FAQ

We specialize in pediatric dentistry, which means our focus is on treating infants, children, and adolescents. Below are common questions and our answers about the best way to care for children’s teeth.

When should I schedule my child’s first visit to the dentist?

We recommend that you make an appointment to see the dentist as soon as your child gets his first tooth. The American Academy of Pediatric Dentistry recommends that a child is seen by 6 months after his/her first tooth erupts or by 1 year old, whichever is first.

What happens during my child’s first visit to the dentist?

The first visit is usually short and simple. In most cases, we focus on getting to know your child and giving you some basic information about dental care. The doctor will check your child’s teeth for placement and health, and look for any potential problems with the gums and jaw. If necessary, we may do a bit of cleaning. We will also answer any questions you have about how to care for your child’s teeth as they develop, and provide you with materials containing helpful tips that you can refer to at home.

How can I prepare my child for his first dental appointment?

The best preparation for your child’s first visit to our office is maintaining a positive attitude. Children pick up on adults’ apprehensions and if you make negative comments about trips to the dentist, you can be sure that your child will fear an unpleasant experience and act accordingly. Show your child the pictures of the office and staff on the website. Let your child know that it’s important to keep his teeth and gums healthy, and that the doctor will help him do that. Remember that your pediatric dentist is specially trained to handle fears and anxiety, and our staff excels at putting children at ease during treatment.

How often should my child visit the dentist?

We generally recommend scheduling check-ups every six months. Depending on the circumstances of your child’s oral health, we may recommend more frequent visits.

How is a pediatric dentist different from other dentists?

All dental specialists (pediatric dentists, orthodontists, oral surgeons, and others) begin by completing dental school, and then continue their education with several years of additional specialized training. During training in the field of pediatric dentistry, your doctor gained extensive knowledge and experience in treating infants, children, and adolescents. Pediatric dentists enjoy working with children, and bring to each patient our expertise in childhood development and behavior. Because our office is geared toward young visitors, you’ll find that our staff, as well as our office design, decorations and activities, all work together to provide an especially friendly and comfortable environment for children.

Baby teeth aren’t permanent; why do they need special care?

Although they don’t last as long as permanent teeth, your child’s first teeth play an important role in his development. While they’re in place, these primary teeth help your little one speak, smile and chew properly. They also hold space in the jaw for permanent teeth. If a child loses a tooth too early due to damage or decay nearby teeth may encroach on that space, which can result in crooked or misplaced permanent teeth. Also, your child’s general health is affected by the oral health of the teeth and gums.

What’s the best way to clean my baby’s teeth?

Even before your baby’s first tooth appears, we recommend you clean their gums after feedings with a damp, soft washcloth. As soon as their first tooth appears, you can start using a toothbrush. Choose a toothbrush with soft bristles and a small head. You can most likely find a toothbrush designed for infants at your local drugstore.

At what age is it appropriate to use toothpaste to clean my child’s teeth?

Once your child has a few teeth, you can start using a non-fluoridated toothpaste on the brush. Use only a tiny amount for each cleaning, and be sure to choose toothpaste that says “swallowable” on the label for children under three, as too much fluoride can be dangerous for very young children. Always have your child rinse and spit out toothpaste after brushing, to begin a lifelong habit he’ll need when he graduates to fluoride toothpaste. Children naturally want to swallow toothpaste after brushing, and swallowing too much fluoride toothpaste can cause teeth to stain. You should brush your child’s teeth for him until he is ready to take on that responsibility himself, which usually happens by age six or seven. Click Hereto read about dental care for your baby.

What causes cavities?

Certain types of bacteria live in our mouths. When these bacteria come into contact with sugary foods left behind on our teeth after eating, acids are produced. These acids attack the enamel on the exterior of the teeth, eventually eating through the enamel and creating holes in the teeth, which we call cavities.

How can I help my child avoid cavities?

Be sure that your child brushes his teeth twice a day with fluoride toothpaste. Flossing daily is also important, as flossing can reach spots between the teeth that brushing can’t. Check with Dr. Penman about a fluoride supplement which helps tooth enamel to be harder and more resistant to decay. Avoid sugary foods and drinks, limit snacking, and maintain a healthy diet. And finally, make regular appointments so that we can check the health of your child’s teeth and provide professional cleanings.

