Category Archives: Pediatric Dentistry

When do I have to stop going to my pediatric dentist?

I have been going to the same dentist my whole life. I am almost 18 years old now, but I absolutely love my pediatric dentist. Everyone is so nice, welcoming and they know me so well. I get anxious but they do the best at keeping me relaxed and calm. Are they going to make me see an adult dentist, now that I’m technically almost an adult? Is it weird if I stay?

-Shayna in North Carolina

Shayna,

Pediatric dentists typically see children and in some cases adults with special needs. Every pediatric dentist has their own policies in place, but many love keeping kiddos all the way through to their adult years. They likely will not kick you out. But you may need to ask more about where your needs are best served.

If you’re still in high school, it may make complete sense for you to remain at the same practice. If you have a need that is beyond their expertise or requires an invasive treatment, it may be in your best interest to move on. For example, if you require a crown, root canal or have some other dental issue that needs to be addressed. In which case, it wouldn’t necessarily mean that your pediatric dentist couldn’t handle your needs, but they just may not encounter them regularly so you would be better off seeing another doctor. Does that make sense?

If dental anxiety of fear is an issue, you may want to look into a general dentist that also offers sedation dentistry or nitrous oxide for mild anxiety. It’s wonderful that you’ve been so happy with your pediatric dentist. Best of luck to you!

This post is sponsored by Cleveland dentist Hylan Dental Care.

Can I be with my child during sedation dentistry?

I was so disappointed to hear that my two year old had a big cavity on one of his back teeth. It was only his second trip to the pediatric dentist. I was surprised to hear they want to use nitrous oxide to help him relax when we bring him back in for the filling. If it helps my son, I’m willing to do it. But I’m still very nervous. When I scheduled the appointment they told me that I couldn’t go back with my son during the treatment. They told me it was their standard policy when using sedation dentistry. Why can’t I go in with him? This is only going to make me more of a nervous wreck. Do you think I should take him elsewhere?

-Becky in Washington

Becky,

It really is up to each pediatric dentist to set their policies. But it is not uncommon, if that gives you any comfort. Realistically, the dentist will probably not force you to stay in the reception area. That said, you need to consider the reasoning they have these policies in place and what is really best for your son. When a parent is anxious about what is happening during treatment, it can unconsciously transfer over to the child. They may react when seeing your uncertainty much more dramatically then if they were with only the staff. Saying something like, “it’s not going to hurt, but squeeze my hand if you need to,” can do much more harm than good.

Nitrous is a mild form of sedation dentistry that is completely safe for children. Also, think about the fact that if your child required a procedure at the hospital that required anesthesia, you wouldn’t be allowed be with the doctor. If you are absolutely uncomfortable, you can talk more to your pediatric dentist about it. Or you can try another dentist. But it may be best in the long run to allow your current dentist to treat your child without you accompanying him. You are always right outside in the waiting room if you are needed.

This post is sponsored by Cleveland dentist Hylan Dental Care.

 

 

 

Help! What do I do about a tooth that was knocked out?

I am a mom of a two active boys. So I see falls all the time. But, we met some friends at the park and my friend’s daughter took a nasty fall. When we ran over to her, we saw what no mother wants to see. She had a mouth full of blood and after closer inspection her tooth was knocked out. We were freaking out because we didn’t know what we were supposed to do? Do you have any tips? I would have felt a lot better knowing what we were supposed to do.

-Sarah in Montana

Sarah,

One of the most frequent emergency dentist visits is because of a knocked out tooth. The big question is, was it a baby tooth? If it is a primary tooth and not a permanent one, the response isn’t as urgent. Call your dentist, they may want to see her to have an exam and make sure there isn’t any underlying damage to the permanent tooth that hasn’t erupted. But otherwise, it’s not too big of a deal.

If the tooth was a permanent tooth, there are some important steps that will increase the chances of saving the tooth.

  1. Find the tooth or portion of the tooth and clean it.
  2. Put the tooth in a cup of milk. It is important that the tooth not dry out.
  3. Call your dentist immediately. It is possible that based on the break, the dentist will want you to place the tooth back in the child’s mouth after it has been cleaned. Some kiddos may be resistant to this, which is understandable.

The dentist will likely want to see the child right away. The treatment plan varies and could involve a root canal treatment, or a splint may assist the healing process. Whatever the case, time is critical. Try to get in immediately for the best outcome.

It’s not necessary that the dentist be a pediatric dentist. Just call your regular dentist and follow their instructions. If the child is already seeing a pediatric dentist, start by calling there.

