children's dentist Archives | Williams Family Dentistry

Does My Three Year Old Need a Pediatric Dentist?

Posted on December 28, 2022 by writeradmin.

I need some advice. I have a three year old that has a dark spot on a back tooth. I can’t quite tell if it is a cavity. I do brush his teeth every night. I’m worried if I take him in they’ll want to do x-rays and I don’t know if he is too young to have radiation. Can you tell me what is the best course of action?

Carrie

Dear Carrie,

toddler

I can tell you are a caring mother and I am glad you are diligent to brush his teeth every day. I recommend increasing that to twice a day as well as flossing once a day. There are flossers with handles that make it easier to get in those tiny mouths. I am especially impressed that you caught something on a back tooth. It is hard to see back there!

To ease your fears, three years old is not too young for dental x-rays. This is especially true these days because most dentists use digital x-rays which hardly has any more radiation in it than you are exposed to naturally. In fact, at his age, he is due for his first check up anyway. Most pediatric dentists prefer to see children early, even as young as one year old. This way their first experiences with the dentist are fun and not an urgent emergency appointment where they may need a filling.

With it being a back tooth, it could be decay or it could also be food or other bacteria trapped there. Those back teeth have lost of pits and grooves. It will be important after his cleaning that you get those back teeth sealed. This is a simple procedure that just paints on a sealant protecting all those crevices that tend to develop cavities.

This blog is brought to you by Lexington, KY Dentist Dr. John Weaver.

Do Dentists Use Restraints on Children?

Posted on August 31, 2022 by writeradmin.

My sister-in-law and I were talking about our children’s teeth. I mentioned that my son loves his dentist. It’s actually where I get most of my reading done while I am waiting in the waiting room. She said I should never let my child go back to the dentist without me there because some dentists restrain children. I was shocked. I think, though, if my son were being restrained he wouldn’t like going to the dentist as much, right? should I be worried?

Pamela

Dear Pamela,

First, to put your mind at ease, I don’t think you need to be worried at all. Your son loves the dentist and I don’t think he would if anything unpleasant was happening. It sounds like you’ve given him a good foundation in dental care so that his appointments are fun and not about painful dental emergencies. It also sounds like he is happy, confident, and self-sufficient. So, don’t let your sister-in-law give you doubts. I am not espousing one method of parenting over another. I know plenty of parents who go back with their children and they do very well also. The key is knowing YOUR child and what works for them.

Second, let’s go over this idea of restraints. There are two types of restraints in dental care. Those pictured to the left are sometimes called mouth restraints or mouth props. They are designed to keep a child’s mouth open during the procedure. This is for their protection.

A colleague in dental school once told me that he didn’t use one and the child bit down while he was drilling. This caused the drill to go through the tooth and into the child’s gums. He’s never done a procedure on a child without one since that horrible incident. This type of restraint I would say is necessary and makes the child comfortable and safe.

There is another type of restraint, called a papoose. I’ve pictured this below.

Pediatric Paposse Board

These are generally only used in situations where there is a dental emergency and the child will not calm down enough for them to get the work done. It feels like a hug on the child and almost always calms them down. Most dentists who regularly work with children have ways of calming even difficult children. Though, sometimes if it is a highly invasive procedure, you may want to consider dental sedation as an alternative.

As I mentioned earlier, I don’t think you have anything to worry about. Your son seems to be perfectly content with his pediatric dentist.

This blog is brought to you by Lexington, KY Dentist Dr. John Weaver.

Why Extract Baby Teeth

Posted on April 19, 2021 by writeradmin.

My six year old daughter has decay on two of her back molars. The dentist is being a bit rude and wants them extracted immediately, but they are baby teeth. Why is that the right choice? Won’t they just come out? Why pay to pull it?

Sara

Dear Sara,

There are a few things going on here. First, I will say I am sorry your daughter’s dentist was rude. I wasn’t there and don’t know your dentist, but is it possible it was more urgency that came across as rude? It is unusual for a children’s dentist to recommend that a back molar be extracted on a child that age. You mention decay. I wonder if that decay had turned into an infection. I know it is a baby tooth and they do come out, however back teeth are different for reasons we’ll go over in a moment.

