Frequently Asked Questions

FREQUENTLY ASKED QUESTIONS

What is Pediatric Dentistry?
A pediatric dentist is a specialist dedicated to the oral health of infants, children, adolescents and patients with special health care needs. Pediatric dentists complete two or three years of additional specialized training (after the required four years of dental school), which includes study in child psychology, growth, and development. They are also trained and qualified to care for patients with medical, physical, or mental disabilities. Their specialization allows them to provide treatment for a wide variety of children's dental problems such as tooth decay and cavities, malocclusion and crooked teeth, and emergency care. The Raleigh Pediatric Dentistry office is specifically designed for treating children from infancy through adolescence, as well as the medically and the physically compromised.  << return to top of page

At what age should my child visit the dentist?
The American Academy of Pediatric Dentistry recommends that a child's first visit to the dentist should occur by 12 months of age. This visit will enable the dentist to evaluate your child and introduce you to proper oral hygiene. Diet, fluoride, finger and pacifier habits and tooth eruption will be discussed to insure optimal dental health. << return to top of page

What guidelines will help children remain cavity free?
The American Academy of Pediatric Dentistry recommends:
. Brush with a fluoride toothpaste twice a day.
. Floss children's teeth once a day.
. Visit your pediatric or general dentist regularly.
. Get enough fluoride through drinking water and other fluoride products and fluoride supplements, if necessary.
. Have sealants applied to the chewing surfaces of permanent back teeth or molars.
. Snack moderately-no more than twice a day. << return to top of page

Tips for helping children develop positive dental habits.
. Set a good example
. Make good oral health a family effort
. Show children that daily brushing and flossing, limited snacking and regular dental checkups are necessary for good oral health
. Support your child when they are able to brush and floss on their own- assisting and performing spot checks as needed << return to top of page

How important is a child's diet in the prevention of cavities?
Although a well-balanced diet is important in preventing cavities and to ensure good general health, cavities are not only the result of what children eat but also the frequency of meals. Frequent snacking without brushing leaves food on the teeth longer and increases the likelihood of a cavity developing. Additionally, frequent "sipping" on sugar-drinks (including juice and soda) in a baby bottle, "sippy" cup, or re-sealable bottle can cause widespread dental cavities. << return to top of page

What are dental sealants and who can benefit from them?
The chewing surface of children's teeth are the most susceptible to cavities and least benefited from fluorides. Sealants are adhesive coatings that are applied to the tops of teeth and can be very effective in preventing tooth decay. Current research has shown that 4 out of 5 cavities in children under age 15 develop on the biting surface of back molars. Molars are the most decayed teeth because plaque accumulates in the tiny grooves of the chewing surfaces. Sealants prevent the cavities that fluoride cannot effectively reach. << return to top of page

What are amalgams (silver fillings)?
Amalgams or silver fillings are used to restore or "fill" decayed areas in teeth. They have a scientifically proven history of safety and effectiveness in restoring teeth.
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What are composites (tooth colored fillings)?
Composites or tooth colored fillings are used to restore fractured teeth and/or areas of decay, especially for front teeth in which cosmetic appearance is important. The shade of the restoration material is matched as closely as possible to the color of the natural tooth. << return to top of page

What are Stainless Steel Crowns?
Stainless steel crowns are silver colored "caps" used to restore teeth that are too badly decayed to hold fillings, need a nerve treatment, or when durability is a concern. Crowns with white facings can be used on front teeth.
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What is a Pulpotomy?
This procedure is a nerve treatment in which the sick portion of the tooth nerve is removed and medicine is placed in order to avoid extracting the tooth.
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What is a Pulpectomy?
A pulpectomy is necessary when the nerve of the tooth is dead. The entire infected pulp is removed and medication is placed in the root canals.
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What is Nitrous Oxide/Oxygen?
Nitrous Oxide (laughing gas) is breathed by your child with oxygen during the restorative appointment. It can be used to relax a mildly anxious child who is still cooperative. << return to top of page

