Preventing and overcoming dental anxiety is very important. Some children love coming to the dentist from day one, whereas others take time to warm up. If your child gets upset during the visit, rest assured that it is normal behavior because they are in an unfamiliar situation – please do not be alarmed or embarrassed. We are all trained to help fearful or anxious children through their dental experience, and as your child matures, we hope to encourage his or her independence and promote self esteem.
If your child is older and has not been to the dentist yet, you should discuss the positive aspects of dentistry with them before the appointment. Try to act relaxed and at ease because if you are stressed and anxious, your child will likely be stressed and anxious as well.
Please avoid mentioning to your child that the dentist may not hurt him/her, as the possibility of pain may have never entered into your child’s mind at all. Instead, reassure your child that Dr. Lisi and her team will be friendly and gentle. Also, avoid using words such as needle, shot, pull, drill, or other words that could create anxiety. We will explain our procedures in ways that your child can understand and will work to decrease any fear or anxiety they may have. For example, we call the suction device “Mr. Thirsty” and the cavities “sugar bugs” to make the dental environment more fun and unthreatening to your child.
A common problem that children face is being fearful about coming to the dentist because they are unsure about what will happen. It is normal to be scared of the unknown, and we work with kids every day to help them feel more comfortable so that they can establish a positive relationship with Dr. Lisi and staff.
There are several things we do to help kids feel comfortable in our office. For example, we don’t rush them into treatment, as some kids take a while to warm up to our staff. We talk to the kids while they are in the treatment areas, and we show them what we will be doing using words that are age-appropriate. Dr. Lisi’s “tell, show, and do” principle helps smooth concerns your child may have.
If you have any specific concerns about your child’s (first) visit, we would love to talk to you about them ahead of time. Please call our office or email us at your earliest convenience.
Endodontic Treatment (Root Canal) / Pulp Therapy
The teeth are made of 4 major tissues: Enamel (the outer and harder part of the teeth to protect), Dentin (protects and supports the crown of the tooth), Cementum (allows the periodontal ligaments to attach to the tooth), and Pulp (also called the Nerve). The pulp is the inner central core of the tooth that contains nerves, blood vessels, connectivity tissue, and reparative cells.
Pulp Therapy is the pediatric dentistry process required to ensure the pulp inside the root of the tooth maintains its vitality and strength to avoid losing the tooth. Pulp Therapy is also referred to as “endodontic treatment”, “children’s root canal”, “nerve treatment”, and the two common forms of pulp therapy in children’s teeth (“pulpectomy”, and “pulpotomy”). The reasons why Dr. Lisi may recommend Endodontic Treatment include:
- Decay has reached the tooth’s pulp (the “living” tissue inside the tooth)
- Development of infection or abscess inside the tooth
- Trauma or injury to the tooth.
Pulpotomy consists of removing the diseased pulp tissue within the crown portion of the tooth. Under this scenario, an agent is placed to prevent bacterial growth and to calm the remaining nerve tissue, followed by the final restoration of the tooth (such as a stainless steel crown).
Pulpectomy consists of completely removing the diseased pulp tissue from the crown through the actual root of the tooth. In this procedure, the canals of the tooth are cleansed, disinfected, and filled with a re-absorbable material if dealing with primary teeth (non re-absorbable material in case of dealing with permanent teeth). The procedure concludes with the proper final restoration of the tooth.
Periodontal (Gum) Care
Periodontics deals with the proper prevention and treatment of the gums, tissues, and bones that support the teeth. Our major objective is to ensure the gum tissues remain healthy to support the proper growth and functioning of all the child’s teeth.
Sedation Dentistry (IV and non-IV)
Sedation Dentistry is a term that describes the use of sedatives for children during a dental procedure. There are different types of sedation methods, including Nitrous Oxide (“laughing gas”), Intra-Venous (IV) sedation, and non Intra-Venous sedation such as oral sedation. Dr. Lisi will discuss with parents/ guardians the proper technique suitable for your child, depending on age, weight, health, and the amount/ type of dental treatment needed.
During the conscious sedation process, your child will be in a calm, relaxed state, yet still responsive. This process promotes cooperation and provides your child with an overall better dental experience. During an IV sedation, your child will be completely “asleep”. An anesthesiologist will be performing the sedation in our dental office – please talk to Dr. Lisi in advance to understand all the procedures and planning required to pursue this route.
