Where Little Smiles Shine Brighter!

How often should dental x-rays taken?

Dental x-rays are a tool used to see where the naked eye can’t. They are only taken when indicated but as a rule, children require them more frequently than adults. Their mouths grow and change rapidly and they are prone to more tooth decay than adults. The American Academy of Pediatric Dentistry recommends x-ray examinations every 6 months for children with a high risk of tooth decay. Children with a lower risk of tooth decay will generally need them once a year.

Why does my child need x-rays if he has never had a cavity?

Our doctors evaluate your child’s growth and development, post-injury status, and orthodontic readiness as well as tooth decay. X-rays allow our doctors to diagnose and treat health conditions that cannot be detected during a clinical examination. If dental problems are found and treated early, dental care is more comfortable for your child and more affordable for you.

How safe are dental x-rays?

Our practice is set up to minimize your child’s exposure to radiation. We use digital x-rays, which require much less radiation than traditional x-rays. The risk is negligible. In fact, dental x-rays represent a far smaller risk than an undetected and untreated dental problem.

Will my child be protected from x-ray exposure?

Lead aprons with thyroid collars are always used when x-rays are taken.

A cavity is when the enamel of the tooth breaks down due to bacteria left on the teeth. The bacteria thrive on foods and drinks containing carbohydrates. The bacteria release acids when exposed to these sugars and starches. If not removed daily, the acids destroy the enamel and a cavity forms.

How do I prevent a cavity?

Four things are needed to cause tooth decay:

   •Tooth

   •Bacteria

   •Sugars and Starches

   •Time

If any one of these things is eliminated, a cavity will not form. We all have bacteria present in our mouths. They cannot be totally eliminated, but they can be reduced by daily flossing and proper brushing. Sugars and starches should be limited. It is not the amount of sugars and starches consumed, but the frequency. Children who snack and “graze” have a much higher incidence of decay than children who eat 3 meals a day with limited snacks. Also watch for hidden sugars. The bacteria cannot tell the difference between sugar from juice or from soda. Some snacks (like cheese and nuts) do not contribute to cavities.

Why is flossing important?

Cavities can be prevented and it is easy! With daily brushing and flossing (don’t miss a day!) and proper nutrition you will be on your way to a cavity-free life. Children under age 8 do not have the fine motor skills to do a thorough cleaning. They will need parental help to keep the gum line areas clean on both the insides and the outsides of the teeth. They also will need help with flossing. It is important that the children see their parents also brush and floss regularly. You can set a good example regarding the importance of maintaining a healthy smile.

Baby teeth have a purpose and it is very important they are kept in place until they are lost naturally.

1. Healthy baby teeth help your child to chew properly. This allows your child to eat a proper and healthy diet.
2.  Baby teeth aid in proper speech development.
3. Most importantly, baby teeth save space for the permanent teeth. A healthy smile can make children feel good about the way they look.

When should my child first see the pediatric dentist?

“First visit by first birthday” is recommended by the American Academy of Pediatric Dentistry (AAPD.org). Your child should visit Dr. Nguyen when the first tooth comes in, usually between six and twelve months. Early examination and preentive care will protect your child’s smile now and in the future.

Why so early? What dental problems could a baby have?

Dental problems can begin early. A big concern is Early Childhood Caries (also known as baby bottle or nursing caries). The earlier we see the child, the better the chance of preventing dental problems. We will review proper nutrition and how to care for your child’s teeth. Cavities are totally preventable with the right care.

When should bottle/breast feeding be stopped?

Children should be weaned between 12 and 14 months to avoid damage to their teeth.

When should I start cleaning my baby’s teeth?

The sooner the better! You will need to help your child brush until he/she are around age 8. All teeth that touch need to be flossed daily. Do not use fluoridated toothpaste until your child is able to spit, around age 3.

Team Approach to Total Health

Good oral health is an important part of total health. When treating children, we often work with pediatricians, other physicians and dental specialists. All young people are served best through this team approach.