What are Space Maintainers?
A space maintainer is used to hold space for a permanent tooth when a baby tooth has been prematurely lost. If space is not maintained, teeth on either side of the missing tooth can drift into the space and prevent the permanent tooth from erupting. << return to top of page

Why are "baby teeth" important?
Primary teeth have been labeled "baby teeth." However, the first tooth is usually lost around age 6 and some primary molars must remain in place until 12 or 13 years of age. Primary teeth are necessary for proper chewing, speech, development of the jaws and esthetics. Care of the primary teeth is important not only for proper function, but also to avoid a number of unpleasant conditions, such as pain, that result from their neglect. << return to top of page

Do you allow parents to come back with their children?
Parents are invited back to observe during the initial exam and checkups. We have a designated parent bench from which you can observe treatment. During restorative treatment of cavities, parents are invited to observe through the clear glass door of the treatment room. This arrangement allows the doctor and staff to communicate with your child directly without distractions or safety concerns. Over time, we hope to bring your child back by themselves to better establish your child's trust and independence. During sedation and general anesthesia treatment, no parents are allowed to observe due to safety concerns. Finally, if you expect your child to do well and enjoy their visit to our office, chances are they will do just that!
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What do I do if my child is in an accident?
If your child has an accident, please call our office as soon as possible. We will see your child immediately. If it is an after-hours emergency, a pager number will be given on the answering machine.

The first 30 minutes after an accident are the most critical to treatment of dental trauma. If a permanent tooth is knocked out, gently rinse, but do not scrub the tooth under water. Replace the tooth in the socket if possible. If this is impossible, place the tooth in a glass of milk or a clean wet cloth and come to the office immediately. If the tooth is fractured, please bring in any pieces you can find.

Our schedule may be delayed in order to accommodate an injured child. Please accept our apologies in advance should an emergency occur during your child's appointment. << return to top of page

What is enamel fluorosis?
If a child is exposed to too much fluoride during the years of tooth development they may face the condition called enamel fluorosis. Too much fluoride can result in defects in tooth enamel resulting in white, yellow or brown splotches, streaks or lines, usually on the front teeth. << return to top of page

How can enamel fluorosis be prevented or treated?
First, your dentist can determine the appropriate fluoride supplementation, if any, that should be given. Your dentist may choose to test the level of fluoride in your child's source of drinking water. After he knows how much fluoride your child receives from their water supply and other sources, they will decide if your child needs a fluoride supplement.

Second, monitor your child's use of fluoridated toothpaste. A smear of paste for young children or pea-sized amount in older children is plenty for fluoride protection. Teach your child to SPIT out the toothpaste. Do not swallow it after brushing.

Once fluoride is part of the tooth enamel, it can't be taken out. The appearance of teeth affected by fluorosis can be greatly improved by a variety of treatments. If your child suffers from severe enamel fluorosis, your dentist can tell you about dental techniques that can enhance your child's smile.
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Should I avoid fluorides all together for my child?
Definitely NO! Fluoride prevents tooth decay. It is an important part of helping your child keep a healthy smile for a lifetime. Getting the correct amount can be easily accomplished with the help of your dentist.
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Do special children have special dental needs?
Yes. we have found that some children with disabilities are more susceptible to tooth decay, gum disease or oral trauma. They may require medication, special diets, or possess oral habits detrimental to dental health. If dental care is started early and followed conscientiously, every child can enjoy a healthy smile.
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How can I prevent dental problems for my special child?
A first dental visit by age one will be the beginning to a lifetime of good dental health. We will obtain a full medical history, perform an examination of your child's teeth and gums, and then develop a preventive care plan specifically designed for your child's needs. << return to top of page

Will preventive dentistry benefit my special child?
Yes! Your child will benefit from the preventive approach recommended for all children- effective daily brushing and flossing, moderation of snacking and proper amounts of fluoride. Home care takes just minutes a day and prevents needless dental problems. Regular professional cleanings and fluoride treatments will allow prevention of dental problems and help catch problems early if they should arise. << return to top of page

