Local Dental Care - Losing Teeth

Pediatric Dentistry: Your Child's First Dental Visit

There are varying recommendations as to when the first pediatric dentistry visit should Pediatric Dentistry recommends that all children should have their baby teeth looked at by a pediatric dentist within six months of the eruption of the first tooth or no later than one year of age.

The American Academy of General and Pediatric Dentistry recommends between 18 and 24 months of age the child should have their baby teeth seen, unless there is an apparent problem. The American Academy of Pediatrics recommends a child be seen by age three, or sooner if there is a need.

Although there may not be many baby teeth to examine at one year of age, the first pediatric dentistry visit can provide parents with valuable information regarding care and prevention through education and counseling. Infants can be infected with the bacteria that cause tooth decay. Many children have decay in baby teeth by the time they are seven years old.

The infant oral health appointment will include:

• A review of the infant's diet and nutrition
• The need for fluoride supplementation considering dietary and other sources of fluoride
• Pediatric dentistry instructions for cleaning the baby teeth and gums
• Discussion regarding pacifier, finger, or other oral habits
• Injury prevention and trauma
• Oral development and normal eruption patterns
• Risk factors for decay in the child's baby teeth

Traumatic injuries to the mouth occur more often as the child progresses through crawling, walking, and running. If the first visit has already occurred, the parent has a doctor who is familiar with the child to call for emergency pediatric dentistry care.

The sooner your child is acquainted with a pediatric dentist and experiences a pediatric dentistry examination, the better for his or her overall perception of the dental visit. The child's temperament will determine how the appointment goes. Do not delay the first visit because you believe your child will not cooperate. You may be pleasantly surprised!

Make the first pediatric dentistry appointment as early in the day as possible. Toddlers are usually more rested in the morning. Try not to communicate your own fears, if any to your child. Your interpretations and expectations are different from your child's. Practice with your child's head on your lap. Depending on the age, explain how he or she should open wide, talk about the little mirror, the tooth counter, and Mr. Clean, who will make the baby teeth shine.

Avoid words such as hurt, drill, or shot. Do not expect too much from your child. The pediatric dentist will manage the behavior with age-appropriate expectations. A favorite toy or blanket can be taken with the child to hold. Some offices offer a "First Visit" videotape to be viewed at home prior to the visit. The book, Going to the Dentist, by Fred Rogers, is a great way to introduce the first visit. Here's to a wonderful first pediatric dentistry visit for your little "First Timer!"

by Jane A. Soxman, DDS

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.

Tooth Care: Space Maintainers

What happens when a primary (baby) tooth is lost too early? An appliance called a space maintainer will be recommended by your pediatric dentist. The area of the mouth and the age of the child will determine the need for and type of space maintainer.

The primary teeth save the space for the permanent teeth. The 20 primary teeth are replaced by 20 permanent teeth. The six-year molars, twelve-year molars, and wisdom teeth will erupt (come in) in the back of the jaw. The bone will begin to grow around five years of age to make room for these teeth. If a primary tooth is lost before the permanent tooth is ready to erupt, other teeth will drift or tip into the empty space. This may block out the spot for the permanent tooth that replaces the primary tooth. The space maintainer will hold the teeth in their proper position.

Primary teeth may be lost early because of decay, crowding, injury, or improper eruption of the permanent teeth. Most space loss occurs during the first six weeks after the loss of the tooth. This may continue over the next six months. A space maintainer should be placed before this loss occurs. Sometimes, space loss cannot be avoided and your dentist can only attempt to preserve the remaining space.

There are many types of space maintainers, but two are most often used. The band and loop is used to hold the space for one tooth. The lingual arch is used to hold the space for two or more teeth that have been lost from both sides of the jaw.

If a primary molar is prematurely lost and the six-year molar has not yet erupted (come in), the parent must watch closely for the eruption of the six-year molar. This is very important because the six-year molar will rapidly tip or drift forward causing space loss. The teeth that replace the first and second primary molars ordinarily do not erupt until between nine and eleven years of age. The six-year molar must be partially erupted to make the space maintainer for early loss of a second primary molar.

Space maintainers are usually made with orthodontic bands and wires. Two appointments are necessary. During the first dental appointment, an orthodontic band is fitted on the tooth next to the space. An impression is taken. Next, the band is removed from the tooth and placed in the impression. A mold of the teeth is made with the band on the tooth. A laboratory will custom make an appliance to exactly fit the space. During the second appointment, the appliance is cemented in place.

The space maintainer is not removed until the permanent tooth begins to erupt. The parent must be sure to tell the dentist when the permanent tooth is erupting. If the space maintainer is not removed at the proper time, the permanent tooth may come in improperly. Your dentist will inform you of the age when your child's permanent tooth will likely appear. Early tooth loss may cause the permanent tooth to be delayed in its eruption or to erupt earlier than expected.

by Jane A. Soxman, DDS

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.