Delmarva Dental Services considers the treatment of children to be a very important responsibility. Unpleasant dental experiences as a child can cause adults to be apprehensive in seeking dental care. Our goal is to make every appointment a pleasant experience. Our pediatric dentist recommends an ‘Early Child Exam’ visit for children 6 months to 3 years of age. This is a ‘show and tell’ introduction to the dental environment. As these children become more comfortable with our office surroundings and staff, we gradually introduce other services such as x-rays, fluoride treatments and preventive sealants. Each child will become familiar and comfortable in his or her own time. Therefore, we make an effort not to rush them. Early dental visits will also help prevent future problems in dental health. Dietary and oral hygiene habits, fluoride intake, and cavity susceptibility are assessed. In addition, oral habits and airway evaluation help us determine potential teeth and jaw developmental problems. Diagnosed at an early age, this approach will save you time and money. It will also prevent your child from unnecessary treatment and allowing them to grow up with a positive attitude toward dental care instead of dreading the thought of going to the dentist.

Early Childhood Examination
Pediatric Fillings
The Early Years
When should children first visit the dentist?

Early Childhood Examination

This is an appointment designed for children under 3 years old who have never been to the dentist. It is a positive “get acquainted” visit with the hygienist. We proceed cautiously in a stepwise manner, not going beyond what the child will tolerate. An infant and many toddlers will sit in their mom or dad’s lap in the dental chair. We first show them the dental chair and light. Then ask them if they want to take a ride in the chair and show their face on a video screen. Next, the hygienist counts and shows them their teeth on a video screen using an intraoral camera. Then we ask them if we can tickle their teeth with a “tooth tickler” and we may polish one and then more teeth with a dental polisher. The hygienist can stop at any point along the way if the child feels anxious. We go over brushing technique with the child and/or parent and recommend a specific toothbrush for their age. We will discuss diet and things you can do at home to clean the teeth. We may discuss the family’s cavity rate and the use of the probiotic, Evora. The dental hygienist discusses the fluoride level in their drinking water with the parent and recommends a fluoride supplement if needed. We may give a fluoride treatment or take x-rays depending upon the child’s age and level of cooperation at the next visit. The most important goal is to make every dental visit a positive and pleasant experience for your child, so he or she will look forward to their next visit.

Pediatric Fillings

Delmarva Dental Services wants children to enjoy coming to the dentist without any fears or apprehension. We plan on achieving this by initially performing simple procedures, progressing to the more complicated ones. Prior to scheduling children for the first filling appointment, we usually schedule them with a hygienist to place preventive sealants. This allows time to become familiar with the instruments, holding their mouth open, staying still, having cotton rolls in the mouth and tolerating unpleasant tastes. It also lessens the chance of needing fillings in the future. When several fillings are needed, we start out with the easiest, progressing to the more complicated and even to multiple fillings. Of course every child is different and we evaluate each one individually. This allows us to customize our treatment accordingly. In order to make children’s dental visits comfortable, the staff will need the help of parents, caregivers, and siblings. Statements with the intent to lessen fear can actually cause children to be apprehensive, create suspicion and mistrust, or have anxiety toward the dental visit. It’s important not to use such phrases as: “It won’t hurt.” “If you’re really good I’ll give you a prize.” or “It only stings for a minute.” Relating your own dental experiences can do the same and are not relevant to what will necessarily take place. Of course, teasing a child about what might happen is even worse. Children are able to sense a parent who is fearful, regardless of the attempts to hide the fact. Many times during treatment a fearful parent, attempting to comfort an unafraid child, will make statements or place their hand on the child. This can unintentionally alarm a child. Our staff sympathizes with concerned parents but our primary goal is for the child to have a pleasant experience. When a parent is fearful, it is best for a more relaxed parent to bring the child or for the fearful parent to remain in the reception area during treatment.

So, what can you say to a child? Don’t offer explanations unless asked and try to say as little as possible. Use positive statements like, “You are going to get a pretty white filling.” “The dentist is going to fix the hole in your tooth.” Do not mention needles, drills, or pain. State that the dentist and his assistants are nice, care about you, and are fun. Your cooperation will help ensure a pleasant dental experience for your child and minimize his or her fear of the dentist; thereby, allowing you a pleasant experience also.

