Category Archives: Pediatric Dentistry

Pediatric Dentistry

Can Teething Cause a Fever?

My baby is a little over 8 months old. She keeps getting fevers. The doctor never finds anything wrong with her and I’m spending a fortune that I can’t afford to spend. Her gums are swollen, too. I was asking a friend about it who has two children and she said that teething can cause a fever and I should slit my baby’s gums so the teeth can come in more easily. Is this accurate? I’m not sure how to slit the gums? Does a dentist do this?

Kathleen

Dear Kathleen,

I’m glad you wrote. Being a mom can be stressful. You want to make sure you are doing the best for your child. Suddenly, you’re expected to be an expert on so many things.

The first thing I would say, emphatically, is to NOT slit your child’s gums. Your baby’s body has a very natural way of dealing with teething. The teeth will break through as they develop. If you ease the way for them, you will find the teeth can come in prematurely which will mean the roots do not have time to fully form.

This is especially important when it comes to your daughter’s back teeth. They have to stay in place until she is around twelve year’s old. With malformed roots, it will difficult for that to happen.

As for your question about whether teething can cause a fever, the answer would be yes. However, it would only be a mild fever. In addition to the fever, you may also notice more drooling than normal, general fussiness, pulling on the ears, and a diminished appetite.

If your daughter is having a hard time with it, there are over-the-counter medications that can be used to ease the discomfort she is in.

After she is able to sit up well for an extended period of time, you should look into getting her established with a pediatric dentist. One of the most common issues I see with young children is that parents tend to wait until there is an urgent dental issue to take them to the dentist. This almost always leads to some dental fear in the children that impacts their view of the dentist for years, sometimes for a lifetime. Getting them to the dentist before there is a problem gives them a positive feeling with the dentist and helps prevent anxiety.

This blog is brought to you by Phoenix Dentist Dr. HIllary Peck.

Pediatric Dentistry

My Son is Sick; What Do I Do About His Toothbrush?

I am a new mom and I never realized how much I did not know until my son was born. He’s got his first real illness and needed a prescription for antibiotics. I’m not sure what to do about his toothbrush. It’s probably got the infection on it. But, he’s still sick so buying a new one might reinfect him, right? Help! What do I do?

Fanny

Dear Fanny,

I can tell you are a great mother. Some of the best moms are constantly trying to learn more to do everything they can for their precious child. You are caring and attentive to your son. Take a deep breath. You are doing much better than you think.

You will often see toothbrush companies promoting the idea that any time you are sick you need to replace your toothbrush or you will reinfect yourself. There is actually no real scientific evidence for this. In fact, the only study on the topic I was able to locate actually said the opposite. It was a 2013 study at the University of Texas that was published by the American Academy of Pediatrics. The results showed that transmission of strep throat via toothbrush did not happen.

The fact of the matter is that, even if you caught a cold just after another cold, it would not be the same cold. It would be a new strain. This is because your body develops antibodies to the strain you had.

If you are still worried, you can clean his tooth brush head with some ordinary household bleach. This will kill any germs and then you will rinse it off thoroughly and it will be fresh as the day you bought it.

One of the best things you can do for your son is start him off with a good pediatric dentist at a young age. It is important he goes to the dentist before there is a an actual problem. This way he associates the dentist with pleasant, fun experiences. Too many parents wait until there is a problem. However, then their first experience is a scary, painful one which will taint his view for years to come. You don’t want to introduce him to the dentist through a dental emergency.

I am sure you are going to do just fine as a mother. You’ve got this.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Pediatric Dentistry

Baby Teeth Didn’t Come Out

Can you help me? I am 16 years old and most of my adult teeth have come in behind my baby teeth. This makes me look hideous. Is there any way to fix this? I’m tired of everyone’s comments and want to be able to smile without feeling like a freak.

Tara

Dear Tara,

teenager smiling with braces

I am sorry this happened to you. I’m a little frustrated on your behalf that your pediatric dentist never took care of this. Maybe you haven’t gotten to go to a dentist? That’s the only legitimate reason I can think of for this type of neglect on the part of a dentist. The good news is that this can be fixed.

