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General Topics

Girl smiling and painting - Pediatric Dentist in Wenatchee, Ephrata and Cashmere, WA

For more information concerning pediatric dentistry, please visit the website for the American Academy of Pediatric Dentistry.


What is a Pediatric Dentist?

Boy smiling outside - Pediatric Dentist in Wenatchee, Ephrata and Cashmere, WAThe pediatric dentist has an extra two to three years of specialized training after dental school, and is dedicated to the oral health of children from infancy through the teenage years. The very young, pre-teens, and teenagers all need different approaches in dealing with their behavior, guiding their dental growth and development, and helping them avoid future dental problems. The pediatric dentist is best qualified to meet these needs.

For more information concerning pediatric dentistry, please visit the website for the American Academy of Pediatric Dentistry.

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What to Expect at Different Ages

Boy in green striped shirt smiling - Pediatric Dentist in Wenatchee, Ephrata and Cashmere, WAPrenatal

  • Because there is a greater risk of health problems during pregnancy, mothers should brush regularly with anti-gingivitis toothpaste
  • Expectant moms should visit their dentist for a check-up early in pregnancy.
  • A baby’s teeth start to form early in pregnancy.
  • A nutritious diet and good oral hygiene will ensure that the mother’s and baby’s teeth will be healthy.

Ages 0-2 years

  • Clean mouth, gums, and tongue with gauze or a washcloth before teeth begin to appear.
  • Pay special attention to lifting the upper lip when brushing the front teeth and brush the gum line.
  • Begin a visit to a dentist when the first tooth appears and no later than 12 months.
  • Parents should brush child’s teeth at least twice a day, after breakfast and before bed.
  • Floss between all teeth that are touching at least once daily.
  • Use a child-sized toothbrush with a smear of fluoride toothpaste.
  • Signs of a healthy mouth include pink gums, white teeth, no mouth sores.

Eruption Of Your Child's Teeth

Children’s teeth begin forming before birth. As early as 4 months, the first primary (or baby) teeth to erupt through the gums are 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 varies.

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).

Ages 2-5 years

  • Begin teaching preschoolers to brush by gripping the brush for the child and guide it around the mouth.
  • Parents should brush child’s teeth at least twice a day, after breakfast and before bed.
  • Continue to help the child to brush until at least years of age.
  • Use a child-sized brush that is easy to grip.
  • Increase toothpaste amount to pea-size as the child learns to spit after brushing.

Ages 5+

  • Brush teeth at least twice a day; after breakfast and before bed.
  • Teach children to brush their tongue to remove bacteria from the mouth.
  • Use a child-sized brush that is easy to grip.
  • Coach brushing until age 11 when most kids can brush on their own.
  • An adult should floss for kids under the age of 8.

Ages 6-12

  • “Mixed dentition” stage.
  • Eruption of permanent teeth may require decision about sealant application.
  • Dentist may recommend a fluoride rinse if child can spit adequately.
  • Activity in sports increases and the permanent upper incisors are greatest risk for trauma… consideration of mouth guards for sports.
  • Increased carbohydrate exposures and more challenges to control diet.
  • All permanent teeth generally erupted by age 12, except possibility of four 2nd molars, which may erupt as late as 13 years and the 3rd molars which erupt between age 17 and 21.
  • Orthodontic check-up by age 7?

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Ages 12-18

Oral development frequently asked questions

Why take my child to a pediatric dentist?

Pediatric dentists are the pediatricians of dentistry. Following dental school, a pediatric dentist has two to three additional years of specialty training in the unique needs of young people, including those with special health needs. We limit our practice to the treatment of children only.

What age should my child stop sucking his/her thumb or pacifier?

Nonnutritive sucking behaviors are considered normal in infants and young children. Prolonged habits (usually after 36 months of age) may result in adverse orthodontic complications (i. e. crowded, crooked teeth or bite problems). If your child is still sucking 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.

Can my child safely use fluoride toothpaste?

A “smear” of fluoridated toothpaste for children less than years of age decreases risk of any adverse effects of too much fluoride (fluorosis). A “pea sized amount” is appropriate for children aged 2-5 years. Parents should always dispense the toothpaste on to a soft-age appropriate brush and assist with brushing in pre-school aged children. To maximize the effects of fluoride in the toothpaste, rinsing after brushing should be minimal or eliminated.

When should I floss my child’s teeth?