Does my child need dental sealants?

Sealants cover the pits and fissures in teeth that are difficult to brush and therefore susceptible to decay. We recommend sealants as a safe, simple way to help your child avoid cavities, especially for molars, which are hardest to reach.

Over the last several years there has been cause and concern over Bisphenol-A in sealant material. The material used in this practice contains Bis-GMA which is a very stable resin monomer.

My child plays sports; how can I protect his/her teeth?

Even children’s sports involve contact, and we recommend mouthguards for children active in sports. If your little one plays baseball, soccer, or other sports, ask us about having a custom-fitted mouthguard made to protect his teeth, lips, cheeks, and gums. Click Hereto read about custom fitted mouthguards.

My Child Grinds His Teeth At Night. Does He need a night guard?

Parents are often concerned about the nocturnal grinding of teeth (bruxism). One theory relates to the pressure in the inner ear at night. If there are pressure changes (like in an airplane taking off or landing) the child will grind to relieve the pressure. Another theory relates to post nasal drip during sleep and an “itchy feeling” in the back of the throat causing the child to grind to relieve the feeling. Your pediatric dentist may want you to consult with your pediatrician to see if an antihistamine may be needed.

The majority of cases of pediatric bruxism do not require any treatment and most children outgrown bruxism. Grinding gets less between six and nine and usually stops between nine and twelve. If excessive wear of the teeth is present, Dr. Penman may recommend a night guard. The negatives are the possibility of choking if the appliance becomes dislodged during sleep and it may interfere with the growth of the jaws.

When and why should my child have dental x-rays taken?

We recommend taking x-rays around the age of two or three. The first set consists of simple pictures of the front upper and lower teeth, which familiarizes your child with the process. Once the baby teeth in back are touching each other, then regular (at least yearly), x-rays are recommended by the AAPD. Permanent teeth start coming in around age six, and x-rays help us make sure your child’s teeth and jaw are healthy and properly aligned. If your child is at a high risk of dental problems, we may suggest having x-rays taken at an earlier age.

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.

In general, children need X-rays more often than adults. Their mouths grow and change rapidly. They are more susceptible to tooth decay than adults. The American Academy of Pediatric Dentistry recommends X-ray examinations every six months for children with a high risk of tooth decay. Children with a low risk of tooth decay require X-rays less frequently.

X-ray films 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 and affordable.

When your child has four upper permanent and four lower permanent teeth and all four six year molars have erupted, Dr. Penman will recommend a panoramic x-ray be taken to look at the twelve remaining permanent teeth that have yet to erupt.

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. Our office uses digital x-rays to further minimize exposure. It also allows for better diagnostic quality.

What is Early Childhood Decay and how do I prevent it?

Infants and children who sleep with a bottle containing anything but water are in danger of developing early childhood decay. Pacifiers dipped in sugar or honey are equally dangerous. While a child sleeps the salivary process slows, which allows liquids remaining in the mouth to pool around the sleeping child’s teeth. Sugars in the liquid combine with bacteria in the mouth to form acid that dissolves the immature enamel. Newly erupted first teeth are highly susceptible to decay. Unfortunately, it does not take long for extensive tooth decay to develop. Early childhood decay is easy to prevent. The following steps will help your child avoid this unpleasant condition:

  • You are not the only person who cares for your child. Warn grandparents and other care givers about the hazards of lulling young children and infants to sleep with bottles and sweetened pacifiers.
  • Remember to massage and cleanse your infant’s gums with a soft cloth or piece of gauze after each feeding. Your pediatric dentist can demonstrate the best position and technique.
  • Visit your pediatric dentist between the arrival of the first tooth and the first birthday. The first visit will focus on prevention, teaching, and any questions you have. This is similar to a well baby visit with your pediatrician.
  • Encourage your child to drink from a cup when she is between 9 and 12 months old.

What about thumb/finger sucking and pacifiers?

Sucking is a natural reflex and infants and young children may use thumbs, fingers and pacifiers on which to suck. It may make then feel secure and happy or provide a sense of security at difficult periods.

