Posts for tag: pediatric dentistry

By Children's Dental Center of New Hampshire
July 18, 2019
Category: Oral Health
ConsciousSedationcanHelpEaseYourChildsDentalVisitAnxiety

The best way to prevent dental visit anxiety in your children is start those visits around their first birthday, and continue with them through childhood. Age One visits are the best way to ensure they're comfortable with the dentist now and that they'll continue the habit into adulthood.

But in spite of your best efforts and those of your dental provider, there's no guarantee your child won't experience dental visit anxiety at some point. If that happens, we recommend conscious sedation.

Conscious sedation is the use of certain medications to help a patient relax. It's not the same as anesthesia, which eliminates pain by numbing tissues (local anesthesia) or inducing unconsciousness (general anesthesia). During conscious sedation a patient remains awake or at the most in a dream-like state, can still respond to touch or verbal commands, and although monitored doesn't require assistance in heart or lung function.

We can induce this relaxed state in a number of ways: orally, with medication given by mouth a short time before the visit; intravenously, the medication delivered through a drip directly into the bloodstream; or by inhalation, usually nitrous oxide gas mixed with oxygen and delivered by mask.

Oral sedation is the most common. On the day of the procedure, we'll give your child one or more sedative drugs, usually in syrup form. For best results we advise they eat a low-fat dinner the night before and not eat or drink any food or liquid afterward. We typically use Midazolam and Hydroxyzine, both of which are proven safe and fast acting.

During the procedure, we'll also assign a team member to monitor their vital signs while they're under the influence of the drugs. We may also employ special positioning or immobilization equipment to keep movement to a minimum.

After the procedure, we'll continue to monitor vitals until they return to pre-sedation levels. The child should remain home the rest of the day to rest and return to school the next day.

Conscious sedation is regulated by states: providers must be trained and licensed to administer sedation drugs with continuing education requirements. Even so, the use of sedation for children is becoming more widespread and helps to safely ensure they're getting the dental care they need.

If you would like more information on comfortable dentistry for children, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Sedation Dentistry for Kids.”

By Children's Dental Center of New Hampshire
May 09, 2019
Category: Oral Health
SimpleStepstoFollowifYourChildhasaToothache

"Mom, my tooth hurts" isn't something you look forward to hearing your child say. But tooth pain is as common as other childhood ailments, so you may have to face it. Here are a few simple steps to make it easier.

First, ask your child where in the mouth it hurts and, if they can, tell you how long it's been hurting. Children's memories aren't always accurate, but you can still get a general idea that you can communicate with your dentist if you take them in.

Next, look in their mouth for anything out of the ordinary: gum swelling or bleeding, or dark spots on the teeth indicative of tooth decay. Look also for hard food particles like popcorn kernels caught between the teeth, which could be causing the pain. Gently floss between the teeth (even if you can't see anything) to remove any caught particles.

You'll also want to help ease their pain. You can apply an ice pack against the painful side of the jaw. Don't place ice directly on the skin, but use a container or cloth alternately against the jaw for a minute or so, and then away for a minute. You can also give them a dose of mild pain reliever like ibuprofen or acetaminophen appropriate for their age and weight—but never rub aspirin or other pain relievers on the gums, which tend to be acidic and can burn the skin.

Finally, you'll need to decide if you need to see a dentist and how soon. It might not be necessary with situations like the trapped food particles, but most of the time it's wise to have your dentist perform an examination for an accurate diagnosis and appropriate treatment. As to how soon, try to see the dentist immediately if the pain has continued from one day to the next or has kept your child up overnight. Otherwise, book an appointment for as soon as the dentist advises, even if the pain subsides.

A toothache at any age is never pleasant, but especially for children. Knowing these steps will help ease their discomfort and get them the relief and treatment they need.

If you would like more information on dental care for children, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “A Child's Toothache: Have a Dental Exam to Figure out the Real Cause.”

By Children's Dental Center of New Hampshire
April 29, 2019
Category: Oral Health
SupportYourChildsTeethDevelopmentwithProperHygieneandDentalCare

Between infancy and the onset of puberty, your child will grow one set of teeth, lose it and grow another; their jaw structure will also change dramatically. This rapid development sets the course for their oral health later in life.

That’s why it’s so important to care for their teeth and gums in these early stages through daily hygiene and regular dental visits for disease prevention and treatment. Hygiene is the cornerstone of this care, and should begin in earnest when your child’s first tooth erupts in the gums, by first gently cleaning around the newly erupted teeth and gums after each feeding with a water-soaked gauze pad.

As they pass their first birthday you can switch to a small, soft-bristled toothbrush and just a smear of fluoridated toothpaste. Children should begin learning to brush around age 2, first by modeling you as you brush together. They should be adept enough by age 6 to brush on their own, at which time you can introduce flossing. We’re more than happy to advise you on technique for both of these hygiene tasks.

