A pediatric dentist is a specialist dedicated to the oral health of infants, children, adolescents and patients with special health care needs. After the required four years of dental school, pediatric dentists complete two or three years of additional specialized training, which include study in child psychology, growth, and development. They are also trained and qualified to care for patients with medical, physical, or mental disabilities. Their specialization allows them to provide treatment for a wide variety of children’s dental needs such as regular cleanings and check-ups, treatment of tooth decay/cavities, behavior management, malocclusion, and emergency care. Children’s Dental Centre is specifically designed for treating children from infancy through adolescence, as well as the medically and the physically compromised.
The American Academy of Pediatric Dentistry and American Academy of Pediatrics recommends that a child’s first visit to the dentist should occur by 12 months of age. This visit will enable Dr. Kaitlin to evaluate your child and introduce you to proper oral hygiene. Along with oral hygiene, diet, fluoride, finger and pacifier habits and tooth eruption will also be discussed to ensure optimal dental health.
Of course! Parents are welcome to be with their children during their dental visit. We know that each child is unique and responds differently to various situations. However, it has been our experience that most children do better with parents in the waiting room. This allows Dr. Kaitlin and staff to communicate with your child without distractions or safety concerns. Over time, giving your child independence to come back by himself/herself will help to establish your child’s confidence and create a trusting relationship with Dr. Kaitlin and staff. During sedation and treatment at the hospital, no parents are allowed to observe due to safety concerns.
The American Academy of Pediatric Dentistry recommends:
- Brush twice a day with a fluoridated toothpaste. Children younger than 8 years old should have help brushing from an adult.
- Floss children’s teeth once a day.
- Visit your pediatric dentist every six months for a cleaning and check-up.
- Have sealants applied to the chewing surfaces of permanent back teeth.
- Eat a healthy diet: limit sugary drinks (juice, soda/pop, lemonade, Kool-Aid, chocolate milk) and limit snacking to two or less times per day
A well balanced diet is not only important for your child’s growth and overall health, but also for their teeth. What our children eat, as well as how often they eat, are important aspects to ensuring healthy teeth. Frequent snacking without brushing leaves food on teeth longer and increases the likelihood of a cavity developing. Sticky snacks such as fruit snacks, sticky candies, and fruit roll-ups/gushers stick to teeth even longer and have a lot of sugar in them to cause cavities. Additionally, frequent ‘sipping’ on sugary drinks (including juice, soda/pop, Gatorade/Powerade, chocolate/strawberry milk) increases your child’s risk of developing cavities. Having these drinks in a baby bottle, sippy cup, or re-sealable bottle can cause widespread dental decay.
The occlusal surface (chewing surface) of children’s teeth are the most susceptible to cavities due to their anatomy being full of grooves that are so deep and narrow that they are actually smaller than a toothbrush bristle! In fact, current research shows that four out of five cavities in children under 15 years old develop on this biting surface on back molars. Sealants help to cover these grooves greatly decreasing the risk cavities on this chewing surface.
Primary, or ‘baby’ teeth, are important for a variety of reasons. They help children to speak more clearly, chew naturally, and also hold space for permanent teeth to erupt when they are ready. For some of these teeth, this is not until your child is approximately 12 years of age. Pain, infection of the gums and jaw bone, impairment of health, premature loss of teeth, emergency room visits, hospitalizations, and malnutrition are just a few of the problems that can occur if baby teeth are neglected. Because tooth decay is a disease caused by bacteria, it can spread so that decay on baby teeth can cause decay on permanent teeth. Therefore, care of your child’s baby teeth is vital to maintaining the oral health of your child.
Six months old is an approximate age when the two lower front teeth (central incisors) will erupt. Following these two teeth will be the two upper central incisors. The remainder of teeth appear during the next 18-24 months, but they do not necessarily come in an orderly sequence from front to back. At 2-3 years of age, all 20 primary ‘baby’ teeth should be present.
The majority of children stop sucking on thumbs, fingers, pacifiers or other objects on their own between two and three years of age without any harm being done to their teeth or jaws. However, children that repeatedly suck on a thumb, finger, pacifier or other object over long periods of time may cause the upper front teeth to tip toward the lip or not come in properly. Dr. Kaitlin will carefully monitor the way your child’s teeth come in and jaws develop. For most children there is no reason to worry about a sucking habit until the permanent front teeth are ready to come in, but it should be discouraged by the age of four.
The most important predictor of success is your child wanting to quit! The majority of children stop sucking habits on their own. This typically occurs when your child is school age due to peer influence. Some children may need the help of their parents. When your child is old enough to understand the possible results of a sucking habit, we can encourage your child to stop and talk about what happens to the teeth if your child doesn’t stop. Typically, this advice along with the support from parents, helps most children quit. If all other options have been exhausted, Dr. Kaitlin may discuss the use of a fixed appliance to discourage the habit.
The American Academy of Pediatric Dentistry recommends an examination by radiographs (x-rays) every six months for children with a high risk of cavities. Radiographs allow Dr. Kaitlin to see between the teeth and often show cavities and/or weaknesses in the teeth that may not be visible with the naked eye. Children need x-rays more often than adults to stay up-to-date with the developments of their teeth. They are always growing and changing so it is important to be current.
