Sunday, May 07, 2006

Children's Dentistry

What is a Children's Dentistry? Well, simply put, it is the specialty of dentistry dealing with the oral health of children.

More specifically and officially, it deals with both the primary and comprehensive preventive and therapeutic oral health care of children from birth to age 21 including those with special health care needs such as Cerebral Palsy or Down's syndrome. It is the only specialty in dentistry that is age defined, not procedure defined. In fact the official name is Pediatric Dentistry. It is one of the recognized specialties of dentistry. Our national organization is the American Academy of Pediatric Dentistry.

When your child is sick you take your child to a Pediatrician. So, in Medicine, there is Pediatrics. In Dentistry, there is Pediatric Dentistry. Originally, we Pediatric Dentists were called "Pedodontists" and we practiced "Pedodontics". Some people got confused with the name and would, from time to time think we were foot doctors! So, they changed the official name so there is no confusion.

Since we provide comprehensive care that means we do a little bit of everything. When a child or teen comes into our office, we will often clean the teeth, take diagnostic x-rays, apply preventive fluoride treatments and give oral hygiene instructions. If we find a problem, we will restore a tooth with a filling or a crown. If the need is there, we may have to remove a tooth or do some other kind of oral surgery. Part of the care we provide is orthodontics or "braces." Although, in our office, we have an orthodontist on staff that handles most of our patient’s orthodontic treatment. Pediatric Dentists are trained to do braces as well. And yes, we see teens up to the age of 21. We even have patients older than that if they are still in University and not on their own yet.

Much of what a Pediatric Dentist is known for is our behavior management skills. Somehow, we have to get a three year old child to sit still, lie down, open his mouth, allow an anesthetic injection, remove or wash out decay, and place fillings all without moving around or crying. Well, that's the idea anyways. Hey, I do it every day, but it's not always easy. With training and experience, we use the most likely methods to achieve the desired goal. Sometimes it's just talking with a child or guiding him through a procedure. Sometimes pharmacologic medications or laughing gas helps out. Sometimes there is just no way to do what we need without going to the hospital and completing extensive treatment with the patient under general anesthesia. So, you can see, there is a fine art of treating the patients dental condition, but doing it in a manner that is as easy as possible, accommodates parental preferences and does so in a cost effective manner. I just have to say, many people and dentists too say how difficult it must be to deal with the kids all day. Well, I'll tell you the kids are easy, it's the parents that usually more difficult to deal with.

Hey, in Pediatric Dentistry, it's not all about drilling and filling, brushing and flossing. It's about caring about the children behind those wonderful smiles!


Here is a link to our office web site for more info: APDA
Here are some answers to some common questions from the American Academy of Pediatric Dentistry: AAPD Frequently Asked Questions

30 comments:

Anonymous said...

Dr. Dean,
I happened upon your site in a search. About a week and a half ago my son fell and hit his mouth on the sidewalk. This caused his two top front teeth to cut him inside his mouth (just behind the lip). The cut has since healed, but I have noticed that the one tooth seems to be slightly gray when compared to the others. Was there possible damamge done to the tooth? Or would it just be bruised in that area causing it to look gray? I'd appreciate if you could help me out. Thanks. Ben

Dr. Dean Brandon said...

Ben,
I am sorry to hear of your child's accident. As you did not mention his age, I will answer this way: If it was a baby tooth that is turning dark you are likely ok, if it is a permanent tooth then I am more concerned about the darkening. I have a post on the blog just about this subject. I think this will link to it: My Child's Tooth is Turning Dark!

I see all shades of gray, so to speak. It can be just a little gray just when the light hits just right or it can be a really purply dark color.

Anonymous said...

Thanks. He is two years old. Your info really helped!

Anonymous said...

My children's dentist just recently told us to give our children a fluoride wash. After telling a friend she told me her dentist said that was a bad idea because fluoride has been linked to childhood leukemia. What should I do?

Dr. Dean Brandon said...

I've never heard of anything of the kind in the scientific and dental literature. If you stick to multiple peer reviewed long term controlled studies over many years you will get as reliable an answer as is possible. Even well educated well intentioned people do not have all the information, that's why there are whole professions devoted to providing the best answers. I base my decisions on the best possible researched information.

Let's put it this way, I give my own children fluoride treatments in the office and fluoride toothpaste at home and I recommend rinses and varnishes when indicated to my patients.

Sarah said...

Dr. Dean,
My daughter recently visted a dentist for a check up. She has a chipped tooth at the front due to a fall. Now previously she was told that nothing can be done untill she was 16yrs old (now 9yrs). The dentist that preformed the check up said that she can have a cap fitted. I am some what concerned of this, so my question is, is she to young for a cap to be fitted? Thanks. Sarah

Dr. Dean Brandon said...