Start to floss when the adjacent tooth surfaces cannot be cleansed with a toothbrush.

At what age should my child have their first dental visit?

“First visit by first birthday” is the rule. Oral health is integral to general health. To prevent problems early on, your child should see a pediatric dentist between 6 and 12 months of age.

Is it normal for my child to grind their teeth at night?

Bruxism, is the habitual, nonfunctional contact between chewing surfaces of the teeth. Approximately 1 in 4 or 5 children “grind” their teeth at night. Preliminary evidence suggests that juvenile bruxism is a self-limiting condition that does not progress to adult bruxism.

Is fluoride safe?

The AAPD and the AAP encourage the use of fluoride to prevent and control cavities. It is documented to be safe and highly effective to re-mineralize enamel and alter the bacterial metabolism of the microbes that cause cavities.

What should I use to clean my baby’s teeth?

A toothbrush will remove plaque bacteria that can lead to decay. Any soft-bristled toothbrush with a small head, preferably one designed specifically for infants, should be used twice a day, most importantly at bedtime.

What is baby bottle tooth decay?

  • BBTD (previously called ‘nursing bottle caries’) is now known as early child caries. It is a pattern of rapid decay often associated with prolonged nursing, bottle-feeding, or frequent use of no-spill training cups containing milk or juice.
  • Avoid putting infants to bed with bottle containing fermentable carbohydrates (i.e. milk, formula, juices)
  • Ad lib breastfeeding should be avoided after the first baby tooth erupts.
  • Encourage drinking from a cup by infants first birthday. Infants should be weaned from the bottle by 12-14 months of age.
  • Between meal snacks and excessive exposures to food or juice or other liquids containing sugars should be avoided.

If my child gets a toothache, what should I do?

Rinse your child’s mouth with warm salt water and apply a cold compress of ice wrapped in a cloth to your child’s face if swollen. Do not put heat or aspirin on the sore area. You may give your child acetaminophen (Tylenol) or ibuprofen (Advil or Motrin) for pain. Do not give children aspirin and closely follow the dosage based on your child’s weight on the bottle. Call our office as soon as possible.

How safe are dental x-rays?

With contemporary safeguards, such as lead aprons and digital x-rays, the amount of radiation received in a dental x-ray 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 treated dental problem.

My child plays sports. How should I protect my child’s teeth?

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

What should I do if my child knocks out a permanent tooth?

First of all, remain calm! If possible, find the tooth and hold it by the crown, not the root. Replace the tooth in the socket and have your child bite on a moist washcloth or gauze. If you cannot replace the tooth in the socket, place the tooth in a container of COLD MILK and take it and your child to us immediately! The faster you act, the better chance we will be able to save the tooth.

How can I help my baby through teething?

Sore gums when teeth erupt are a normal part of the eruption process. The discomfort may be eased with teething biscuits, toast, or cool teething rings.

Why do you fix cavities in baby teeth when they will eventually fall out?

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 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 orthodontic concerns 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 for the overall health of your child.

What causes tooth decay?

Four things are necessary for cavities to form – a tooth, bacteria, sugar or other carbohydrates, and time. Dental plaque is a thin, sticky 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 acid that attack the tooth enamel. With time and repeated acid attacks, the enamel breaks down and a cavity forms.

Can I stay in the room with my child during his/her visit?

We welcome parents to remain with their child throughout their visit to our practice, with the exception of general anesthesia. Parents are not allowed into hospital operating rooms or surgical center anesthesia suites.

How do I make my child’s diet safe for his/her teeth?

Make sure your child has a balanced diet, including one serving each of: fruits and vegetables, breads and cereals, mild and dairy products, and meat fish and eggs. Limiting the servings of sugars and starches will also aid in protecting your child’s teeth from decay. You can also ask your pediatric dentist to help you select foods that protect your children’s teeth.

How do dental sealants work?

Sealants work by filling in the crevasses on the chewing surfaces of the teeth. This shuts out food particles that could get caught in the teeth, causing cavities. The application is fast and comfortable and can effectively protect teeth for many years.

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General Topics

Why Are The Primary Teeth Important?

It is very important to maintain the health of the primary teeth. Neglected cavities can and frequently do lead to problems which affect developing permanent teeth. Primary teeth, or baby teeth are important for (1) proper chewing and eating, (2) providing space for the permanent teeth and guiding them into the correct position, and (3) permitting normal development of the jaw bones and muscles. Primary teeth also affect the development of speech and add to an attractive appearance. While the front 4 teeth last until 6-7 years of age, the back teeth (cuspids and molars) aren’t replaced until age 10-13.

