Dave Atherton, DDS

What Is A Pediatric Dentist?
Dental Emergencies
My child's permanent teeth look yellow, is this normal?

My child has a tooth that is dark. Is this normal?
My child has a "pimple" on the gum!
When will my baby start getting teeth?
Tooth Development
Tooth Development Diagram for quick reference
What is double tooth syndrome?
When should my child have their First Dental Visit?
Why are the Primary teeth so important?
How often should my child brush their teeth?
How do I floss my child's teeth?
What's the best toothpaste for my child?
When are X-Rays needed?
How can diet help my child's teeth?
What are sealants?
What is fluoride?
Does your child grind his teeth at night?
Is thumb sucking harmful to the teeth?
What is the best time for orthodontic treatment?

When are mouth guards recommended?
Disclaimer

Frequently Asked Questions
Dr. Atherton has provided information pertaining to commonly asked questions. Information provided is not intended to be a diagnostic tool but is for general educational purposes only. If you have any questions or concerns about your child's oral health, please contact Dr. Atherton's office or, a pediatric dentist in your area. The American Academy of Pediatric Dentists website (AAPD) can help you locate a pediatric dentist near you.

What Is A Pediatric Dentist?
A pediatric dentist is the dental equivalent of a pediatrician in the medical world and he/she has two to three years of specialized training after dental school. This training is dedicated to the oral health of children from infancy through the teenage years, including those with special needs. The very young, pre-teens, and teenagers all need different approaches in dealing with their behavior, guiding their dental growth and development, and helping them avoid future dental problems. The pediatric dentist is best qualified to meet these needs.

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Dental Emergencies
Toothache: Clean the area of the affected tooth thoroughly. Rinse the mouth vigorously with warm water or use dental floss to dislodge impacted food or debris. If the pain still exists, contact your child's dentist. DO NOT place aspirin on the gum or on the aching tooth. If the face is swollen apply cold compresses and contact Dr. Atherton's office immediately.

Cut or Bitten Tongue, Lip or Cheek: Apply ice to bruised areas. If there is bleeding apply firm but gentle pressure with a gauze or cloth. If bleeding does not stop after 15 minutes or it cannot be controlled by simple pressure, take the child to hospital emergency room.

Knocked Out Permanent Tooth: Find the tooth!! Do not handle or try to clean the tooth. Place it in a zip lock bag with cold, plain, milk and pack ice around the outside of the bag. Call Dr. Atherton's office immediately. Fast action improves the chances of saving the tooth. Don't forget to bring the tooth!

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My child's permanent teeth look yellow, is this normal?
Permanent or adult teeth are normally one to two shades darker than primary teeth and can look odd when compared to the adjacent primary teeth which are often quite white. Adult teeth are usually varying shades of light yellow or sometimes grey but not white.

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My child has a tooth that is dark. Is this normal?
A single tooth that is darker than the other teeth around it is usually a result of trauma. This is quite common on the upper front primary teeth (they get hit a lot!!) and is the tooth equivalent of a bruise. A dark tooth does not automatically mean the tooth is dead! They often return back toward the original color as they heal. If you have any concerns or questions, please contact Dr. Atherton's office.

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My child has a "pimple" on the gum!
This can be a serious condition and is usually a sign that a tooth is non-vital (dead) and has become infected. The pimple is a fistula, or drain, that forms to allow drainage of pus. The tooth involved will usually require a root canal or extraction to remove the source of infection. Antibiotics alone are not adequate for treatment in most cases. Please call the office immediately, if you see this condition.

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When will my baby start getting teeth?
Teething, the process of baby (primary) teeth coming through the gums into the mouth, is highly variable among individual babies. Some babies are literally born with teeth and others won't get a single tooth until age 15 to 18 months. In general, the first baby teeth are usually the lower front (anterior) teeth and usually begin erupting between the ages of 6-8 months. See Tooth Chart below for more details.