I don't do many permanent porcelain crowns till children have finished growing, usually in the later teens. Each case is different however.

Anonymous said...

Dr. Dean,
My 8 year old daughter just came back from the dentist and I have a few questions that I was hoping you could answer for me. First of all what is a pulp treatment and is it necessary in an 8 year old? Also, he told us that she needed to have 2 crowns put on her molar teeth is this completely necessary or would fillings be good enough? Lastly, our dentist gives Nitrous Oxide when he works on our girls teeth, is there any reason to give this other than to "calm their nerves"? I am beginning to think that him not using this so my girls could see how uncomfortable the dentist really is would make them take better care of their teeth. Thanks for your help, Melanie

Dr. Dean Brandon said...

I very much disagree with the concept that children should fear dental treatment or should be made to be uncomfortable at the dentist. My experience is that if kids have a generally good time at the dentist they will take better of their teeth and get regular dental care. I cannot say as to specific treatment, but I usually (not always) but almost always, use nitrous oxide for operative dentistry especially if the child is a little anxious. There is a lot of info on this blog that you may want to spend some time reading about. I encourage you to spend some time checking out this information. I think you would find it enlightening.

Anonymous said...

One of my 4 year old daughter's front teeth is badly decayed, it has also affected the one next to it. Her dentist wants to leave the tooth to fall out on its own, will it affect the permanent tooth and should he be doing something to protect the tooth like a crown? I am a bit concerned about doing nothing with it when the damage is so bad.

Dr. Dean Brandon said...

Sometimes I will leave a decayed tooth if I think it will not cause problems. However, I would ask when the tooth will natuarally fall out. If it's an upper front tooth it will likely not fall out till she is 7 years old or more. I would consult a pediatric dentist if you have not already.

Anonymous said...

My son had an accident where he dislodged one front baby tooth and lost the other, the dislodged tooth was decayed but the dentist did not remove it as my son was already distressed and he thought this was unnecessary on subsequent visits. The tooth has fallen out naturally but the permanent tooth has an imperfection like a small hole in the enamel, I called the dentist, he is going in tomorrow, the dentist believes it is due to the dental trauma, but could it be due to the decay, which is more likely. I believe that because the tooth was dislodged the permanent tooth came in directly behind the decayed tooth could this mean it is decay but the baby tooth came out before the permanent tooth erupted so is this likely as it was still in the gum, or could the root of the baby tooth been touching the tooth and decayed it?

Dr. Dean Brandon said...

See what he says. You also might want to read my post on "White spots on teeth enamel hypoplasia"

skye said...

My daughter is 4 yrs. old. As part of a routine check up w/ her regular dentist, I was told she had an extra tooth. I was shown her xrays, and sure enough, she does. Its between her 2 front teeth, growing down, instead of up, thankfully. But, its coming in much faster than her adult front teeth. Its probably grown in 50% longer/ more. Its also shortening the root of one of those front (baby) teeth. Her dentist recommends keeping an eye out for it, he says we can probably pull it within the year. By then it will hopefully be visible from the backside. My concern is, does this advice sound right? And most articles I've googled, have said their children with an extra front tooth, had 1 of their permanent front teeth grow in SIDEWAYS!!!! And will she need braces? She's only 4.... I'm devastated that she should have oral problems already. Both her front teeth are needing pulpectomies (I probably spelled that wrong). Not another cavity in her mouth.... Could this be from the extra tooth wreaking havoc? And, is it hereditary? I have very strong, straight teeth. Her father does not. He had to have his eyeteeth pulled cause they grew way up on the gums. And many of his teeth grew in crooked. He, and BOTH his parents had dentures by age 30- 35. Please let me know what you think...
Thanks so much,

Dr. Dean Brandon said...

See my post on Extra teeth Mesiodens

rikkimarie38 said...

i have an 8 year old son and recently took him to the dentist and found he has 7 cavities... im just curious on the chances of them spreading to his adult teeth if they were to be left. it just seems like a shame to pay for the expenses for them to fall out in a year.... thanks.

Dr. Dean Brandon said...

Depends on where the cavities are located. Obviously he is at risk for cavity formation. Please take note of tooth eruption charts. Many baby molars do not "fall out" till 12 years of age. See my post on They are just baby teeth, why fix them? and other related posts.

Dr. Dean Brandon said...

