Dental Topics & FAQ

What is a Paediatric Dentist?

A paediatric dentist focuses on oral health and unique needs of young people and limits his/her practice to treat children only. Paediatric dentists have an additional three years of specialised training (after the required 5 years of dental school) to acquaint them with the special needs and remedies available to children.

Children are not just smaller version of adults. There are many significant differences between an adult’s and a child’s anatomy, physiology and psychology. Special oral care knowledge is required to treat infants and children through adolescence, including those with special health needs.

We are concerned about your child’s total health care. Good oral health is an important part of total health. Establishing us as your child’s “Dental Home” provides us the opportunity to implement preventive dental health habits that keep a child free from dental/oral disease. We focus on prevention, early detection and treatment of dental diseases, and keep current on the latest advances in dentistry for children.

Pleasant visits to the dental office promote the establishment of trust and confidence in your child that will last a lifetime. Our goal, along with our staff, is to help all children feel good about visiting the dentist and teach them how to care for their teeth. From our special office designs, to our communication style, our main concern is what is best for your child.

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Early Infant Oral Care

When should I bring my child for the first dental visit?
Children should visit the dentist by their first birthday. Children who have established a “dental home” early are more likely to receive appropriate preventive and routine oral health care. They are also more comfortable and relaxed at the dentist as they get familiar with the environment.

When will my Baby Start Getting Teeth?
Most babies start to get their first tooth by 6 month of age. All 20 baby teeth would usually be in the mouth by 3 years of age.

When should I start brushing my baby’s teeth?
You should start cleaning your child’s teeth as soon as they appear. A small, pea-size dab of fluoride toothpaste can be used. On outer and inner surfaces of the teeth, place toothbrush at a 45-degree angle and start along gum line; use gentle, short, strokes against the gumline. On chewing surfaces, hold the brush flat and brush back and forth.

When should I floss my child’s teeth?
Flossing daily removes plaque and food particles between teeth and below the gumline. You should start flossing your child’s teeth even when they have only their primary teeth, especially their teeth have no or minimal space between them. You will have to help your young children to floss as many children do not have the manual dexterity of manipulate the floss.


Why are Primary Teeth so Important?

Keeping baby teeth healthy is important because some of these teeth may remain in the mouth until your children are 12 or 13 years old.

Baby teeth help children to chew properly and to speak clearly. They also save space for the developing adult teeth under the gum so that when it is time for them to erupt they will appear in the proper positions in the mouth.

If tooth decay occurs as the baby teeth are not well taken care of, the child may experience pain and could develop an infection such as an abscess. Dental decay will never get better because we never stop eating/drinking, which provide carbohydrate sources for the germs. It is simpler to fix and costs less when the decay (hole) is small. When left untreated or too late, teeth become infected, which require Root Canal Therapy or Extraction. These treatments are difficult and costly. Space maintainer is usually required after the extraction of back molar because the space tends to close and there is problem with adult teeth being impacted. This would require future orthodontic expansion of the space. Sometimes, orthodontic space opening does not work, which necessitates surgical removal of impacted adult tooth. Infected baby teeth may also affect normal development of adult teeth lying directly underneath. Children with decay may have problems eating, sleeping and focusing because of this pain and as a result, may not grow and develop normally.

A child with visible decay may become self-conscious and not want to smile or laugh.


Eruption of your child's teeth

The twenty baby teeth are already forming before birth. A baby’s front four teeth usually erupt first. Most babies start to get their first tooth typically by about 6 to 9 months of age, although some children don’t have their first tooth until 12 months old. The rest of the twenty baby teeth appear in pairs along the sides of the jaw until the child is about three years old. The pace and order to their eruption varies. All 20 baby teeth would usually be in the mouth by 3 years of age.

The first permanent teeth begin to erupt at about 6 years of age include molars behind the back baby teeth along with lower central incisors. Some permanent teeth replace baby teeth and some don’t. This process will continue until approximately age fourteen. In many cases, it is not the age that primarily determines eruption of teeth, but the available space from individual jaws that house the teeth. It is important to allow enough time for natural growth of the jaw to occur.

Don’t worry if some teeth are a few months early or late as all children have different eruption patterns.