We tell our patients what we are doing, and do so in an honest, matter of fact way. Children do much better with explanation followed by immediately doing what is shown to them. They worry if too much preparation goes into an appointment. We follow the principals of Tell/Show/Do. The TELL phase involves an age appropriate explanation of the procedure. The SHOW phase is used to demonstrate a procedure up to the point where the instrument is performed. The DO phase is then initiated and the treatment is performed.

We use age appropriate terms to describe our procedures. You may hear your child describe things using some of the following words:

Kid friendly terms

•Jelly

•Nose

•Tooth Pillow

•Tooth Ring

•Raincoat

•Princess tooth/superman tooth

•WhistleMotorcycle

•Instrument/Procedure

•topical anesthetic

•nitrous/oxygen

•bite block

•clamp

•rubber dam

•silver crown/cap

•high speed handpiece

•slow speed handpiece

During your child’s time with us, we ask that you refrain from using certain words that promote dental fear. We also ask that you do not tell them about your personal dental experiences. Don’t make promises you won’t be able to keep.

“NO” words

•Needle or shot

•hurt or won’t hurt

•don’t be afraid

•Mommy or Daddy will stay with you

Thank you for your cooperation. We want your child to have a positive dental experience. This can only happen with help from you.

How do I make my child’s diet safe for his teeth?

First, be sure your child has a balanced diet. A balanced diet includes foods from the following major food groups: Fruits and Vegetables; Breads and Cereals; Dairy Products; Meat, Fish and Eggs. Foods containing sugars and starches cause tooth decay. Foods with starch include breads, pasta, and such snacks as pretzels, goldfish crackers, and potato chips. There is hidden sugar in all sorts of foods. It can be added to your peanut butter, mayonnaise, salad dressing or many other processed foods. Be a label reader!

Should my child give up all foods with sugar or starch?

Not at all! You need to be sure to be selective with him/her. The stickier the food is, the higher the chance that it will form a cavity.

When is the best time to give my child a treat?

The best time is just after a meal and not in between meals. While your child is eating a meal, extra saliva is produced which helps to wash out the sugars. Each bite or sip of a sugary or starchy food or drink produces acids on the teeth for 20 minutes. So, if your child walks around with a sippy cup filled with a sugary drink, every sip results in 20 minutes of acid production. The child is better off drinking the whole cup at one sitting at a meal.

My baby is still on the bottle, what should I do?

Don’t nurse your child to sleep or put her to bed with a bottle. If she must have a bottle at night, put only water in it. Sugars left in the mouth at night do the most damage. Most children leave the milk in their mouth while sleeping, sucking occasionally. Early Childhood Caries are caused by this habit.

What are some good snacks?

Cheeses, yogurt, nuts, fresh fruits and vegetables, popcorn and unsweetened breads are good to give to your child. Water is the best drink to give him/her between meals. This helps him/her to establish a good lifelong habit of drinking water during the day.

What snacks should I avoid?

Sugary items such as soft drinks, sports drinks, sweet teas, lemonade and candies should be eaten for special occasions only. Avoid other sticky or chewy foods, including fruit roll ups, gummy bears, taffy, and chewy candies.

Thumb sucking is natural and a normal reflex utilized by infants to soothe themselves. They generally lose interest once they develop other coping skills. Ideally, children should stop thumb sucking by the age of 4.

Pacifiers are not a substitute for thumb sucking. They, too, can affect the teeth in the same way as sucking fingers and thumbs. However, you can control and modify the pacifier easier than the thumb or finger habit.

How hard a child actually sucks on his/hers fingers or thumbs will determine whether or not dental problems will result. Some children rest their thumbs passively in their mouths, making them less likely to have problems than those who vigorously suck their thumbs.

Up until the age of 3, children are too young to actively try to get them to stop. See if they will stop on their own with positive reinforcement. Focus only on daytime thumb sucking first.

