Tag Archives: Phoenix Pediatric Dentist

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


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 do pediatric dentists treat children who won’t cooperate?

Many dentists enjoy treating children, even children who are somewhat difficult to treat. They enjoy them, have fun with them, and find fulfillment in focusing on the children and helping them receive the care they need and deserve. However, even if a parent does all he or she can to prepare a child for their appointment, one of the biggest obstacles in treating children is their movement. Some children will not lay still.

Methods for Controlling Child Movement During Dental Procedures

One way a dentist could attempt to control movement is with the use of a mouth prop, called a molt mouth gag to prevent the young patients from biting down during a procedure, and causing further pain and damage.

photo of a mouth molt gag
Mouth molt gag

However, some children are more difficult to control and need more restraint, in order to treat them effectively and safely. Even with multiple attempts to calm them down, some children still throw their arms and legs, risking their safety and preventing treatment. For these children, parents will be asked for permission to physically restrain their child. When permission is granted, the dentist may wrap the child in a papoose, and then complete the treatment.

Child in dental office wrapped in papoose

The papoose technique is not meant to be harmful, traumatic, or mean. It is only used on incredibly strong-willed children who refuse to lay still, thus making it impossible to treat them safely. It ultimately allows the child to calm down.

When the successful treatment is complete, the child will be congratulated, often given a chance to pick a toy or treat from the prize box or treasure chest, and walk away feeling good.

This article was provided by the office of Phoenix pediatric dentist Dr. Hillary Peck.


Is my child too young for a flipper?

My three year old daughter lost her two front teeth after she experienced a nasty fall on our front sidewalk. We recently moved to a new community and were testing the waters with a new dentist. When we visited with him about her losing her front teeth, I asked about flippers, or some form of cosmetic teeth. The dentist rudely informed me that she was too young for a flipper and and will not cooperate for that sort of procedure. Do you agree? I assume a procedure like this wouldn’t be covered by our medical coverage, and the kits which can be purchased online are all made for adults. I am just concerned about future repercussions of this and taking any more time than we already have to address the issue. Thank you for your input!

Dear Mary,
How awful that your young daughter experienced such a fall! It is also unfortunate that the dentist you visited gave you such a response. Nonetheless, he is correct. It would be nearly impossible for a child the age of your daughter to understand the importance of complying with a procedure for a flipper. In addition, there are other issues to consider for a child of this age.

Issues With Young Child Receiving a Flipper

Safety is a major concern. Just as it is hazardous to allow young children to play with small toys, or toys with small parts that have the potential to come loose and cause them to choke, something like a flipper has the potential to also come loose and is also a choking hazard.

Functionality is also a consideration. Metal clips or plastic parts clip or press against the other teeth in order to hold a flipper in place. Because a child’s mouth and teeth are constantly developing and changing at this age, it would be impossible for an appliance such as this to stay in place for any lengthy period of time.

Positive Points to Consider with Premature Loss of Front Teeth

Fortunately, there are some positive points to consider in this situation. To start with, your daughter’s baby teeth won’t move because of missing front teeth. When baby teeth change position, it is a result of missing back teeth lost too early. When this is the case, a space maintainer is often a necessity. A second consideration is that, at this age, children are not self-conscious about missing teeth. Children of all ages are missing teeth, either because they haven’t grown in yet, or because they have lost their baby teeth and their permanents have yet to grow in. Therefore, it is quite common to see a child without all of his or her teeth.

Overall, this is not an issue to worry about.

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

How to prepare for a child’s first dental appointment

We have scheduled our 5 year old son for his first dental visit. He is very shy and quite apprehensive to people he isn’t comfortable around. Are there are specific ways we can prepare him so he will not be afraid?

Thank you,

Dear Brooke,
It can definitely be stressful to take your child to the dentist for his or her first time. However, there are many things you can do to make the experience a fun and teachable one. The biggest thing to remember is that if you are stressed or anxious, he will feel that. Try not to say things like, “Don’t be afraid,” “It’s not scary,” or “It won’t hurt,” when you discuss the dental appointment. Be sure to remember that any negative dental experiences you have had are your experiences and not necessarily indicative of the type of experience he will have. Talk about the appointment like it is a natural thing for him to do, but show excitement about it being his first appointment, like you would his first haircut. It is a great idea to let him come along with you to one of your appointments, so he can become familiar with the office, the staff, and the routine. If this is not an option, or you are using a new office, call ahead to to find out what you can expect, or visit the office’s website, in order to talk with him about it. Read books about going to the dentist, or watch cartoons. You could also role play at home, first with you playing the dentist role, then switch and let your son be the dentist. But, again, the most important component in this is to build-up the experience as a positive one.

It is also a good idea to try to schedule a morning appointment, so he can be well-rested and have had a good breakfast beforehand. Be sure to arrive to your appointment somewhat early, to allow your son a chance to become used to the office. If, by chance, your office does not allow parents to accompany children to the exam room, you should be aware beforehand to decrease his anxiety about this. However, if you are able to go back, snap a photo of her being a good patient and cooperating.