Eruption Of Your Child's Teeth

Children’s teeth begin forming before birth. As early as 4 months, the first primary (or baby) teeth to erupt through the gums are 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 varies.

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).

Dental Emergencies

Child holding loose tooth - Pediatric Dentist in Wenatchee, Ephrata and Cashmere, WA
Toothache: Clean the area of the affected tooth. Rinse the mouth thoroughly with warm water or use dental floss to dislodge any food that may be impacted. If the pain still exists, contact your child's dentist. Do not place aspirin or heat on the gum or on the aching tooth. If the face is swollen, apply cold compresses and contact us immediately.

Cut or Bitten Tongue, Lip or Cheek: Apply ice to injured areas to help control swelling. If there is bleeding, apply firm but gentle pressure with a gauze or cloth. If bleeding cannot be controlled by simple pressure, call a doctor or visit the hospital emergency room.

Knocked Out Permanent Tooth: If possible, find the tooth. Handle it by the crown, not by the root. You may rinse the tooth with water only. DO NOT clean with soap, scrub or handle the tooth unnecessarily. Inspect the tooth for fractures. If it is sound, try to reinsert it in the socket. Have the patient hold the tooth in place by biting on a gauze. If you cannot reinsert the tooth, transport the tooth in a cup containing the patient’s saliva or milk. If the patient is old enough, the tooth may also be carried in the patient’s mouth (beside the cheek). The patient must see a dentist IMMEDIATELY! Time is a critical factor in saving the tooth so call us right away.

Knocked Out Baby Tooth: This is not usually an emergency, and in most cases, no treatment is necessary.  You may call during business hours, or call our emergency number if you need reassurance or have questions that you feel need immediate attention.

Chipped or Fractured Permanent Tooth: Contact us immediately. Quick action can save the tooth, prevent infection and reduce the need for extensive dental treatment. Rinse the mouth with water and apply cold compresses to reduce swelling. If possible, locate and save any broken tooth fragments and bring them with you.

Chipped or Fractured Baby Tooth: Contact us.  Generally, this is not an emergency.

Severe Blow to the Head: Take your child to the nearest hospital emergency room immediately.

Possible Broken or Fractured Jaw: Keep the jaw from moving and take your child to the nearest hospital emergency room.

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Dental Radiographs (X-Rays)

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.

Dental Radiographs (X-Rays) - Pediatric Dentist in Wenatchee, Ephrata and Cashmere, WA

Radiographs detect much more than cavities. For example, radiographs may be needed to survey erupting teeth, diagnose bone diseases, evaluate the results of an injury, or plan orthodontic treatment. Radiographs 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.

The American Academy of Pediatric Dentistry recommends radiographs every six to 18 months depending on the risk of tooth decay.  We can assess each child’s risk and recommend the appropriate interval for radiographs.  Approximately every 3 years, it is a good idea to obtain a complete set of radiographs, either a panoramic (shows jaws and teeth) and bitewings (shows between the teeth) or periapicals (shows the whole tooth) and bitewings.

Pediatric dentists are particularly careful to minimize the exposure of their patients to radiation. With contemporary safeguards, the amount of radiation received in a dental X-ray examination is extremely small. The risk is negligible. In fact, the dental radiographs represent a far smaller risk than an undetected and untreated dental problem. Lead body aprons and shields will protect your child. Today’s equipment filters out unnecessary x-rays and restricts the x-ray beam to the area of interest. High-speed film and proper shielding assure that your child receives a minimal amount of radiation exposure.

What's The Best Toothpaste For My Child?

Child Brushing Teeth - Pediatric Dentist in Wenatchee, Ephrata and Cashmere, WATooth brushing is one of the most important tasks for good oral health. Many toothpastes, and/or tooth polishes, however, can damage young smiles. They contain harsh abrasives, which can wear away young tooth enamel. When looking for a toothpaste for your child, make sure to pick one that is recommended by the American Dental Association as shown on the box and tube. These toothpastes have undergone testing to insure they are safe to use.

Remember, children should spit out toothpaste after brushing to avoid getting too much fluoride. If too much fluoride is ingested, a condition known as fluorosis can occur. If your child is too young or unable to spit out toothpaste, consider providing them with a fluoride free toothpaste, using no toothpaste, or using only a "pea size" amount of toothpaste.  Please come see us for a custom fluoride recommendation.