Flossing daily removes plaque and food particles between teeth and below the gumline. You should start flossing your child’s teeth even when they have only their primary teeth, especially their teeth have no or minimal space between them. You will have to help your young children to floss as many children do not have the manual dexterity of manipulate the floss.


Dental Radiographs (X-rays)

Radiographs (x-rays) are vital for a complete examination of your child. There are many “hidden” problems that cannot be detected by a clinical exam, eg. cavities between the teeth, disease of the nerves and roots of the teeth, missing teeth etc. Radiographs allow the dentist to diagnose these problems and treat them accordingly.

It is recommended that radiographs and examination every six months for children with high decay risk. On average, radiographs can be obtained every year for children that have moderate and low decay risk. Our digital radiograph system at the office significantly reduces radiation exposure to your children. Together with other protective devices, such as lead aprons and shield, the risk of radiation is negligible. In fact, the dental radiographs represent a far smaller risk than an undetected and untreated dental problem.


Why are Dental X-rays necessary?
X-rays are often the best way to identify problems that aren’t externally visible. X-rays are very essential in doing a complete and thorough dental examination. They are especially important in diagnosing serious conditions early to allow for effective treatment before you experience discomfort. X-rays show bone anatomy and density, decay between the teeth or how extensive the decay is, whether an abscess is present, impacted teeth, or if children have permanent teeth.

What's the best toothpaste for my Child?

One of the best ways to keep your child brushing is by having fluoride toothpaste on hand that is pleasing and easy to use. The taste can make brushing a more enjoyable experience, leading to more thorough brushing.

It is important to brush your child’s teeth twice a day with a fluoridated toothpaste to help strengthen tooth enamel.



Does your child grind their teeth at night? (Bruxism)

Children often grind their teeth when their teeth are erupting. This is not uncommon, nor is it a problem if it is mild. However, more severe cases can lead to a malocclusion. Malocclusion generally leads to a need for Orthodontics or the child can develop TMJ problems.

If you have any concerns about your child’s grinding of teeth, be sure to have Dr. Chinh or his Associates check for signs of excessive wear so an effective treatment can be used to prevent serious problems.



Thumb or Pacifier Sucking

Why Do Children Suck Their Thumbs/Pacifier?
Children suck on things because sucking is one of a baby’s natural instincts. Sucking makes them feel secure and content, and may induce drowsiness. Prolonged thumb sucking (or pacifier sucking) interferes with the proper growth of the mouth and the alignment of the teeth. This improper development, if not corrected, will change the appearance of the child’s face.

Can problems result from prolonged thumb or pacifier sucking?
The intensity of the sucking is a factor that determines whether or not dental problems may result. Children who rest their thumbs passively in their mouths are less likely to have difficulty than those who vigorously such their thumbs. Some aggressive thumb suckers may cause problems with their baby teeth. The good news is as long as your child stops the habit before the permanent front teeth come in (at around 5-6 years old), there should not be any lasting changes on the alignment of teeth and jaws.

Pacifiers can affect the teeth essentially the same way as sucking fingers and thumbs. However, pacifier use is often an easier habit to break.

What should I do with my child’s thumb sucking or pacifier habit?
Most children stop on their own between the ages of two and four years. Sucking thumbsuckinggradually lessens during this period, as children spend more of their waking hours exploring their surroundings. If your child does not stop on his or her own, you can try to discourage the habit by age four.

You can consider:

• Instead of scolding your child for thumb sucking, praise him when he doesn’t suck his thumb, especially during difficult periods.
• Remember that children often suck their thumbs when feeling insecure or seeking comfort.
• Focus on correcting the cause of the anxiety and comfort your child.
• Reward your child when he or she avoids sucking during difficult periods, such as being separated from you.
• Explain to older children the dangers of thumb sucking and involve them in choosing the method to break the habit.

If you need help stopping your child’s thumb sucking habit, we can provide you with a patient-friendly dental appliance that will break the habit. Contact Us for more information and an appointment.

What is Pulpotomy?

When the nerve of a primary tooth becomes infected or abscessed, a pulpotomy or pulpectomy is necessary to save the tooth. During a pulpotomy the infected part of the nerve is removed and a sedative medication is placed inside the tooth to prevent sensitivity and to promote healing. A pulpectomy requires the total removal of the nerve. (In permanent teeth this is referred to as Root Canal Therapy).