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Tooth Development
Children's teeth begin forming before birth. As early as 4 months, the first primary (or baby) teeth to erupt through the gums are the lower central incisors, followed closely by the upper central incisors. Although all 20 primary teeth usually appear by the age of 3 years old, the pace and the order of their eruption will vary among individuals. Permanent teeth begin appearing around age 6, starting with the first molars and lower central incisors. This process continues until approximately age 21. Adults have 28 permanent teeth, or up to 32 including the third molars (or wisdom teeth).

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TOOTH DEVELOPMENT
Link to Tooth Development Diagram.

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What is double tooth syndrome?
This is a condition where a new permanent tooth has erupted and the primary tooth it replaces is still present. Double tooth syndrome will usually self-correct but occasionally requires the dentist to help out by extracting the over-retained primary tooth.

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When should my child have their First Dental Visit?
According to the American Academy of Pediatric Dentistry (AAPD), your child should visit the dentist by his/her 1st birthday. Your child's first visit is usually an “exam only” while being held in the parent's lap. It's intended as a way to review hygiene practices, diet and avoidance of high risk behaviors in regards to the early formation of cavities.

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Why are the Primary teeth so important?
It is very important to maintain the health of the primary teeth. Neglected cavities can and frequently do lead to problems which affect developing permanent teeth. Primary teeth, or baby teeth are important for (1) proper chewing and eating, (2) providing space for the permanent teeth and guiding them into the correct position, and (3) permitting normal development of the jaw bones and muscles. Primary teeth also affect the development of speech and add to an attractive appearance. While the front 4 teeth last until 6-7 years of age, the back teeth (cuspids and molars) aren't replaced until age 10-13.

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How often should my child brush their teeth?
Begin brushing your child's teeth with a little water a soon as the first tooth appears. If you are considering using tooth paste before the child is 2 years of age, ask Dr. Atherton or your physician first. Parents should supervise tooth brushing, twice daily, and make sure children only use an amount of fluoride tooth paste equal to a grain of rice and avoid swallowing it. Children should be taught to spit out remaining tooth paste.

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How do I floss my child's teeth?
Flossing removes plaque between the teeth where a toothbrush can't reach. Flossing should begin when any two teeth touch. You should floss the child's teeth until he or she can do it alone, typically by age 8 to 10 years. Specific techniques will be shown to you at your child's appointment.

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What's the best toothpaste for my child?
When looking for toothpaste for your child make sure to pick one that is recommended by the American Dental Association. These toothpastes have undergone testing to insure they are safe to use. Avoid whitening or desensitizing toothpastes as they have higher fluoride levels and are too abrasive for everyday use in children. Remember, children should spit out toothpaste after brushing to avoid ingesting too much fluoride.. If your child is too young or unable to spit out toothpaste, consider providing them with fluoride free toothpaste, using no toothpaste, or using only a "grain of rice" amount of toothpaste.

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When are X-Rays needed?
Pediatric dentists, acting in accordance with guidelines from the American Academy of Pediatric Dentistry, recommend x-rays only when necessary to protect your child's dental health. For example, x-rays maybe needed to diagnose tooth decay, abnormalities, injury or orthodontic treatment. Dr. Atherton can discuss the need for x-rays.

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How can diet help my child's teeth?
Healthy eating habits lead to healthy teeth. Like the rest of the body, the teeth, bones and the soft tissues of the mouth need a well-balanced diet. Children should eat a variety of foods from the five major food groups. Most snacks that children eat can lead to cavity formation. The more frequently a child snacks, the greater the chances for tooth decay. How long food remains in the mouth also plays a role. For example, hard candy and breath mints stay in the mouth a long time, which cause longer acid attacks on tooth enamel. If your child must snack, choose nutritious foods such as vegetables, low-fat yogurt, and low-fat cheese which are healthier and better for children's teeth.

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What are sealants?
A sealant is a clear or shaded plastic material that is applied to the chewing surfaces (grooves) of the back teeth (premolars and molars), where four out of five cavities in children are found. This sealant acts as a barrier to food, plaque and acid, thus protecting the decay-prone areas of the teeth.