 

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

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 (teeth getting shorter) 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, when people are chewing gum, etc. to equalize pressure) the child will grind by moving his jaw to relieve this pressure.

The majority of cases of pediatric bruxism do not require any treatment. If excessive wear of the teeth (attrition) is present, then a mouth guard (night guard) may be indicated. The negatives to a mouth guard are the possibility of choking if the appliance becomes dislodged during sleep and it may interfere with growth of the jaws. The positive is obvious by preventing wear to the primary dentition.

The good news is most children outgrow bruxism. The grinding decreases between the ages 6-9 and children tend to stop grinding between ages 9-12.

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Thumb Sucking

Child sucking thumb - Pediatric Dentist in Wenatchee, Ephrata and Cashmere, WASucking is a natural reflex and infants and young children may use thumbs, fingers, pacifiers and other objects on which to suck. It may make them feel secure and happy, or provide a sense of security at difficult periods. Since thumb sucking is relaxing, it may induce sleep.

Thumb sucking that persists beyond the eruption of the permanent teeth can cause problems with the proper growth of the mouth and tooth alignment. How intensely a child sucks on fingers or thumbs will determine whether or not dental problems may result. Children who rest their thumbs passively in their mouths are less likely to have difficulty than those who vigorously suck their thumbs.

Children should cease thumb sucking by the time their permanent front teeth are ready to erupt. Usually, children stop between the ages of two and four. Peer pressure causes many school-aged children to stop.

Pacifiers are no substitute for thumb sucking. They can affect the teeth essentially the same way as sucking fingers and thumbs. However, use of the pacifier can be controlled and modified more easily than the thumb or finger habit. If you have concerns about thumb sucking or use of a pacifier, please consult us.

A few suggestions to help your child get through thumb sucking:

  • Children often suck their thumbs when feeling insecure. Focus on correcting the cause of anxiety, instead of the thumb sucking.
  • Children who are sucking for comfort will feel less of a need when their parents provide comfort.
  • Reward children when they refrain from sucking during difficult periods, such as when being separated from their parents.
  • We can encourage children to stop sucking and explain what could happen if they continue.
  • If these approaches don’t work, remind the children of their habit by bandaging the thumb or putting a sock on the hand at night. We may recommend the use of a mouth appliance.

What Is Pulp Therapy?

The pulp of a tooth is the inner, central core of the tooth. The pulp contains nerves, blood vessels, connective tissue and reparative cells. The purpose of pulp therapy in Pediatric Dentistry is to maintain the vitality of the affected tooth (so the tooth is not lost).

Dental caries (cavities) and traumatic injury are the main reasons for a tooth to require pulp therapy. Pulp therapy is often referred to as a "nerve treatment", "children's root canal", "pulpectomy" or "pulpotomy". The two common forms of pulp therapy in children's teeth are the pulpotomy and pulpectomy.

A pulpotomy removes the diseased pulp tissue within the crown portion of the tooth. Next, an agent is placed to prevent bacterial growth and to calm the remaining nerve tissue. This is followed by a final restoration (usually a stainless steel crown).

A pulpectomy is required when the entire pulp is involved (into the root canal(s) of the tooth). During this treatment, the diseased pulp tissue is completely removed from both the crown and root. The canals are cleansed, disinfected and, in the case of primary teeth, filled with a resorbable material. Then, a final restoration is placed. A permanent tooth would be filled with a non-resorbing material.

What Is The Best Time For Orthodontic Treatment?

Boy with retainer - Pediatric Dentist in Wenatchee, Ephrata and Cashmere, WADeveloping malocclusions, or bad bites, can be recognized as early as 2-3 years of age. Often, early steps can be taken to reduce the need for major orthodontic treatment at a later age.

Stage I – Early Treatment: This period of treatment encompasses ages 2 to 6 years. At this young age, we are concerned with underdeveloped dental arches, the premature loss of primary teeth, and harmful habits such as finger or thumb sucking. Treatment initiated in this stage of development is often very successful and many times, though not always, can eliminate the need for future orthodontic/orthopedic treatment.

Stage II – Mixed Dentition: This period covers the ages of 6 to 12 years, with the eruption of the permanent incisor (front) teeth and 6 year molars. Treatment concerns deal with jaw malrelationships and dental realignment problems. This is an excellent stage to start treatment, when indicated, as your child’s hard and soft tissues are usually very responsive to orthodontic or orthopedic forces.