Is Raleigh Pediatric Dentistry prepared to care for special children?
Dr. Dave had 3 years of advanced training beyond dental school. His specialty education provided additional training that focused specifically on care for children with special needs. Additionally, our office is designed to be physically accessible for special patients. Pediatric dentists, because of their expertise, are often the clinicians of choice for the dental care of adults with special needs as well.
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Will my child need special care during dental treatment?
Every child is unique. As such, each child requires a plan of treatment specifically designed for their needs. Some special children require restraint or mild sedation. If a child needs extensive evaluation and treatment, your dentist may suggest providing care at a local hospital. Dr. Dave had comprehensive education in behavior management, sedation and anesthesia techniques. We will chose a plan of care specifically designed for your child, then discuss the benefits, limits and risks of that plan with you. << return to top of page

What is interceptive orthodontics?
As a child grows and matures, there may be indications that your child's teeth may not develop into normal position and biting relationships. Your dentist may inform you that your child may need orthodontic treatment once their permanent teeth have fully erupted. << return to top of page

Interceptive orthodontic treatment (commonly referred to as Phase I) allows minor tooth movement during an early developmental time in your child's life. This type of treatment may include fixed or removable appliances, spacers, and/or braces. Early treatment may have the benefit of eliminating or minimizing the need for additional treatment later in life. << return to top of page

What are athletic mouth protectors?
Athletic mouth protectors are soft plastic mouth guards made specifically for your child's teeth. They protect the teeth, lips, cheeks and tongue. They can help protect children from such serious head and neck injuries as concussions and jaw fractures. Increasingly, organized sports are requiring mouth guards to prevent injury to their athletes. Research shows that most oral injuries occur when athletes are not wearing mouth protection. We recommend you wear a mouthguard whenever you are in an activity with a risk of falls or of head contact with other players or equipment. This includes football, baseball, basketball, soccer, hockey, skateboarding, rollerblading, and gymnastics. Any mouthguard works better than no mouthguard therefore select one that is comfortable to wear. If a mouthguard feels bulky or interferes with speech or breathing, it will be left in the locker room. You can buy mouthguards in sports stores that are pre-formed or "boil-and-bite." Different types and brands vary in terms of comfort, protection and cost. Alternatively, we can make customized mouth guards. While they may cost a little more, they are more comfortable and more effective in preventing injuries.
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Are thumb, finger and pacifier habits bad for the teeth and jaws?
The majority of children stop sucking on thumbs, fingers, pacifiers or other objects on their own between two and three years of age without any harm being done to their teeth or jaws. However, children that repeatedly suck on a finger, pacifier or other object over long periods of time may cause the upper front teeth to tip toward the lip or not come in properly. We will carefully monitor the way your child's teeth come in and jaws develop. For most children there is no reason to worry about a sucking habit until the permanent front teeth are ready to come in, but it should be discouraged by the age of four. << return to top of page

What can I do to stop my child's habit?
The majority of children stop sucking habits on their own. Some children may need the help of their parents. When your child is old enough to understand the possible results of a sucking habit, We can encourage your child to stop and talk about what happens to the teeth if your child doesn't stop. Typically, this advice along with the support from parents, helps most children quit. If all other options have been exhausted, your dentist may discuss the use of a fixed appliance to discourage the habit. << return to top of page

What is general anesthesia?
General anesthesia provides a way of effectively completing dental care while a child is unconscious. Due to the risks of any surgical procedure and high cost, usually only children with severe anxiety and/or severe tooth decay are recommended for general anesthesia. Typically, these children are young or have compromised health issues. Standard behavior management techniques may not be effective to accomplish treatment. << return to top of page

Is general anesthesia safe?
YES. While normal risks are always present with surgery, a pediatric anesthesiologist will put your child to sleep. They are responsible for delivering the general anesthesia, monitoring and the medical care of the child. Many precautions are taken to provide safety for the child during general anesthesia care. Patients are monitored closely during the general anesthesia procedure by anesthesia personnel who are trained to manage complications. We will discuss the benefits and risks involved with general anesthesia and why it is recommended for your child's treatment.
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What special considerations are associated with the general anesthesia appointment?
Most times, your child's surgery will be done on an "outpatient" basis. This means they will have their surgery in the morning and be allowed to go home in the afternoon.

