Pediatric Dentistry - FAQs

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 that 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,” “children’s root canal,” “pulpectomy.” or “pulpotomy.” The two common forms of pulp therapy in children’s teeth are the pulpotomy and pulpectomy.

Pulpotomy: 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 in the form of a stainless steel crown.

Pulpectomy: A pulpectomy is required when the entire pulp is involved, including the root canals 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.

Parents are often concerned about the nocturnal grinding of teeth, a condition called bruxism. Often, the first indication is the noise created by the child grinding on their teeth during sleep. Sometimes, the parent may notice wear on the teeth, causing them to look shorter.

The primary cause of bruxism involves a psychological component. Stress due to a new environment, divorce, changes at school, and other causes can influence a child to grind their teeth. Another cause 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 is present, then a mouth guard (night guard) may be indicated.

The good news is most children outgrow bruxism. The grinding decreases between the ages six to nine and children tend to stop grinding between ages nine to 12. If you suspect bruxism, discuss this with your pediatrician or pediatric dentist.

Radiographs (also called 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. They are used to:

• See how your child’s teeth are erupting (coming into the mouth)
• See the number, size and position of teeth that are still inside the gums
• Find out whether there are missing teeth or extra teeth
• Monitor mouth and teeth injuries
• Determine whether the teeth or mouth are infected
• Prepare for braces and other orthodontic treatment
• Detect problems that can’t be seen with a visual exam
• Identify bone diseases
• Diagnose cavities in between teeth that are touching each other

The American Academy of Pediatric Dentistry recommends radiographs and examinations every six months for children with a high risk of tooth decay. On average, most pediatric dentists request radiographs approximately once a year. Approximately every 3 years, it is a good idea to obtain a complete set of radiographs, either a panoramic and bitewings or periapicals and bitewings.

Dental X-rays are very safe and expose your child to a minimal amount of radiation. When all standard safety precautions are taken, today’s X-ray equipment is able to prevent unnecessary radiation and allows the dentist to focus the X-ray beam on a specific part of the mouth. High-speed film enables the dentist to reduce the amount of radiation the patient receives. A lead body apron or shield will be placed over the child’s body. Make sure the shield covers your child’s neck to protect the thyroid gland. It also should extend all the way to the thighs to protect the genitals and reproductive organs.

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 your dentist 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: With proper action, permanent teeth can be saved after they’ve been knocked out. Carefully follow the instructions below if this happens to your child.

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 your child 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 (inside the cheek area). The patient must see a dentist IMMEDIATELY! Time is a critical factor in saving the tooth.

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

Chipped or Fractured Permanent Tooth: Contact your pediatric dentist 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 or Fractured Baby Tooth: Contact your pediatric dentist.

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.

Tooth 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.

A fluoride-containing toothpaste is one way to guarantee that your children’s teeth get enough fluoride exposure. Make sure that only a tiny smear or pea-sized amount is used for your child to brush with.

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 taking extra precaution to use only a “pea size” amount of toothpaste.

Many people don’t think that a child’s primary teeth (oftentimes referred to as their “baby teeth”) are all that important. However, this could not be farther from the truth.

Primary teeth will serve as the guides for your child’s permanent teeth. They hold the spots open for the permanent teeth and will naturally fall out when the permanent teeth push against their roots. If your child’s primary teeth fall out too early, the permanent teeth may shift into misalignment, which will result in a need for orthodontic treatment.

These primary teeth will also help your kid with the critical tasks of chewing properly and speaking clearly. And finally, getting into the habit of a proper oral hygiene regimen for primary teeth will help develop healthy dental habits for when your child’s permanent teeth come in.

Typically, your child’s 20 primary teeth will begin to appear between six and nine months of age. The first ones to erupt are usually the two lower front teeth, shortly followed by the two front upper teeth. After that, the first molars will come in, followed by the canines.

If your baby happens to experience any teething discomfort during this time, please don’t hesitate to let us know and we’ll advise you on how to treat it most effectively.

To properly clean your infant’s gums and newly erupted teeth, you should gently wipe them with a water-soaked gauze pad or a damp washcloth after each feeding. You should start establishing a daily brushing routine for your child by the age of two. When brushing your child’s primary teeth, it’s best to use a small, soft-bristled toothbrush and a thin strip of toothpaste that contains fluoride. You’ll probably need to help your child with this task until the age of six.

A pediatric dentist is a dentist that is dedicated to the oral health of children from infancy through the teenage years. Pediatric dentists require two to three extra years of specialized training after dental school in order to properly treat young patients. The very young, pre-teens, and teenagers all need different approaches in dealing with their dental health, guiding their teeth’s growth and development, and helping them avoid future dental problems. A pediatric dentist is trained to meet these needs, and our pediatric dentists are some of the most qualified pediatric dentists in the Austin, TX area.