For more information on oral health care needs, please visit the website for the American Academy of Pediatric Dentistry.

Our pediatric dentists have a minimum of an extra two years of specialized training and is dedicated to the oral health of children from infancy through the teenage years. The very young, pre-teens, and teenagers all need different approaches in dealing with their behavior, guiding their dental growth and development, and helping them avoid future dental problems. The pediatric dentist is best qualified to meet these needs.

 Your Child’s First Dental Visit

According to the American Academy of Pediatric Dentistry (AAPD), your child should visit the dentist by his/her 1^st birthday (see Early Infant Oral Care). You can make the first visit to the dentist enjoyable and positive. Your child should be informed of the visit and told that the dentist and his staff will explain all procedures and answer any questions. The less to-do concerning the visit, the better.

 Why Are The Primary Teeth So Important?

Radiographs (X-Rays) are a vital and necessary part of your child’s dental diagnostic process. Without them, certain dental conditions can and will be missed.  Radiographs are not something to be afraid of, but instead something to be respected.

X-Ray’s detect much more than cavities. For example, X-Rays may be needed to survey erupting teeth, diagnose bone diseases, evaluate the results of an injury, or plan orthodontic treatment. X-Rays allow dentists to diagnose and treat health conditions that cannot be detected during a clinical examination. If dental problems are found and treated early, dental care is more comfortable for your child and more affordable for you.

The American Academy of Pediatric Dentistry recommends X-rays and examinations every six months for children with a high risk of tooth decay. On average, most pediatric dentists request radiographs approximately once a year. Approximately every 3 years it is a good idea to obtain a complete set of radiographs, either a panoramic and bitewings or periapicals and bitewings.

Pediatric dentists are particularly careful to minimize the exposure of their patients to radiation. With contemporary safeguards, the amount of radiation received in a dental X-ray examination is extremely small. The risk is negligible. In fact, the dental X-rays represent a far smaller risk than an undetected and untreated dental problem. Lead body aprons and shields will protect your child. Today’s equipment filters out unnecessary X-rays and restricts the X-ray beam to the area of interest. High-speed film digital radiographs and proper shielding assure that your child receives a minimal amount of radiation exposure.
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Your child’s safety is important to us!  No one has a bite like yours.

Click here for more information on Toothprints®.

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FINDING YOUR CAR IN THE PARKING LOT;
The Role of Parents and Direct Support Professionals in Providing Attention
to Oral Healthcare Needs of the Child with Special Needs.

A vast amount of information is available and awaits us at every turn, in all media forms, and through every contact with our healthcare providers.  Pamphlets, articles, booklets, the internet, newsletters, magazines... all provide access to oral health knowledge that we all need to have. We read about brushing and flossing, the importance of periodic dental visits, diet and nutrition, protection of teeth at Special Olympic events and during
other sports, early treatment of crooked teeth, the importance of fluoride, and the list goes on.  We have seen pictures severe gum disease, malocclusions and broken teeth, while Web sites direct us to dental offices which provide services to our children. Articles tell stories of unmet dental needs in the special patient population, and about how to deal with the financial restraints put on both patients and providers.

Don't be nervous or afraid to bring your very young child to the dentist because you think that either the dentist will be hard to deal with or it may be difficult for the dentist to deal with your child, and therefore worried the experience will be a disaster. The longer you wait, the harder it may be.

If only we could pull in to a parking lot, get out of the car, head toward the neon sign that reads "Same-day Dental Care Here", and stroll back to the car and exit with perfect pearly whites. The typical dental journey, however, sends us in so many directions that when we come out we cannot even find our car in the parking lot. What can we do?

Plain and simply, good oral hygiene begins at home and it begins early-- soon after the primary tooth erupts. Good oral health requires discipline and parents and caregivers need only follow these four simple steps to assure a healthy smile:

Step 1: Early infant oral care is important for all children.
Step 2: Start looking for a dentist NOW.
Step 3  Do your part: Keep your appointments.
Step 4: Advocate as part of the team.

Children with special needs need a head start.