A physical examination - is required prior to a general anesthesia appointment to complete dental care. This physical examination provides information to ensure the safety of the general anesthesia procedure. We will advise you about any evaluation appointments that may be requested.

Prior to surgery - Minimal discussion to your child about the appointment may reduce anxiety. Explain they are "going to go to sleep when their teeth are being fixed".

Eating and drinking - It is important NOT to have a meal the night before general anesthesia. You will be informed about food and fluid intake guidelines prior to the appointment.

Changes in your child's health - If your child is sick or running a fever, contact our office immediately! It may be necessary to arrange another appointment.

Usually, children are tired following general anesthesia. You may wish to return home with minimal activity planned for your child until the next day. After that, you can usually return to a routine schedule. << return to top of page

What is conscious sedation?
Conscious sedation is a way of using medication to relax a child without the loss of consciousness. << return to top of page

Who should be sedated?
We recommend that those children with severe anxiety and/or the inability to relax are candidates for sedation. Usually these children are young or have trouble managing their anxiety. << return to top of page

Why use conscious sedation?
Conscious sedation aids in calming a child so that he or she can accept dental treatment in a more relaxed state. This can prevent injury to the patient and provide a better environment for delivering quality dental care. Keep in mind that it is difficult to do dentistry on a moving child. << return to top of page

What medications are used?
There are many different agents that can be used for conscious sedation- there are inhalation agents (laughing gas) and medicines that are drunk from a cup. None of these sedatives render the child unconscious. Recommendations of which medication to be used are based on the child's age, level of anxiety, amount of dental work that needs to be completed and length of appointment. << return to top of page

Is sedation safe?
Dr. Dave had 3 years of advanced training to administer, monitor and manage sedated patients. He is certified in CPR/Pediatric Advanced Life Support and exceeds the standard of care in his monitoring and emergency equipment. Additionally, he has taken numerous continuing education classes and is certified by the NC Board of Pediatric Sedation.
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Why is oral health important when you are pregnant?
Now that you are pregnant, it is more important than ever to take better care of your teeth and gums. During pregnancy you will experience significant changes, including changes in your oral health.

"Pregnancy gingivitis" is a condition that commonly occurs in the second or third month of pregnancy and can become more severe through the eighth month.

The hormonal changes that occur during pregnancy may cause a greater reaction to dental plaque, resulting in an increased amount of swelling, bleeding and redness of the gums.

Research now suggests a link between gum disease in pregnant women and premature low birth weight babies. A recent study, conducted by researchers at the University of North Carolina School of Dentistry, suggests that every year as many as 45,500 premature births may be linked to gum disease. That is 19% of the 250,000 premature babies born every year- more than attributed to smoking and alcohol use combined. << return to top of page

What can you do?
Since your oral health has implications that directly affect your pregnancy, it is extremely important to pay close attention to the signs of gum disease. Dental professionals recommend having more frequent dental cleanings. It is very important to maintain a proper daily oral care routine, including brushing and flossing.

If tenderness, bleeding or gum swelling occur at any time during your pregnancy, see your general dentist or dental hygienist immediately.

Please let us know:

• Is yours a high-risk pregnancy?
• In which month of pregnancy are you?
• Have you noticed any changes in your oral health?
• Are you taking any medications?
• Have you noticed gum inflammation, swelling, redness or bleeding?
• Have you noticed any loose teeth?

Our concern for your total health including oral care is critical to your unborn baby's development. Early identification of oral health problems, such as gum disease, may help reduce the risk of complications in your pregnancy.

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