Bear in mind, I have not examined your daughter, but here are some possibilities and what to do about them.

1. The teeth are deeply decayed and they going to break and lead to infection. If there is enough of the tooth left to save some of it, you could do a pulpotomy and place a dental crown on it. A pulpotomy is simply a child’s version of a root canal treatment.

You mentioned that their teeth come out. So you are likely now wondering why do a pulpotomy when you can just get rid of the tooth? While it is fine for most baby teeth to be removed prematurely, the back molars need to stay in place until she is twelve years old, when her next set of molars typically come in. In a six year span, her other teeth will drift toward the empty space, then when her adult molars finally do come in, there will not be space for them and it will turn into a crowding problem that needs orthodontics to fix. Getting the crown, will preserve that position so the adult teeth can come into the right place.

2. The tooth is already infected beyond what a pulpotomy can help. Tooth infections are considered dental emergencies. This is because the antibiotics cannot “treat” the infection only hold it back temporarily. If a dentist doesn’t get in there and remove the infected pulp, the infection will spread. Think about how close your daughter’s jaw is to her heart, lungs, and brain. Sadly, people still die of tooth infections, even though it is completely treatable.

If her decay and infection have progressed, then even though it is a molar the tooth will have to be extracted. If that happens, make sure to get a space maintainer. This is a device they can place which will keep the space protected so there won’t be crowding.

Because your daughter is likely already in some pain and you don’t want it to be a traumatic situation for her that makes her afraid of dentists for the remainder of her life, I recommend you go to someone who uses dental sedation. This way it will be an anxiety-free/pain-free experience for her.

This blog is brought to you by Lexington, KY Dentist Dr. Weaver.

White Fillings for Children

Posted on October 7, 2020 by writeradmin.

My son needs a filling. I don’t want a silver filling in his mouth because of the mercury content. But, my pediatric dentist said that children can’t have them. I don’t really believe him because I know other children that have had the white fillings. Why would he lie?

Caitlyn

Dear Caitlyn,

Many general dentists will see entire families

It may not be that he lied, as much as he has trouble doing composite fillings on children. While it can be done, it is a tad more difficult with children. This is because composite fillings have to stay completely dry during the process. With children, who like to wiggle and move their tongues, that can seem impossible. But, like I said earlier, it can be done.

Don’t push your current pediatric dentist into doing it. This procedure is a totally different method than is used for the amalgam (silver) fillings. If he’s hesitating, he’s not ready. Instead, I would go to a general dentist who enjoys treating children. Ideally, you’d want one who considers themselves a mercury-free dentist or even a holistic dentist. Both of them will be very experienced with composite fillings. In fact, it will be all they place.

General dentists are still qualified to work with children. They all do a pediatric rotation and have the skills necessary. They just didn’t want to only treat children. However, not all dentists who are willing to work with children actually enjoy working with children. You want a dentist who enjoys them because that will create a more positive experience for your child.

So how do you know which dentists actually LIKE children? One good hint is the age at which they are willing to begin treating them. If they’re willing to work with toddlers, they enjoy children. If they want to wait until your child is around seven or eight years old, I’d look for someone else.

This blog is brought to you by Lexington, KY Dentist Dr. John Weaver.

Daughter Resists Dental Care

Posted on July 29, 2020 by writeradmin.

My five-year-old daughter hates the dentist. She’s hard to treat under the best of circumstances, but the last few appointments it has become clear she has a lot of decay, more than I would expect for a child her age. I assure you we do brush her teeth. They can’t get to it because she won’t stay still in the chair. Every time they try she takes off running. What do we do to get her the treatment she needs?

Pamela

Dear Pamela,

Kids are tricky sometimes, but it is fairly normal for them to be rambunctious. One thing I would suggest is you find a pediatric dentist who also offers dental sedation. This way your daughter can receive all the treatment she needs while sleeping through the whole procedure.

What you don’t want is to let the needed treatment go and then have a dental emergency on your hands. This can not only end up with your daughter in a lot of unnecessary pain, but dental emergencies have a way of turning into life-threatening emergencies quickly.