The Early Years

Does your child show any of the following signs? A narrow upper arch, causing crooked teeth, can be the result of:

Upper respiratory restrictions such as infected tonsils, adenoids, asthma, and allergies.
Thumb, finger, or blanket sucking.
Tongue-tied: this is where the tip of the tongue is attached to the floor of the mouth.
Tongue thrusting (irregular swallowing pattern).
Extended pacifier use.
A narrow lower arch, caused by a narrow upper arch.
The lower jaw is too far back.
Upper jaw and teeth protrude out or retract too far back.

Why should these problems be considered for correction, between the ages of 3 to 10 years old?

During this time, the bones in the head are still developing. Sometimes nature needs a little help to get the upper and lower arches in correct alignment with the skull, making this the opportune time to take corrective measures.
The pre-maxilla, the front part of the upper arch, stops growing between the ages of 8-10 and 80% of all facial growth is done by age 10.
When the maxilla, the upper arch, and the vertical dimension are correct, this allows the lower jaw to grow properly, laying the foundation necessary to achieve that full, beautiful smile.

Advantages of having a full, beautiful smile:

Lowers the risk of injury to protruded upper teeth
Improves the width of dental arches
Reduces social pressures caused by the appearance of the teeth
Improves fullness (support) of the lips
Influences growth of the jaws in a positive manner
Guides permanent teeth into better positions
Improves speech
Increases the stability of treatment results
Improves lip closure
Reduces the probability of impacted teeth
Reduces the need to extract permanent teeth
Reduces the need for jaw surgery
Reduces the potential of damage to the jaw joints (TMJ)
Takes advantage of the growth period before reaching the teenage years
Shortens the time a patient has to be in braces achieving better results

Corrective procedures by parents:

Stop the use of pacifiers: There are techniques and devices available to help the parent and child understand the damage of pacifier use.
Deform the tip of the pacifier (cut the tip off little by little making it unusable).
Stop the child from sucking a thumb or finger by applying unpleasant tasting solutions bought over-the-counter on the thumb or finger. Thumb or finger blocking gloves can be worn as a preventative measure. For more information on TGuard go to http://tguard.com/.
Correcting respiratory or allergy problems: Breathing should be done thru the nose, not the mouth. Talk to your child’s doctor, ENT, or allergist concerning possible corrective procedures. We can supply you with a “Respiratory Packet” for more information. Part of this packet includes the book “Your Mouth, Your Life” by David Page. Visit his website at www.smilepage.com
Correcting a “tongue tied” condition: Most general dentists or oral surgeons can perform this simple procedure.
Correcting a tongue thrusting habit: After correcting the cause, exercises can then be used to eliminate the lingering habit. Just call 410-742-3000 or e-mail us at dds@delmarvadentalservices.com for a list of exercises.
Correcting a “mouth breathing” habit: Once the reason for the mouth breathing has been identified and corrected, put tape over closed lips for a period of time each day. This is not cruel treatment and can assist in retraining the child to breathe through the nose. A list of these exercises is also available from our office. The appliance that can be used for correcting mouth breathing is the T4K, a rubber type of removable appliance that is worn 1 hour a day and all night. It helps train the tongue to move into its proper position during swallowing and develops the arches properly by attempting to keep the lips together.
Widen narrow arches: The use of expansion appliances, either removable or fixed for upper and/or lower arches.

When should children first visit the dentist?

It is important for every child to visit the dentist early. The Center for Disease Control (CDC) study found 19.5 percent of children ages 2-5 have untreated cavities. A 2013 study for Delta Dental found the average age a child visits the dentist is 2.6 years. Unfortunately, waiting until after 2 years of age may result in a toothache or the need for a filling. This can be prevented by following the American Dental Association and American Academy of Pediatric Association’s recommendation for the first dental visit being between age 6 months and 1 year. At Delmarva Dental Services we even have an “Early Child Examination” specifically for children under 3 years. Early dental visits have the following advantages: reduces the chances of having cavities, the child has a better dental experience, the child ends up less fearful of the dentist and there is less chances of needing braces later

Children’s Dentistry