Thank you for your question.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Horrified by dental emergency for a young child.

I came across a highly disturbing article about a young girl that needed to have all 16 of her teeth pulled. This wasn’t in the United States, but I was wondering what the protocol would be for an emergency dentist visit here in the US? Does this happen more than we hear about? I just can’t imagine the fear this little girl must have endured. And shouldn’t there have been some kind of signals before it was too late to have taken such drastic measures?

– Carol in Texas

Carol,

You are likely referring to the following article that seems to have drawn a lot of interest from media sources. It was published in The Daily Mail. Assuming this is the article you are referring to, it involved a four-year-old little girl. She was in terrible pain and started becoming increasingly withdrawn and reserved. The pain got to be too much and her mother finally took her to the dentist. The main factor that became apparent was that she was aloud to have a bottle anytime of day. Imagine a child being bottle-fed, 24 hours, around the clock. The decay was so severe the tooth extractions was the only logical solution.

We don’t know all the facts, only what the article disclosed. But dentists agree that bottles should not be given before bed. This practice is commonly referred to as “baby bottle rot.” Many times parents will give a late night bottle to soothe a child or put them to sleep. But if they fall asleep while drinking, the liquid stays in the teeth for hours and increases the likelihood of decay in young children and babies.

Pediatric dentists in the United States advise that parents take children to the dentist, as soon as the teeth erupt. Early monitoring and regular checkups should prevent any dental emergencies or extreme situations that could be detrimental to children’s oral health. This was indeed an extreme case that you are referencing. The parents need to take initiative to pave the way for their children’s health teeth and gums.

Thank you for your question. Prevention is always key when avoiding dental emergencies.

This post is sponsored by Cleveland dentist Hylan Dental Care.

How do I really know this dentist is safe?

I’m freaking out after seeing a story about a pediatric dentist that has been harming children. This makes me so sick! How will I ever know if the dentist is safe for my child? The parents stated that the work he did for their children was sub-standard and resulted in thousands of dollars of work elsewhere. Also, he was said to have done treatment without parental consent on minors and even scared kids by placing them in a straight-jacket. What? This is absurd. How can a dentist that has been practicing dentistry for four decades get away with something like this? Do you have tips on selecting a safe pediatric dentist?

– Sandra in Alabama

Sandra,

You must be referring to this particular case in Florida.You’re right, there is no excuse for that kind of behavior. It sounds like scenes straight from a horror film. Although it doesn’t justify the events that took place or the number of children affected by his actions, it does sound like the dentist has willingly surrendered his license. There will likely be more details that surface throughout the trial.

As more families come forward, it also sounds like he was the only Medicaid provider in the area. Sadly, he was their only choice if they wanted their children to get dental care. Ultimately, the best piece of advice with any medical procedure is that is something doesn’t feel right, it’s not worth it.

A pediatric dentist or family-oriented general dentist should be open and honest. He or she will be happy to explain procedures and always receive parental consent before any procedure with a child. Feel free to interview office staff, tour the office, and schedule a consultation to get all your questions answered.

It is not uncommon for the dental professionals to request parents stay in the reception room during a child’s exam. Typically, this is because children are more agreeable and work better with dental staff in a parent’s absence. But if you are uncomfortable in any way, you should have every right to accompany or check on your child. Every pediatric dentist office is different. Yet don’t hesitate to ask questions and make sure you and your child are comfortable.

In response to the restraint devices that were used, these are very seldom used anymore. Decades ago, they were used more often. But today, they are really only used during a sedation dentistry appointment with a child or during a unique situation with a special needs or confrontational. Feel free to ask your dentist about their policy and use of restraint devices in their practices.

Bottom line – be active at the appointment. Be engaged. Don’t just drop them off and hope for the best. This type of extreme situation is rare, but a good reminder that even though a dentist is licensed, doesn’t guarantee anything about the actual experience or treatment plan.

Remember, this is a rare instance which is likely why the media has brought it to light.

Thank you for your question.

This post is sponsored by Cleveland dentist Hylan Dental Care.

Why does my baby need tooth extractions?

I have an 18 month old that just went into the pediatric dentist for the first time. We decided to take him in because his front teeth didn’t look like they were the same color. We thought maybe he had a lack of vitamins or minerals or something. Well, we were stunned when the dentist told us the discoloration was from decay and he wants to extract them. This was shocking to me? We waiting so long for these little teeth to finally break through and now he wants to pull them? Have you ever heard of this?

Also, he isn’t old enough to get sedation dentistry apparently so they are recommending he be put under with general anesthesia. Here, I was hoping for a fun photo op of my son’s first dental appointment and I leave mortified.