A mouth guard is another piece of sports equipment. Athletic mouth guards are made of soft plastic and fit comfortably to the shape of the upper teeth. They do more than just protect a child’s teeth, lips, cheeks and tongue. Research has shown that they also protect against head and neck injuries, concussions and jaw fractures. Any mouth guard works better than no mouth guard and when children have mouths that are constantly changing, finding a good mouth guard can be difficult. When your child is older and their teeth are more ‘stable’, a custom-fitted mouth guard fitted by your doctor is your child’s best protection against sports-related injuries. Ask us what we recommend!
Try to remain calm. If possible, find the tooth. Hold it by the crown (part you can see when the tooth was in the mouth). Do not hold the root. Do not scrub the tooth clean. Replace the tooth in the socket and hold it there with a clean washcloth or towel. If you can’t put the tooth back in the socket, place the tooth in a clean container with milk or Gatorade and take your child immediately to our office. If it is after regular business hours, please call the office at 712-722-5565 and your call will be forwarded to Dr. Kaitlin. Dr. Kaitlin will advise you on the next course of action and in most cases, will meet you at Children’s Dental Centre as soon as possible.
The first 30 minutes after an accident are the most critical so the faster you act, the better your chances of saving the tooth.
Nitrous oxide, also known as ‘laughing gas,’ is a combination of nitrous oxide and oxygen. When inhaled, it reduces anxiety and has a calming effect on the child. This allows the patient to still be awake but be more relaxed and respond more favorably to dental treatment. In our experience, a mildly anxious child who is cooperative has the best effect from nitrous oxide.
Oral conscious sedation is a method that uses medication to relax a child and gain an amnesic effect without a child losing consciousness. Dr. Kaitlin has two years of advanced training to administer, monitor, and manage sedated patients. She is certified in CPR and Pediatric Advanced Life Support and exceeds the standard of care in her monitoring and emergency equipment. Dr. Kaitlin has been granted a special permit to practice pediatric oral conscious sedation by the Iowa Board of Dental Examiners.
Dr. Kaitlin and staff use conservative dosing regimens and monitors to optimize the safety of your child. Recommendations regarding which medication should be used are based on the child’s age, level of anxiety, amount of dental work that needs to be completed, and the length of the appointment. Dr. Kaitlin and staff require an examination appointment to assess your child’s dental needs and medical health in order to ensure that oral conscious sedation is the best method of treatment. In our experience, a moderately anxious and reserved young child has the best effect from conscious oral sedation.
Medical stabilization is used during oral conscious sedation for the child’s protection, and no parents are allowed back during this procedure in order to focus on the child.
General anesthesia provides a way of effectively and efficiently completing dental care while the child is unconscious and unaware of any treatment being performed. General anesthesia is performed at a hospital with the help of a nurse anesthetist and/or an anesthesiologist, who has advanced training in administering general anesthesia, managing a child during general anesthesia, and the medical care of the child before, during, and after the procedure. Yes, this is a safe procedure and is the same technique used to put tubes in a child’s ears or to have their tonsils removed. However, because it is surgery, there are always normal risks.
Due to the risks of any surgical procedure and high cost, typically only children with severe anxiety and/or severe tooth decay are recommended for general anesthesia. These children are usually very young or have complex medical histories in which standard behavior management techniques may not be effective to safely accomplish treatment in a traditional dental setting. Dr. Kaitlin will discuss the benefits and risks involved with general anesthesia and explain the rationale of what may be recommended for your child.
Every child is unique. Because this is the case, each child requires a plan of treatment specifically designed for their needs. Children’s Dental Centre is specially designed to be accessible to all patients, and we are happy to serve your child’s needs as best as we can. Many times children with special needs are more susceptible to tooth decay, gum disease, and facial growth abnormalities. Because of this, it is important that these children are seen early and started on a preventive oral health program to optimize their dental health. Dr. Kaitlin has received extensive training in the treatment of special needs children and understands that all children deserve a healthy, beautiful smile.
The pulp chamber is where the nerve and the blood supply of the tooth are located in the central core of the tooth. There are two different kinds of pulp therapy that can be done on a primary (‘baby’) tooth. A pulpotomy maintains the vitality of the affected tooth. Dr. Kaitlin removes the diseased part of the dental pulp while leaving the healthy portion intact. A disinfectant and ‘medicine’ is placed over the remaining pulp, and the tooth is sealed with a crown in order to protect and strengthen the remaining tooth structure.
A pulpectomy is necessary when the nerve of the tooth is dead. The entire pulp is infected and removed with a medication placed in the root canals. Again, a crown is placed over the tooth to strengthen and preserve the tooth in the mouth. The advantage is just that, preserving the tooth in the mouth. This holds space for the permanent tooth developing below it and allows the tooth to still be used for function.
Fluoride varnish is a wonderful alternative to the foam that many of us parents received when we were younger. It is a much improved method of decay prevention for our patients. The fluoride varnish has a longer working time increasing the potential release of ‘tooth vitamins’ (fluoride) to prevent decay and remineralize incipient lesions. To maximize the benefits of fluoride varnish abide by the following recommendations:
- Avoid eating or drinking for 20 minutes after placement of the varnish.
- Eat a soft, nonabrasive diet for the remainder of the day.
- Do not floss or brush teeth the day/night of the varnish application. The following morning, use an old toothbrush to brush due to the ‘sticky’ nature of the varnish. Then, get out your child’s new toothbrush from Dr. Kaitlin and resume brushing twice a day with fluoride toothpaste.
A space maintainer is used to hold space for a permanent tooth when a baby tooth has been prematurely lost or extracted. If space is not maintained, teeth on either side of the missing tooth can drift into the space and prevent the permanent tooth from erupting.