Frequently Asked Questions

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Why Should I Take My Child to a Pediatric Dentist?

A Pediatric Dentist is a dental specialist specifically trained and dedicated to the oral health of children with an emphasis on monitoring their facial growth and development. At Small Smiles we are designed to care for and treat children from infancy through adolescence. We also specialize in the care for children with special medical or physical needs.

Why does Small Smiles Treat Baby Teeth?

Primary or baby teeth are designed to function throughout the childhood years. In fact, baby molars usually are not lost until the pre-adolescent years (12-14 years of age) Baby teeth not only help aid in proper digestion of food, they also are important in the development of children's jaws and facial structures. Another important function of baby teeth is to provide space in the jaws to guide the permanent teeth into proper position. Baby teeth have relatively thin enamel, and can become decayed or infected faster than permanent teeth. These infections can affect the developing permanent teeth. A healthy, disease-free mouth creates a strong environment for permanent teeth and jaws to develop and grow.

What are Sealants?

Made from a tooth colored (white) plastic material, sealants are flowed into the deep grooves and pits on the chewing surface of a tooth. Sealants shield away harmful bacteria and food.

How do Sealants Work?

Even children who take good care of their teeth by proper brushing and flossing are at risk for cavities. Toothbrush bristles are often too thick to reach into pits and fissures of certain teeth. Bacteria, plaque and food build-up in these pits place those teeth at risk of decay. Sealants work by "sealing" or covering the pits so harmful food and bacteria cannot collect there, thus greatly reducing the risk of cavities on the chewing surface of those teeth.

Which Teeth Should be Sealed?

Typically, the permanent six- and twelve-year molars are most at risk for dental decay. However, any tooth (baby or permanent) with deep pits may benefit from the protection of dental sealants.

What if My Child has a Thumb Sucking or Pacifier Habit?

Infants and young children will often use thumbs, fingers or pacifiers to satisfy their sucking needs. Most children grow out of their "oral phase" by the age of four. At this age, most dental problems associated with oral habits will self correct. After permanent teeth begin to erupt, the chances for tooth and jaw correction from an oral habit decrease significantly.

At Small Smiles, we feel positive reinforcement is the best way to motivate your child to quit their oral habit. If your child is over the age of five and you are out of ideas to help them stop their habits, please talk with Dr. Dave. A more aggressive approach may be appropriate. There are many options, including retainers or consulting with Oromyofacial Specialists that we can recommend to help your child.

What are Nerve Treatments?

If a baby tooth is infected, Dr. Dave may recommend the procedure of removing the unhealthy part of the nerve in that tooth. The procedure is called a Pulpotomy. Baby teeth respond well to the removal of the infected portion of the nerve while the healthy portion of the nerve is preserved. The decay is removed and medicine is placed over the healthy portion of the nerve. The tooth is then lined with a temporary filling and a silver crown is usually placed over the tooth to prevent it from fracturing. This procedure allows the tooth to remain in the mouth until the permanent tooth erupts.

What if My Child has Special Needs?

At Small Smiles we welcome children with special needs. Dr. Dave completed two additional years of Pediatric Training after graduating Dental School with an emphasis on children with special needs. Some of these children are at a higher risk for tooth decay, gum disease or dental malocclusions, while others require special diets or medication, which can affect their oral health. Children with physical impairments, which may affect their ability to maintain good oral habits, will get extra attention from Dr. Dave to ensure proper dental care is available. Our office is architecturally designed to be physically accessible for any physical challenge. Small Smiles prides itself on specialized dental care so every child can enjoy a healthy smile.

What if My Child has a Dental Emergency?

If your child has a dental emergency, please call our office as soon possible at 630.527.8686. We will always have time to see your child in pain. If it is an after hours emergency, a pager number will be given on the answering machine.

Our schedule may be delayed to accommodate an injured child. Please accept our apologies for any inconvenience this may cause at your child's scheduled appointment.

Knocked-Out Teeth

If your child knocks out a permanent tooth, the first hour is the most critical for treatment and future long-term success. Gently rinse the tooth in water but do not scrub the root or you may damage the delicate living cells on its surface. If possible, gently place the tooth back into its socket. If this is not possible, place the tooth in a glass of milk, not water, and contact the office immediately. If the knocked-out tooth is a baby tooth, do not try to put it back in your child's mouth. Dr. Dave will normally not attempt to re-implant the tooth, as this may cause trauma to the underlying permanent tooth.

Broken Tooth

If your child's tooth is fractured, rinse their mouth with warm water and place a cold compress on their face over the broken tooth to reduce swelling. Call our office immediately.

Abscessed Tooth/Swollen Gums

If the swelling is small and well defined or a bump on the gums is visible, call the office for antibiotics. Please inform us if your child has any new drug allergies.

Wisdom Teeth

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The removal of wisdom teeth has become so commonplace that it is almost a rite of passage for young adults. Wisdom teeth are a type of molar that is found in the very back of your mouth. There are four wisdom teeth: upper left, upper right, lower left, and lower right. These teeth usually appear in late teens or early twenties but may become impacted (fail to erupt) due to lack of room in the jaw or angle of entry. The most common type of impacted wisdom tooth is "mesial", meaning that the tooth is angled forward toward the front of your mouth.