Stage III – Adolescent Dentition: This stage deals with the permanent teeth and the development of the final bite relationship.

Adult Teeth Coming in Behind Baby Teeth


Adult tooth behind baby tooth - Pediatric Dentist in Wenatchee, Ephrata and Cashmere, WAThis is a very common occurrence with children, usually the result of a lower, primary (baby) tooth not falling out when the permanent tooth
is coming in.  In most cases if the child starts wiggling the baby tooth, it will usually fall out on its own within two months. If it doesn't, then contact us, where they can easily remove the tooth.  The permanent tooth should then slide into the proper place.

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Early Infant Oral Care

Perinatal & Infant Oral Health

Boy with pregnant mother - Pediatric Dentist in Wenatchee, Ephrata and Cashmere, WAThe American Academy of Pediatric Dentistry (AAPD) recommends that all pregnant women receive oral healthcare and counseling during pregnancy. Research has shown evidence that periodontal disease can increase the risk of preterm birth and low birth weight. Talk to your doctor or dentist about ways you can prevent periodontal disease during pregnancy.

Additionally, mothers with poor oral health may be at a greater risk of passing the bacteria which causes cavities to their young children. Mother's should follow these simple steps to decrease the risk of spreading cavity-causing bacteria:

  • Visit your dentist regularly.
  • Brush and floss on a daily basis to reduce bacterial plaque.
  • Proper diet, with the reduction of beverages and foods high in sugar & starch.
  • Use a fluoridated toothpaste recommended by the ADA and rinse every night with an alocohol-free, over-the-counter mouth rinse with .05 % sodium fluoride in order to reduce plaque levels.
  • Don't share utensils, cups or food which can cause the transmission of cavity-causing bacteria to your children.
  • Proper use of xylitol chewing gum (4 pieces per day by the mother) can decrease a child’s caries rate.

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

The American Academy of Pediatrics (AAP), the American Dental Association (ADA), and the American Academy of Pediatric Dentistry (AAPD) all recommend establishing a "Dental Home" for your child by one year of age. Children who have a dental home are more likely to receive appropriate preventive and routine oral health care.

The Dental Home is intended to provide a place other than the Emergency Room for parents.

You can make the first visit to the dentist enjoyable and positive. If old enough, your child should be informed of the visit and told that the dentist and their staff will explain all procedures and answer any questions. The less to-do concerning the visit, the better.

It is best if you refrain from using words around your child that might cause unnecessary fear, such as needle, pull, drill or hurt. Pediatric dental offices make a practice of using words that convey the same message, but are pleasant and non-frightening to the child.

When Will My Baby Start Getting Teeth?

Teething, the process of baby (primary) teeth coming through the gums into the mouth, is variable among individual babies. Some babies get their teeth early and some get them late. In general, the first baby teeth to appear are usually the lower front (anterior) teeth and they usually begin erupting between the age of 6-8 months.

See "Eruption of Your Child’s Teeth" for more details.

Baby Bottle Tooth Decay (Early Childhood Caries)

Baby sleeping with bottle - Pediatric Dentist in Wenatchee, Ephrata and Cashmere, WAOne serious form of decay among young children is baby bottle tooth decay. 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.

After each feeding, wipe the baby’s gums and teeth with a damp washcloth or gauze pad to remove plaque. The easiest way to do this is to sit down, place the child’s head in your lap or lay the child on a dressing table or the floor. Whatever position you use, be sure you can see into the child’s mouth easily.

Child with sippy cup - Pediatric Dentist in Wenatchee, Ephrata and Cashmere, WASippy Cups

Sippy cups should be used as a training tool from the bottle to a cup and should be discontinued by the first birthday. If your child uses a sippy cup throughout the day, fill the sippy cup with water only (except at mealtimes). By filling the sippy cup with liquids that contain sugar (including milk, fruit juice, sports drinks, etc.) and allowing a child to drink from it throughout the day, it soaks the child’s teeth in cavity causing bacteria.