I did want to address her extensive decay. I do believe that you care about your daughter and that you are brushing her teeth as any good parents would. For her to develop significant decay at her age would mean that she is having tons of snacks and possibly juice or soda throughout the day.

It may mean some tougher love on your part but if she is snacking a lot or drinking sugary drinks, her body doesn’t have time to keep her teeth properly defended from all the intake. My suggestion would be to limit her snacking to no more than one a day. You’ll likely find she is eating her meals better as well, as a result of having to wait on her food.

This blog is brought to you by Lexington, KY dentist Dr. John Weaver.

Can a Tooth Infection Cause a Fever?

Posted on March 31, 2020 by writeradmin.

I’m worried about my daughter but my pediatric dentist won’t see her during the quarantine. She’s had a loose tooth bothering her and now she has a fever. I called in but they said a tooth infection doesn’t have a fever. Is that true? Do I really have nothing to worry about?

Mandy

Dear Mandy,

I’m hoping there is some sort of miscommunication here. Maybe what your pediatric dentist said is that a tooth infection doesn’t usually have a fever. However, any infection can cause a fever. Before you panic, that doesn’t mean your daughter does have an tooth infection.

My guess is you are very diligent with her dental care. Unless there was a cavity they were watching at her last checkup, there likely isn’t one now that has progressed far enough to become an infection. It’s likely she’s fighting something else off right now. You mentioned the tooth is loose and bothering her. Sometimes loose teeth can be painful themselves.

Because of COVID-19, they’re asking us to stay quarantined and only treat essential cases. I’m sure this is making you nervous because it feels like you don’t have access to the care you need for your daughter. You’re a caring mother and want the best for her. Here’s my recommendation.

Keep an eye on her. If the pain in her tooth gets worse, pull it. It’s loose and should come out without too much problem. If there is an infection there, pulling the tooth will take care of it.

If you do that and she’s still in pain a couple of days after you pulled the baby tooth, you can call the dentist back and tell him you want to come in for an emergency dental appointment. It shouldn’t still be hurting a couple of days after it is removed.

This blog is brought to you by Lexington, KY Dentist Dr. John Weaver.

Is a Pulpotomy Really Necessary?

Posted on January 31, 2020 by writeradmin.

My daughter has an infection on a baby molar. My dentist wants to do a pulpotomy on it. What I don’t understand is why we just don’t pull the molar. It’s not her permanent one. When I asked her dentist, he just said, “Because as her dentist I’m telling you this is the best option.” What I wanted to say was, “Well, as her parent I want to know why.” but I was too chicken. I’ve scheduled the appointment but I really want to know why before I follow through with this.

Jen

Dear Jen,

The answer to this really depends on the age of your daughter. Her baby molars need to stay in place until she is around twelve years old when her permanent molars come in. When they’re significantly younger than this, one option is to do a pulpotomy. This is essentially a child’s version of a root canal treatment. It will help her retain a necessary tooth.

Another option is to extract the infected molar, however, you will need to place a space maintainer where the tooth once was. This is a more invasive treatment, but sometimes becomes necessary when the tooth cannot be saved.

If you don’t do either of those, the infection will spread. Tooth infections are considered dental emergencies and need to be taken seriously. The jaw is close to the heart, brain, and lungs. You don’t want the infection to reach any of those areas.

If you extract the tooth without a space maintainer then her other teeth will shift into the open space. When her permanent molars start to come in, it will lead to crowding of her teeth. Then, you’re talking about needing orthodontics which could have been prevented. Keeping this space secured is much less expensive.

A Word about Your Pediatric Dentist’s Response

I’m not happy with your his response to your question. You are the parent and he is ethically obligated to give you all the options available in treatment. In doing that, it means also explaining the pros and cons to each option, along with his explanation for his recommendation.

His arrogance in being questioned makes me wonder whether he’s giving you any of your other options. This isn’t the best care for your child. While you need to get your daughter’s infection dealt with. I think you should start looking for a new dentist for her. If you live in a small town which doesn’t have many pediatric dentists, you can also see a general dentist who is good with children.

This blog is brought to you by Lexington, KY Dentist Dr. John Weaver.