A tooth may become abscessed from deep decay, a cracked or broken tooth, or trauma. The only alternative to Pulp Therapy is an extraction.

After the primary tooth has undergone Pulp Therapy it is more brittle and must be crowned to give the tooth strength for chewing pressure. Brush and floss the tooth the same as the other teeth and visit your paediatric dentist regularly for preventive check-ups.


What is a Stainless Steel Crown?

Stainless Steel Crowns are placed on primary teeth to protect, seal and strengthen a tooth:

• After large decay has been removed
• After a pulpotomy has been performed
• To correct a malformed tooth
• To preserve a tooth with severe attrition

Stainless steel crowns are considered a good temporary restoration to save the primary tooth until the permanent tooth can erupt and take its space. Keeping the primary tooth if at all possible is very important.

A primary tooth can be restored with a stainless steel crown during one appointment. The decay is removed, the tooth is shaped for a crown then the crown is cemented. A crowned tooth must be brushed and flossed just like other teeth.


What is a Space Maintainer?

When a primary tooth is lost prematurely the teeth can drift into the new space crowding out the permanent tooth that is supposed to erupt into that space in the future. A space maintainer keeps baby teeth from shifting into the space where the tooth was lost so the permanent tooth can erupt in its natural proper space. As the permanent tooth erupts, your paediatric dentist will remove the appliance.

Space maintainers can help eliminate the need for extensive orthodontics in the future.


Info For Teens

Teenage Teeth Facts
At this age you now have teeth that will be with you for the rest of your life. By caring for them appropriately you can ensure the brightest, healthiest smile possible.

You have not outgrown cavities – Teens can actually have a higher incidence of tooth decay due to frequent snacking, busy schedules, and poor nutrition.

Healthy smiles are attractive – Not only is a clear, white smile a sign that you care about how you look, but nobody finds yellowing teeth, swollen gums, or bad breath attractive. Brushing, flossing, and keeping your dental appointments every 6 months are all important aspects of keeping your smile healthy and beautiful.

Movie star mouth – It seems that celebrities all have perfectly straight, white teeth. If you have concerns about crooked or yellowing teeth, consult your dentist regarding the various treatments available to create your best smile. If you take care of your teeth now, they will look good for a lifetime.

Teen FAQs
How much time do I have to spend brushing my teeth? – At least two to three minutes twice daily. Don’t forget to brush your gumline and floss once a day as well. You’ll have your teeth for the rest of your life and it’s up to you to keep them bright and beautiful. A few minutes a day is a small price to pay for a lifetime of beautiful and healthy teeth.

Do sugary snacks really hurt my teeth? – The more often you eat between meals, the more plaque forms on your teeth. Sugar is the most cavity causing choice that you can make. Try to choose foods that are less damaging and more nutritionally balanced, like fruits, vegetables, or nuts. Your teeth will thank you and so will your body. If you can’t avoid snacking between meals, be sure to brush your teeth after you eat or drink.

I play sports, is it really that important to wear one of those mouthguards? – Yes. A custom fit mouthguard from your dentist (or even a store bought version) can prevent tooth damage, tooth loss, certain brain injuries, not to mention the pain and healing involved in any dental injury. Professional athletes wear them to protect their smiles, and so should you.

Is smoking really that bad for my teeth? – Smoking can cause gums to recede, teeth to yellow and rot, tongue sores, and mouth cancers. Not only will you look and smell bad, but you can die from it. So yes, it’s a bad choice to make. Better never to start than to become involved in something that could negatively affect the rest of your life.

Will getting a mouth piercing affect my teeth? – A lot of kids think piercings are cool, only to find out that it is a serious medical issue to put holes in your body. If done improperly your tongue or lips can become infected and swollen, your airway could become blocked, or you could even have your teeth cracked by metal studs or jewellery pieces.


- Brush your child’s teeth at least twice a day: after breakfast and before bed. Use a pea-sized amount of fluoridated toothpaste on your child’s toothbrush and encourage kids brushingNOT to swallow.
- Continue to help your child brush until at least age nine or older.
- Replace your toothbrush every three months and always use a new toothbrush after you’ve had a cold

- Flossing cleans between the teeth where the toothbrush cannot reach.flossing
- Help your child floss his/her teeth once a day: Ease floss in between the teeth. Curve the floss around the tooth at the gumline and gently sweep up and down.

