GENERAL TOPICS:
What are differences between an Pediatric and an Adult Dentist?

What time does the doctor recommend to see small children?
How are appointments scheduled?
Dr. Bates's advice during the child's visit
Fluoride
What causes bad breath?
Dental Radiographs

EARLY INFANT ORAL CARE:
Are baby teeth even important?
When should my child first visit the dentist?
Thumb sucking
Non patients during the visits

PREVENTION:
Good oral health for your child
Causes of bad breath in children

ADOLESCENT DENTISTRY:
Smoking and oral health
Poor oral hygiene
Gum disease
Cavities
Oral cancer
Dry mouth
Bacteria of the toungue

For more information on oral health care needs, please visit the website for the American Academy of Pediatric Dentistry. __________________________________________________________________________        
What are differences between a Pediatric and an Adult Dentist? 

A pediatric dentist attends dental school and completes the same training as other dentists. Once this part of his education is complete, a pediatric dentist will need two or three years of pediatric training. This speciality education allows a pediatric dentist to provide oral care and treatments for infants and children.

These dentists typically only treat patients who have not yet completed adolescence. Unlike adult dentists, these individuals are trained to work with young patients and recognize early problems in developing teeth. They can recognize oral disorders and diseases that may affect young children. Childhood is a period of rapid development, and it is important to recognize problems early to prevent long-term consequences.
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Recommended time for small children 

We recommend that preschool aged children be seen in the morning, as they are fresher at this time and we can work more slowly with them for their comfort. School-age children with complex treatment plans are scheduled in the morning for this same reason. Remember, a dental appointment is considered an excused absence! Missing school can be kept to a minimum when regular dental care is continued.
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How are appointment scheduled? 

In order to cut down on wait time once you reach our office, please provide our office with needed insurance and registration information by registering online prior to your appointment.

We recommend that preschool aged children be seen in the morning, as they are fresher at this time and we can work more slowly with them for their comfort. School-age children with complex treatment plans are scheduled in the morning for this same reason. Remember, a dental appointment is considered an excused absence! Missing school can be kept to a minimum when regular dental care is continued.

Our regular cleaning appointments usually last about 30 minutes per child. Since we reserve those 30 minutes specifically for your child, we ask that you notify our office at least 24 hours  in advance if you need to cancel or reschedule your appointment. Another patient who needs our care can then be scheduled in that slot. We realize that unexpected things can happen, but we ask for your assistance in notifying us as far in advance as possible.
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Dr Bates advice during the child's visit 

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

How does fluoride work?

When element fluoride is used in small amounts on a routine basis is helps to prevent tooth decay. It encourages “remineralization,” a strengthening of weak areas on the teeth. The sports are 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.
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Will my child need fluoride supplements?


Children between the ages of six months and 16 years may require fluoride supplements. The pediatric dentist considers many different factors before recommending a fluoride supplement. Bottled, filtered and well waters vary in their fluoride amount, so a water analysis may be necessary to ensure you r child is receiving the proper amount. 
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What type of toothpaste should my child use?


Recommended Toothpaste Your child should use toothpaste with fluoride and the     American Dental Association Seal of Acceptance. Young children, especially pre-school aged children, should not swallow any toothpaste. Careful supervision and only a small pea-sized amount on the brush are recommended. If not monitored, children may easily swallow over four times recommended daily amount of fluoride in toothpaste.
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How safe is fluoride?


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, and other forms of fluoride supplementations must be carefully monitored in order to prevent a potential overdose and unsightly spots on the developing permanent teeth. Do not leave toothpaste tubes where young children can reach them. The flavors that help encourage them brush may also encourage them to eat toothpaste.
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What is topical fluoride?

Topical fluoride comes in a number of different forms. Gels and forms are placed in fluoride trays and applied at the dental office after your child’s teeth have been thoroughly cleaned. Fluoride varnish is one of the newest forms of topical fluoride applied at the dentist office. It has been documented to be safe and effective to fight dental decay through a long history of use in Europe. The advantages of varnish are:

  1. Decreases the potential amount of fluoride digested.
  2. Continue to “soak” fluoride into the enamel for approximately 24 hours after the original application.
  3. This method is especially useful in young patients and those with special needs that may not tolerate fluoride trays comfortably.
  4. Easily and quickly applied to the teeth. 
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
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Cause of bad breath in children 

Tooth decay or lack of adequate tooth brushing allows bacteria to stagnate in the mouth - which leads to halitosis. This is one of the more common causes of halitosis in children. Eighty-five percent of bad breath in children comes from problems in the oral cavity.

