FREQUENTLY ASKED QUESTIONS

Feel free to poke around our most asked about topics!

How is a Pediatric Dentist different from others?

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.

At The Tooth Factory we don’t just enjoy working with children, it is all we do! Our office was designed for young visitors.  You’ll find that our staff, office decorations and activities all work together to provide an especially friendly and comfortable environment for children.

Baby teeth aren't permanent. Why do they need care?

Although they don’t last as long as permanent teeth, your child’s first teeth play an important role in his/her development. While they’re in place, these primary teeth help your little one speak, smile and chew properly. They also hold space in the jaw for permanent teeth. If a child loses a tooth too early (due to damage or decay), nearby teeth may encroach on that space, which can result in crooked or misplaced permanent teeth. Your child’s general health is also affected by the oral health of the teeth and gums.

When should my child have dental X-RAYS taken?

We recommend taking X-rays around the age of two and a half or three. The first set consists of simple pictures of the front upper and lower teeth, which the doctor will use to check for trauma and cavities.  If the baby teeth in back are touching one another, then cavity detecting X-rays are recommended on an annual basis. Permanent teeth start coming in around age six, and X-rays help us make sure your child’s teeth and jaw are healthy and properly aligned. If your child is at a high risk of dental problems, we may suggest having X-rays taken more frequently.

Are dental X-RAYS really necessary?

It is common for parents to request that no radiographs be taken on their children, but the reasoning behind their request varies.  The usual concerns expressed are fear of radiation, discomfort, and cost.  Please allow us to explain why radiographs are so important and why they are a necessary part of optimal patient care.

A visual dental examination, that is, an exam without radiographs, allows Dr. CC to see only 3 of 5 exposed surfaces on each tooth (that’s 60% of each tooth). Also, keep in mind that 2/3 of each tooth lies below the gum line and into the bone. A visual exam allows Dr. CC to see only what is happening above the gum line.  So if only 1/3 of the tooth is above the gum line, and he is only able to see 60% of that 1/3, doing a dental exam without radiographs is essentially allowing her to inspect only 18% of each tooth. That is not a very thorough exam. Radiographs are necessary to evaluate and definitively diagnose most oral diseases and conditions.  Most commonly what we find is dental decay and periodontal disease, but in many cases, we find much more than that.  Very few of our patients have only permanent teeth.  Most have a combination of baby and adult teeth, and their smiles are still developing. Radiographs help us confirm that their smiles are developing normally and make it possible to detect problems early.  We can determine when permanent teeth are erupting ectopically and may need assistance in finding a path into the mouth.  We can find out early if crowding and misalignment is going to be an issue, and often take steps to eliminate the need for orthodontics or minimize the amount of time spent in braces.

Another important reason to have dental radiographs is for forensic purposes.  More than 800,000 children in America are reported missing each year. Since the passage of the Missing Children Act in 1982, and the creation of the National Crime Information Center, the dental profession has provided much of the information used to compare missing persons with the unidentified living and dead. Numerous cases have been published in which law enforcement agencies called upon dentists to provide information that proved vital to the identification process. The Tooth Factory recognizes the importance of our role in the provision of data for identification of missing and/or deceased children. God forbid any of our patients should ever go missing, but if it ever happens, we would like to be prepared to assist the authorities, in any way possible, to help the families in their time of need.

If radiation exposure is your main concern, we completely understand. That is why The Tooth Factory follows all the ADA/FDA guidelines and recommendations to minimize our patients’ exposure.   We take the minimum number of radiographs necessary to perform our exams.  We use lead aprons, thyroid collars, beam collimation and we have the most advanced sensors on the market, which require the least amount of exposure to obtain a diagnostic image.  We take every step possible to minimize exposure, but in reality, the amount of radiation we use is so low that it can be considered close to negligible.   On average, Americans receive a radiation dose of about 620 millirem each year. The average dental radiograph exposes the patient to 1.5 mrem.  We take 2-4 images every 12-24 months.  So even on our highest risk patients that get radiographs take every year, we are only exposing them to about 6 mrem per year.  We get a lot more radiation from the food we eat (about 30-40 mrem/year) than we do from dental x-rays. For those of us who work with and around radioactive material, the U.S. Nuclear Regulatory Commission (NRC) has established standards that allow exposures of up to 5,000 mrem per year.

