Q: What is a Pediatric Dentist?

A pediatric dentist (pedodontist) has two years of specialized training (after the required four years of dental school) and is dedicated to the oral health of children from infancy through the teenage years.

Q: Why is it important to be a Diplomate of the American Board of Pediatric Dentistry?

Being a Diplomate means that a pediatric dentist’s credentials have been verified, while successfully completing an advanced educational program accredited by the ADA and voluntary examinations beyond Florida’s pediatric dentists’ standards. A Diplomate has demonstrated unique knowledge and skill at the very highest standards set by the American Board of Pediatric Dentists (www.abpd.org). Dr. Kristin and Dr. Alvarez are two pediatric dentists in Brevard County that hold the distinction of being Diplomates.

Q: When should my child first see the dentist?

The American Academy of Pediatric Dentistry (AAPD) recommends that the first visit to the pediatric dentist occur within 6 months following the first tooth eruption, but no later than 1 year of age. Benefits of an early dental visit include:

  • Establishing a “dental home” for your child, which is so helpful in emergency situations
  • Becoming accustomed to the child-friendly environment at the dentist’s office
  • Discussing ways to prevent tooth decay, stopping cavities before they start
  • Cavities can form in baby teeth at any age; should your child develop cavities, early treatment will prevent potential infections, abscesses, and/or damage to developing permanent teeth

Q: Are baby teeth really important to my child?

Primary, or “baby” teeth, are important for many reasons. Not only do they help children speak clearly and chew naturally, but they also aid in forming a path that permanent teeth can follow when they are ready to erupt. Children need their teeth as much as adults do to chew and smile. Untreated tooth decay can lead to:

Pain: Which may then lead to missed school, difficulty eating and even malnutrition.

Infection: Baby teeth can become infected, causing damage to the developing permanent teeth and may lead to potentially life-threatening swelling or abscess.

Space Loss: If baby teeth are removed due to decay before the adult teeth arrive, shifting of the teeth will occur, which may lead to serious crowding in the future.

Q: How can I prevent decay caused by bottles or nursing?

One serious form of decay among young children is baby bottle tooth decay (early childhood caries). This condition is caused by frequent and long exposures of an infant’s teeth to liquids that contain sugar. Among these liquids are milk (including breast milk), formula, fruit juice, and other sweetened drinks.

Putting a baby to bed for a nap or at night with a bottle other than water can cause serious and rapid tooth decay. Sweet liquid pools around the child’s teeth giving plaque bacteria an opportunity to produce acids that attack tooth enamel. If you must give the baby a bottle as a comforter at bedtime, it should contain only water. If your child won’t fall asleep without the bottle and its usual beverage, gradually dilute the bottle’s contents with water over a period of two to three weeks.

Q: What can I do to help my child with teething?

Teething is one of those unfortunate stages all kids must go through. The best things for teething are the frozen teething rings and Infants’ Tylenol (acetaminophen), although you may wish they were more effective. Topical anesthetics (ex. Orajel) may provide some temporary relief but do not last as long or work as well as Infants’ Tylenol; in addition, these medications must be used with caution as children may swallow them, get a stomachache and potentially overdose.

Q: When and how should my child’s teeth begin to erupt?

Children’s teeth begin forming before birth. As early as 4 months, your child’s first teeth to erupt will be the lower central incisors, followed closely by the upper central incisors. Although all 20 primary teeth usually appear by age 3, the pace and order of their eruption will vary.

Permanent teeth begin appearing around age 6, starting with the first molars and lower central incisors. This process continues until approximately age 21. Adults have 28 permanent teeth or up to 32 including the third molars (or wisdom teeth).

Q: Is it OK for my child to use a pacifier or suck his/her thumb?

Yes, it is normal for children to explore their world by placing everything in his/her mouth, including a pacifier or a thumb up to age 3. Ideally, all habits should cease by 12 months, which seems easier with the pacifier because you can take it away. For the thumbsucker, age 3 is the time to gently encourage your child to stop.