Is this normal? My son is a breastfed baby so I have no idea how he would have such extreme decay. Any insight is welcome. Thank you!

– Paulette in Michigan

Paulette,

Breastfeeding is definitely the most nutritious way to go for your baby’s first year of life. Unfortunately, it has been known to cause tooth decay in infants. This is because the sugars in breast milk ferment and they are amplified by the bacteria inside a baby’s mouth. For example, streptococcus mutans is a bacteria that metabolizes different carbohydrates. This particular bacteria creates an acidic environment which can cause decay.  Your son may have a higher level of this bacteria present causing him to be more prone to problems with his oral health.

It may be wise to try to wean your son from nighttime feedings. In the early months, these feedings are imperative for nutrition and development, but as your son gets older, they are more out of habit and comfort. If your son falls asleep while nursing, the milk has a tendency to pool up in their mouth and sit on front teeth over night. Also, our saliva subsides at night so it doesn’t clean the teeth like it normally would during the day. These factors or a combination of them likely lead to your son’s decay.

It may be wise to take yous son into the pediatric dentist every six to twelve months to monitor the decay, especially if your family has a history. Also, dental hygiene should begin as soon as your child’s teeth erupt.

Unfortunately, if the teeth cannot be restored than they will need to be extracted. The good news is, as you know, these are his baby teeth. You wouldn’t want to leave the decayed teeth in place because it would leave your son to be prone to pain and possible infection. Permanent teeth will erupt between six and eight years old. It sounds like your pediatric dentist is making the right recommendations. Sorry, that you had to learn the hard way.

Thank you for your question. Hopefully it will help other mothers.

This post is sponsored by Cleveland dentist Hylan Dental Care.

My pediatric dentist threatened to restrain my child.

My son just turned three years old. We have been to the pediatric dentist several times with absolutely no problems. They have all been positive experiences up to this point. Well, at the last visit he was so comfortable, it seemed that he didn’t want to leave the play/greeting area. In fact, he did throw a tantrum. But, I have a hard to believing this is the first tantrum at a pediatric dentist’s office.

The dentist called me out and told me that if I didn’t get my child under control that they would sedate him or they would restrain him for treatment. I was livid! Is this a normal practice? I was so embarrassed and am in no way comfortable with the thought of having my child restrained. I walked out and will not be returning. In my opinion, this is absurd, especially at a pediatric dentist. Wouldn’t you think they would try to work with the child. I could have accompanied her chair side and with a little patience I’m sure we could have had him cooperate with no further problem. Am I overreacting?

– Mad Mom in Illinois

Dear Mom,

The good news is that you left that pediatric dentist and avoided what sounds like could have been a horrifically traumatizing appointment for you both.

Most pediatric dentists will go out of their way to create a positive, welcoming experience for you and your child. It is surprising that there was no effort given to work through the behavior issue your son was having.

A “papoose board” is legal and used at the discretion of the pediatric dentist. This method will require your permission to move forward with such treatment. But there is a good chance that you approved this practice when you filled out all the initial new patient paperwork. Your consent was likely given somewhere in the fine print. But it is good customer service to discuss it with you and make sure you are agreeable prior to moving forward when a situation arises.

Some dentists will also recommend sedation dentistry for certain treatments or if a child is extremely anxious or nervous. Most times, the dentist will make every effort to re-direct the child’s attention in game playing, watching a movie, or a chair ride. And if the child remains uncooperative, sedation dentistry like nitrous oxide (or goofy gas) would be the first step before restraints are suggested. The next progression for treatment would be the papoose board. Then, if all else failed and the child still resists, sedation can be given in a hospital setting.

The pediatric dentist didn’t necessarily do anything wrong, but it doesn’t sound like the situation was handled very well. Hopefully you are able to find another practice that is a better fit for your family. It doesn’t necessarily have to be a pediatric dentist, many general dentists love seeing kiddos and are successful in treating the routine needs of most children. Good luck and thanks for sharing your story.

This post is sponsored by Cleveland dentist Hylan Dental Care.

How do I tell our family dentist not to use flouride?

Our family all sees the same dentist. He’s not a pediatric dentist but he is a family-oriented dentist. Well, it’s time to take my daughter in for her first dental appointment. I’m nervous because I don’t want her to get fluoride. I like to take a holistic approach to our family’s lifestyle. Is there a good way to tell them how I feel about it? Do I need to notify them in advance?