Many offices give children toothbrushes and other goodies such as balloons or tokens when they are finished. If the dental office does not provide these, it’s a great idea to have a toothbrush and small toy or reward to give him at the end of the appointment. You just want to be sure to reinforce the good behavior.

Also, please remember, if the visit is not as positive as you hoped for, and practiced for, don’t fret. Many children take time to become comfortable to new places and things. It will be good to have already been in the office and provided the experience. Then, try again after a few months. Good luck!

This post is sponsored by the office of Phoenix pediatric dentist, Dr. Hillary Peck.

Does my child’s baby tooth need a filling?

My daughter is seven years old. One of her baby teeth has a cavity and her pediatric dentist says it needs filled. I’m struggling with this prognosis. If the tooth is going to eventually fall out, does it really need filled? Or, is the dentist just wanting the money?

Thank you,

Dear Ann,

If the tooth with the cavity on it happens to be one of your daughter’s eight front teeth, there is no reason to have it filled. However, if the tooth in question is in the back, there are several reasons to fill it, as it could be a few years before the tooth falls out since some baby teeth stay in a child’s mouth until age 12 or more. In fact, there are some adults who still have baby teeth due to no permanent teeth growing in under them. An x-ray is the only way to know this or not. Needless to say, if the tooth with the cavity is a back tooth, she needs to have it filled in order to keep the tooth and hold the space for the adult teeth to come in correctly.  Letting things go and not filling the tooth will cause further decay to build up and she will eventually have to have the tooth extracted, which can be a traumatic experience for a child. If the tooth is pulled, a space maintainer will be needed, in order to keep the space for the adult tooth. If the tooth is removed or comes out too soon, and nothing is put in its place, the other teeth takeover the space and will prevent the eruption of the permanent tooth. This would cause a definite need for orthodontics in her future. Another point to consider, if the tooth in question is her last baby tooth, is is likely it is her six-year molar. This is a permanent tooth and would most definitely require a filling.

This post was written by the office of Phoenix pediatric dentist, Dr. Hillary Peck.

Should my child be seen for a painful loose tooth?

My elementary-aged son seems to be getting ready to lose his first tooth. He recently had his dental check-up with her pediatric dentist and we were told everything appeared good and normal. However, lately he has been complaining that it feels like one of his front two teeth is getting bigger. Then, he recently bit down on a carrot and immediately started to cry. There was blood and the tooth appeared to be out of place. I thought this might all be due to the tooth preparing to fall out, but am starting to second-guess myself. Is this normal? Should I have her seen?

Thank you,

Dear Bethany,

Each tooth that is lost fights of small battle in the process which leads to it falling out. First, the permanent, adult tooth pushes the baby tooth up. This may be what is causing him to feel like his tooth is increasing in size. Next, the ligaments, which help the tooth stay in place, start to expand and strain, like small rubber bands. At times, they tighten back to their original state, white other times, they stay stretched and snap. It is quite possible the tooth was in fact loose and the ligaments were already stretched. Then, when he bit into the carrot, the bite forced the tooth out of alignment and caused some of the ligaments to snap. In this situation, popsicles are great, as well as avoiding hard foods. The tissue around the tooth was likely traumatized, but it’s unlikely any long-term issues or serious damage were caused to the adult tooth coming in. If your son is not in any pain now, and the area seems to be healing on its own, it’s not crucial that he be seen. However, if you are not certain, or will feel better doing so, seeing a pediatric dentist would be a good idea. In a rare situation, additional damage could be causes, which could require dental intervention. But, it sounds like stocking up on soft foods and popsicles is a good idea…and prepare for a visit from the Tooth Fairy!

This post is sponsored by the office of Phoenix pediatric dentist, Dr. Hillary Peck.

Should I see a pediatric dentist for my child’s loose tooth?

My elementary school-aged son has had loose front-teeth for a couple of months now. He complains that they hurt and give her trouble when he eats and applies pressure on them from his tongue. When I look at them, I can see them moving around and that they are very loose, so I can tell they are ready to come out. However, he will not let me near him in order to extract them myself, nor will he pull them out himself. I know a pediatric dentist could remedy the issue quickly and easily but am not sure this is something for which they see patients? I know they will pull teeth that need to be pulled, but will they remove a tooth that is basically hanging by a thread?


Dear Dan,

The ligaments which hold a tooth in place are just like a rubber band. They will stretch out but then tighten back up, causing the process of losing a baby tooth to be quite a process. It appears that your son could be experiencing this to some extent, which could be why it is taking the tooth longer to fall out on its own than you might be used to.

It’s generally a good idea to let baby teeth do their thing until they fall out naturally. Attempting to pull a baby tooth prematurely not only hurts the child but can cause unnecessary trauma to the area. The baby tooth also helps keep the space open for the adult tooth to come in.

If the tooth is bothering your child, seeing a pediatric dentist would not be a bad idea. He or she can assess the situation and ensure nothing out of the ordinary is happening or causing the delay. If the dentist determines that the baby tooth will not come out on its own, he or she may suggest extraction as a solution. But, if you think your son will oppose a dentist, as he does when you try to touch the tooth, it may be better to wait it out and let nature take its course.