The first priority is to make sure your child is brushing regularly, including his tongue - twice a day. Take a close look at your child's tongue. Does it have a thick coating? The dead cells on a child's tongue can harbor many thousands of bacteria that cause bad breath.

Be sure your child brushes the back of his tongue since this is the most common area where bacteria can hide.If this doesn't solve the problem, make a dental appointment for your child to check for tooth decay and to remove any plaque along the gum line that could be contributing to halitosis.
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Another Cause of Bad Breath in Children:


Post-Nasal DrainageThis is one of the most common causes of bad breath in children. Secretions draining into the throat from infected sinuses or allergies are an ideal breeding ground for bacteria. If your child has nasal stuffiness, discolored nasal mucous, nighttime cough, fever, facial swelling, or allergy symptoms, consult his pediatrician. Rarely, a child will push a foreign body into his nose, which leads to halitosis.
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Children with Bad Breath May Have a Dry Mouth

Another cause of bad breath in children is a dry mouth from low saliva production. This isn't as common in children, as in adults, but children who are anxious and nervous may not produce enough saliva.Childhood bad breath can also be due to mouth breathing, medications, and not drinking enough fluids. Children who have asthma and breathe through their mouth more are predisposed to halitosis because their mouth dries out. Some autoimmune diseases can do it too, but these are more frequently seen in adults.
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More Serious Causes of Bad Breath in Children


Occasionally, bad breath in a child can be a sign of a more serious problem. A child who has a fruity odor to his breath may have diabetes. Bad breath in children can also be a sign of kidney failure or liver disease. Sometimes children with bad breath have GERD (gastroesophageal reflux disease), which can be associated with infection with a bacteria called H. pylori. These are all conditions that your child's pediatrician can diagnose through an exam and appropriate blood work.
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Causes of Bad Breath in Children: The Bottom Line?


Bad breath is usually not a sign of serious disease in children, although it can be. If your child's halitosis doesn't improve with good dental hygiene, it's time to consult a pediatrician and dentist.References:Merck Manual. Eighteenth Edition. 2006. Pediatric Dental Health. "Halitosis and Bad Breath in Children" 
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Dental Radiographs 

Dental X-rays are a useful diagnostic tool when helping your dentist detect damage and disease not visible during a regular dental exam. How often X-rays should be taken depends on your present oral health, your age, your risk for disease, and any signs and symptoms of oral disease. For example, children may require X-rays more often than adults because their teeth and jaws are still developing and their teeth are more likely to be affected by tooth decay than those of adults. Your dentist will review your history, examine your mouth and then decide whether or not you need X-rays.

If you are a new patient, the dentist may recommend X-rays to determine the present status of your oral health and have a baseline to help identify changes that may occur later. A new set of X-rays may be needed to help your dentist detect any new cavities, determine the status of your gum health or evaluate the growth and development of your teeth. If a previous dentist has any radiographs of you, your new dentist may ask you for copies of them. Ask both dentists to help you with forwarding your X-rays.

Dental Radiographs (X-Rays)

Dental X-ray exams are safe; however, they do require very low levels of radiation exposure, which makes the risk of potentially harmful effects very small. Dental X-ray tools and techniques are designed to limit the body's exposure to radiation and every precaution is taken to ensure that radiation exposure is As Low As Reasonable Achievable (the ALARA principle). A leaded apron minimizes exposure to the abdomen and should be used when any dental radiograph is taken. Also, a leaded thyroid collar can protect the thyroid from radiation, and should also be used whenever possible. The use of a leaded thyroid collar is recommended for women of childbearing age, pregnant women and children.

If you are pregnant, tell your dentist. During your pregnancy, you may need to have X-rays taken as part of your treatment plan for a dental disease. Use of the leaded apron and thyroid collar will protect you and your fetus from radiation exposure. Dental X-rays do not need to be delayed if you are trying to become pregnant or are breastfeeding.
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Early Infant Oral Care 

Are baby teeth even important? 

Children Teeth AnatomyRegardless of the fact that they will eventually be replaced by adult teeth, baby teeth are very important to a child's health and development. These teeth allow a child to vocalize and speak properly. They are important for chewing and eating as children begin to eat semi-solid and solid foods. Baby teeth also help form the path that will be used by the adult teeth. 