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What is fluoride?
Fluoride is an element, which has been shown to be beneficial to teeth. However, too little or too much fluoride can be detrimental to the teeth. Little or no fluoride will not strengthen the teeth to help them resist cavities. Excessive fluoride ingestion by preschool-aged children can lead to dental fluorosis, which is a chalky white to even brown discoloration of the permanent teeth. Many children often get more fluoride than their parents realize. Being aware of a child's potential sources of fluoride can help parents prevent the possibility of dental fluorosis.
Some of these sources are:

  • Too much fluoridated toothpaste at an early age.
  • The inappropriate use of fluoride supplements.
  • Hidden sources of fluoride in the child's diet.

These sources combined with fluoridated water can increase the chance of fluorosis. The easiest way to determine whether your water is fluoridated is to call you water district's phone number which is listed on your water bill. They can tell you what your fluoride level is. If you do not have fluoridated water, Dr. Atherton will discuss the optimum supplementation with you. Remember, fluoride is valuable and beneficial to the teeth but like anything, it can be over done. When in doubt, call Dr. Atherton!

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Does your child grind his teeth at night? (Bruxism)
Parents are often concerned about their children grinding their teeth at night while sleeping. This grinding can be quite loud! It is essentially normal as nearly all children will do this periodically. If your child is teething, has loose teeth, or is going through a rapid growth spurt they will grind their teeth much more vigorously. Pediatric bruxism is not typically stress related (unlike adults) and usually disappears by age 12 to 14 years old without treatment. In rare cases where heavy tooth wear is present in permanent teeth, a mouth guard may be indicated. Patients with severe digestive problems (G.E.R.D.) and those on ADD medications can fall into this category.

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Is thumb sucking harmful to the teeth?
Sucking is a natural reflex and infants and young children often may use thumbs, fingers, pacifiers and other objects on which to suck. Non-nutritive sucking habits can have a profound effect on your child's orthodontic status. Although most children discontinue these sucking habits on their own before the permanent teeth erupt, some children continue to the point of causing long term problems with the alignment of teeth and jaws. Dr. Atherton can evaluate your child's oral habits and recommend an intervention if necessary.

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What is the best time for orthodontic treatment?
Developing malocclusions, or bad bites, can be recognized as early as 2-3 years of age. The optimum time of treatment will vary with the severity and type of problem and the maturity of the patient. Often, early steps can be taken to reduce the need for major orthodontic treatment at a later age or make the definitive treatment easier to accomplish.

Stage I – Early Treatment: This period of treatment encompasses ages 4 to 6 years. At this young age, we are concerned with underdeveloped dental arches, the premature loss of primary teeth, and harmful habits such as finger or thumb sucking. Treatment initiated in this stage of development is often very successful and many times, though not always, can eliminate the need for future orthodontic/orthopedic treatment.
Stage II – Mixed Dentition: This period covers the ages of 6 to 12 years, with the eruption of the permanent incisor (front) teeth and 6 year molars. Treatment concerns deal with jaw malrelationships and dental realignment problems. This is an excellent stage to start treatment, when indicated, as your child's hard and soft tissues are usually very responsive to orthodontic or orthopedic forces.
Stage III – Adolescent Dentition: This stage deals with the permanent teeth and the development of the final bite relationship.

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When are mouth guards recommended?
When a child begins to participate in recreational activities and organized sports, injuries can occur. A properly fitted mouth guard, or mouth protector, is an important piece of athletic gear that can help protect your child's smile, and should be used during any activity that could result in a blow to the face or mouth. Mouth guards help prevent broken teeth, and injuries to the lips, tongue, face or jaw. A properly fitted mouth guard will stay in place while your child is wearing it, making it easy for them to talk and breathe. Ask Dr. Atherton about custom and store-bought mouth protectors.

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Disclaimer
Dr. Atherton's web site is provided for contact information and educational purposes only. It is not intended to replace regular checkups or, the consultation of a pediatric dentist therefore, no diagnosis, treatment, warrantees or guarantees are being provided on this web site. Specific dental advice may only be provided under the care of a licensed practitioner in your state. Information and names within this site may be subject to copyright and trademark protection with all rights reserved.

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Dr. Dave and his staff