The last reason, and a very important one from a professional perspective, is that we have a legal duty to provide competent care, and radiographs are vital for a proper diagnoses. Without the necessary films, we compromise our ability to provide competent care. Many offices even have a policy that states if a patient refuses to have the necessary radiographs, the patient will be dismissed from the practice. While this practice may seem rather inflexible and harsh, it may be the wisest policy from a legal and professional standpoint.  Even if it is at the request of the patient, if a radiograph is not taken when it is needed for proper diagnosis, and later a serious dental or medical problem arises, Dr. CC, as the healthcare provider can be held liable.  No signed waiver or signed refusal would protect her in court.  No patient, or parent, can give consent for a dentist to be negligent. In fact, Dr. CC malpractice insurance carrier, while not specifically prohibiting it, recommends not accepting patients who refuse radiographs. Their literature reads as follows: “Dentists should proceed with great caution when patients insist on sub-standard care that may lead to serious harm. Treating without x-rays may lead to unreasonable results or risks, and withdrawing from care may be necessary. If a lawsuit is filed, the dentist’s professional judgment will be scrutinized.”

We very much want you to be comfortable with our office’s policies and Dr. CC is more than happy to discuss with you, in person or over the phone, any concerns you may still have.  Please let us know how we can be of service and help!

Does your child grind their teeth at night? (Bruxism)

Parents are often concerned about the nocturnal grinding of teeth (bruxism). Often, the first indication is the noise created by the child grinding on their teeth during sleep. Or, the parent may notice wear (teeth getting shorter) to the dentition. One theory as to the cause involves a psychological component.

The majority of cases of pediatric bruxism do not require any treatment. If excessive wear of the teeth (attrition) is present, then a mouth guard (night guard) may be indicated.

The good news is most children outgrow bruxism. The grinding decreases between the ages 6-9 and children tend to stop grinding between ages 9-12. If you suspect bruxism, discuss this with Dr. CC at your next appointment.

What is Pulp Therapy?

The pulp of a tooth is the inner part of the tooth.  The pulp contains nerves, blood vessels, connective tissue and reparative cells. The purpose of pulp therapy in Pediatric Dentistry is to maintain the vitality of the affected tooth (so the tooth is not lost).

Dental caries (cavities) and traumatic injury are the main reasons for a tooth to require pulp therapy.  Pulp therapy is often referred to as a “nerve treatment”, “children’s root canal”, “pulpectomy” or “pulpotomy”.  The two common forms of pulp therapy in children’s teeth are the pulpotomy and pulpectomy.

A pulpotomy removes the diseased pulp tissue within the crown portion of the tooth.  Next, an agent is placed to prevent bacterial growth and to calm the remaining nerve tissue.  This is followed by a final restoration.

A pulpectomy is required when the entire pulp is involved (into the root canal(s) of the tooth).   During this treatment, the diseased pulp tissue is completely removed from both the crown and root.  The canals are cleansed, disinfected and, in the case of primary teeth, filled with a resorbable material.  Then, a final restoration is placed.  The difference with a permanent tooth is a permanent tooth would actually be filled with a non-resorbing material.

When should I schedule my child's first visit to the dentist?

The American Academy of Pediatric Dentistry recommends that a child be seen when the first tooth appears, or no later than his/her first birthday.  We at The Tooth Factory like to start sooner.  In fact, we like to meet with moms before their babies are even born! Why?  Because there are a lot of steps expectant mothers can take even at that these early stages to prevent disease not only in their own mouths, but also in the mouths of their children for years to come.  We like to see babies early too. 100% of cavities can be prevented with proper eating and brushing habits.  The sooner we start with these good habits, the less likely your child will ever need to have a cavity fixed.

