pediatric dentistry

Frequently Asked Questions

When should I take my child to the dentist for the first check up?

In order to prevent dental problems, your child should see a pediatric dentist when the first tooth appears, or no later than his/her first birthday.

What is the difference between a pediatric dentist and a family dentist?

Pediatric dentists are the pediatricians of dentistry. A pediatric dentist has two to three years specialty training following dental school and limits his/her practice to treating children only. Pediatric dentists are primary and specialty oral care providers for infants and children through adolescence, including those with special health needs.

How often does my child need to see the pediatric dentist?

Children younger than age three should be seen once a year. When they reach three years a check-up every six months is recommended in order prevent cavities and other dental problems. Your pediatric dentist can tell you when and how often your child should visit based on their personal oral health.

Why is it necessary to take my child to the pediatric dentist every six months?

The pediatric dentist will want to see your child at regular and frequent intervals for several reasons. Regular visits keep the child familiar with the pediatric dentist and his or her staff and encourage a pleasant, confident attitude in the child regarding this necessary, lifelong health practice. Also, as the child develops and grows, the pediatric dentist will want to be certain that tooth eruption and proper jaw development are progressing normally or, if not, that corrective measures are undertaken in time. Appropriate preventive measures such as regular applications of fluoride on the tooth surfaces, placement of pit and fissure sealants on newly erupted teeth, and reinforcement of good daily health practices (brushing, flossing, and dietary advice) can be continually encouraged by the pediatric dentist and his or her staff when the child is a regular and frequent visitor to the dental office. If decay or other dental defect has occurred, it will be detected in the early stages when it is easier and less costly to treat.

Can I stay with my child during the first visit?

Yes, you may stay with your child.  We even have adjoining exam rooms for parents with more than one child being examined at the same time.

Are thumb sucking and pacifier habits harmful to my child’s teeth?

Thumb and pacifier sucking habits will generally only become a problem if they go on for a very long period of time. Most children stop these habits on their own, but if they are still sucking their thumbs or fingers when the permanent teeth arrive, a mouth appliance may be recommended by your pediatric dentist.  Ask us about “David Decides” and “Mavala”.

Why is fluoride so important?

Fluoride has been shown to dramatically decrease a person’s chances of getting cavities by making teeth stronger. Fluoride in the drinking water is the best and easiest way to get it. Most major cities have fluoride in the drinking water system. In communities where the water district does not fluoridate the water, fluoride supplements should be given to your child until their twelve year molars are fully erupted (approximately age 12 years). Your pediatric dentist or pediatrician can help determine if your child needs fluoride supplements or not.

How do I know if my child is getting enough flouride?

Have your pediatric dentist evaluate the fluoride level of your child’s primary source of drinking water. If your child is not getting enough fluoride internally through water (especially if the fluoride level is deficient or if your child drinks bottled water without fluoride), then your pediatric dentist may prescribe fluoride supplements.

How safe are dental x-rays?

There is very little risk in dental X-rays. Pediatric dentists are especially careful to limit the amount of radiation to which children are exposed. Our office uses Digital Radiography.  This form of computerized radiography uses a standard dental x-ray generator as its radiation source.

An intra-oral sensor that is placed in the mouth collects the image.  The benefit of digital radiography is that it reduces radiation exposure 80-90% compared to traditional radiograph which means less exposure and less risk.

When will my baby start getting teeth?

Usually the two lower front teeth (central incisors) erupt at about six months of age, followed shortly by the two upper central incisors. During the next 18 to 24 months, the rest of the baby teeth appear, although not in orderly sequence from front to back. All of these 20 primary teeth should be present at two to three years of age.

Is there anything I can do to comfort my baby while he is teething?

Some children appear to be comforted during the normal eruption process by chewing on a teething biscuit, a piece of toast, or a frozen teething ring. Teething medications that can be rubbed on the gums to reduce the discomfort are available at your pharmacy.

Should I worry about thumb or finger sucking?