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Prevention

Care Of Your Child's Teeth

Good Diet = Healthy Teeth

Good Diet - Pediatric Dentist in Wenatchee, Ephrata and Cashmere, WAHealthy eating habits lead to healthy teeth. Like the rest of the body, the teeth, bones and the soft tissues of the mouth need a well-balanced diet. Children should eat a variety of foods from the five major food groups. Most snacks that children eat can lead to cavity formation. The more frequently a child snacks, the greater the chance for tooth decay. How long food remains in the mouth also plays a role. For example, hard candy and breath mints stay in the mouth a long time, which cause longer acid attacks on tooth enamel. If your child must snack, choose nutritious foods such as vegetables, low-fat yogurt, and low-fat cheese, which are healthier and better for children’s teeth.

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How Do I Prevent Cavities?

Good oral hygiene removes bacteria and the left over food particles that combine to create cavities. For infants, use a wet gauze or clean washcloth to wipe the plaque from teeth and gums. Avoid putting your child to bed with a bottle filled with anything other than water. See "Baby Bottle Tooth Decay" for more information.

For older children, brush their teeth at least twice a day. Also, watch the number of snacks containing sugar that you give your children.

The American Academy of Pediatric Dentistry recommends visits every six months to the pediatric dentist, beginning at your child’s first birthday. Routine visits will start your child on a lifetime of good dental health.

We may also recommend protective sealants or home fluoride treatments for your child. Sealants can be applied to your child’s molars to prevent decay on hard to clean surfaces.

Seal Out Decay

A sealant is a protective coating that is applied to the chewing surfaces (grooves) of the back teeth (premolars and molars), where four out of five cavities in children are found. This sealant acts as a barrier to food, plaque and acid, thus protecting the decay-prone areas of the teeth.

Tooth Before Sealant - Pediatric Dentist in Wenatchee, Ephrata and Cashmere, WA

 Before Sealant Applied

Tooth After Sealant - Pediatric Dentist in Wenatchee, Ephrata and Cashmere, WA

After Sealant Applied

Fluoride

Fluoride is an element, which has been shown to be beneficial to teeth. However, too little or too much fluoride can be detrimental to the teeth. Little or no fluoride will not strengthen the teeth to help them resist cavities. Excessive fluoride ingestion by preschool-aged children can lead to dental fluorosis, which is a chalky white to even brown discoloration of the permanent teeth. Many children often get more fluoride than their parents realize. Being aware of a child’s potential sources of fluoride can help parents prevent the possibility of dental fluorosis.

Some of these sources are:

  • Too much fluoridated toothpaste at an early age.
  • The inappropriate use of fluoride supplements.
  • Hidden sources of fluoride in the child’s diet.

Two and three year olds may not be able to expectorate (spit out) fluoride-containing toothpaste when brushing. As a result, these youngsters may ingest an excessive amount of fluoride during tooth brushing. Toothpaste ingestion during this critical period of permanent tooth development is the greatest risk factor in the development of fluorosis.

Excessive and inappropriate intake of fluoride supplements may also contribute to fluorosis. Fluoride drops and tablets, as well as fluoride fortified vitamins should not be given to infants younger than six months of age. After that time, fluoride supplements should only be given to children after all of the sources of ingested fluoride have been accounted for and upon the recommendation of your pediatrician or pediatric dentist.

Certain foods contain high levels of fluoride, especially powdered concentrate infant formula, soy-based infant formula, infant dry cereals, creamed spinach, and infant chicken products. Please read the label or contact the manufacturer. Some beverages also contain high levels of fluoride, especially decaffeinated teas, white grape juices, and juice drinks manufactured in fluoridated cities.

Parents can take the following steps to decrease the risk of fluorosis in their children’s teeth:

  • Use baby tooth cleanser on the toothbrush of the very young child.
  • Place only a pea sized drop of children’s toothpaste on the brush when brushing.
  • Account for all of the sources of ingested fluoride before requesting fluoride supplements from your child’s physician or pediatric dentist.
  • Avoid giving any fluoride-containing supplements to infants until they are at least 6 months old.
  • Obtain fluoride level test results for your drinking water before giving fluoride supplements to your child (check with local water utilities).

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Mouth Guards

Child in football helmet with mouth guard - Pediatric Dentist in Wenatchee, Ephrata and Cashmere, WAWhen a child begins to participate in recreational activities and organized sports, injuries can occur. A properly fitted mouth guard, 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.

Mouth guards 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 us about custom and store-bought mouth protectors.

 

Xylitol - Reducing Cavities

The American Academy of Pediatric Dentistry (AAPD) recognizes the benefits of xylitol on the oral health of infants, children, adolescents, and persons with special health care needs.