This content is brought to you by office of Phoenix pediatric dentist, Dr. Hillary Peck.

Why are there white spots on my child’s teeth?

My son is a healthy, growing 14 month-old little boy. He is eating what he should be at this age and was breastfed for his first year. Recently, his front two teeth started to appear and have white spots on them. I haven’t seen this before and wondered if it is something I should have checked by a pediatric dentist, or mention it to my child’s pediatrician? I am not sure if this is something I should be concerned about, or if I should just let it be.

Thank you,

Dear Abby,

It is recommended by the American Dental Association that children visit a dentist for the first time after their first year of age and following the arrival of their first teeth. Typically, this is a quick visit to ensure that everything is developing as it should. It is not like that of an adult visit, which would normally include x-rays, a cleaning, and an exam. Most insurance companies cover this visit as a diagnostic visit and even have a  different billing code for it.

The spots you mention are somewhat concerning. Spots such as these are often times called decalcification spots, or signs of early decay.  They appear when minerals are removed from the tooth and it becomes exposed. Although this doesn’t mean she has a cavity, the exposure of the tooth can cause decay and lead to future cavities. It’s important that your child is seen by a pediatric dentist right away, as they may suggest fluoride treatments to strengthen the tooth and prevent future decay.

This decalcification is not typically seen in children this young and may be the cause of another issue. It’s important to take steps to care for your child’s teeth, but, at this point, it is too early to be seeing signs of decay. Therefore, it could be a problem with the development of your child’s teeth and you should work with your pediatric dentist, as well as your child’s doctor, to better determine the cause.

This post is sponsored by the office of Phoenix pediatric dentist, Dr. Hillary Peck.

Why won’t my daughter’s dentist use fluoride varnish?

Our previous pediatric dentist painted something on our daughter’s teeth, instead of using fluoride trays. We were thankful for this because it prevented the nasty taste that comes along with the trays.

Unfortunately, we had to change dental offices, for insurance reasons, and our new provider uses the trays. When I worriedly asked the hygienist, I was assured that this was a new foam version, with a better taste.

Well, my daughter hated it! She spat it out immediately and began crying hysterically.

When I asked about the painted version, used in our previous dental office, I was told it was “too new” and they don’t stock it. Was the painted version an experimental treatment used on my daughter? I am also now worried about how future dental visits will go.

Thank you,

Jen Smith

Dear Jen,

In regards to your question about the painted fluoride treatment, please rest assured that the varnish method is not experimental. It has been recommended by the American Academy of Dentists since 2006. It is the preferred method for children because it is easy to apply and tolerated much more positively by kids.

However, some dentists are resistant to change, even regarding something like fluoride varnish that has been successful for over a decade. The foam you are referring to is also safe, effective, and trusted, but the varnish is a more favorable option for children. It seems the choice to use the foam method is being made by personal preference, and your dentist should not have advised that it was “too new” or untrustworthy.

In regards to your question about your future dental visits being scared, please keep in mind that if you are fearful or nervous, your daughter will see this and feel the same. Dental trauma and anxiety can be difficult to overcome. If you are ever nervous or questioning a treatment that your child is receiving, try not to let this show on your face. If possible, ask to pause the treatment and speak to the provider in private, so as to not alarm your child. This will allow you to, hopefully, get your questions answered, and feel calm and confident going into the treatment, which will, in turn, help your child to feel the same and have a positive experience with her pediatric dentist.

This post is brought to you by the office of Phoenix pediatric dentist, Dr. Hillary Peck.

Why are silver fillings used with children?

I am a mom of three children under 10. Two of my three have had cavities in need of fillings. The pediatric dentist placed a silver filling for both children. I have also noticed that other children in our lives have silver fillings as well. As an adult, I know I would prefer a filling that matches the natural color of my teeth. I’m just wondering if there is some medical reason that the dentist uses the silver fillings on children?

Thank you,


Dear Stacey,

Thank you for writing. There are several reasons pediatric dentists place silver fillings on children.

  1. Cost: Stainless steel or amalgam fillings cost less than the natural tooth-colored crowns, normally placed on adults. Because baby teeth are eventually replaced by permanent teeth, dentists typically use this option, because these fillings are premade in various shapes and can be placed less expensively.
  2. Decreases number of visits: Because most young children are feeling wiggly, dentists often use nitrous oxide or an anesthesia before a procedure. Therefore, limiting the number of visits is important. This is another advantage to using the premade fillings.
  3. Strength and effectiveness: When a significant portion of the tooth structure is damaged or lost, it needs the full coverage and strength that the stainless steel provides.
  4. The tooth is protected longer: the stainless steel helps to prevent sensitivity, future decay and the need for repairs.

Recommended: The American Academy of Pediatrics recommends the stainless steel crowns. Therefore, dentists who place these on children are following the recommendation.

This post is sponsored by the office of Phoenix pediatric dentist, Dr. Hillary Peck.