Frequently asked questions

A: The American Academy of Pediatric Dentistry recommends a child's first visit to take place by the first year of age. You are your child’s best advocate! Keep in mind that you, “the parent”, must begin to clean your child’s teeth as soon as the first tooth erupts, in addition, good dietary habits must also start early. Brushing your child’s teeth at an early age, even if they fuss, will only start you on the road to a healthy and beautiful smile

2. Q: When should my child begin to brush her teeth?

A: Brushing should actually begin before children are capable of doing it themselves. A wet cloth or gauze effectively cleans gums and removes plaque after nursing and establishes a good habit early on. Gentle brushing with a soft bristle brush begins with the first tooth and flossing, when most primary teeth are in. At six or seven, children can brush on their own, with careful supervision. By eight or nine years old they can floss on their own too. The American Academy of Pediatric Dentistry says "a good rule of thumb is this... When children are accomplished enough in caring for their own needs that they can get up, bathe and dress themselves and comb their hair without your help - then they are ready to accept full responsibility for their mouth-cleaning program!"

3. Q: Can all children grow up cavity-free?

A: Ten years ago, we might have said no. But today's research and new, easy-to-follow professional advice indeed make it possible for almost every child to grow up cavity-free. Remember: It is as simple as brushing and flossing your child’s teeth. You, “the parent”, must take charge.

4. Q: How can I prevent cavities?

A: The American Academy of Pediatric Dentistry advises:

Brush with fluoride toothpaste twice a day. Floss your children's teeth once a day until they are able to do it themselves - around age 8 or 10. Visit your pediatric dentist twice a year. Get enough fluoride through drinking water, fluoride products, and when indicated, through fluoride supplements. Have sealants applied to the chewing surfaces of permanent back teeth or molars soon after they come in. Healthy snacks, fresh fruits and vegetables, are the best choices.

5. Q: Is diet important in the prevention of cavities?

A: Though a balanced diet is certainly important in preventing cavities, experts agree that cavities are not only the result of what children eat, but also how often they eat. Frequent snacking without brushing leaves food on the teeth longer and promotes tooth decay.

6. Q: What are good and bad foods for the teeth?

A: Although foods such as milk, fruits and vegetables contribute to strong bones and healthy teeth and gums, even they can promotes tooth decay in the absence of good oral hygiene. Particles of food that are trapped on tooth surfaces are considered to contribute to cavity development. Because of their texture, some foods are retained in the mouth longer than others are. However, foods that are perceived by consumers to be "sticky" are not always those that are retained longest in the mouth. Research continues in this area. Table sugar (sucrose) was once considered the sole dietary culprit in cavity formation. Recent research, however, indicates that all starches also play a role. When complex carbohydrate foods such as bread, corn flakes, pasta, crackers, and potato chips are allowed to remain in the mouth for several hours, the bacteria that live in the mouth break down these starches into sugars. This process produces acids that attack teeth and a cavity will result if the mouth is not cleaned. For this reason, sugars and starches are best reserved for mealtime when saliva production is increased and when naturally rinsing foods and beverages also are being consumed.

7. Q: Can you provide information on snacking?

A: First of all, snacking in moderation is the key since children often don't brush after snacking, allowing particles of food to remain in the mouth. Research has shown that certain snack foods have anti-cavity power. Cheese, including aged cheddar, Monterey Jack and Swiss – alone or with an accompaniment – is an excellent snack choice. This is because cheese stimulates production of saliva which clears carbohydrates (sugars and starches) and harmful acids, re-mineralizes teeth, and also neutralizes harmful acids. New research also indicates that cheese coupled with good oral hygiene can heal small breaks in tooth enamel where cavities can form. Raw fruits and vegetables also are great snack choices. Should your child want something sweet, caramel or some kinds of chocolate and hard candies that dissolve and clear the mouth quickly may be alternatives. And if the child wants something crunchy, studies show that peanuts and cashews fight plaque and neutralize the bacteria that causes tooth decay. In addition to providing dentally preferred snacks, it is also important to alternate snack choices to incorporate variety, moderation and balance into a child's overall diet. Discuss snacking and snack choices with Dr. Perez or the hygienist.

8. Q: If our water supplies are fluoridated, should my child also use fluoridated toothpaste?

A: Absolutely. It was once believed that dietary fluoride (fluoride taken into the body through food and water) was more effective than topical fluoride (fluoride applied to the teeth with toothpaste, mouth rinses or in-office fluoride treatments). Today, professionals maintain that both sources of fluoride are equally influential in preventing tooth decay. Toothpaste provides daily fluoride boosts that are necessary in keeping your child's teeth cavity-free. Keep in mind you only need a microscopic amount of toothpaste, less than a pea sized. If your child is resistant before the age of 3, consider using no toothpaste or a toddler's toothpaste without fluoride.

9. Q: Is it possible to get too much fluoride?

A: Parents often worry about too much fluoride could cause dental fluorosis. We can assess the amount of fluoride your child is receiving from drinking water, toothpaste, mouth rinses and in-office fluoride treatments and also will consider the need for a dietary fluoride supplement. The small percentages of children who incur severe dental fluorosis typically consume over-fluoridated water on a regular basis or eat their toothpaste. The U.S. Public standard for optimum water fluoridation Health Service assures us that water fluoridation is safe and effective. Confirm with your local water company if necessary, that your community observes the Environmental Protection Agency's (0.7 to 1.2 parts per million). It's also a good idea to teach small children to use a very small amount of toothpaste for brushing.