• Instead of scolding children for thumb sucking, praise them when they are not.
• Children often suck their thumbs when feeling insecure or bored. Try to determine the cause and focus on redirecting the child.
• Reward children when they refrain from sucking during times they have done it in the past (watching TV, riding in the car, etc.).
• Our doctors and staff can encourage your child to stop sucking and explain what could happen if he/she continue.

Once your child has stopped daytime sucking, then you can work on nighttime. First, your child needs to know he/she can stop at night, be positive. These suggestions only work if he/she have completely stopped daytime sucking and want to quit at night, too.

• The use of a “batter’s glove” with Velcro on the sucking hand while the child sleeps helps to train their subconscious to stop the habit.
• A sock on the preferred hand taped around the wrist to keep him/her from removing it during the night.
• An ace bandage placed around the elbow on the arm that is favored. You place it loosely to trigger the subconscious as it will be more difficult to bend that arm to put the thumb in the mouth.

Most children do grind their teeth, and there is no cause for concern. The majority of cases of pediatric bruxism do not require any treatment.

Parents are often concerned about nighttime grinding of their child’s teeth (bruxism). Most children do grind their teeth and there is no cause for concern. The majority of cases of pediatric bruxism do not require any treatment. If excessive wear of the teeth (attrition) is present, then a mouth guard (night guard) may be indicated. This is rarely suggested as children’s teeth are in transition and the night guard will not “fit” for long. Our doctors will evaluate your child and if there is any cause for concern, she will inform you.

The good news is most children outgrow bruxism. The grinding lessens between the ages of 6-9 and children tend to stop grinding between ages 9-12.

How does fluoride work?

Fluoride is an element and it occurs naturally in some water supplies. When it is taken in the proper quantities on a routine basis it helps prevent tooth decay. When the teeth are forming, it helps make them strong. It then helps the teeth in the mouth by making weaker areas stronger. It is most effective when combined with a healthy diet and good oral hygiene.

Will my child need fluoride supplements?

When a child’s permanent teeth are forming, our doctors may prescribe a fluoride supplement to be taken by mouth. If there is decay present during an examination, she may decide on a topical prescription fluoride that is brushed on the teeth every night. Our doctors will consider many factors before prescribing a fluoride supplement for your child. First, she will need to know if your water supply has fluoride in it. You may need to check with your water supplier to see if you have fluoride in your water.

How safe is fluoride?

Fluoride is documented to be safe and highly effective in the fight against tooth decay in the recommended dosage. Research indicates water fluoridation is the most cost-effective method.

What are topical fluoride treatments?

Topical fluorides are recommended following all dental cleanings as the tooth will readily “absorb” it at this time. It may be done by any number of methods: foam, gel or varnish.

Both the American Academy of Pediatric Dentistry and the American Dental Association recommend fluoride treatments following every prophylaxis (cleaning). Your insurance may not pay for it every time, but we plan treatment based on your child’s needs and not on your insurance coverage.

How do our doctors help with dental anxiety?

Dr. Nguyen have special training to help anxious children feel secure during dental treatment. Having our kid-friendly office helps, too. All of our staff members have chosen to work in a pediatric dental practice because they love children.

How will our doctors help my child feel comfortable?

There are many methods to help children feel comfortable with dental treatment. Our doctors and staff utilize the “Tell-Show-Do” technique which is very effective for children. Coaching, distraction, and parent participation are other possibilities to give your child confidence in dentistry. By far the most preferred technique is praise. Every child does something right during a dental visit and we will always tell him/her that. Nitrous oxide (laughing gas) is used during restorative visits, which also helps to calm some children.

What if a child doesn’t cooperate for their dental care?

Our primary goal is to deliver safe treatment for your child. Occasionally, a child may require more assertive forms of behavior management to protect him or her from injuring himself/herself. These management techniques include the use of voice control, distraction techniques, protective stabilization or the recommendation of completing the procedures with sedation.

