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Your child shines with every smile. Let's keep it that way. A lifetime of healthy teeth starts with good brushing habits, good nutritional choices, and trust in the dentist. By teaming up with you, we can ensure that your child has a vibrant smile all the way into adulthood.

Your First Visit
pediatric dentistry pc office waitingroom10During your child's first visit to our office, you may have some questions to ask us. We are happy to answer your questions at any time. Many parents ask us the following questions. We hope these answers will be helpful to you and to your child.

How may I best prepare my child if this is his/her first visit and what is the procedure at this visit?

You can prepare your youngster for his/her first visit to the dentist in several ways. Try to act relaxed and at ease. Children may sense a parent's anxiety. Tell your child that we will "count" and "take pictures" of his/her teeth. Do not use any fear-provoking words, such as "hurt," "drill," "pull," or "needle." Avoid statements like the "doctor will not hurt you." (If someone says to you, "Don't think of a banana," what is the first thing you think of? A banana! It's the same with the word "hurt.")

We will thoroughly explain each of our procedures to your child in terms of that he/she can understand. Be assured that we will treat your children as caringly as we treat our own.

Boy in red shirt thumb upAt this first visit, we will emphasize oral hygiene techniques to be practiced by both you and your child. We will answer any questions you may have. Depending on your child's age, comfort, and level of cooperation, we may do a cleaning and a fluoride treatment. We will perform a full examination of the teeth and gums and we will also evaluate their bite.

X-rays will be taken as necessary to ensure a thorough and comprehensive examination. Subsequent appointments for any necessary dental treatment will be scheduled as needed. When dental treatment has been completed, your child will be placed on a periodic exam schedule and you will receive a reminder card when a visit is due.

At the conclusion of your child's exam, the doctor will meet with you to explain her findings and recommend a course of treatment, if necessary. Before you leave the office, our financial secretary will discuss fees and payment options. Your goals as a parent and our goals as dentists are the same — to keep your child's teeth and mouth in good health and to make that process pleasant for everyone.

What is your philosophy of treatment?

Boy brushing teeth with orange toothbrushOur emphasis is on prevention, both in the dental office and at home. We recommend regular periodic exams and cleanings, and thorough home care routines. Home care includes limiting sweets, brushing two times a day, flossing at least once a day, and sometimes a topical application of fluoride. Because the primary teeth form the basis of the adult dentition, we will do everything possible to preserve the integrity of your child's dentition while fostering a healthy and relaxed attitude toward dental care.

Ortho BracesAPainToday, orthodontic treatment is being taken more seriously at a younger age than it was when we were kids. In our day, it was normal to see the orthodontist for the first time during our teen years and to go through high school with metal braces. Today, the recommendation is to see the orthodontist as soon as a child's permanent teeth come in, which could be around the age of 6 or 7.

Why the Earlier Treatment?

Orthodontists today consider the time that a child's bone structure is still developing to be the best time to determine changes that need to be made. This does not mean that all kids will receive orthodontic treatment immediately following this first appointment; it is simply a good idea to get things started early in order to determine the best treatment plan for your child.

In addition, orthodontic treatment that takes place early in a child's life, while their jaw is still developing, can help to prevent overcrowding. Since this is such a prevalent problem in children, it can be an amazing treatment for some kids. This could prevent the need to extract teeth, which was the more traditional treatment method when going through braces. The ability to help the jaw expand and permanent teeth to erupt in their correct positions is a step forward for orthodontic treatment, and could help many kids today avoid those awkward teenage years with braces.

Root Canals
The Problem
Endodontist patientendo3Decay that has reached the nerve/pulp of the baby tooth.

The Solution
Like adult root canals, the dentist will access the nerve chamber of the tooth, and remove some of the nerve/pulp of the tooth. Unlike adult root canals, this is a very short procedure, as only part of the pulp needs to be removed, and does not require the time-consuming filling of adult root canals.

If the tooth has been symptomatic, this procedure will likely alleviate the pain. It also allows for the tooth to be preserved until it is ready to fall out naturally.

Pulpotomies have a 90% success rate. Occasionally, the nerve of the tooth is so badly damaged that it does not respond to pulp therapy, resulting in the need for extraction of the offending tooth. Certain circumstances increase the likelihood of failure with pulpotomies. Your dentist will discuss your child's situation with you during diagnosis.

Alternatives to Pulpotomy

The only alternative to a pulpotomy is extraction and placement of a space maintainer. However, if it is possible to save the baby tooth, this is the best alternative because it preserves the appropriate spacing for the adult dentition.

Close up of composite filling being set with bright lightThe grooves and depressions that form the chewing surfaces of the back teeth are extremely difficult, if not impossible, to thoroughly clean removing all bacteria and food. As bacteria reacts with the food, acids form and break down tooth enamel, causing cavities. Recent studies indicate that 88 percent of total cavities in American school children are caused this way.

Tooth sealants protect these susceptible areas by sealing the grooves and depressions, preventing bacteria and food particles from depositing in these areas. Sealant material is a resin typically applied to the back teeth, molars, premolars and areas prone to cavities. It lasts for several years, but needs to be checked during regular appointments.