Most children stop on their own between two and four years of age. Thumb sucking that extends beyond the eruption of the permanent teeth can cause problems with the growth of the mouth and alignment of the teeth. How intensely a child sucks their thumb or fingers will determine whether or not dental problems may result. Children who rest their thumbs or fingers passively in their mouths are less likely to have difficulty stopping than those who vigorously suck their thumbs or fingers.

Pacifiers are no substitute for thumb sucking. They can also affect the teeth the same way as sucking a thumb or fingers. Taking a pacifier away too early may cause a child to substitute his fingers or thumb for the pacifier. However, the use of the pacifier can be controlled and modified more easily that the thumb or finger habit. If you have concerns about thumb or finger sucking or the use of pacifiers consult with Dr. Penman. Click Hereto read more about thumb sucking.

What about fluoride?

When the element fluoride is used in small amounts on a routine basis it helps to prevent tooth decay. It encourages “remineralization,” a strengthening of weak areas on the teeth. These spots are the beginning of cavity formation. Fluoride occurs naturally in water and in many different foods, as well as in dental products such as toothpaste, mouth rinses, gels, varnish and supplements. Fluoride is effective when combined with a healthy diet and good oral hygiene.

Fluoride is documented to be safe and highly effective. Research indicates water fluoridation, the most cost effective method, has decreased the decay rate by over 50 percent. Only small amounts of fluoride are necessary for the maximum benefit. Proper toothpaste amount must be supervised in order to prevent unsightly spots on the developing permanent teeth. Do not leave toothpaste tubes where young children can reach them. The flavors that help encourage them to brush may also encourage them to eat toothpaste.

Children under the age of three may not have the proper skills to expectorate toothpaste. There are many non-fluoridated tooth cleansers on the market for young children.

Children who benefit the most from fluoride are those at highest risk for dental decay. Risk factors include a history of decay, high sucrose carbohydrate diet, orthodontic appliances and certain medical conditions such as dry mouth.

Certain foods contain high levels of fluoride, especially powdered concentrated infant formula, soy-based infant formula, infant dry cereals, creamed spinach and infant chicken products. Please read the label or contact the manufacturer. Many decaffeinated teas and white grape juices also contain fluoride. It is best to discuss with your child’s pediatrician and pediatric dentist these options before supplementing with drops in order to avoid fluorosis.

What if my child needs a filling? What will you use?

If your child has decay in a molar and needs a restoration or “filling” we will restore the tooth with a tooth colored filling material called composite. This is often referred to as a “white filling.” Our office does not use amalgam or “silver fillings”.

If your child has decay or fractures a front tooth we will use the same composite material placed in a crown form and match the color to your child’s tooth, or the adjacent tooth if the tooth in question has darkened. This is called a composite crown. If needed due to the depth of the decay we do have porcelain over stainless steel crown available. We do not use plain stainless steel crowns on anterior teeth. Click Hereto read about stainless steel crowns vs. white crowns.

After Dr. Penman has evaluated the tooth or teeth in question and diagnosed your child, he will discuss with you the best treatment available.

What is conscious sedation?

Conscious sedation is a management technique that uses medications to assist the child to cope with fear and anxiety and cooperate with dental treatment. Children who have a level of anxiety that prevents good coping skills or are very young and do not understand how to cope in a cooperative fashion for the delivery of dental care should be sedated. Conscious sedation is often helpful for some children who have special needs. It aids in allowing a child to cope better with dental treatment. This can help prevent injury to the child from patient movement and promote a better environment for providing dental care. Many different medications can be used for conscious sedation. Your pediatric dentist will discuss different options for your child. Sedation is safe when administered by a trained pediatric dentist who follows the sedation guidelines of the American Academy of Pediatric Dentistry. Dr. Penman will discuss sedation options and patient monitoring for the protection of your child.

In order to alleviate potential anxiety in your child, Dr. Penman may recommend minimal discussion of the dental appointment with your child. Should your child become ill, contact our office to see if it is necessary to postpone the appointment. It is very important to follow the directions of your pediatric dentist regarding fasting from fluids and foods prior to the sedation appointment.

Dr. Penman will not discharge your child until your child is alert and ready to go. Children who have been sedated are usually requested to remain at home for the rest of the day with adult supervision. Dr. Penman will discuss specific post-sedation instructions with you, including appropriate diet, physical activity, and requested supervision.