The use of XYLITOL GUM by mothers (2-3 times per day) starting 3 months after delivery and until the child was 2 years old, has proven to reduce cavities up to 70% by the time the child was 5 years old.

Studies using xylitol as either a sugar substitute or a small dietary addition have demonstrated a dramatic reduction in new tooth decay, along with some reversal of existing dental caries. Xylitol provides additional protection that enhances all existing prevention methods. This xylitol effect is long-lasting and possibly permanent. Low decay rates persist even years after the trials have been completed.

Xylitol is widely distributed throughout nature in small amounts. Some of the best sources are fruits, berries, mushrooms, lettuce, hardwoods, and corn cobs. One cup of raspberries contains less than one gram of xylitol.

Studies suggest xylitol intake that consistently produces positive results ranged from 4-20 grams per day, divided into 3-7 consumption periods. Higher results did not result in greater reduction and may lead to diminishing results. Similarly, consumption frequency of less than 3 times per day showed no effect.

To find gum or other products containing xylitol, try visiting your local health food store or search the Internet to find products containing 100% xylitol.

Beware of Sports Drinks

Sports Drinks - Pediatric Dentist in Wenatchee, Ephrata and Cashmere, WADue to the high sugar content and acids in sports drinks, they have erosive potential and the ability to dissolve even fluoride-rich enamel, which can lead to cavities.

To minimize dental problems, children should avoid sports drinks and hydrate with water before, during and after sports.  Be sure to talk to us before using sports drinks.

If sports drinks are consumed:

  • reduce the frequency and contact time
  • swallow immediately and do not swish them around the mouth
  • neutralize the effect of sports drinks by alternating sips of water with the drink
  • rinse mouthguards only in water
  •  seek out dentally friendly sports drinks

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Adolescent
Dentistry

Teens smiling - Pediatric Dentist in Wenatchee, Ephrata and Cashmere, WA

Tongue Piercing - Is It Really Cool?

You might not be surprised anymore to see people with pierced tongues, lips or cheeks, but you might be surprised to know just how dangerous these piercings can be.

There are many risks involved with oral piercings, including chipped or cracked teeth, blood clots, blood poisoning, heart infections, brain abscess, nerve disorders (trigeminal neuralgia), receding gums or scar tissue. Your mouth contains millions of bacteria, and infection is a common complication of oral piercing. Your tongue could swell large enough to close off your airway!

Common symptoms after piercing include pain, swelling, infection, an increased flow of saliva and injuries to gum tissue. Difficult-to-control bleeding or nerve damage can result if a blood vessel or nerve bundle is in the path of the needle.

So follow the advice of the American Dental Association and give your mouth a break – skip the mouth jewelry.

Tobacco - Bad News In Any Form

Tobacco in any form can jeopardize your child’s health and cause incurable damage. Teach your child about the dangers of tobacco.

Smokeless tobacco, also called spit, chew or snuff, is often used by teens who believe that it is a safe alternative to smoking cigarettes. This is an unfortunate misconception. Studies show that spit tobacco may be more addictive than smoking cigarettes and may be more difficult to quit. Teens who use it may be interested to know that one can of snuff per day delivers as much nicotine as 60 cigarettes. In as little as three to four months, smokeless tobacco use can cause periodontal disease and produce pre-cancerous lesions called leukoplakias.

If your child is a tobacco user you should watch for the following that could be early signs of oral cancer:

  • A sore that won’t heal.
  • White or red leathery patches on the lips, and on or under the tongue.
  • Pain, tenderness or numbness anywhere in the mouth or lips.
  • Difficulty chewing, swallowing, speaking or moving the jaw or tongue; or a change in the way the teeth fit together.

Because the early signs of oral cancer usually are not painful, people often ignore them. If it’s not caught in the early stages, oral cancer can require extensive, sometimes disfiguring, surgery. Even worse, it can kill.

Help your child avoid tobacco in any form. By doing so, they will avoid bringing cancer-causing chemicals in direct contact with their tongue, gums and cheek.

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Wenatchee Office 246 N. Mission St.
Wenatchee WA 98801
509-664-5000
info@wenatcheepediatricdentistry.com
Monday
8:00 am - 5:00 pm
Tuesday
8:00 am - 5:00 pm
Wednesday
8:00 am - 5:00 pm
Thursday
8:00 am - 5:00 pm
Friday
Closed
Saturday
Closed
Sunday
Closed