First, if you have all your permanent teeth, the baby teeth will need to be removed. Don’t try to do this yourself. It needs to be done by a dentist. Then, the adult teeth can be moved into their proper place with orthodontics.

Whenever an adult tooth is erupting and the baby tooth is still in place, it is always best to remove the baby tooth as quickly as possible. This way you can minimize any misalignment. It doesn’t guarantee the teeth will come in properly aligned but does greatly increase the chances.

Sometimes a baby tooth doesn’t come out because of congenitally missing teeth, which simply means the adult teeth didn’t form and all you have is the baby tooth. In that case, you try to keep the baby tooth as healthy as possible and then, when all your teeth have erupted, you can have the baby tooth removed, open up the space for a replacement tooth and you are ready for a prosthetic tooth.

I hope this helps. You can get the smile you want.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck, an affordable Scottsdale Dentist.

Pediatric Dentistry

Tooth Infection and Fevers

I called our pediatric dentist’s office to schedule an emergency appointment because my daughter has a fever and has been saying her tooth hurts. They said that a tooth infection will not be the cause of her fever and they don’t think she’ll need an emergency appointment. I tried to ask some more questions but they didn’t seem to want to answer them. Am I confused? I thought any infection could cause a fever.

Yoon

Dear Yoon,

happy girl in a dental chair

I hope there is just some miscommunication here. Yes, you are correct, any infection can cause a fever. That includes tooth infections. While most do not, it would be foolish to write it off. Any time a tooth hurts it is a good idea to check it out.

The bigger issue I have here is the way they blew off the questions you had. A good pediatric dentist is willing to talk to parents and make sure they are comfortable and understand the need or lack of need for a treatment.

If they’re blowing you off and acting too rushed, they may have too many patients to adequately serve your daughter well. If this continues, I recommend looking into another pediatric dentist who has more time for their patients.

I don’t know the age of your daughter, but cutting teeth can also cause a fever and tooth discomfort. If you’re concerned, I suggest you call them again and tell them you really want her seen. If they don’t agree, there are general dentists who work with children that also do emergency dental appointments. They can probably schedule her in more quickly.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Pediatric Dentistry

Child Restraints in Dental Care

I just read an article online about a dentist who was strapping down children during their dental appointments. Is this a common practice? It seems pretty barbaric to me, especially in this day and age. I don’t have children myself. I’m just curious.

Len

Dear Len,

I wish I new the article you were talking about. There are a couple of kinds of legitimate restraints that are used in pediatric dental care, but without seeing the article I can’t tell you if that was one of them. What I can tell you is what is commonly used and why.

Mouth props used in dental care

The first type of restraint is pictured above. These are mouth props and are designed to prevent patients, including children from closing their mouth or biting down during a procedure. This is for their protection as much as the dentists.

I have a colleague who, while attending dental school was observing a classmate perform a filling on a child. He did not use a mouth restraint and, at some point, the child bit down which caused the drill to go into her jaw. He told me he never forgot that and has always used a mouth restraint ever since.

Papoose board

Another type of restraint is called a papoose board. These are not as commonly used. In fact, most dentists that I know only use them in the most serious of circumstances.

A good pediatric dentist knows how to put most children at ease. Every once in a while, however, you get a child whose fear causes them to get out of control. In some cases, using just a little nitrous oxide helps. But, if you have a child with a dental emergency and they are completely uncooperative a papoose board can save them.

Almost every dentist I know that has had to use one, said the moment the child was wrapped in the board, it helped them feel more secure and they calmed down enough to get the work done they desperately needed.

I hope this helps clear some things up. It’s great that you care about kids.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Pediatric Dentistry

Five Years Old’s Teeth Rotting

I need some advice, My five year old daughter has some problems with her molars. Two of them have small cavities and two of them have lost about 30% of their structure. I want some advice of what to do about this before I take her to a pediatric dentist. Will they have to be removed? She’s awful young to have to lose teeth. She is saying that it hurts when she chews so I know I need to bring her in.