Thumb sucking is perfectly normal for infants; most children stop by age two. If your child does not stop thumb sucking, discourage it by age four. Prolonged thumb sucking can create crowded, crooked teeth and bite problems. Your pediatric dentist will be glad to suggest ways to address a prolonged thumb sucking habit.

When should I start cleaning my baby's teeth?

You should start cleaning your baby’s teeth as soon as the teeth come in, because harmful plaque begins to form as soon as teeth erupt.

What should I use to clean my baby's teeth?

A toothbrush will remove plaque bacteria that can lead to decay. Any soft-bristled toothbrush with a small head, preferably one designed specifically for infants, should be used at least once a day at bedtime.

Toothpaste: when should we begin using it and how much should we use?

Fluoridated toothpaste should be introduced when your child has teeth. A smear of fluoridated toothpaste is recommended for children less than 2 years of age. A pea size amount of toothpaste is appropriate for children aged 2 thru 5 years.

Parents should dispense the toothpaste onto a soft, age appropriate sized toothbrush and perform or assist with tooth brushing of pre-schooled aged children.

To maximize the benefits of fluoride in the toothpaste, rinsing after brushing should be kept to a minimum or eliminated altogether.

Should I use an electric toothbrush on my child's teeth?

Some children, and some adults, seem to do a more effective job of cleaning the teeth with the aid of an electric toothbrush. It is often a matter of patient preference, and the novelty of the electric toothbrush may even motivate your child to brush more frequently. The pediatric dentist may suggest an electric toothbrush for some children.

How can I prevent decay caused by nursing?

Avoid nursing children to sleep or putting anything other than water in their bed-time bottle. Also, learn the proper way to brush and floss your child’s teeth. Take your child to a pediatric dentist regularly to have his/her teeth and gums checked. The first dental visit should be scheduled by your child’s first birthday.

Are baby teeth really that important to my child?

Primary, or “baby” teeth, are important for many reasons. Not only do they help children speak clearly and chew naturally, they also aid in forming a path that permanent teeth can follow when they are ready to erupt.

My 2 year old child has a cavity in a tooth. Should the tooth be filled?

Yes, it should be treated as soon as possible to avoid pain and infection.

My child's baby teeth had a lot of decay. Does this mean that the permanent teeth will be just as bad?

Very likely, unless the cause can be determined and proper preventive and corrective steps are taken.

What should i do if my child has a toothache?

First, rinse the irritated area with warm salt water and place a cold compress on the face if it is swollen. Give the child acetaminophen for any pain, rather than placing aspirin on the teeth or gums. Finally, see a dentist as soon as possible.

how do I make my child's diet safe for his teeth?

Make sure your child has a balanced diet, including one serving each of: fruits and vegetables, breads and cereals, milk and dairy products, and meat fish and eggs. Limiting the servings of sugars and starches will also aid in protecting your child’s teeth from decay. You can also ask your pediatric dentist to help you select foods that protect your children’s teeth.

What is a sealant?

A sealant is a clear or shaded plastic material that is applied to the chewing surfaces of the back teeth (premolars and molars), where decay occurs most often. This sealant acts as a barrier, protecting the decay prone areas of the back teeth from plaque and acid.

How do dental sealants work?

Sealants work by filling in the grooves on the chewing surfaces of the teeth. This shuts out food particles that could get caught in the teeth, causing cavities. The application is fast and comfortable and can effectively protect teeth for many years.

What can I do to protect my child's teeth during sporting events?

Soft plastic mouth guards can be used to protect a child’s teeth, lips, cheeks and gums from sports related injuries. A custom-fitted mouth guard developed by a pediatric dentist will protect your child from injuries to the teeth, face and even provide protection from severe injuries to the head.

What should I do if my child falls and knocks out a permanent tooth?

The most important thing to do is to remain calm. Then find the tooth. Hold it by the crown rather than the root and try to reinsert it in the socket. If that is not possible, put the tooth in a glass of milk and take your child and the glass immediately to the pediatric dentist.

Why should the baby teeth be filled, since they will be lost anyway?

