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Early Orthodontic Treatment for Children

The majority of patients undergoing orthodontic care are children and teens. When kids are young, their jaws are constantly growing to accommodate new teeth. It is during this time that the teeth are easily moved, allowing for a shorter treatment time – especially in patients who undergo early treatment. Braces, retainers, and spacers are just some of the orthodontic appliances commonly used in children’s orthodontics. Although not all kids need orthodontic treatment, all kids need exams at an early age. Some signs that a child may eventually require orthodontic treatment include:

  • Jaw is disproportionate to the face
  • Has a habit of frequent thumb-sucking
  • Chronically breathes from the mouth rather than the nose
  • Primary teeth fall out too soon or too late
  • Exhibits malocclusion (overbite/underbite)
  • Visible crowding

Did you know?

that children should have their first orthodontic screening no later than age 7? This orthodontic evaluation is used to identify jaw irregularities and developmental complications that could indicate the need for orthodontic treatment in the future. Early screenings make it possible to get early treatment, with some children beginning progressive orthodontic treatments as early as age 7.

Frequently Asked Questions

Do I need to bring my child to an orthodontist?

If your child is at least 7 years old or is exhibiting any of the symptoms listed above, you should schedule an appointment as soon as possible. Your child’s orthodontist can take steps to correct a bad bite, fill in gaps, and straighten the teeth all before your child reaches the teen years.

What should I expect at my child’s first orthodontist appointment?

Your child’s first orthodontic screening will include a visual examination as well as maxillofacial x-rays. Your child’s orthodontist may also ask you questions about your child’s habits, such as thumb and finger-sucking. Based on the results of this analysis, the orthodontist will discuss options and timeframes for treatment if applicable.

Will I need to follow any special instructions if my child is fitted for a dental appliance?

Yes. If your child is fitted for a fixed orthodontic appliance, such as braces, you will need to follow careful instructions to ensure the device is not damaged or broken. This includes monitoring your child’s diet to ensure it does not include hard foods, candies, popcorn kernels, or anything else that could cause damage. You’ll also need to ensure your child properly brushings and flosses around the appliance to protect the teeth from decay during treatment.

Nitrous Oxide/Oxygen

Nitrous oxide/oxygen- also known as ‘laughing gas,’ nitrous oxide is highly effective for giving children a sense of euphoria during their dental experiences. Nitrous oxide/oxygen is a colorless gas that gives off a ‘sweet’ scent. It is administered throughout pediatric procedures under the oversight and care of a licensed professional. Whether your child has special needs, is afraid of the dentist or is simply too active to sit still through a dental treatment, nitrous gas sedation is a helpful tool for getting pediatric dental patients to relax and cooperate, while still allowing them to maintain a state of awareness.

How safe is nitrous oxide/oxygen?Frequently Asked Questions

Very safe. Nitrous oxide/oxygen is perhaps the safest sedative in dentistry. It is well tolerated, it has a rapid onset, is reversible, can be adjusted in various concentrations and is non-allergenic. Your child remains fully conscious and keeps all natural reflexes and will be capable of responding to a question or request.

What should I expect when my child is sedated with nitrous?

Your child will be asked to breathe in a mixture of nitrous gas and oxygen from a mask at the beginning of his or her appointment. The amount of gas administered will be monitored and adjusted throughout treatment to help him or her relax while staying completely alert and responsive. Nitrous often makes children experience a sense of well-being and relaxation. Since it may produce a feeling of euphoria or giddiness it is often called laughing gas. It also has mild pain-relieving properties. At the end of the laughing gas treatment, oxygen is administered to help alleviate the effects of the gas in your child’s system and return him or her to a natural state of awareness.

Are there any special instructions prior to Nitrous Oxide/Oxygen treatment?

First, give your child little or no food in the two hours preceding the dental visit (occasionally nausea or vomiting occurs when a child has a full stomach). Second, tell your pediatric dentist about any respiratory condition that makes breathing difficult for your child as it may limit the effectiveness of nitrous oxide/oxygen treatment.

Will I need to follow any special instructions when caring for my child following sedation?