Laurie

Dear Laurie,

young boy smiling with toothbrush

I love that you are trying to figure out the best thing for your daughter. At her age, all of her teeth are all baby teeth and she needs them for many years to come. It is important you get her to see a pediatric dentist as soon as possible. This is especially true for her back teeth. They need to stay in her mouth until she is about twelve years old.

The molars with the small cavities will definitely be able to be saved. The ones where you estimate there is 30% loss of structure, I hope can be saved with a dental crown.

If they cannot be saved, it will be imperative that your dentist place a space maintainer there. If the molars are just removed, the remainder of her teeth will drift into that open space. then, when her twelve year old molars try to come in, there will not be enough space. This will lead to crowding and expensive orthodontics.

The extent of her decay is a little unusual for her age. It may be time for a bit of tough love on your part. She can brush her teeth twice a day just like she is supposed to, but if she is a frequent snacker it will sabotage her oral health. This is because one of the biggest proponents of oral health is our saliva, which contains bacteria fighting minerals. If she is a frequent snacker or drinks a lot of juice, does not give her salvia enough time to do its job.

I would limit her to one or two snacks a day and make sure she is not drinking a lot of juice or sodas.

One other thing. I know you are trying to get all your ducks in a row before seeing the pediatric dentist, which is admirable, but don’t put it off. These cavities can easily turn into a tooth infection, which will be a dental emergency.

This blog is brought to you Phoenix Dentist Dr. Hillary Peck.
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Pediatric Dentistry

Broken Front Tooth in Child

My seven year old daughter broke a front tooth after a fall. The dentist said it is not anything to worry about and he can schedule me for six weeks from now. I really want this taken care of immediately and asked him for a referral. Instead, he told me that the nerves needed time to settle before anything could be done and no one would see me sooner. Is that accurate?

Karen

Dear Karen,

No, there is no reason to wait. My only guess as to why he said that is he wanted to keep you at his practice. That being said, I do want to check something. Did he do an x-ray and tell you everything is fine and he can do the repair in six weeks or did he just tell you everything was fine when you tried to schedule an appointment without actually seeing her? If he didn’t examine her, I would feel more at ease if she at least had an x-ray done to see what you are dealing with.

If there is no damage to the pulp, then a cosmetic fix is all she will need. This can be solved with dental bonding, but you’ll want to go see a cosmetic dentist for that.

If the pulp was damaged, there may be a point where she’ll need a dental crown because the tooth will start turning gray. However, that is a wait-and-see situation.

Find a different pediatric dentist for your daughter. You can even see a general dentist who treats children. They all did a pediatric rotation and she will be in safe hands.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Pediatric Dentistry

Does My Son Really Need a Pulpotomy?

My pediatric dentist wants to schedule my son, who is only 6 years old, for a pulpotomy procedure. Is this really necessary for a baby tooth that is going to fall out anyway?

Susanna

Dear Susanna,

I am glad you wrote. I never want parents to allow their child to have a procedure they don’t understand. For those who may not know, a pulpotomy is a child’s version of a root canal treatment. It is only useful if the tooth is a molar.

While most baby teeth can come out early with no serious repercussions, back molars need to stay in place until your son is around 12 years old. Otherwise, the adjacent teeth will begin to shift or tip into the empty place. Then, when his adult molars erupt, you are looking at a lot of crowding and expensive orthodontics. Every parent wants to avoid braces if at all possible.

So, if it is a back tooth, you will either want to get the pulpotomy or extract the tooth and then have a space maintainer placed to keep the area open for the adult teeth.

If it is not a back tooth, then you will not need the pulpotomy. However, it is also important that you deal with the tooth. I am assuming that he suggested this treatment because the tooth has an infection. These are considered dental emergencies so you will not want to leave it.

Infections spread. If you think about how close your child’s jaw is to his heart, lungs, and brains, you can see how these things can turn life-threatening quickly.

If your pediatric dentist was not willing to explain why he or she thought you needed one, I feel strongly you would be better served with a different dentist for your precious son. Parents are the ones responsibile for their children and they deserve to have all the information in order to make the best possible decisions for their children.

