Dental Topics



General Topics

What Is A Pediatric Dentist?

A 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.

Dr. Pong and Dr. Trisha are both board certified in pediatric dentistry and have advanced training in behavior management and sedation techniques.

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 (canines and molars) aren’t replaced until age 10-13.

Eruption Of Your Child's Teeth

Tooth Eruption Chart - Pediatric Dentist in Cincinnati, OHChildren’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

Dental Emergencies - Pediatric Dentist in Cincinnati, OHToothache: 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 our office 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 Dr. Pong or Dr. Trisha 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 washcloth or folded paper towel/napkin. If you cannot reinsert the tooth, transport the tooth in a cup containing the patient’s saliva or milk. The patient must see a dentist IMMEDIATELY! Time is a critical factor in saving the tooth.

Knocked Out Baby Tooth: Contact our office during business hours. This is not usually an emergency, and in most cases, no treatment is necessary.

Chipped/Fractured Permanent Tooth: Contact our office 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 to the dentist.

Chipped/Fractured Baby Tooth: Contact our office to discuss your options.

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.

Dental Radiographs (X-Rays)

X-Rays are a vital and necessary part of your child’s dental diagnostic process.

Dental Radiographs (X-Rays) - Pediatric Dentist in Cincinnati, OH

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.

The American Academy of Pediatric Dentistry recommends radiographs and examinations every six months for children with a high risk of tooth decay. At Smiles4Kids, our doctors prescribe x-rays based on your child’s needs. Most children benefit from cavity-check x-rays one time each year. A different x-rays is usually recommended every three to five years to evaluate growth, development and orthodontic needs.

We are particularly careful to minimize the radiation exposure to our patients. 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, thyroid collars 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. We use digital radiography in our office to further reduce the exposure.

What's The Best Toothpaste For My Child?

Brushing Teeth - Pediatric Dentist in Cincinnati, OHFor children under two years of age, the American Academy of Pediatrics and the American Academy of Pediatric Dentistry recommend a “grain of rice” amount of kid’s toothpaste WITH fluoride.

For children two and older, we recommend a “pea size” amount of kid’s toothpaste with fluoride.

A responsible adult should always assist with and supervise tooth brushing for children under eight years old. Some older children may benefit from assistance. Check your child’s report card or ask us how they are doing.


Is Fluoride Safe?

Fluoride is a naturally occurring element (like salt or calcium) that has been scientifically proven to control tooth decay. At home, we recommend a “grain of rice” size of toothpaste for kids under two years old and a “pea size” amount for kids older than two years. You can encourage your child to spit out the toothpaste if they are old enough to understand.

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

Parents are often concerned about the night time grinding of teeth (bruxism). Often, the first indication is the noise created by the child grinding on their teeth during sleep. 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 or sinuses 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 do not require any treatment. The grinding decreases between the ages 6-9 and children tend to stop grinding between ages 9-12. We do not recommend anything be placed in the mouth of small children to prevent the teeth from touching (night guard.) This causes restriction of jaw growth. We will re-evaluate once all of the permanent teeth are erupted in the early teenage years. If your teen is having symptoms, please discuss these with us.

Thumb Sucking

Thumb Sucking - Pediatric Dentist in Cincinnati, OHSucking 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 let us know.

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.
  • Your pediatric dentist 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. Your pediatric dentist 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 and blood vessels. The purpose of pulp therapy in pediatric dentistry is to maintain the vitality of the affected tooth (so the tooth is not lost).

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", "baby root canal.” The technical term is pulpotomy. A pulpotomy removes the diseased pulp tissue within the crown portion of the tooth. Next, a medicine is placed to prevent bacterial growth and to calm the remaining nerve tissue. This is followed by a white crown on front teeth and a silver crown on back teeth.

What Is The Best Time For Orthodontic Treatment?

Orthodontic Treatment - Pediatric Dentist in Cincinnati, OHOrthodontic TreatmentDeveloping 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.



Early Infant Oral Care

Perinatal & Infant Oral Health

Perinatal & Infant Oral Health - Pediatric Dentist in Cincinnati, OHPerinatal & Infant Oral Health: The 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 babies. 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.
  • Use of xylitol chewing gum (4 pieces per day by the mother) can decrease a child’s caries rate.
  • Never clean a pacifier by putting it in your mouth.

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. We 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 Bottle Tooth Decay - Pediatric Dentist in Cincinnati, OHOne 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 soft toothbrush 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.

Sippy Cups

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, soda, etc.) and allowing a child to drink from it throughout the day, it soaks the child’s teeth in sugar giving plaque bacteria an opportunity to produce acids that attack tooth enamel. It is important to note that the type of sugar is not important in the cavity process. Organic foods/juices and watered down drinks can cause the same type of cavity process.


Prevention

Care Of Your Child's Teeth

Brushing Tips - Pediatric Dentist in Cincinnati, OHBrushing Tips:

  • Starting at birth, clean your child's gums with a soft cloth and water.
  • As soon as your child's teeth erupt, brush them with a soft-bristled toothbrush.
  • If they are under the age of 2, use a small "smear" of toothpaste.
  • If they're 2-5 years old, use a "pea-size" amount of toothpaste.
  • Be sure and use an ADA-accepted fluoride toothpaste.
  • When brushing, the parent should brush the child's teeth until they are old enough to do a good job on their own.

Flossing Tips:

  • Flossing removes plaque between teeth and under the gumline where a toothbrush can't reach.
  • Flossing should begin when any two teeth touch.
  • Be sure and floss your child's teeth daily until he or she can do it alone.

Good Diet = Healthy Teeth

Good Diet - Pediatric Dentist in Cincinnati, OHHealthy 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.

Gummy vitamins are popular among children for the fun characters on the label and the great flavor. However, they contain sugar and are sticky like fruit snacks. That means they can cause cavities. We recommend a chewable vitamin. Just check the label to make sure it’s sugar free!


How Do I Prevent Cavities?

Good oral hygiene removes bacteria and the food particles that combine to create cavities. For infants, use a clean washcloth or soft toothbrush 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 by your child’s first birthday. Routine visits will start your child on a lifetime of good dental health.

Dr. Pong or Dr. Trisha may also recommend protective sealants 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 white plastic material 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. Sealants do not last forever and are designed to protect your child until he/she is old enough to properly clean those new permanent molars and control his/her diet.

Sealant-Before - Pediatric Dentist in Cincinnati, OH
Before Sealant Applied

Sealant-After - Pediatric Dentist in Cincinnati, OH
After Sealant Applied

Mouth Guards

Mouth Guards - Pediatric Dentist in Cincinnati, OHWhen a child begins to participate in recreational activities and organized sports, injuries can occur. A properly fitted mouth guard 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.

We can make a custom fit mouth guard that is easy to breath, drink and speak with. Ask us about them!

 


Adolescent Dentistry

Teens - Pediatric Dentist in Cincinnati, OH

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 damage, 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.

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.


E-Cigarettes or “Vaping”

You and/or your teen may believe that e-cigarettes or vaping is safer than traditional cigarettes. However, the ingredients in e-cigarettes can vary widely without the user knowing. In Ohio, it is illegal for anyone under 18 to buy, sell or use an e-cigarette. The cartridges typically contain dangerous levels of nicotine as well as other poisons and chemicals. In fact, the lethal dose of nicotine for a child is often only one-tenth of a cartridge and only one-half for an adult! They are addictive and can cause eye, throat or airway problems as well as asthma and other harmful effects.