Some suggest that a pacifier habit is easier to break than a thumb habit because you can throw a pacifier away. Positive reinforcement works best, such as success calendars (Ask for our activity sheet), or ignore your child while he/she is sucking and only respond when the sucking stops. For pacifiers, a helpful trick is to wean your child by progressively cutting off small pieces of the tip each week until the entire nipple is gone. For thumbsuckers, some people have reported success with painting nails with a bitter-tasting liquid or hot peppers.

Prolonged oral habits may cause your child’s upper front baby teeth to flare out and give the appearance of an “overbite”. If your child continues to have an oral habit past age 6, the permanent teeth will likely become affected, and you should discuss a plan to help your child stop the habit with the dentist.

Q: How can I prevent my child from getting cavities?

First, take care of your own teeth! You are your child’s best role model!

  • Begin brushing your child’s teeth twice a day as soon as the first one comes in. This will get them used to the routine!
  • Use the right amount and kind of toothpaste. If your child is determined “high caries risk” by the dentist – a thin smear of toothpaste with fluoride is recommended. This way, if your child is not a proficient spitter, minimal toothpaste is ingested, yet the child still reaps the benefits of fluoride on the teeth. For “low caries risk” patients, fluoride-free toothpaste is recommended until the child is a proficient spitter! It is important to use the recommended amount of toothpaste with fluoride, as swallowing too much fluoride may cause stains to form in the permanent teeth.
  • Floss – Any adjacent baby teeth that are touching are ready for flossing!
  • Start early with good dietary habits – Feed your child healthy foods, such as fruits, vegetables, and protein as well as calcium-rich foods such as milk, yogurt, and cheese will help build strong teeth and bones.
  • Limit the amount of soda, juice and sports drinks your child drinks. Avoid putting these sugary drinks in sippy cups to minimize sugar directly contacting the teeth.
  • To prevent baby bottle tooth decay, avoid putting your child to bed with a bottle or sippy cup. Begin to wean your child from bottle use or ‘at will’ breastfeeding around his/her first birthday.

Q: How safe are dental x-rays?

There is very little risk in dental x-rays. Pediatric dentists are especially careful to limit the amount of radiation to which children are exposed. Radiographs (x-rays) are a vital and necessary part of your child’s dental diagnostic process. Without them, certain dental conditions can and will be missed. X-rays detect much more than cavities. For example, x-rays may be needed to survey erupting teeth, diagnose bone diseases, evaluate the results of an injury, or plan orthodontic treatment. X-rays allow dentists to diagnose and treat health conditions that cannot be detected during a clinical examination. If dental problems are found and treated early, dental care is more comfortable for your child and more affordable for you.

X-rays are taken for most children by age 3. We follow AAPD guidelines for dental x-rays, which are an important and necessary part of our comprehensive care for your child. The AAPD recommends x-rays and exams every 6 months for children with a high risk of tooth decay.

Q: What should I do in a dental emergency?

Toothache: Clean the area of the affected tooth thoroughly. Rinse the mouth vigorously with warm water or use dental floss to dislodge impacted food or debris. DO NOT place aspirin on the gum or on the aching tooth. If your child’s face is swollen, apply cold compresses. Contact Dr. Kristin immediately.

Cut or Bitten Tongue, Lip or Cheek: Apply ice to bruised areas. If there is bleeding apply firm but gentle pressure with a gauze or cloth. If bleeding does not stop after 15 minutes or it cannot be controlled by simple pressure, take your child to the hospital emergency room, then contact Dr. Kristin.

Bumped or Knocked Out Baby Tooth : Be on the lookout for changes in color (yellowing, darkening), sensitivity, looseness, or infection, which may appear as a “bubble” on the gums or “gum boil.” There is always a chance that the developing permanent tooth could be damaged in some way (most often damage appears as a small discoloration or defect on the permanent tooth); if this occurs, treatment for the permanent can wait until the permanent teeth come in. Contact Dr. Kristin immediately.