Option 1: Traditional Dental Appointments With No Sedation

Without sedation, our doctors can only treat one quarter of the mouth at a time, which means treatment may need to be done in multiple appointments.

This may not be an option for a very young child who is not able to lie still. The use of a papoose stabilization board may be required to ensure the safety of the child throughout the procedure. Nitrous oxide analgesia (laughing gas) may be used to help the child relax. The child will also have a local anesthetic delivered to the area being treated. The child will have to be watched closely for 4 to 5 hours following the procedure to be sure he/she does not chew his/her lip, tongue, or cheek.

Pros:

Least expensive method.Parents are able to spread out the appointments to fit their budget or to maximize insurance benefits.

Cons:

Multiple appointments, children tend to get “dental fatigue” by the third appointment.Patient has memory of all of the treatment.Patient is numb and will need to be watched closely following procedures.

Option 2: Conscious Sedation Appointments

This can reduce the number of the appointments needed, most of the time in half. Conscious sedation involves giving the child a medication by mouth as a drink or in the nose as a spray before the procedure. It can have an amnesia effect, but the child is awake throughout the procedure. The child will also have a local anesthetic delivered to the area being treated. The child will have to be watched closely for 4 to 5 hours following the procedure to be sure they do not chew their lip, tongue, or cheek.

Pros:

Can have an amnesia effect, child may have little to no memory of the procedure.Lessens the number of appointments required to complete treatment.

Cons:

Children can still be combative and may yell for treatment.

Is generally more expensive than option 1 and most insurance will not cover sedation.Patient is numb and will need to be watched closely following procedures.

Option 3: IV Sedation Appointment

All treatment can be completed in one IV sedation visit. There is generally no local anesthesia required, so there is no concern regarding the child chewing his/her lip or cheek following the appointment. We are able to take any necessary x-rays if we have been unable to get them in the past due to age or cooperation. These x-rays allow us to create a more accurate treatment plan.

All treatment is completed in one visit. The child is given medication while sitting on his/her parent’s lap, and once it takes effect, the child is moved to the dental operatory. After treatment is completed, the child wakes up with a parent in the room. The child has no memory of the treatment.

Pros:

All treatment is completed in one visit.Children will have no memory of the treatment.X-rays previously not taken due to cooperation can be obtained.

Cons:

Most expensive option and the sedation portion may not be covered by insurance.If x-rays are not obtained prior to the sedation appointment, the full extent of the decay may not be known. Once x-rays are taken and new decay is found, it needs to be treated at the sedation appointment. This may result in greater costs at the treatment visit than previously planned.

Dental insurance may not cover all procedures completed in this visit, depending on your maximum benefits per calendar year.

Dr. Nguyen follow the recommendation for use of stainless steel crowns as set by the American Academy of Pediatric Dentistry (AAPD). These guidelines are the following:

1. If a pulpotomy (nerve treatment) is indicated.
2. The tooth has such a large area of decay making the remaining tooth structure insufficient to hold a traditional filling.
3. A tooth that has formed incorrectly or has fractured.

Our general dentist said the tooth could be filled.

Our doctors have undergone specialized training to treat primary (baby) teeth. They are treated differently than permanent teeth and not all general dentists follow the AAPD recommendations. The stainless steel crowns are the best treatment for your child, when indicated. If a filling were to be done on the tooth after our doctors have recommended a stainless steel crown, the filling could fail. Your child might need to have the tooth retreated in the future (which might not be covered by your insurance) or extracted. In most cases, the stainless steel crown should last until the tooth comes out naturally.

Are there any alternatives (white crowns)?

At this time, there are not. Some companies are starting to make stainless steel crowns with a white coating on the cheek side. They are inferior to the traditional stainless steel crowns as the white covering chips and does not hold up over time. Our doctors will not use inferior materials on your child. We keep hoping that the materials improve, and if this becomes the case, we will begin offering them.

Why do children lose their baby teeth?