Also here:
Just got an e-mail, bad decay

Luiza said...

hi my 6 year old son had two of his teeth removed because the fillings were falling out and he had peri apical infection. the teeth that had been removed were urd and ure. I was told that those were milk teeth. Now I am concerned there was mistake and they remowed one of his adult teeth .before he had 22 teeth. There was 5 on each side exept for upper right side where there was 7 teeth,. Now he has 4 teeth a gap after 2 removed and one last one. Does it mean that he had adult tooth removed or is it possible to have extra tooth? he did not have any x-ray to check and i was told not to worry, but i cant stop thinking that there was a mistake

Dr. Dean Brandon said...

I cannot say, but highly unlikely that a permanent tooth is mistaken for a baby tooth. Some back (milk) molars do have large roots if removed early, but no, a permanent molar has very large roots and crown IMOP.

Dr. Dean Brandon said...

BTW, I always try and get x-rays before treatment. Some kids though, that is not possible due to behavior or other reasons.

Anonymous said...

Hi Dr. Brandon,

I just graduated from high school a year early and want to pursue my long time interest in becoming a pediatric dentist. I've been admitted to UC Irvine Honors Program and hope to follow through with their pre dental program. My question is regarding volunteering and internships for those who have just finished high school. Throughout high school I've petitioned my dentist to let me volunteer or shadow at his office and got repeatedly turned down. Do you have any suggestions or recommendations for someone my age? Or should I just wait until I finish a year in college so that I can join UCLA's summer dental internship program?

As a side note, what was your undergraduate major? I know you can major in basically anything if you fulfill the pre-reqs, but I'm more inclined towards the sciences. Do you think a biochemistry major would prepare me well for dental school?

Thank you for your time.

Sincerely,
Shri

Dr. Dean Brandon said...

I am happy to hear you are considering dentistry and Pediatrics in particular. I majored in Biology and Minored in Chemistry. Biochemistry is certainly an excellent major choice if you like it. I loved Biochemistry. If you made A's in that, I am sure it would be good for you. Doing research is also a big plus once you get he opportunity. Don't get too hung up on the major, we had a History major accepted in my class. All that really matters is getting the requirements that are needed (which almost add up to a Chemistry or Biology major). and--good grades or an improving grade profile. Do something you like, something you are good at, and something that might open other doors if needed.

Please read more here on the blog on the posts (and comments and responses) to similar questions I have had over time on the blog here.

If you dentist is not keen on letting you shadow, I'd ask another dentist. Make sure you visit specialists and general dentists. If you are ever in Huntsville, you are welcome to shadow here if you let us know in advance!

Anonymous said...

Thanks for your reply. I took AP Bio this year and tended to do best in Genetics and Biochemistry so that's where my idea came from.
Also I wanted to know if being double jointed could affect my performance if I were to become a dentist. I am severely double jointed in my fingers and I don't have any problems grasping anything, but when I write timed essays I get a terrible case of writers cramp much worse than my peers. I really hope it doesn't get in the way of anything!

Dr. Dean Brandon said...

I would not think double jointed would make any adverse difference. Fine motor coordination is more important then gross motor skills. Good luck. Let me know how it goes. PS I am writing a book about how to survive dental school. Check back. May be out in about a year or sooner.

pallavi said...

Dr.
my 5yr old daughter is having tooth decay problem . Initially i avoided as its her milk tooth ..but now decay is spreading to all other teeth . I consult a doctor who suggesting me to go for Root canal treatment for front teeth and rest for filling . Is this treatment is OK with this age. Pl suggest

Dr. Dean Brandon said...

Decay is common in young children. What treatment may be be indicated depends on the extent of decay. "root canals" are not too common in baby teeth bUt pulpotomies are. Read more on this blog about those procedures. A good pediatric dentist can help treat your child.

Stephanie T. said...

My son fell on some brick stairs when he was 3.5 years old and chipped his front top tooth. He is now 5.5 years old and has a cavity in that tooth. It does not seem to bother him and the tooth is slightly discolored. He still eats things like apples and many other foods and it does not hurt him. Should I have the cavity filled or just let the tooth fall out? He has already lost his two front bottom teeth so I am assuming that it won't be long before his top teeth fall out.

Dr. Dean Brandon said...

Upper front baby teeth usually fall out about 7 years of age. The lateral incisors at 8 to 9 years of age. I'd get a dentist's opinion as some kids are early and some are late in loosing teeth. If I thought a tooth will fall out in 6 months without any toothache, I would not restore it, just observe it if that is what the parent wanted. Otherwise, you have to see how deep the decay is, etc.

Anonymous said...

Every time I need help with a dental question I come to this site! it really helps a lot and I just wanted to say, thank you!