Knocked Out Permanent Tooth: Find the tooth. Handle the tooth by the crown, not the root portion. You may rinse the tooth but DO NOT clean or handle the tooth unnecessarily. Inspect the tooth for fractures. If it is sound, try to reinsert it in the socket. Have the child hold the tooth in place by biting on gauze. If you cannot reinsert the tooth, transport the tooth in a cup containing the patient’s saliva or milk. The tooth may also be carried in the patient’s mouth. The patient must see a dentist IMMEDIATELY! Time is a critical factor in saving the tooth.

Q: How do sealants work?

A sealant is a clear or shaded plastic material that is applied to the chewing surfaces (grooves) of the back teeth (premolars and molars), where more than 80% of cavities are found. This sealant acts as a barrier to food, plaque, and acid, thus protecting these decay-prone areas of the teeth.

Q: Is Fluoride good for my child’s teeth?

Fluoride helps fight future cavities by strengthening tooth enamel Fluoride mainly works when it comes into contact with enamel. Vitamins containing fluoride and fluoride tablets that are swallowed are less effective at preventing decay and may increase the risk of fluorosis, which can lead to staining of permanent teeth.

Mouth rinses with fluoride can be of benefit to children at risk for dental decay who are old enough to rinse and spit (usually children 6 years old and up).

Q: What happens if my child grinds his teeth at night (Bruxism)?

A: Parents are often concerned about the nocturnal grinding of teeth (bruxism). Often, the first indication is the noise created by the child grinding on their teeth during sleep. Or, the parent may notice wear to the dentition. One theory as to the cause involves a psychological component. Stress due to a new environment, divorce, changes at school; etc. can influence a child to grind their teeth. Another theory relates to pressure in the inner ear at night. If there are pressure changes (like in an airplane during take-off and landing) the child will grind by moving his jaw to relieve this pressure.

The good news is most children outgrow bruxism. The grinding gets less between the ages 6-9 and children tend to stop grinding between ages 9-12. The majority of cases of pediatric bruxism do not require any treatment. If you suspect bruxism, discuss this with your pediatrician or pediatric dentist.

Q: Does my child need a mouthguard?

When a child begins to participate in recreational activities and organized sports, injuries can occur. A properly fitted mouthguard, or mouth protector, is an important piece of athletic gear that can help protect your child’s smile, and should be used during any activity that could result in a blow to the face or mouth.

Mouthguards help prevent broken teeth, and injuries to the lips, tongue, face or jaw. A properly fitted mouth guard will stay in place while your child is wearing it, making it easy for them to talk and breathe. Ask Dr. Kristin about custom and store-bought mouth protectors.

Q: What is nitrous oxide, is it safe?

When administered in a dental environment, Nitrous Oxide (laughing gas) is actually a combination of two gases, oxygen, and nitrous oxide. When inhaled it has a calming effect on the patient and allows the patient to enjoy a more relaxed state which allows him/her to respond more favorably to dental care. During the administration of nitrous oxide, your child will remain fully awake, alert and able to respond to commands. Once the procedure is complete, and the desired calming is no longer needed, the nitrous oxide is eliminated from your child’s system by breathing oxygen for a few moments.

Q: Have you ever seen a kid look forward to visiting the dentist?

We see it every day! Why? Just look around and you will see we make visits to the dentist fun for kids. (That’s right we said fun!) It starts the moment they come in the door. In addition to learning the most up-to-date treatments available for a wide variety of children’s dental problems, we also learn how to deal with the behavioral aspects. That is why many parents choose a pediatric dentist for their child’s dental needs.

Q: Why Melbourne?

A growing number of kids meant a whole lotta smiles! With kids growing at such a rapid pace, Brevard County was in need of a pediatric dentist to take care of all these precious smiles. Sunshine Smiles Pediatric Dentistry opened in 2010 and the Space Coast couldn’t be happier to have a new pediatric dentist in town.

Q: How does the Tooth Fairy handle a swallowed tooth, wiggly tooth or lost tooth?

I’m sure one of these letters will help out the Tooth Fairy…

Tooth Fairy Letters

Do you have a question that is not answered here?

Please contact us and we will get back to you! You can also look at mychildrensteeth.org for more information.