When a tooth is impacted, it may need to be removed. If it is not removed, you may develop gum tenderness, swelling, or even severe pain. Impacted wisdom teeth that are partially or fully erupted tend to be quite difficult to clean and are susceptible to tooth decay, recurring infections, and even gum disease.

Each patient's situation is unique, and your dentist will take x-rays and discuss your particular needs with you. If your dentist recommends removal of your wisdom teeth, it is best to have them removed sooner than later. As a general rule, wisdom teeth are removed in the late teens or early twenties because there is a greater chance that the teeth's roots have not fully formed and the bone surrounding the teeth is less dense. These two factors can make extraction easier.

In order to remove a wisdom tooth, your dentist first needs access to it. To make this process most comfortable, your dentist will numb the area with a local anesthetic. Your dentist can even use additional medication to safely sedate you during the extraction if you are feeling nervous about the procedure. Because the impacted tooth is frequently under the gums and still encased in your jaw bone, your dentist will need to remove a portion of the covering bone to extract the tooth. To minimize the amount of bone that must be removed, your dentist will often "section" your wisdom tooth so that each section can be removed through a small opening in the bone.

Once the teeth have been extracted, the healing process begins. Healing time varies depending on the degree of difficulty related to the extraction. Your dentist will share with you what to expect and provide instructions for an efficient healing.

Gum Disease

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Gum disease (also called periodontal disease) is an infection of the tissues that support your teeth. It is a major cause of tooth loss in adults. Because gum disease is usually painless, you may not know you have it. At each regular checkup the dentist will measure the depth of the shallow v-shaped crevice (called a sulcus) between your tooth and gums to identify whether you have gum disease.

healthy gums

Gum disease is caused by plaque, a sticky film of bacteria that constantly forms on the teeth. These bacteria create toxins that can damage the gums.

Periodontal diseases attack just below the gum line in the sulcus, where they cause the attachment of the tooth and supporting tissues to break down. As the tissues are damaged, the sulcus develops into a pocket; generally, the more severe the disease, the greater the depth of the pocket.

Periodontal diseases are classified according to the severity of the disease. The two major stages are gingivitis and periodontitis.

gingivitis

Gingivitis

In the early stage of gum disease, called gingivitis, the gums become red, swollen and bleed easily. At this stage, the disease is still reversible and can usually be eliminated by daily brushing and flossing.

periodontitis

Periodontitis

In the more advanced stages of gum disease, called periodontitis, the gums and bone that support the teeth become seriously damaged. Whereas healthy gums and bone anchor teeth firmly in place, infected gums can cause teeth to become loose, fall out, or have to be removed by a dentist.

Some factors increase the risk of developing periodontal disease:

  1. Tobacco smoking or chewing
  2. System-wide diseases such as diabetes
  3. Some types of medication such as steroids, some types of anti-epilepsy drugs, cancer therapy drugs, some calcium channel blockers, and oral contraceptives
  4. Bridges that no longer fit properly
  5. Crooked teeth
  6. Fillings that have become defective
  7. Pregnancy

If you notice any of the following signs of gum disease, see the doctor immediately:

  1. Gums that bleed easily
  2. Red, swollen, tender gums
  3. Gums that have pulled away from the teeth
  4. Persistent bad breath or bad taste
  5. Pus between your teeth and gums
  6. Permanent teeth that are loose or separating
  7. Any change in the way your teeth fit together when you bite
  8. Any change in the fit of partial dentures

It is possible to have periodontal disease and have no warning signs.
That is one reason why regular dental checkups and periodontal examinations are very important. Treatment methods depend on the type of disease and how far the condition has progressed.

Good oral hygiene at home is essential to keep periodontal disease from becoming more serious or recurring. You don't have to lose teeth to periodontal disease. Brush regularly, clean between your teeth, eat a balanced diet, and schedule regular dental visits for a lifetime of healthy smiles.

Extractions

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There are times when it is necessary to remove a tooth. Sometimes a baby tooth has misshapen or long roots that prevent it from falling out as it should, and the tooth must be removed to make way for the permanent tooth to erupt. At other times, a tooth may have so much decay that it puts the surrounding teeth and jaw at risk of decay, so your doctor may recommend removal and replacement with a bridge or implant. Infection, orthodontic correction, or problems with a wisdom tooth can also require removal of a tooth.

When it is determined that a tooth needs to be removed, your dentist may extract the tooth during a regular checkup or may request another visit for this procedure. The root of each tooth is encased within your jawbone in a "tooth socket," and your tooth is held in that socket by a ligament. In order to extract a tooth, your dentist must expand the socket and separate the tooth from the ligament holding it in place. While this procedure is typically very quick, it is important to share with your doctor any concerns or preferences for sedation.

Once a tooth has been removed, neighboring teeth may shift causing problems with chewing or with your jaw joint function. To avoid these complications, your dentist may recommend that you replace the extracted tooth.

Teeth for Life

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At birth people usually have 20 primary (baby) teeth, which often erupt through the gums as early as six months of age.

These teeth are then shed at various times throughout childhood. By age 21, all 32 of the permanent teeth have usually erupted.

LEARN MORE

Getting to know your teeth is fun! Learn all about your teeth with our fun, interactive, and educational diagrams:

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