Good Diet = Healthy Teeth
Putting a child to bed with a bottle containing formula, milk, juice or soda or sleeping with your child so that they breast feed at will can lead to nursing caries. Unswallowed sweet liquids in the mouth support bacteria that attack the teeth and can lead to severe caries. Protect your child from early childhood caries by putting them to sleep only with a pacifier or a bottle of water.

Sugar is not only found in lollies and chocolate!
- Bacteria in the mouth convert sugar and starch from our food into an acid which causes snackscavities.
- Watch for hidden sugars and starches in many natural or processed foods like fruits, vegetables, crackers, potato chips, peanut butter and sauce.
- Your child does NOT have to give up all foods with sugar or starch. Just limit the frequency of snacking to no more than 2-3 times a day: The more a child snacks and nibbles; the greater chance of having cavities.

Eat Smart!
- Food with sugar or starch is safer for the teeth if it is eaten with a meal, not as snack. Avoid eating sticky foods, such as fruit snacks or toffee because they are not easily washed away from the teeth by saliva or water.

- Fluoride is effective in preventing cavities when combined with a healthy diet and good oral hygiene. It slows down enamel breakdown and makes the teeth more resistant to bacterial acid attack.

Orthodontic Topics

What is Orthodontics?
When describing orthodontics, most people just refer to braces. While the majority of orthodontic cases involve braces, there are alternatives that may be used for younger children. Arch expanders and training appliances for younger children can minimise or eliminate the need for braces when problems are treated early enough.

What are the Benefits of Orthodontics?
- Reduce the risk of injury – prominent teeth are more prone to trauma
- Reduce the risk of decay – crooked teeth are harder to clean
- Reduce the risk of developing TMJ problems
- Eliminate the excessive wear on your teeth that can be caused by a poorly aligned bite
- Correcting abnormal tooth alignment can help prevent certain speech problems
- Straight teeth provide a healthier, more attractive smile
- A beautiful smile increases confidence and self-esteem

What is an Orthodontic Evaluation?
Orthodontic treatment with braces begins with an evaluation appointment. Dr. Chinh will first visually determine if your child is a good candidate for orthodontic treatment, or if another treatment would be more appropriate. If your child is a good candidate for orthodontic treatment, Dr. Chinh will take impressions of your child’s teeth, special x-rays of their jaw joint, head and teeth, and very important measurements of their teeth and mouth.

Next is a consulting appointment to discuss the treatment plan. The treatment plan is based on the records taken at the evaluation. The consult includes:
- Specific treatment recommendation
- Expected length of treatment
- Expected cost of treatment

When should My Child be Evaluated?
If your child develops an “open bite”, sucks their thumb, has a noticeable tongue thrust, or you are otherwise concerned about the development of your child’s teeth, no matter what the age, contact us right away for a consult with Dr. Chinh. Otherwise, children should be evaluated by the age of 6 for orthodontic treatment. In the past, a child was 11 or 12 before brackets were actually placed on the teeth to straighten them. This may still hold true in most cases, but there are new techniques that can correct problems early, while a child is still growing. This may eliminate the need for braces in the future, or if the child does still need braces, the treatment will be less complicated, usually shortening the period of time.

What is an Arch Expander?
An Arch Expander is one example of orthodontic treatment available for younger patients. Many times an arch expander can be used to create a proper alignment of the arches so permanent teeth have room to erupt in a natural position. The use of an arch expander will generally minimise or eliminate the need for braces when the patient gets older.

What are Braces?
Braces are retainers, bonded brackets, arch wires and elastic bands that move crowded or spaced teeth into a “normal” position for appearance, prevention and function. Patients with poorly aligned teeth tend to have much more tooth decay, gum disease and jaw joint problems. Recently invented brackets and new techniques make orthodontic treatment faster and more comfortable than ever.

How do Braces work?
Over a period of time, teeth will shift if constant, gentle pressure is applied. Brackets are bonded to the front surface of each tooth and wires are attached to the brackets with elastic bands. The slight tension on the wire is gently transferred to the bracket through the elastic band.

What are Retainers?
Once the teeth have been moved into proper position, a retainer is sometimes used to keep the teeth in place until they have “settled”. Retainers can be fixed (bonded to the teeth) or removable.