Category Archives: 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.

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.

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.
Click here to read our Dental tips for Parents.

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.

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.

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.

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.

Is a Pediatric Dentist or General Dentist Better for a Special Needs Teen?

Hi,

I recently became a foster parent to a teen with special needs. He just wants to be treated like everyone else, so I’m not sure which dentist to take him to. he’s not a child, so he may balk at a pediatric dentist, but I think they may be more patient with him. I’m worried he may be nervous if I take him to a general dentist’s office, and the staff may not be used to treating patients like him.

Which should I go to? Any advice?

Elizabeth, from Raleigh, NC

 

Hi Elizabeth,

Your worries are valid and echo a lot of concerns shared by parents of special needs children and teens.

Either dentist will be able to accommodate your teen. A pediatric dentist is a dentist who has had additional post-graduate education pertaining specifically to children’s oral needs. Be sure to check your prospective dentist’s credentials, and feel free to call the dentist’s office with questions. Most pediatric dental offices will treat toddlers or young children in addition to teens. Dr. Peck in Phoenix, AZ has dental tips for parents on her website for what parents can expect for children at the dentist.

However, you should involve him in the decision-making process. Ask him where he would like to go, and check websites together. To make him feel more comfortable, see if you can schedule a walk-through of the office prior to your appointment, so he knows what to expect. If you have a dentist’s appointment coming up, invite him along to show him its no big deal. Little things like these can make a big difference when it comes to your child’s treatment.

This blog post is brought to you by Phoenix pediatric dentist, Dr. Hillary Peck, of Peck Family Dentistry.

How Expensive is a Pediatric Dentist?

Hi there,

I have a six-year-old daughter and currently take her to see our family dentist. Recently, I was thinking of switching, though. Our family dentist does not seem used to working with such young children. My daughter was chided for fidgeting during her last cleaning. I think seeing a pediatric dentist would be a good change, but I am a single parent on a strict budget. Do pediatric dentists usually charge more, or would the price be the same as a family dentist?

Taylor, from Rochester, NY

 

Hi Taylor,

Pediatric dentists are general dentists who have undergone additional training to hone their skills. Each office sets their own fees. You’ll have to check with pediatric dentists in your area to compare prices.

If you are able to find a pediatric dentist in your insurance network, the price will be about the same. The insurance company dictates the fees that dentists can charge. If the work your child needs is preventative, such as cleanings, your plan should cover it. If you go outside your network, the fees may vary.

You don’t necessarily have to see a pediatric dentist. Many general dentists are comfortable working with children – you just need to find an office that sees a lot of children. This way, you won’t need to worry about higher fees, either.

Call your insurance beforehand. They can let you know pricing if you see a specialist, or even refer you to an in-network pediatric dentist. If you do not have insurance, call individual offices and ask for a price quote on common, preventative services. This way, you can make an informed decision on whether you will stick with your current family dentist.

This blog post is brought to you by Phoenix pediatric dentist, Dr. Hillary Peck.

What Can I Do About My Son’s Broken Baby Teeth?

Hi,

Our family dentist is recommending an extraction for two of my son’s back teeth. She found that some of his back teeth have broken from decay and have cavities. However, he is only 7 and still has his baby teeth. Isn’t he too young for extractions? What should I do?

Thank you,

Noel, from Charleston, South Carolina

 

Hi Noel,

Yes, your family dentist is correct – your son does need these teeth extracted. If these teeth are not removed, the decay can spread down to your son’s jaw and cause more problems down the line. If your son had his adult teeth, a root canal would be an option, but it’s not available for baby teeth.

When certain baby teeth are extracted, a space maintainer can be placed in your child’s mouth. Space maintainers are placeholders, and will prevent your son’s molars from growing in sideways.

If you dentist did not recommend these to you, you should seek a second opinion from a pediatric dentist. Dentists with additional training and experience in treating children would be your best option.

For more information on how to prepare your son for his upcoming appointment, you can check Dr. Peck’s dental tips for parents page.

This blog post is brought to you by Phoenix pediatric dentist, Dr. Hillary Peck, of Peck Family Dentistry. Please note that pediatric dentistry is not a specialty recognized by the ADA, but Dr. Peck is comfortable and experienced in treating the needs of children.