If you can’t find a great pediatric dentist in your area, there are plenty of general dentists who love to treat entire families, including their children. Each of them has done a pediatric rotation and will be qualified to provide their dental care.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Pediatric Dentistry, Uncategorized

Two Sets of Teeth in Youth

I have two sets of teeth for some of my teeth. I mean that I have both the baby teeth and the adult teeth in my mouth at the same time. How do I fix this? I’m 16 and want a pretty smile before I leave for college.

Kaycie

Dear Kaycie,

teenager smiling with braces

If you have been under the care of a dentist this whole time, you need a new dentist. This should have been addressed a long time ago. You don’t have to see a pediatric dentist. It can also be a general dentist, especially at your age. Though, I would look for a general dentist who also treats children. They tend to be more patient.

To get your mouth in proper alignment, the first thing you will need to do is have every baby tooth that has an adult tooth erupted also extracted. Make sure whoever you end up with does a full set of x-rays so you are sure which teeth have the adult teeth.

From there you have three possible scenarios.

Scenario 1: All Your Adult Teeth Have Erupted

In this situation, you have all of your adult teeth and they have all erupted. If that is the case, the solution is fairly simple and can be done in two steps. Step one is for you to have your baby teeth extracted.

Once that is completed, step two is to have your teeth straightened with orthodontics. You are not limited to metal wires and brackets and more. These days, Invisalign can handle most cases. If you’re unfamiliar with Invisalign, they use clear aligners to straighten your teeth.

Scenario 2: Not All Your Adult Teeth Have Erupted

If you have the adult teeth, but they still haven’t erupted, your dentist can open the area to make it a bit easier. In most cases, they’ll come in after that.

Then, once they are in, you can then get orthodontics done as suggested in the previous scenario.

Scenario 3: You Don’t Have All Your Adult Teeth

In some cases, a patient will have genetically missing teeth. That means there never was an adult tooth to replace the baby one. When this happens, you will still need orthodontics to open up the space where all the teeth are in their proper positions. Once that happens, you will start with a temporary tooth replacement, such as a dental flipper, in order to keep the opening in the right place.

When you are older and your jaw is fully developed, it will be time to get a more permanent replacement. The ideal tooth replacement is a dental implant, so that is what I’d recommend. Though, your dentist can give you all the options.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.

Pediatric Dentistry

Dental Flipper for a Toddler

My son, who is 3 years old fell and lost his two front teeth as a result. I spoke with my pediatric dentist about getting him a dental flipper and he refused. I looked online for the do it yourself kind, but they only make those for adults. What would you recommend for me to get him a flipper? I am worried about his teeth shifting.

Morgan

Dear Morgan,

young boy smiling with toothbrush

I wish your pediatric dentist would have explained things rather than just refuse. Parents are always better off knowing the reasoning behind the recommendations and decisions their child’s caregiver is putting forth.

Reasons Children Can’t Have a Dental Flipper

You noticed that there were only DIY flippers for adults. That is because it is dangerous for children to use a Dental Flipper.

First, they are removable. Just as we are careful with the size of toys we let our children play with, we try to do the same thing with any type of removable device. Otherwise, it is a choking hazard.

Second, they are removable. No, I didn’t make a mistake typing that twice. It is a rare toddler or even older child who will keep in an orthotic device. It is much more likely it will be removed and lost in a short period of time.

Third, they stay in by clasping onto other teeth. Your son’s jaws and teeth are in a constant state of growth right now. This means he will outgrow the flipper quickly and often.

The Really Good News

I know you are worried about your son’s teeth shifting which can lead to overcrowding of his adult teeth. That shows you pay attention to your son’s dental health. The good news is, with his front teeth that won’t be an issue.

When we talk about the importance of tooth retention in children, it is with their baby molars. This is because the adult molars don’t come in until the child is around 12-years-old. In that amount of time and given the placement, the teeth will shift.

If it ever happens that a child of yours does need to have a molar removed, getting a space maintainer will be important.

This blog is brought to you by Phoenix Dentist Dr. Hillary Peck.