Even though these primary teeth are called “baby teeth”, some of them must serve until the child is at least twelve years old, sometimes longer. Neglect of the baby teeth can result in pain, infection of the gums and jaws, impairment of general health, and premature loss of teeth, which is a major cause of orthodontic problems. Also, cavities tend to form in teeth that are next to other teeth with unfilled cavities, because decay is really an infection and will spread if left untreated. It is unwise to leave active decay in the mouth. Decay on baby teeth can cause decay on permanent teeth. Unfortunately, most children with untreated decay on baby teeth will develop decay on permanent teeth.

Why do the permanent teeth look so much more yellow than the baby teeth?

Permanent teeth are normally yellower than primary teeth, but they appear even more so because you are comparing them with the lighter baby teeth still in the mouth.

How can parents help prevent tooth decay?

Parents should take their children to the dentist regularly, beginning with the eruption of the first tooth. Then, the dentist can recommend a specific program of brushing, flossing, and other treatments for parents to supervise and teach to their children. These home treatments, when added to regular dental visits and a balanced diet, will help give your child a lifetime of healthy habits.

My child has a double row of front teeth. Why is this, and what should be done about it?

This is not an uncommon occurrence. Sometimes the permanent teeth begin to come in before the baby teeth are lost. When this happens, unless the child can work the baby teeth out by himself within a few weeks, the pediatric dentist may have to remove them. Once the baby tooth is out, the tongue usually moves the permanent tooth forward into its proper position, if space permits. If this crowded condition should occur in the upper jaw, the baby teeth should be removed immediately. Sometimes it is necessary for the pediatric dentist to move the permanent tooth forward with an orthodontic appliance.

Is it all right for my child to remove her own baby teeth when they become loose?

Perfectly all right. As the tooth loosens, it is natural for a child to assist the process, which may take several weeks.

What about the big space between my 8 year old's two upper front teeth?

Usually there is no need for concern. The space can be expected to close in the next few years as the other front teeth erupt. If there is a problem, your pediatric dentist will recognize it.

Frequently Asked Anesthesia Questions

How safe is anesthesia for my child?

Office based anesthesia is very safe when all guidelines are followed and anesthetic is administered by an anesthesiologist.

How many times a month do you put children to sleep?

Dr. Devany sees 45-50 patients per month at the offices she visits. Dr. Devany is usually at our office 2-3 days each month and we will see around 10-15 patients total over those days.

Will I be able to stay in the room?

You will only be in the room for the induction/going to sleep.  Once your child is asleep, you will be asked to go back out to the lobby. However, you will be brought back to the room after treatment is completed, so you will be there while your child is waking up. Your child will never know you were gone.

Will the N20 nose put my child to sleep?

No. The N2O is meant to relax your child and help them cooperate. It is also a pain medicine so the IV does not bother most children as much.

What type of drugs does Dr. Devany use?

For Plan A: Propofol, Ketamine, and Versed
For Plan B: Ketamine and Versed; Propofol after the IV is started.

Appropriate dosage is given based upon child’s weight and age.

Why would Dr. Devany do Plan B or Plan A?

Plan B is chosen when it will be less traumatic than enforcing Plan A. Plan B is used when a child is very uncooperative. Dr. Devany will decide which plan is best upon meeting your child.

How long will it take for my child to wake up?

It takes about 15 to 40 minutes.

Will my child feel nauseous when he/she wakes up?

Very rarely – about 3% get nauseous at home.

Will my child's mouth be numb?

No. The only time Lidocaine is given is if there are one (or more) teeth which need to be extracted. The Lidocaine will then be given through the IV so the doctor doesn’t have to do any injections in the mouth.

Will my child be given any pain medication after the procedure?

Pain medication is not usually administered after the procedure, but some IS given during the procedure. The doctors and the recovery assistant will go over post treatment care with you. If you are concerned that your child is in severe pain, call to speak with the doctor and he/she may prescribe a pain reliever. Typically, Ibuprofen is all that is needed to ease your child’s discomfort.

Why is there a 2 adult requirement?

We require 2 adults so that 1 person can focus on driving and getting home safely while the second adult can focus on the child and his/her needs.