Many children with special needs develop jaw growth and tooth alignment problems early. Although recognized by dentists, parents and DSP's many times these malocclusions are left untreated simply because the child has a disability. We need to remember, the only reason for not doing orthodontic treatment is poor oral hygiene or unmanageable behavior, both of which have potential for improvement. The presence of a disability is NOT a contraindication to receiving orthodontic treatment. Parents need to work with their child's dentist to be sure that specialized therapy, such as periodontia or orthodontia, is improved. Start early... be disciplined... be part of the dental team; the reward will be in your child's smile for a lifetime and you will always be able to find your car in the parking lot.

Dr. David Tesini
Past President of the Academy of Dentistry for Persons With Disabilities.

 DVD on Treating Autistic Patients

A new DVD helps dentists and their staff members learn strategies that can help in treating patients with autism.

We call the program “The D-Termined” program because we feel that it takes determination from parents, caregivers and our dental staff to make this program successful.  We are determined to make this program work.  Developed by Dr. Tesini, “The D-Termined Program of Repetitive Tasking and Familiarization in Dentistry”, offers five steps to help patients with autism acclimate to the dental environment.

http://www.nlmfoundation.org/media/dental_clips.htm

You tube D-Termined Program

We have recommended a repetitive tasking (familiarization) experience for your child.  This is done by having your child come into the office for multiple visits during our morning hours.  Our main goal is to teach the child coping mechanisms so that they can learn to tolerate and have positive dental experiences.  The appointments will allow us to establish a rapport and a sense of trust with your child slowly using many small accomplishments to progress toward the ultimate goal.  Steps that may seem small such as sitting in the dental chair, not crying or keeping “hands on tummy” are actually viewed as successful.

Dental team members play a significant role in working with the patient on repetitive tasking, minimizing the time required by the dentist during the familiarization process.  We may involve you in preparing the child for the visit(s) by having you view a prepared video and/or practicing what we have shown the child in the clinic.

The program and expected goals are unique and adapted to each child’s individual tolerance level, and because of this we would ask to have this questionnaire filled out prior to your appointment and bring it along with your child.

CLICK HERE FOR PRE-APPOINTMENT INFORMATION FOR CHILDREN WITH SPECIAL NEEDS
PROGRAM QUESTIONNAIRE FOR PARENT/GUARDIAN

Begin daily brushing as soon as the child’s first tooth erupts. A pea-size amount of fluoride toothpaste can be used after the child is old enough not to swallow it. By age 4 or 5, children should be able to brush their own teeth twice a day with supervision until about age seven to make sure they are doing a thorough job. However, each child is different. Your dentist can help you determine whether the child has the skill level to brush properly.

Proper brushing removes plaque from the inner, outer and chewing surfaces. When teaching children to brush, place toothbrush at a 45 degree angle; start along gum line with a soft bristle brush in a gentle circular motion. Brush the outer surfaces of each tooth, upper and lower. Repeat the same method on the inside surfaces and chewing surfaces of all the teeth. Finish by brushing the tongue to help freshen breath and remove bacteria.

A sealant is a clear or shaded composite material that is applied to the chewing surfaces (grooves) of the back teeth (premolars and molars), where four out of five cavities in children are found. This sealant acts as a barrier to food, plaque and acid, thus protecting the decay-prone areas of the teeth.
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One serious form of decay among young children is baby bottle tooth decay. This condition is caused by frequent and long exposures of an infant’s teeth to liquids that contain sugar. Among these liquids are milk (including breast milk), formula, fruit juice and other sweetened drinks.

Putting a baby to bed for a nap or at night with a bottle other than water can cause serious and rapid tooth decay. Sweet liquid pools around the child’s teeth giving plaque bacteria an opportunity to produce acids that attack tooth enamel. If you must give the baby a bottle as a comforter at bedtime, it should contain only water.  If your child won't fall asleep without the bottle and its usual beverage, gradually dilute the bottle's contents with water over a period of two to three weeks. 

Teething, the process of baby (primary) teeth coming through the gums into the mouth, is variable among individual babies. Some babies get their teeth early and some get them late. In general the first baby teeth are usually the lower front (anterior) teeth and usually begin erupting between the age of 6-8 months. See "Eruption of Your Child’s Teeth" for more details.
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Children’s teeth begin forming before birth. As early as 4 months, the first primary (or baby) teeth to erupt through the gums are the lower central incisors, followed closely by the upper central incisors. Although all 20 primary teeth usually appear by age 3, the pace and order of their eruption varies.