Age one is also the time for them to begin regular dental visits for cleanings and checkups. This will help us stay ahead of any developing decay or other issues and perform preventive treatments like dental sealants or fluoride applications. It will also help your child become comfortable with the dental office, which can make it easier for them to develop a long-term habit of regular dental care.

There are also habits you should practice (or avoid) that support good oral health for your child. For example, you shouldn’t allow them to sleep with a pacifier or a bottle filled with anything but water. Breast milk and formula contain some forms of sugar that bacteria can feed on; if this becomes too frequent it can result in higher acid levels that soften enamel and lead to decay. You should also take preventive actions to protect your child from teeth-damaging injuries like playing too close to hard furniture.

All these common sense measures support your child’s oral development. You can then let Nature takes its course as your child develops a healthy mouth for a lifetime.

If you would like more information on oral care for children, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Top 10 Oral Health Tips for Children.”

By Children's Dental Center of New Hampshire
March 30, 2019
Category: Oral Health
HowtoMaximizeYourChildsDentalHealthPotential

There’s a potential threat lurking in your young child’s mouth—tooth decay. This destructive disease can not only rob them of teeth now, it could also impact their dental health long into their adult years.

That’s why we focus heavily on decay prevention measures even in primary (“baby”) teeth, as well as early treatment should it still occur. It’s a straightforward treatment strategy: minimize the factors that contribute to disease and maximize those that protect against it.

We can represent the disease-causing factors with the acronym BAD. Bad bacteria top the list: they produce oral acid that erodes tooth enamel. Couple that with an Absence of healthy saliva function, necessary for acid neutralization, and you have the potential opening for tooth decay. Poor Dietary habits that include too much added sugar (a prime food source for bacteria) and acidic foods help fuel the decay process.

But there are also SAFE factors that can help counteract the BAD. Promoting better Saliva function helps control acid levels, while Sealants applied to chewing surfaces strengthen these vulnerable areas against decay. We can prescribe Antimicrobials in the form of mouth rinses that reduce abnormally high bacterial concentrations. Fluoride applied directly to the enamel bolsters its mineral content. And an Effective diet high in nutrition and low in sugar or acidic foods rounds out our protective measures.

Promoting SAFE factors greatly reduces the risk of childhood tooth decay. To keep on track it’s important to start regular, six-month dental visits beginning around your child’s first birthday. These visits are the most important way to take advantage of prevention measures like sealants or topical fluoride, as well as keeping an eye out for any signs of decay.

And what you do at home is just as important. Besides providing a teeth-friendly diet, you should also brush and floss your child’s teeth every day, teaching them to do it for themselves when they’re old enough. Playing it “SAFE” with your child’s dental health will help ensure your child’s teeth stay decay-free.

If you would like more information on dental care for your child, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Taking the Stress out of Dentistry for Kids.”

By Children's Dental Center of New Hampshire
February 18, 2019
Category: Oral Health
EncourageYourChildtoStopThumbSuckingAroundAge3

One of the biggest concerns we hear from parents is about their child's thumb sucking habit. Our advice: if they're under age 4, there's no need for concern — yet. If they're older, though, you should be concerned about the possible effect on their bite.

Thumb sucking is a universal habit among infants and toddlers and is related to their swallowing pattern during feeding. As they swallow, their tongue thrusts forward to create a seal with the lips around the breast or a bottle nipple. Many pediatricians believe thumb sucking replicates nursing and so has a comforting effect on infants.

Around age 4, though, this swallowing pattern begins to change to accommodate solid food. The tongue now begins to rest at the back of the top front teeth during swallowing (try swallowing now and you'll see). For most children, their thumb sucking habit also fades during this time and eventually stops.

But for whatever reason, some children don't stop. As the habit persists, the tongue continues to thrust forward rather than toward the back of the top front teeth. Over time this can place undue pressure on both upper and lower front teeth and contribute to the development of an open bite, a slight gap between the upper and lower teeth when the jaws are shut.

While late childhood thumb sucking isn't the only cause for an open bite (abnormal bone growth in one jaw is another), the habit is still a prominent factor. That's why it's important that you start encouraging your child to stop thumb sucking around age 3 and no later than 4. This is best accomplished with positive reinforcement like rewards or praise.

If they've continued the habit a few years after they should have stopped, we may also need to check to see if their swallowing mechanism has become stunted. If so, we may need to use certain exercises to retrain their tongue to take the proper position during swallowing.

While you shouldn't panic, it's important to take action to stop thumb sucking before it becomes a long-term problem. A positive, proactive approach will help avoid costly orthodontic problems later in their lives.

If you would like more information about thumb or finger sucking, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “How Thumb Sucking Affects the Bite.”



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Children's Dental Center of New Hampshire

(603) 673-1000

 [email protected] 

7 State Route 101aAmherst, NH 03031-3132