No. Nitrous oxide/oxygen will naturally leave your child’s body within five minutes of stopping the flow of gas.

Will Nitrous Oxide/Oxygen work for all children?

Nitrous oxide/oxygen may not be effective for all children especially those with severe anxiety, nasal congestion, or discomfort wearing a nasal mask.

Emergency Care

When your child needs urgent dental treatment, we are ready to help. Below are a few tips on what to do if your child has a dental emergency.

What should I do if my child has a toothache/swelling?

  • First, rinse the irritated area with warm salt water and place a cold compress on their face if it is swollen.
  • Give your child over-the-counter children’s pain medication and dose according your child’s weight and age. Do not place heat or aspirin on the teeth or gums.
  • Finally, call us as soon as possible, pain and swelling may be a sign of a dental infection.

What should I do if my child’s baby tooth is knocked out?

Contact us as soon as possible. The baby tooth should not be replaced because of the potential subsequent damage to the developing permanent tooth.

What should I do if my child’s permanent tooth is knocked out?

Find the tooth. Hold the tooth by the crown (the white part), not by the root (the yellow part). Replace the tooth in the socket immediately, if possible. If contaminated, rinse gently with cold tap water (do not scrub or clean it with soap) and put the tooth back in its place. Bite on a clean gauze or a wash cloth to hold it in position If you can not put the tooth back in, place it in a cup of milk or saline. When milk or saline are not available, place the tooth in the child’s mouth (between the cheeks or gums). Go the dentist immediately, the faster you act, the better your chances of saving the tooth.

What if a tooth is chipped or fractured?

Rinse the mouth with water and apply cold compress to reduce swelling if the lip also was injured. If you can find a broken tooth fragment, place it in cold milk or water and bring it with you to the dental office. Sometimes the fragment can be reattached; however, if it cannot be attached the tooth can be repaired with a composite filling.

What about a severe blow to the head or a jaw fracture?

Call 911. You need immediate medical attention. A severe head injury can be life threatening.

Your child’s risk of dental injuries can be reduced greatly by following a few simple suggestions.

  1. By wearing protective gear including a mouth guard during sporting activities
  2. Always use a car seat for young children and require seat belts for everyone else in the car
  3. Childproof your home to prevent falls and electrical injuries

Sports/Night Guard

Sports Guard

Active children are healthy children, but recreation and sports can present a threat to your child’s oral health. Athletic mouth guards can help protect your child’s teeth from a knee, elbow club, ball, racket or just about any other object flying toward his or her face. For maximum effectiveness, a sports mouth guard should fit well and be properly cleaned between usages. Custom mouth guards provide the best fit for active children and teens and can be acquire through your child’s dentists

Night Guard

Teeth grinding during childhood is normal. Although its often a parental concern, children will often outgrow this habit. However if the habit continues once their permanent teeth have come in and there are signs of wear, we will recommend a custom made night-guard.

For both the mouth guard and night guard a mold will be taken of your child’s teeth which will be used to make a model and a custom-fitted guard.

Pediatric Oral Surgery

Extractions

There may be instances where teeth need to be extracted or removed when they can not be saved by any other treatment. This may be due to decay, infection or trauma.

In cases where your child has crowding or a lack of space in the jaws for all of their teeth or if they have retained primary teeth, extractions may also be indicated.

If your child needs to have a tooth or teeth extracted, we will provide the service utilizing local anesthesia and nitrous oxide if needed, to provide the most comfortable experience for your child.

Restorative Care

Composite Fillings (Tooth-Colored Fillings)

Composite fillings-also known as tooth colored fillings are dental restorations that are natural in appearance. Composite fillings are made of ceramic and resin compounds that chemically bond to the teeth so that more of the natural tooth is preserved. They can be used to fill in decayed areas of the teeth as well as repair chipped and broken teeth.

Baby Teeth Crowns

When a tooth is severely decayed or broken due to trauma. A crown may be recommended in order to restore function and esthetics and overall protection of the tooth. The molar baby teeth may be covered with stainless steel crowns while the front teeth are covered with either a composite crown or stainless steel with ceramic facing. Full ceramic crowns are also available however more tooth structure removal is required in order to place these restorations.