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 and pacifiers 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 should cease thumb sucking by the time their permanent front teeth are ready to erupt. Usually, children stop between the ages of three 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 your child uses a pacifier, use a clean pacifier - one recommended by your child's doctor or dentist.  Never dip the pacifier into any sweet substance.

You can only intervene successfully when the child says "YES" and wants to stop. "GETTING TO YES" involves three steps:
Step One:  Create "Awareness" of the habit; this step deals with making the child aware of his/her habit and then asking if he/she wants to stop.
Step Two:  Discuss the "Detrimental" effects...This step deals with explaining to the child that the thumbsucking habit is undesirable.
Step Three:  Possible "interventions" to discuss with the pediatric dentist include:

• POSITIVE REINFORCEMENT (touch-feely)

• CHARTS (visual reinforcement)

• MITTENS (hot in the summer)

• BAND-AIDS (cool!!)

• 'THUMBS AWAY' (yuk)

• ELBOW PADS  (I like this one)

• ORAL APPLIANCES (expensive)

Click here for a copy of our Thumbsucking or "Getting to Yes" pamphlet.

Please talk to your dentist or hygienist if you have any questions or concerns. 
 

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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 – Interceptive Treatment: This period of treatment encompasses ages 2 to 6 years. At this young age, we are concerned with underdeveloped 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 malrelationships 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.

When a child begins to participate in recreational activities and organized sports, injuries can occur. A properly fitted mouth guard, or mouth protector, is an important piece of athletic gear that can help protect your child’s smile, and should be used during any activity that could result in a blow to the face or mouth.

Mouth guards help prevent broken teeth, and injuries to the lips, tongue, face or jaw.  Mouthguards can also prevent concussions.  A properly fitted mouth guard will stay in place while your child is wearing it, making it easy for them to talk and breathe.

A custom mouthguard has the most superior fit and comfort level. An impression is taken in the dental office and a guard is made to fit the mold. They come in a variety of colors and are perfect for those that have completed orthodontic treatment and have all permanent teeth. 

Please print and complete the Fluoride Source Awareness Survey.  This survey is intended to increase parents' awareness of the potential sources of fluoride which your child is receiving from a a variety of sources.

To print the survey you will need Adobe Acrobat Reader.  If you do not have Adobe Acrobat, please click here to download it for free to your computer.

Click here to print the Fluoride Source Awareness Survey    

You might not be surprised anymore to see people with pierced tongues, lips or cheeks, but you might be surprised to know just how dangerous these piercings can be.

There are many risks involved with oral piercings including chipped or cracked teeth, blood clots, or blood poisoning. Your mouth contains millions of bacteria, and infection is a common complication of oral piercing. Your tongue could swell large enough to close off your airway!

Common symptoms after piercing include pain, swelling, infection, an increased flow of saliva and injuries to gum tissue. Difficult-to-control bleeding or nerve damage can result if a blood vessel or nerve bundle is in the path of the needle.

Tobacco in any form can jeopardize your child’s health and cause incurable damage. Teach your child about the dangers of tobacco.

Smokeless tobacco, also called spit, chew or snuff, is often used by teens who believe that it is a safe alternative to smoking cigarettes. This is an unfortunate misconception. Studies show that spit tobacco may be more addictive than smoking cigarettes and may be more difficult to quit. Teens who use it may be interested to know that one can of snuff per day delivers as much nicotine as 60 cigarettes. In as little as three to four months, smokeless tobacco use can cause periodontal disease and produce pre-cancerous lesions called leukoplakias.

If your child is a tobacco user you should watch for the following that could be early signs of oral cancer:

• A sore that won’t heal.

• White or red leathery patches on the lips, and on or under the tongue.

• Pain, tenderness or numbness anywhere in the mouth or lips.

• Difficulty chewing, swallowing, speaking or moving the jaw or tongue; or a change in the way the teeth fit together.

Because the early signs of oral cancer usually are not painful, people often ignore them. If it’s not caught in the early stages, oral cancer can require extensive, sometimes disfiguring, surgery. Even worse, it can kill.