A baby tooth usually stays in until a permanent tooth underneath pushes it out and takes its place. Unfortunately, some children lose a baby tooth too soon due to an accident or disease. When a tooth is lost too early, our doctors may recommend a space maintainer to prevent future space loss and dental problems.

Why all the fuss? Baby teeth eventually fall out on their own!

Baby teeth are important to your child’s present and future dental health. They encourage normal development of the jaw bones and muscles. They save space for the permanent teeth and guide them into position. Remember: Some baby teeth are not replaced until a child is 12 years old. Space maintainers are so important, in fact, that most insurance companies will pay 100% for them. You will need to check with your specific insurance company for your particular benefits.

What are space maintainers?

Space maintainers hold open the empty space left by a prematurely lost tooth. They steady the remaining teeth, preventing movement until the permanent tooth takes its natural position in the jaw. It’s more affordable-and easier on your child-to keep teeth in normal position with a space maintainer than to move them back in place with orthodontic treatment.

What special care do space maintainers need?

Dr. Nguyen have four rules for space maintainer care. First, no sticky candy or chewing gum. Second, don’t tug or push on it with your tongue or fingers. Third, keep it clean with conscientious brushing and flossing. Fourth, and most important, continue with routine dental care.

What are sealants?

Sealants protect the grooved and pitted surfaces on the chewing surfaces of back teeth. They are made of a tooth-colored resin and are placed on a decay-free tooth to prevent a cavity from forming.

How do they work?

The grooves in permanent molars are narrow and deep. Food and bacteria build up in these crevices, placing your child in danger of tooth decay. Sealant material flows into these grooves sealing them off from the elements, which helps decrease the risk of decay in the chewing surfaces of the back teeth.

How long do sealants last?

Research shows that sealants can last for many years if properly cared for. If your child has good oral hygiene and avoids biting hard objects (ice, pencils, pens), sealants will last longer. Our doctors will check the sealants during routine dental visits and reapply or repair when necessary.

What is treatment like?

The application of a sealant is quick and comfortable. It takes only one visit. The tooth is first cleaned and dried. The sealant material flows into the grooves of the tooth and is hardened with a blue light. Your child will be able to eat immediately after the appointment.

If my child has sealants, can he still get a cavity?

He needs to brush and floss to keep the plaque from all surfaces. He can still get a cavity between the teeth from not flossing where a sealant doesn’t cover. The same plaque that causes cavities can eat through a sealant if left there for long periods of time. That’s why good brushing and regular dental visits are so important to be sure the sealants do their job.

Our doctors use composite resin filling material whenever indicated. Sunbeams Pediatric Dentistry is an amalgam-(silver) free dental practice.

Resin restorations have many advantages over amalgam fillings. Resin restorations require a smaller preparation, which means removing less tooth structure. The material releases fluoride into the tooth to help prevent further decay.

Resin restorations are more technique-sensitive than amalgam fillings and require more care when placing them. We feel your child is worth this extra effort!

We base all of our treatment on what is best for your child and not on specific dental insurance coverage. Your insurance may not cover resin fillings at the same level as amalgam fillings.

The pulp of a tooth contains the blood supply and nerves. A healthy pulp is ideal, but if it is sick, medicine needs to be placed to maintain the vitality of the tooth.

Tooth decay and trauma are the main reasons for a tooth to require pulp therapy. Pulp therapy is often referred to as a nerve treatment, baby root canal, pulpectomy, or pulpotomy. The two common forms of pulp therapy in children’s teeth are the pulpotomy and pulpectomy.

A pulpotomy removes the sick pulp tissue in the pulp chamber only. Once this is removed, medicine is placed to prevent bacterial growth and to calm the remaining nerve tissue. A stainless steel crown is generally placed at this time.

A pulpectomy is required when the entire pulp is involved, down the canals and not just in the chamber of the tooth. During this treatment, the diseased pulp tissue is completely removed from both the crown and root. The canals are cleaned, disinfected and filled with a resorbable material. Then a final restoration is placed.

What is nitrous oxide/oxygen?