Special Needs
Little girl trying to floss her teethAt Pediatric Dentistry of Portland, we work with children who have a wide range of needs. Many children (including patients diagnosed with high anxiety) can benefit from a graduated introduction to dental visits and dental care, particularly if it is their first experience.

The Special Needs Child
A knowledgeable dentist can help prepare you and your child for changes in oral structures, issues with feeding, and future development changes.

Some children lack the ability to fully open their mouths due to jaw development and may have difficulty brushing and flossing regularly, leaving them at risk for developing cavities. Children with sensory challenges may be averse to the texture or sensation of toothpaste and a toothbrush. Other children may have a limited diet higher in sugar which can affect oral development.

Finding a dental team that listens, becomes a therapeutic partner, and has resources available to families is key in establishing a life-long relationship toward the health of your child.

Sedation Dentistry
For children with special needs or high anxiety, our office provides several methods of sleep dentistry to calm their fears; call our office to learn more about sedation dentistry.

Healthy Dental Tips

Baby in striped shirt holding toothbrush in mouthIf you are the parent of a small child, you've already discovered that establishing habits early saves a lot of grief later. Did you know that you can begin motivating children toward good oral health practices as young as two years of age?

According to an article on the American Academy of Pediatric Dentistry website, 40-50% of children "will be affected by tooth decay by age five." Such conditions can mean loss of school hours for a child and loss of work hours for parents. Taking a little time here and there to begin oral health training could save your child from needless suffering and save you time and money.

Here are a few tips for making dental care more fun:
•  Help apply the correct amount of toothpaste and brush your teeth alongside your child
•  Buy your child a toothbrush with a small head and extra-soft bristles
•  Let your child choose a toothbrush
•  While your child brushes, play a favorite song or tell a two-minute story to establish the recommended length of time for brushing
•  Make sure each day includes crunchy vegetables and fruits. Offer these when you know your child is hungry
•  Schedule regular checkups and encourage your child to ask the dentist a question or two. We love to talk with kids about anything — not just teeth!

Encouraging good nutrition, routine dental care and regular dental visits will help your child adopt good oral health habits early and naturally.

Baby in orange shirt with two teeth smilingIt's important to teach your child good oral hygiene habits early, because cavities can start even before babies have visible teeth! Babies have 20 primary teeth that are already present in the jaws when they're born. Primary teeth start coming in around 6 months of age, and create a healthy foundation for adult teeth by maintaining space in the jaw.

What About Baby Teeth?
If a primary (baby) tooth is lost too early, the permanent (adult) teeth can start to move into the empty space and make it difficult for the other permanent teeth to find room when they come in. This leads to crooked or crowded teeth. Starting your baby off with the best oral care can lead to a lifelong healthy smile. Remember, both the American Academy of Pediatric Dentistry and the American Dental Association recommend that your child have their first visit no later than age two.

How Do Cavities Start?
Little girl wearing glasses with arms crossed smilingCavities form when germs that feed on sugar and produce acid begin to eat away at the tooth enamel. If left untreated, cavities can continue to develop into the dentin and eventually the pulp, which can cause your child pain.

Babies are born without these harmful bacteria in their mouth, and studies have proven that parents typically infect their children before age 2. Bacteria is transferred when parents eat from the same eating utensil as their baby, or when they hold their toddler's pacifier in their mouth. If parents have had cavities themselves, they are more likely to have cavity-causing germs to pass along.

The teeth, bones and soft tissue of the mouth require a healthy, well-balanced diet. A variety of foods from the five food groups helps minimize (and avoid) cavities and other dental problems. Most snacks that children eat cause cavities, so children should only receive healthy foods like vegetables, low fat yogurt and cheese, all of which promote strong teeth.

Tooth Decay Prevention
Mother helping Daughter to Brush TeethTooth decay is a progressive disease resulting from the interaction of bacteria that naturally occur on the teeth and sugars in the normal diet. Sugar causes a reaction in the bacteria, causing it to produce acids that break down the minerals in teeth, forming a cavity. Dentists remove the decay and fill the tooth using a variety of fillings, restoring the tooth to a healthy state. Nerve damage can result from severe decay and may require a crown (a crown is like a large filling that can cap a tooth, making it stronger or covering it). Avoid unnecessary decay by strict adherence to a dental hygiene regimen: brushing and flossing twice a day, regular dental checkups, healthy diet and fluoride treatment. Practicing good hygiene promotes healthy teeth and avoids costly treatment.

Preventing Baby Bottle Tooth Decay
Tooth decay in infants can be minimized or totally prevented by not allowing sleeping infants to breast or bottle-feed. Infants that need a bottle to comfortably fall asleep should be given a water-filled bottle or a pacifier. Our office is dedicated to fighting baby bottle tooth decay. Let us know if you notice any signs of decay or anything unusual in your child's mouth.

Child wearing striped shirt sucking thumbFluoride is a substance that helps teeth become stronger and resistant to decay. Drinking water treated with fluoride and regular brushing and flossing lowers the risk of cavities.

Dentists can evaluate the level of fluoride in a primary drinking water source and recommend fluoride supplements (usually in the form of tablets or drops), if necessary.

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Portland, Oregon 97232

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