PATIENT INFO

A toothbrush with soft bristles and a small head, especially one designed for infants, is the best choice for infants. Brushing at least once a day, at bedtime, will remove plaque bacteria that can lead to decay.

Dr. Aarons recommends the first dental visit at or before age two. If there is something that concerns you before the child turns two, you are certainly welcome to make an appointment earlier. It's better to come in for a visit and be certain that there is nothing wrong rather than wait and possibly have potential problems early with the child's teeth. The sooner a problem is found, usually the easier it is to be corrected.  

Pediatric dentistry is a dental specialty that focuses on the oral health of young people. Following dental school, a pediatric dentist has two to three years additional specialty training in the unique needs of infants, children and adolescents, including those with special health needs.

Baby bottle tooth decay is a pattern of rapid decay associated with prolonged nursing. It happens when a child goes to sleep while breast-feeding and/or bottle-feeding. During sleep, the flow of saliva is reduced and the natural self-cleansing action of the mouth is diminished. Avoid nursing children to sleep or putting anything other than water in their bedtime bottle. Encourage your child to drink from a cup as they approach their first birthday. He/she should be weaned from the bottle at 12-14 months of age.

Thumb and pacifier sucking habits that go on for a long period of time can create crowded, crooked teeth or bite problems. If they are still sucking their thumbs or fingers when the permanent teeth arrive, a mouth appliance may be recommended by your pediatric dentist. Most children stop these habits on their own.

The American Dental Association recommends use of a smear of toothpaste from eruption of the first tooth to age 3 years followed by use of a pea-sized amount for children aged 3 to 6 years.

To comfort your child, rinse his/her mouth with warm salt water and apply a cold compress or ice wrapped in a cloth on your child's face if it is swollen. Do not put heat or aspirin on the sore area, but you may give the child acetaminophen for pain. See us as soon as possible.

Fluoride has been shown to dramatically decrease a person's chances of getting cavities by making teeth stronger. Fluoride in the drinking water is the best and easiest way to get it, but to make sure your child is getting enough fluoride, have your pediatric district evaluate the fluoride level of your child's primary source of water. If your child is not getting enough fluoride internally through water (especially in communities where the water district does not fluoridate the water or if your child drinks bottled water without fluoride), your pediatric dentist may prescribe fluoride supplements.

With contemporary safeguards, such as lead aprons and high-speed film, the amount of radiation received in a dental X-ray examination is extremely small. Even though there is very little risk, pediatric dentists are particularly careful to minimize the exposure of child patients to radiation. In fact, dental X-rays represent a far smaller risk than an undetected and untreated dental problem.

A mouth guard should be a top priority on your child's list of sports equipment. Athletic mouth protectors, or mouth guards, are made of soft plastic and fit comfortably to the shape of the upper teeth. They protect a child's teeth, lips, cheeks and gums from sports-related injuries. Any mouth guard works better than no mouth guard, but a custom-fitted mouth guard fitted by our doctor is your child's best protection against sports-related injuries.

At about 6 months, the two lower front teeth (central incisors) will erupt, followed shortly by the two upper central incisors. The remainder of the baby teeth appear during the next 18 to 24 months but not necessarily in an orderly sequence from front to back. At 2 to 3 years, all of these 20 primary teeth should be present.

First of all, remain calm. If possible, find the tooth and hold it by the crown rather than the root. Replace the tooth in the socket and hold it there with clean gauze or a washcloth. If you can't put the tooth back in the socket, place the tooth in a clean container with milk and take your child and the glass immediately to the pediatric dentist. The faster you act, the better your chances of saving the tooth.

Sore gums when teeth erupt are part of the normal eruption process. The discomfort is eased for some children by use of a teething biscuit, a piece of toast or a frozen teething ring. Your pharmacy should also have medications that can be rubbed on the gums to reduce the discomfort.

Usually, the space will close in the next few years as the other front teeth erupt. We can determine whether there is cause for concern.