10. Q: What are dental sealants?

A: Dental sealants protect the chewing surfaces of back teeth where most cavities in children are found. Made of clear or shaded plastic, sealants are painted onto the tiny grooves and depressions in the molars. By "sealing out" food and plaque from these surfaces, reduce the risk of decay. They are quickly and painlessly applied to any baby teeth and permanent teeth that are likely to have decay on the biting surface. Sealants must be checked periodically and replaced when necessary, though they generally last for several years. Sealants are a great preventive measure against tooth decay. "Sealants make sense". Both Dr. Perez's children have had their teeth sealed!

11. Q: Can all children benefit from dental sealants?

A: Yes. Studies show that 4 out of 5 cavities in children under age 15 develop on the biting surface of back molars. Molars commonly decay because plaque accumulates in the tiny grooves of the chewing surfaces. Though fluoride works to prevent cavities on the smooth surfaces of teeth, it is not as effective on the biting surfaces of back teeth. Sealants prevent the cavities that fluoride cannot effectively reach. As a preventive mechanism, sealants are an important part of a cavity-free generation.

12. Q: How can I help my child develop tooth brushing into a habit?

A: If you want to motivate your children, start by being a good role model with your own daily brushing, flossing, and limited snacking program. Let them also notice that you follow a regular dental checkup schedule. You can interest young children by making mouth cleaning a family event they would not want to miss. As they grow, praise their efforts as well as their newfound independence with the habit and it will instill a sense of pride in a job well done.

13. Q: Is it important to care for my child's baby teeth since they will eventually come out anyway?

A: Proper care of baby teeth is instrumental in enhancing the health of the growing adult teeth. The primary teeth guide the permanent teeth into position and allow normal development of the jawbone and muscles. Because primary teeth hold space for their successors, early loss or damage can severely affect the outcome of the permanent teeth. As with adults, children need healthy teeth and mouths to chew food easily, learn to pronounce words properly, speak clearly and smile with confidence.

14. Q: What should I do in case my child chips or knocks out a tooth?

A: Time is of the essence. If it is a permanent tooth and it has been completely knocked out, find the tooth. Hold the tooth by the crown, if dirty rinse the tooth in cool water, do not wipe the tooth and gently replace the tooth into the socket. Determine the front of the tooth, hold the tooth in position and ask your child to bite on a guaze or handkerchief. If you do not feel comfortable with placing the tooth back into your child’s mouth, place the tooth in milk and contact the office to bring your child to the office immediately 301.718.1012. NEVER DELAY – the sooner your child is seen by the dentist, the better his/her chance of saving the tooth. If the tooth has been broken, save any fragments or pieces by storing them in milk and make an emergency visit to the dentist’s office.

If it is a “baby” tooth, broken or knocked out, call the office for an emergency examination. Remember that a pediatric dentist should examine all injuries to the mouth. A chipped or broken tooth can usually be repaired.

15. Q: What does it mean if my child's teeth are sensitive to hot and cold?

A: Sensitive teeth are not uncommon and can be symptomatic of anything from a harmless sinus headache to more serious problems such as bruxism (teeth grinding), cavities, loose fillings, or receding gums. Sensitivity also can be magnified by tiny cracks beneath the outer enamel created by chewing on hard objects. Dental treatment sometimes inflames the pulp or nerves inside the teeth making them sensitive. If your child complains of momentary pains caused by hot or cold elements , consider all possible causes and consult your pediatric dentist. Fleeting sensations are rarely grounds for worry. If these pains tend to linger, however, call the office for an examination.

16. Q: My teeth have always been crooked is there anything that can be done to make sure that my child's teeth come in straight?

A: Fortunately, orthodontic treatment has come a long way, especially with early intervention procedures. As your pediatric dentist monitors your child's development, he or she can teach your child to avoid oral habits that encourage orthodontic problems. Your pediatric dentist can also identify malocclusion (abnormal dental alignment) right away and actively intervene to guide the teeth as they emerge in the mouth. Many times, early orthodontic treatment can prevent more extensive treatment later. Though your child may need braces, new preventive techniques can minimize time needed to wear them.

17. Q: How often should my child receive fluoride treatments?

A: The American Dental Association recommends fluoride treatments twice a year for you child's teeth.

18. Q: How often should my children brush?

A: Did you know that a third of all kids do not brush before bedtime, after a day of snacking and meals? Children should be brushing twice a day optimally before bed and after breakfast. If there's a history of decay, they should brush after snacks, too.

19. Q: How often should we change toothbrushes?

A: The American Academy of Pediatric Dentistry recommends getting a new toothbrush every three or four months. However, if the bristles become splayed, they no longer do the right cleaning job, so change sooner. Also, get a new brush after a cold or virus to avoid spreading those germs.

20. Q: How do I know if my child is doing a good job brushing?

A: Simple answer: he or she is probably not, so you have to check. We really prefer parents to assist with brushing until children are 8 or 10 (when they can write in cursive legibly.) But how to check? Most people (adults included) miss the outside of the upper molars at the gum line and the lower molars next to the tongue. Children also tend to miss the facial areas, and the resulting dull, dingy look is probably plaque. A simple PLAQUE DETECTOR is made with food coloring and water. Mix the solution and swab the teeth with a cotton tipped applicator. Voila! – the food coloring highlights the plaque! Make sure to use good lighting when checking your child’s brushing habits. You can also ask your dentist for plaque disclosing chewable tables.

21. Q: How can I motivate my child to want to brush?

A: Great question, and the hardest to answer! Make it fun, make them responsible for their own dental health. Each child needs different motivation. For little ones trying out their independence, remember you are the parent and “because I said so” is often the only reason you need to give. Try “the dentist says…” if that helps, since doctors and dentists are authority figures in their eyes. You are your child’s greatest role model…Set a good example! If your goal is the same as ours, “healthy teeth” is non-negotiable.