ice cubes – whirl in blender 1 min.
11)Popcorn – pop before they come home from school – have ready
12)Unsweetened cereals / corn flakes (check label for sugar content) with milk & raisins or fresh fruit.

Cleft Lip and Cleft Palate

Cleft lip and cleft palate are common birth defects. An infant with a cleft lip typically has a gap or indentation in the upper lip; an infant with a cleft palate has a gap in the roof of the mouth. Approximately one to two newborns of every 1,000 will have a cleft lip, a cleft palate or both, although frequency varies.
Many hereditary and environmental factors contribute to the development of cleft lip and cleft palate. Clefts result from improper growth and merging of the lip and palate tissues during the first trimester of pregnancy. Infants who have a cleft lip or palate may have abnormalities (particularly to their head, neck or internal organs) that, together with their cleft, are part of a syndrome.

With proper treatment, most infants with cleft lip or palate can lead a normal life. Without proper treatment, an infant with cleft lip and palate may develop related and often irreversible problems, including failure to grow, recurrent ear infections that can cause hearing loss, speech difficulties and developmental and psychological problems.

Symptoms At Birth: Gap in or indentation of the lip (cleft lip), gap in the roof of the mouth (cleft palate) or both Flattened or unusually shaped nose, which may accompany cleft lip

Infancy to Adolescence The following symptoms sometimes occur, particularly in children with a cleft palate: Difficulty feeding, possibly including nasal (food coming out of the nose), choking and coughing during feeding fatigue and irritability (particularly when feeding problems exist)

Poor weight gain and development (particularly when feeding problems exist) Accumulation of fluid in the middle ear with chronic infection (see Otitis Media) Missing, malformed or extra teeth Hearing loss (especially if ear infections are not treated)

Difficulty breathing through the nose Impaired facial growth Speech problems Self-esteem and psychological problems Maturation problems and learning delays

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