Primary, or "baby," teeth are important for many reasons. Not only do they help children speak clearly and chew naturally, they also aid in forming a path that permanent teeth can follow when they are ready to erupt. Some of them are necessary until a child is 12 years old or longer. Pain, infection of the gums and jaws, impairment of general health and premature loss of teeth are just a few of the problems that can happen when baby teeth are neglected. Also, because tooth decay is really an infection and will spread, decay on baby teeth can cause decay on permanent teeth. Proper care of baby teeth is instrumental in enhancing the health of the your child.

Four things are necessary for cavities to form -- a tooth, bacteria, sugars or other carbohydrates and time. Dental plaque is a thin, sticky, colorless deposit of bacteria that constantly forms on everyone's teeth. When you eat, the sugars in your food cause the bacteria in plaque to produce acids that attack the tooth enamel. With time and repeated acid attacks, the enamel breaks down and a cavity forms.

Use a toothbrush with soft bristles and a small strip of fluoride toothpaste, unless the child is under the age of 3. If a child is younger than age 3, parents should clean their child’s teeth with water and a soft-bristled toothbrush. After age 3, parents should supervise brushing. Use no more than a pea-sized amount of toothpaste and make sure children do not swallow excess toothpaste.
When you brush your teeth, move the brush in small circular motions to reach food particles that may be under your gum line. Hold the toothbrush at an angle and brush slowly and carefully, covering all areas between teeth and the surface of each tooth. It will take you several minutes to thoroughly brush your teeth. Brush up on the lower teeth, down on the upper teeth and the outside, inside and chewing surface of all of your front and back teeth. Brush your tongue and the roof of your mouth before you rinse.

Brush your teeth four times daily to avoid the accumulation of food particles and plaque:
• In the morning after breakfast
• After lunch or right after school
• After dinner
• At bedtime

As soon as the bristles start to wear down or fray, replace your toothbrush with a new one. Do not swallow any toothpaste; rinse your mouth thoroughly with water after you finish brushing. It is important to carefully floss and brush daily for optimal oral hygiene.

For areas between the teeth that a toothbrush can’t reach, dental floss is used to remove food particles and plaque. Dental floss is a thin thread of waxed nylon that is used to reach below the gum line and clean between teeth. It is very important to floss between your teeth every day.

Pull a small length of floss from the dispenser. Wrap the ends of the floss tightly around your middle fingers. Guide the floss between all teeth to the gum line, pulling out any food particles or plaque. Unwrap clean floss from around your fingers as you go, so that you have used the floss from beginning to end when you finish. Floss behind all of your back teeth.
Floss at night to make sure your teeth are squeaky clean before you go to bed. When you first begin flossing, your gums may bleed a little. If the bleeding does not go away after the first few times, let a staff member know at your next appointment.

Caries, or tooth decay, is a preventable disease. While caries might not endanger your life, they may negatively impact your quality of life.

When your teeth and gums are consistently exposed to large amounts of starches and sugars, acids may form that begin to eat away at tooth enamel. Carbohydrate-rich foods such as candy, cookies, soft drinks and even fruit juices leave deposits on your teeth. Those deposits bond with the bacteria that normally survive in your mouth and form plaque. The combination of deposits and plaque forms acids that can damage the mineral structure of teeth, with tooth decay resulting.

Your teeth expand and contract in reaction to changes in temperature. Hot and cold food and beverages can cause pain or irritation to people with sensitive teeth. Over time, tooth enamel can be worn down, gums may recede or teeth may develop microscopic cracks, exposing the interior of the tooth and irritating nerve endings. Just breathing cold air can be painful for those with extremely sensitive teeth.

Gum, or periodontal, disease can cause inflammation, tooth loss and bone damage. Gum disease begins with a sticky film of bacteria called plaque. Gums in the early stage of disease, or gingivitis, can bleed easily and become red and swollen. As the disease progresses to periodontitis, teeth may fall out or need to be removed by a dentist. Gum disease is highly preventable and can usually be avoided by daily brushing and flossing. One indicator of gum disease is consistent bad breath or a bad taste in the mouth.