– Jade in Colorado

Jade,

Holistic dentistry is gaining popularity as more and more people are taking ownership of the health and dental care. More than ever before, an emphasis is being placed on what is being placed in the body. There are natural or holistic dentists around that incorporate these philosophies into their daily services.

Regarding the fluoride issue specifically, pediatric dentists will likely be on the side that fluoride treatments have successfully helped to prevent cavities through the years. Generally speaking, most dentists agree with this practice. Many also feel that the earlier children receive the treatments, the better.

Are you concerned about if your daughter will ingest the fluoride? Or are you adamantly against using fluoride for holistic preferences? There is absolutely nothing wrong with contacting your dentist in advance to let them know of your concerns. If you have been seeing this family dentist for some time, there is a good chance he will listen to your concerns and work through them with you. For example, they may offer an alternate delivery method, like a brush or foam to help limit any swallowing. So it would be good to call in and talk through the specific practices used at your dentist.

That said, if you do not wish your daughter to receive fluoride, you have every right to voice your preferences. Open, honest communication with any health practitioner is vital to a beneficial doctor-patient relationship.

This post is sponsored by Cleveland dentist Hylan Dental Care.

My son is scared of the dentist!

My son is only 7 and he is so scared of the dentist. It feels like it’s not worth the fight, but I know he needs to go. I’m afraid too, so I’m not much encouragement. Do you have any pointers to help him get over his fear of the dentist?

– Rachel in Virginia

Rachel,

Dental fear is one of the most common phobias in the United States. This usually stems from a bad or painful experience as a child. So the first question that you should consider is why he might be so scared? Did he have a bad experience when he was younger? If so, that needs to be addressed. Discuss what happened and why. Explain that he will not have to worry about that moving forward and why.

Another thing to think about is how you talk and act about going to the dentist, especially since you have admitted of being apprehensive yourself. You may be transferring your nervous energy onto him without even realizing it.  Prepare him for a positive experience by talking about what to expect. Also, you may want to consider a possible reward afterwards, so he doesn’t associate negative feelings.

Then, consider your current dentist. Would you consider him or her a gentle dentist? Are they willing to take it slow, or do they just want you in and out? How is the practice geared toward children? There are pediatric dentists out there that love treating kiddos. They will go out of their way to make it fun and positive. Toys, movies, rewards are what you can expect and they are all geared to make your child feel welcome, relaxed, and comfortable.

If your son just can’t get over his fear, you may want to consider nitrous oxide. At a pediatric dentist they may refer to it is goofy gas. It will help your child relax in the chair and the dosage can be monitored. Most pediatric dentists feel it is completely safe. This may help get a few good visits under your belt.

But the single most important factor is you. How you prepare him and how your respond are the example he is seeing. Are you nervous or calm? Be intentional about how you are portraying the visit.

Good luck!

This post is sponsored by Cleveland dentist Hylan Dental Care.

I’m scared for my son to get sedation dentistry?

My four-year old son sees a pediatric dentist and has to have a couple of fillings done. Because he’s so little, the doctor doesn’t think he’ll sit still and wants to sedate him for treatment. I can understand that and I’m okay with it, but I want to be able to be with him the whole time. The assistant said the doctor doesn’t allow it, though. I’m really not comfortable with him being alone. Should I bother trying to push the issue or just find a new office? Is there anything I can say to the doctor to make her change her mind?

– Chris in North Carolina

Dear Chris,

Generally speaking, assistants know the doctor’s policy well and any information they give you is solid. However, if you disagree with a guideline or have questions, it’s always a good idea to talk directly with the doctor. There are no magic words that can be said to make her change her mind if this is a steadfast office rule. Nevertheless, if you explain what you’d like to have happen, it will give her the chance to tell you why she has that specific policy, issue a final decision, or make an allowance. As a pediatric dentist, she’s likely been through this scenario numerous times before, and her policies are based upon her personal experience.

It may set your mind at ease to know that your son will never be alone. Because it’s a sedation dentistry procedure, someone will be looking after him and monitoring his status the entire time. Some pediatric dentists will allow a parent to be present until the child is sedated, others will allow a parent to be there the whole time, and some will not allow parents in the back room at all. This is because parents can be comforting to a child, cause the child to be fearful, or even hinder the doctor from providing treatment. Even if a parent sets out with the best of intentions, it’s not always possible to predict how Mom or Dad will react during the procedure.

When you speak with the doctor, she can explain policies and procedures. Knowing what will happen throughout the course of treatment, as well as any safety protocol, may make you feel comfortable enough that you won’t feel the need to switch dentists, even if they ask you to wait outside.

This post is sponsored by Cleveland dentist Hylan Dental Care.