Root canal treatments for baby teeth

Root canal treatment for baby teeth is used to remove infected pulp from the inside of a tooth. By removing infected pulp tissues, we can preserve the child’s tooth instead of having to extract it. There are two types of pulp therapy: pulpotomy and pulpectomy. A pulpotomy is performed when only a portion of the pulp needs to be removed; whereas pulpectomies are used to remove all of the pulp tissue. Following a pulp therapy treatment the tooth is often replaced with a crown until the permanent adult tooth replaces it.

Preventive Care

Preventive dentistry involves the care for teeth and gums to avoid cavities, gum disease, wear of the teeth, and trauma. Preventive dental care involves the combination of both home and the following dental office activities.

Caries Risk Assessment.

Your child’s first visit will include an evaluation of their risk of getting cavities. This evaluation is based on many factors including your child’s age, biological factors, protective factors, and clinical findings.

Dental cleanings and screenings.

A dental cleaning (prophylaxis) is typically recommended every six months to remove dental plaque and stains you’re unable to remove yourself, as well as to check for signs of tooth decay.

Fluoride Varnish.

Fluoride is a compound that contains fluorine, a natural element. Using small amounts of fluoride on a routine basis can help prevent tooth decay. At your child’s dental appointment topical fluoride is applied to the tooth enamel as a preventive agent.

The fluoride varnish will be brushed or “painted” on the enamel. Children who benefit most from fluoride are those at high risk factors including a history of previous cavities, a diet high in sugar or carbohydrates, orthodontic appliances, and certain medical conditions such as dry mouth.

X-rays.

X-rays enable dentists to look for signs of dental problems that are not visible to the naked eye, such as cavities between teeth and problems below the gum line. X-rays may also be needed to survey erupting teeth and diagnose bone diseases, evaluate the results of an injury or plan orthodontic treatment.

Pediatric dentists are particularly careful to minimize the exposure of child patients to radiation. With contemporary safeguards, the amount of radiation received in a dental x-ray examination is extremely small. In addition, your child will wear a lead body apron and shields for protection. Our practice utilizes digital x-rays and proper shielding to assure that your child receives minimal amount of radiation exposure.

Mouth guards.

Mouth guards, particularly a custom-made mouth guard prescribed by your dentist to provide a better fit can be worn during sporting activities to protect against broken teeth. Mouth guards also are used to treat teeth grinding (bruxism), which can wear down teeth.

Orthodontic Evaluation.

A bad bite (malocclusion) can impair eating and speaking, and crooked teeth are hard to keep clean. Correcting an improper bite with orthodontics that may include appliances or the use of dental braces limits the possibility of future dental problems. Your pediatric dentist may recommend an orthodontic evaluation if needed.

Sealants.

Sealants protect the grooved and pitted surfaces of the teeth, especially the chewing surfaces of back teeth where most cavities in children are found. They are made of clear or shaded plastic. Sealants are applied to the teeth to help keep them cavity-free.

Sealants are usually placed on teeth that are at the most risk for decay; the six-year and twelve-year molars. They may also be recommended on permanent premolars and primary molars.

The application of a sealant is quick and comfortable. It takes only one visit. The tooth is first cleaned and dried. The sealant is then flowed into the grooves of the tooth and allowed to harden with a special light. Your child will be able to eat right after the appointment.

Dental Exam

Prior to the exam we will review your child’s medical and dental history . During the exam your child will receive a head and neck examination, and we will check your childs teeth, gums and soft tissues and bite/tooth development. We will also do a caries risk assessment, discuss diet and oral hygiene routines and answer any questions you may have.

Depending on your childs age and need, X-rays and fluoride treatments are often provided during the dental exam.

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.

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

A check-up every six months is recommended in order prevent cavities and other dental problems. However, your pediatric dentist can tell you when and how often your child should visit based on their personal oral health.

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. Lead aprons and digital x-rays are used to ensure safety and minimize the amount of radiation.