Canker sores (aphthous ulcers) are small sores inside the mouth that often recur. Generally lasting one or two weeks, the duration of canker sores can be reduced by the use of antimicrobial mouthwashes or topical agents. The canker sore has a white or gray base surrounded by a red border.

A bite that does not meet properly (a malocclusion) can be inherited, or some types may be acquired. Some causes of malocclusion include missing or extra teeth, crowded teeth or misaligned jaws. Accidents or developmental issues, such as finger or thumb sucking over an extended period of time, may cause malocclusions.

Tooth decay is a progressive disease resulting in the interaction of bacteria that naturally occur on the teeth and sugars in the everyday diet. Sugar causes a reaction in the bacteria, causing it to produce acids that break down the mineral in teeth, forming a cavity. Dentists remove the decay and fill the tooth using a variety of fillings, restoring the tooth to a healthy state. Nerve damage can result from severe decay and may require a crown (a crown is like a large filling that can cap a tooth, making it stronger or covering it). Avoiding unnecessary decay simply requires strict adherence to a dental hygiene regimen: brushing and flossing twice a day, regular dental checkups, diet control and fluoride treatment. Practicing good hygiene avoids unhealthy teeth and costly treatment.

The grooves and depressions that form the chewing surfaces of the back teeth are extremely difficult (if not impossible) to clean of bacteria and food. As the bacteria reacts with the food, acids form and break down the tooth enamel, causing cavities. Recent studies indicate that 88 percent of total cavities in American school children are caused this way.

Tooth sealants protect these susceptible areas by sealing the grooves and depressions, preventing bacteria and food particles from residing in these areas. Sealant material is a resin typically applied to the back teeth, molars and premolars and areas prone to cavities. It lasts for several years but needs to be checked during regular appointments.

Fluoride is a substance that helps teeth become stronger and resistant to decay. Regularly drinking water treated with fluoride and brushing and flossing regularly ensures significantly lower cavities. Dentists can evaluate the level of fluoride in a primary drinking water source and recommend fluoride supplements (usually in tablets or drops), if necessary.

Sucking is a natural reflex that relaxes and comforts babies and toddlers. Children usually cease thumb sucking when the permanent front teeth are ready to erupt. Typically, children stop between the ages of 2 and 4 years. Thumb sucking that persists beyond the eruption of primary teeth can cause improper growth of the mouth and misalignment of the teeth. If you notice prolonged and/or vigorous thumb sucking behavior in your child, talk to your dentist.

Here are some ways to help your child outgrow thumb sucking:
• Don’t scold a child when they exhibit thumb sucking behavior; instead, praise them when they don’t thumb suck.
• Focus on eliminating the cause of anxiety—thumb sucking is a comfort device that helps children cope with stress or discomfort.
• Praise them when they refrain from the habit during difficult periods.
• Place a bandage on the thumb or a sock on their hand at night.

Begin by cleaning around the sore tooth meticulously. Using warm salt water, rinse the mouth to displace any food trapped between teeth. UNDER NO CIRCUMSTANCES should you use aspirin on the aching tooth or on the gum. In the event of facial swelling, apply a cold compress to the area. For temporary pain relief, acetaminophen is recommended. See a dentist as soon as possible.

Ice can be applied to any bruised areas. For bleeding, apply firm (but gentle) pressure with sterile gauze or a clean cloth. If the bleeding does not stop with pressure or continues after 15 minutes, go to an emergency room.

Rinse the area with warm water. Put a cold compress over the facial area of the injury. Recover any broken tooth fragments. Get immediate dental attention.

Recover the tooth, making sure to hold it by the crown (top) and not the root end. Rinse, but do not clean or handle the tooth more than necessary. Reinsert the tooth in the socket and hold it in place using a clean piece of gauze or cloth. If the tooth cannot be reinserted, carry it in a cup containing milk or water. Because time is essential, see a dentist immediately.