How can I do to better prepare my child's for her/his first dental appointment?

The best preparation for your kid’s first visit to our office is maintaining a positive attitude. Children pick up on adults’ apprehensions, and if you make negative comments about trips to the dentist, you can be sure that your child will fear an unpleasant experience and act accordingly (Check out our My First Visit tab). Show your child the pictures of the office and staff on the website. Let your child know that it’s important to keep his teeth and gums healthy and that the dentist will help him do that. The Tooth Factory staff is specially trained to handle fears and anxiety.  Putting children at ease during treatment is our specialty.

How often should my child visit the dentist?

We generally recommend scheduling checkups every six months. Depending on the circumstances of your child’s oral health, we may recommend more frequent visits.

What about Thumb Sucking?

Sucking is a natural reflex and infants and young children may use thumbs, fingers, pacifiers and other objects on which to suck. It may make them feel secure and happy, or provide a sense of security at difficult periods. Since thumb sucking is relaxing, it may induce sleep.

Thumb sucking that persists beyond the eruption of the permanent teeth can cause problems with the proper growth of the mouth and tooth alignment. How intensely a child sucks on fingers or thumbs will determine whether or not dental problems may result. Children who rest their thumbs passively in their mouths are less likely to have difficulty than those who vigorously suck their thumbs.

Children should cease thumb sucking by the time their permanent front teeth are ready to erupt. Usually, children stop between the ages of two and four. Peer pressure causes many school-aged children to stop.

Pacifiers are no substitute for thumb sucking. They can affect the teeth essentially the same way as sucking fingers and thumbs. However, use of the pacifier can be controlled and modified more easily than the thumb or finger habit. If you have concerns about thumb sucking or use of a pacifier, let’s talk about it at your next appointment.

A few suggestions to help your child get through thumb sucking:

  • Instead of scolding children for thumb sucking, praise them when they are not.
  • Children often suck their thumbs when feeling insecure. Focus on correcting the cause of anxiety, instead of the thumb sucking.
  • Children who are sucking for comfort will feel less of a need when their parents provide comfort.
  • Reward children when they refrain from sucking during difficult periods, such as when being separated from their parents.
  • Dr. C.C.’s loves to encourage children to stop sucking and explain what could happen if they continue.  And almost always, kids take her seriously and follow her direction!  Come on in and give it a whirl!
  • If these approaches don’t work, remind the children of their habit by bandaging the thumb or putting a sock on the hand at night and lastly We may recommend the use of a mouth appliance.
What is the Best Time for Orthodontic Treatment?

Developing malocclusions, or bad bites, can be recognized as early as 2-3 years of age. Often, early steps can be taken to reduce the need for major orthodontic treatment at a later age.

Stage I – Early Treatment: This period of treatment encompasses ages 2 to 6 years. At this young age, we are concerned with underdeveloped dental arches, interferences within the dental arches, the premature loss of primary teeth, and harmful habits such as finger or thumb sucking. Treatment initiated in this stage of development is often very successful and many times, though not always, can eliminate the need for future orthodontic/orthopedic treatment.

Stage II – Mixed Dentition: This period covers the ages of 6 to 12 years, with the eruption of the permanent incisor (front) teeth and 6 year molars. Treatment concerns deal with jaw molar relationships and dental realignment problems. This is an excellent stage to start treatment, when indicated, as your child’s hard and soft tissues are usually very responsive to orthodontic or orthopedic forces.

Stage III – Adolescent Dentition: This stage deals with the alignment of permanent teeth and the development of the final bite.

Additional Resources

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Our office is in-network with nearly every PPO insurance provider to help you get the most of your dental benefits. We’re a preferred provider with Delta Dental, GEHA, Ameritas, Aetna, BlueCross Blueshield and more! For patients without insurance that require out-of-pocket expenses, we offer CareCredit payment plans with 0% interest and affordable monthly payments.

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