Baby (primary) teeth start falling off naturally to allow the permanent teeth to erupt. So it is common for primary teeth to start wiggling when the permanent teeth come in, and in 2 months or less, losing them. If the primary teeth do not fall off during these 2 months, please contact Dr. Lisi to easily remove the tooth without any complication. This is important to ensure the permanent teeth will grow in their proper place.
Many kids grind their teeth during the night – this is called bruxism. Sometimes parents/ guardians can hear the noise created by the child grinding on their teeth while sleeping, or can notice wear to the dentition (teeth getting smaller/ shorter). There are some possible explanations to this phenomenon such psychological stress, pressure to the inner ear at night, or pressure changes (like in an airplane).
The good news is that pediatric bruxism does not require any treatment most of the time, as children will generally outgrow it. Sometime if there is excessive grinding, a night mouth guard may be used. Most grinding activities decrease between ages 9-12 years of age. But please always discuss bruxism with Dr. Lisi.
Sucking is a normal activity and natural reflex in infants and young children. Children use pacifiers, thumbs, fingers, or any other object they can reach to suck. Sucking provides security and happiness, and it relaxes kids to the point of falling asleep.
The major risk of thumb sucking arises when the permanent teeth start to erupt, as it can create problems with tooth alignment and with the proper growth of the mouth. The more vigorous the sucking occurs, the higher the risks to induce problems. So it is important to work with the child so that by the time their permanent teeth are ready to erupt, he/she has ceased thumb sucking.
Pacifiers have the same impact as thumb sucking, so discourage its use if possible. But it is worth noting that the use of the pacifier can be more easily controlled and modified, so it can be used as a means to remove any sucking activity from your child. Here as some suggestions on how to help your child get through thumb sucking – please consult Dr. Lisi if you have any questions or concerns:
- Sucking creates comfort – find other activities that also provide comfort to your child.
- Sucking can be a result of insecurity – focus on removing the source of anxiety in your child.
- Praise and reward your child when he/she refrains from sucking.
- Reinforce Dr. Lisi’s suggestions to your child about why thumb sucking is not good in the long run.
- Discuss with Dr. Lisi other options to encourage your child to stop sucking (bandages, mouth appliances, putting a sock in their hands).
Xylitol is a sugar alcohol found in low concentrations in the fibers of many fruits and vegetables, and can be extracted from various berries, oats, and mushrooms. It is also found in lettuce, hardwoods, and corn cobs. It is often used as sweetener, but it has been demonstrated to be beneficial for dental health by helping reduce cavities, as it helps induce re-mineralization of deeper layers of the enamel of the teeth.
The American Academy of Pediatric Dentistry has highlighted the benefits of Xylitol on the oral health of children of all ages, including adults. It is available now in chewing gum, lozenges, and nasal spray. Several studies have demonstrated it can reduce cavities to a third, and so far there are no negative impacts known in humans.
Suggested doses of Xylitol include consuming it 3-7 times per day, with a total of 4-20 grams during the day. Please consult with Dr. Lisi and with your doctor for the proper intake of Xylitol.
Brushing teeth with the appropriate toothpaste at the appropriate age is very critical in oral hygiene. But be aware of some of the pitfalls with toothpaste. To start with, please select a toothpaste that is recommended by the American Dental Association (ADA) – some toothpastes contain harsh abrasives which can damage the young tooth enamel. For infants and young children that cannot spit out toothpaste, just use a gauze or clean cloth to wipe his/her gums and teeth – no need to use toothpaste as long as you clean them often. You can also use a fluoride-free toothpaste until they know to spit it out. Please see the section about Fluoride to understand the risks of Fluorosis in young children.
Using Baby Bottles and Sippy Cups
Baby bottles are great tools to allow young children to ingest liquids and hydrate. But avoid your baby falling asleep with a bottle that contains other that water – leaving food in your baby’s mouth can be an accelerator of cavities.
Sippy cups are also very practical tools to train young children to stop using baby bottles. Doctors recommend kids to stop using them after the first birthday. At times other than feeding, make sure you fill the sippy cup with water, to avoid feeding the bacteria that cause cavities.