Contact our office during regular business hours.  This is not usually an emergency, and in most cases, no treatment is necessary.

Possible Broken Jaw
In the event of jaw injury, tie the mouth closed with a towel, tie or handkerchief. Go immediately to an emergency room.
Bleeding After a Baby Tooth Falls Out
Fold a piece of gauze and place it (tightly) over the bleeding area. Bite down on the gauze for 15 minutes; if bleeding continues, see a dentist.
Cold or Canker Sores
Over-the-counter medications will usually provide temporary relief. If sores persist, visit your dentist.

Normally the first tooth erupts between ages 6 to 12 months. Gums are sore, tender and sometimes irritable until the age of 3. Rubbing sore gums gently with a clean finger, the back of a cold spoon or a cold, wet cloth helps soothe the gums. Teething rings work well, but avoid teething biscuits—they contain sugar that is not good for baby teeth.

While your baby is teething, it is important to monitor the teeth for signs of baby bottle decay. Examine the teeth, especially on the inside or the tongue side, every two weeks for dull spots (whiter than the tooth surface) or lines. A bottle containing anything other than water and left in an infant’s mouth while sleeping can cause decay. This happens because sugar in the liquid mixes with bacteria in dental plaque, forming acids that attack the tooth enamel. Each time a child drinks liquids containing sugar, acids attack the teeth for about 20 minutes. When awake, saliva carries away the liquid. During sleep, the saliva flow significantly decreases and liquids pool around the child’s teeth for long periods, covering the teeth in acids.

The primary, or “baby,” teeth play a crucial role in dental development. Without them, a child cannot chew food properly and has difficulty speaking clearly. Primary teeth are vital to development of the jaws and for guiding the permanent (secondary) teeth into place when they replace the primary teeth around age 6.

Since primary teeth guide the permanent teeth into place, infants with missing primary teeth or infants who prematurely lose primary teeth may require a space maintainer, a device used to hold the natural space open. Without a maintainer, the teeth can tilt toward the empty space and cause permanent teeth to come in crooked. Missing teeth should always be mentioned to your family dentist. The way your child cares for his/her primary teeth plays a critical role in how he/she treats the permanent teeth. Children and adults are equally susceptible to plaque and gum problems—hence, the need for regular care and dental checkups.

A child’s first dental visit should be scheduled around his/her first birthday. The most important part of the visit is getting to know and becoming comfortable with a doctor and his staff. A pleasant, comfortable first visit builds trust and helps put the child at ease during future dental visits. If possible, allow the child to sit in a parent’s lap in the exam room. Children should be encouraged to discuss any fears or anxiety they feel.

Primary teeth are important for several reasons. Foremost, good teeth allow a child to eat and maintain good nutrition. Healthy teeth allow for clear pronunciation and speech habits. The self-image that healthy teeth give a child is immeasurable. Primary teeth also guide eruption of the permanent teeth.

The teeth, bones and soft tissue of the mouth require a healthy, well-balanced diet. A variety of foods from the five food groups helps minimize (and avoid) cavities and other dental problems. Most snacks that children eat cause cavities, so children should only receive healthy foods like vegetables, low-fat yogurt and cheeses, which promote strong teeth.

A child’s teeth actually start forming before birth. As early as 4 months of age, the primary or “baby” teeth push through the gums—the lower central incisors are first, then the upper central incisors. The remainder of the 20 primary teeth typically erupt by age 3, but the place and order varies.
Permanent teeth begin eruption around age 6, starting with the first molars and lower central incisors. This process continues until around age 21. Adults have 28 secondary (permanent) teeth—32 including the third molars (wisdom teeth).

Tooth decay in infants can be minimized or totally prevented by not allowing sleeping infants to breast or bottle-feed. Infants that need a bottle to comfortably fall asleep should be given a water-filled bottle or a pacifier. Our office is dedicated to fighting baby bottle tooth decay. Let us know if you notice any signs of decay or anything unusual in your child’s mouth.