If problems with baby teeth are not treated, they can create unpleasant symptoms as well as have long-term effects. Diseased or damaged teeth can be very painful and disrupt normal eating and speech. This can lead to consequences like malnutrition, avoidance of certain foods and slow language development. If speaking and eating cause pain or are simply uncomfortable, a child may be reluctant to do these things. Improperly positioned baby teeth that are not corrected may lead to misaligned adult teeth.
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Child's first visit 

Our office, as well as the American Academy of Pediatric Dentistry, recommends that your child visit the dentist by his/her 1st birthday.
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Thumb sucking 

Thumb Sucking ChildKids suck their thumbs because it's comforting and calming. Your 2-year-old probably practiced this habit while he was still in the womb and perfected it as an infant. Now he turns to his thumb when he's tired, scared, bored, sick, or trying to adjust to challenges such as starting daycare or preschool for the first time or enduring long car rides. He may also use his thumb to fall asleep at bedtime and to lull himself back to slumber when he wakes up in the middle of the night

However, if thumb sucking continues beyond the age of 5 -- when the permanent teeth begin to come in -- dental problems may occur. Depending on the frequency, intensity, and duration of the sucking, the teeth can be pushed out of alignment, causing them to protrude and create an overbite. The child may also have difficulty with the correct pronunciation of words. In addition, the upper and lower jaws can become misaligned and the roof of the mouth might become malformed.
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Non patients during the visit 

For the safety and privacy of all patients, other children who are not being treated should remain in the reception room with a supervising adult.
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Prevention 

Good oral health for your child  

Tooth decay and other oral diseases that can affect children are preventable. The combination of dental sealants and fluoride has the potential to nearly eliminate tooth decay in school-age children. Dental visits are just part of the plan, of course. Tooth brushing is also crucial from the start.  If your baby has even one tooth, it's time to start tooth brushing.
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__________________________________________________________________________Tooth BrushesEven before your baby has teeth, you can gently brush the gums, using water on a soft baby toothbrush, or clean them with a soft washcloth. Once there are additional teeth, parents to buy infant tooth brushes that are very soft. Brushing should be done twice daily using a fluoridated toothpaste. Flossing should begin when two teeth touch each other.
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__________________________________________________________________________ Health MealEncourage your children to eat regular nutritious meals and avoid frequent between-meal snacking. Protect your child's teeth with fluoride. Use a fluoride toothpaste. If your child is less than 7 years old, put only a pea-sized amount on their toothbrush.If your drinking water is not fluoridated, talk to a dentist or physician about the best way to protect your child's teeth.Talk to your child's dentist about dental sealants. They protect teeth from decay.If you are pregnant, get prenatal care and eat a healthy diet. The diet should include folic acid to prevent birth defects of the brain and spinal cord and possibly cleft lip/palate.
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Adolescent Dentistry 

Poor oral hygiene :

Poor oral hygiene can lead to a variety of dental and medical problems such as gum disease, infection, bone loss, heart disease, strokes and more. Regular check ups and cleanings can prevent these problems as well as provide you with good oral hygiene.
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Gum Disease: 

Periodontal disease, also called gum disease, is mainly caused by bacteria from plaque and tartar build up. Other factors that have the potential to cause gum disease may include:
  • Tobacco use
  •  Clenching or grinding your teeth
  •  Certain medications Genetics
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Cavities :

A cavity is a hole in the tooth that is caused by decay. Decay occurs when plague, the sticky substance that forms on teeth, combines with the sugars and / or starches of the food we eat.

This combination produces acids that attack tooth enamel. The best way to prevent tooth decay is brushing twice a day, flossing daily and going to your regular dental check ups. Eating healthy foods and avoiding snacks and drinks that are high in sugar are also ways to prevent decay.
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Dry mouth (xerostomia): 
 
Dry mouth, also called xerostomia, is a common problem among older adults. In fact, the Oral Cancer Foundation estimates that 20 percent of elderly people suffer from dry mouth and this condition is also a hidden cause of tooth loss and gum disease in 30 percent of adults.
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Oral cancer 

According to The Oral Cancer Foundation, someone dies from oral cancer every hour of every day in the United States alone. Over 300,000 new cases of oral cancer are diagnosed every year, worldwide. This serious dental disease which pertains to the mouth, lips or throat is often highly curable if diagnosed and treated in the early stages. __________________________________________________________________________
Bacteria on the tongue :

According to the American Dental Association, you should brush your teeth twice a day. Brushing your teeth helps to remove plaque which causes tooth decay and can lead to gum disease.
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Smoking and Oral health 

Smoking and oral healthcareSmoking and other tobacco products can lead to gum disease by affecting the attachment of bone and soft tissue to your teeth. More specifically, it appears that smoking interferes with the normal function of gum tissue cells. This interference makes smokers more susceptible to infections, such as periodontal disease, and also seems to impair blood flow to the gums - which may affect wound healing
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