Nitrous oxide/oxygen (often called “Laughing Gas”) is a blend of 2 gases, oxygen and nitrous oxide. When inhaled, it is absorbed by the body and has a calming effect. Normal breathing eliminates nitrous oxide/oxygen from the body.

How will my child feel when breathing nitrous oxide/oxygen?

Your child will get to choose from many flavors to smell. He/She will feel calm and relaxed. Your child will be fully awake while inhaling the nitrous oxide.

How safe is nitrous oxide/oxygen?

It is perhaps the safest sedative in dentistry. It is mild, easily taken then quickly eliminated from the body.

Are there any lingering effects or special care after nitrous oxide/oxygen?

No. All the nitrous oxide is completely out of your child’s system by the time the appointment is over. At the end of the appointment the child is given 100% oxygen to breathe for several minutes. After the appointment no special care is required.

Are there special instructions prior to having nitrous oxide/oxygen?

Tell Dr. Nguyen about any respiratory condition that makes breathing through the nose difficult for your child. Also tell our doctors of any medications your child may be taking.

Will nitrous oxide/oxygen work for all children?

Pediatric dentists know that not all children are alike! Some children will not need or benefit from the use of nitrous oxide/oxygen, although most do. Dr. Nguyen have undergone comprehensive training to administer nitrous oxide in a safe environment for your child.

We are very excited to offer our patients the option of having their treatment done with the benefit of in-office IV sedation. A Board Certified Pediatric Anesthesiologist will be present and perform the sedation. Dr. Nguyen will perform all necessary dental treatment.

There are many benefits to having your child’s treatment performed under IV sedation.

• All dental work can be done in one day.
• The child is asleep during the IV sedation. He/She are not aware of the treatment being done.
• He/She go to sleep in their parents arms, and wake up with a parent in the room.
• He/She do not, generally, need to be numb for treatment. This can eliminate the numb feeling following the procedure, which can last up to 4 hours. Young children do not understand this feeling and can potentially chew the inside of their cheek and lip.
• In some cases, medical insurance will pick up some or all of the costs associated with the anesthesia. Parents will need to contact their medical providers to see if this is a covered expense. Once the appointments are booked, the pediatric anesthesiologist can assist in the paperwork concerning this aspect.
• We can take necessary dental x-rays when the child is asleep, which allows us to see if there are more areas affected and to treat such areas at the same time. This may result in a change in the original treatment plan given at the child’s examination visit, but can benefit the child by reducing the need for additional future procedures.

Please go to the anesthesiologist’s website for additional information regarding IV sedation for your child.

What is conscious sedation?

Conscious sedation is a management technique that uses medication to help the child cope with fear and anxiety in order to receive dental care.

Who should be sedated?

Children who have a level of anxiety that prevents good coping skills should be sedated. The very young child who does not understand how to cope in a cooperative fashion for the safe delivery of dental care should be sedated. It is also helpful for some children with special needs.

Why utilize conscious sedation?

Conscious sedation aids in allowing a child to cope better with dental treatment. This can help prevent injury to the child from sudden patient movements and promotes a better environment for providing dental care.

Is sedation safe?

Sedation is safe when administered by a trained pediatric dentist who follows the sedation guidelines of the American Academy of Pediatric Dentistry. Dr. Nguyen will discuss sedation options and patient monitoring for the protection of your child. As with any type of anesthesia, there are risks that our doctors will discuss with you.

Will my child be asleep?

No, your child will be awake during the procedure. The benefit for some children is that conscious sedation can cause an amnesia- like effect. Most children cry throughout the treatment and this should be anticipated. Protective stabilization is used to keep the child safe during the procedure.

What special instructions should I follow before the sedation?

In order to alleviate potential anxiety in your child, our doctors recommend minimal discussion of the dental appointment with your child. Should your child become ill, contact our office to see if it will be necessary to postpone the appointment. It is very important to follow the directions regarding fasting from fluids and foods prior to the sedation appointment.