Pediatric FAQ

The American Academy of Pediatric Dentistry recommends a first visit by the first birthday or within six months of the first tooth coming in. We see children from age 2 and up, so if your child is younger, your pediatrician or a pediatric dentist can do that first check and we will take over at 2. Bringing a 2 year old in for a simple ride in the chair and a tooth count sets up every visit that follows.

Cold and firm pressure, in that order. A chilled (not frozen) teething ring, a clean cold washcloth to gnaw on, or a clean finger rubbed firmly along the gums all work. Children's acetaminophen or ibuprofen at the dose your pediatrician recommends is reasonable for a rough night. Skip benzocaine and lidocaine teething gels, which the FDA has warned against for young children, and skip amber teething necklaces entirely because of choking and strangulation risk. One more thing worth knowing: teething causes drooling, fussiness, chewing, and sometimes a slightly raised temperature, but it does not cause a high fever or diarrhea. If your baby has those, call your pediatrician.

Yes, and this is the question we answer most often. Baby molars stay in the mouth until roughly age 10 to 12, so a cavity at 5 has years to cause trouble. Untreated decay leads to pain and infection, can damage the permanent tooth forming underneath, and interferes with eating, sleeping, and school. Losing a baby tooth early also lets the neighboring teeth drift into space the permanent tooth was going to need, which turns a small filling into an orthodontic problem later.

Most children stop on their own between ages 2 and 4, and before then it is generally not worth a fight. It becomes a dental concern if it continues past about age 4, when permanent teeth are on the way, because sustained sucking can push the front teeth forward and narrow the shape of the palate. What works is praise rather than punishment: find the trigger (usually tiredness, boredom, or stress), offer a substitute, use a gentle physical reminder at night such as a sock or bandage over the thumb, and let your child be a partner in quitting rather than the target of it. If the habit persists, we can talk about an appliance. Pacifiers follow the same logic and are usually easier to stop.

A sealant is a thin protective coating painted into the deep grooves on the chewing surfaces of the back molars. Most cavities in children start in those grooves, simply because the bottom of the groove is narrower than a toothbrush bristle and cannot be cleaned. Placing one takes a few minutes, involves no drilling and no numbing, and is one of the highest-value preventive things we do. They usually go on the first permanent molars soon after they come in around age 6, and on the second molars around age 12. Sealants wear down over time, so we check them at every visit and repair them when needed.

Yes, at the amounts used in dental care and community water. Fluoride strengthens enamel as it forms and can reverse the very earliest stages of decay before a cavity ever needs filling. The risk from too much is dental fluorosis, which is faint white flecking in developing teeth, and it comes from swallowing large amounts of toothpaste over years. That is precisely why the amount matters: a rice-grain smear under 3, a pea from 3 to 6, and adult supervision. If you have concerns about fluoride, tell us and we will go through the options with you rather than talk past you.

Every six months for most children. Kids who get cavities easily, wear braces, or have specific risk factors often do better at three or four month intervals, and a genuinely low-risk child may not need to come more often than twice a year. We will tell you which describes your child based on what we find, not on a default schedule.

Call us at (713) 668-8383 first, then act based on which kind of tooth it is. If it is a baby tooth, do not try to put it back in. Reinserting a baby tooth can damage the permanent tooth forming above it. Control the bleeding with clean gauze and gentle pressure, keep your child calm, and call us. If it is a permanent tooth, time matters enormously. Pick the tooth up by the crown, the white chewing part, never by the root. If it is dirty, rinse it briefly in milk or saline (water if that is all you have) without scrubbing it. If you can, place it back into the socket and have your child bite gently on gauze to hold it there. If you cannot, put it in a cup of cold milk, not water, or have an older child hold it inside their cheek. Then get to a dentist as fast as you can. The sooner a permanent tooth is back in its socket, the better its chances.

Keep it short, positive, and light on detail. Tell your child the dentist is going to count their teeth and take pictures, and leave it there. Avoid the words shot, drill, hurt, and pain, even inside reassurance like it will not hurt, because children hear the frightening word and miss the rest. Do not tell stories about your own bad dental experiences where they can hear. Book a morning appointment when patience is highest, bring a comfort object, and read a picture book about a dentist visit beforehand. Most important: tell us your child is nervous when you book, so we plan a slower visit from the start. Nitrous oxide sedation is available if your child needs more help than that.

Usually starting around age 6 with the lower front teeth and finishing around age 12, though the range of normal is wide and early or late is rarely a problem on its own. Loose teeth are fine to wiggle. One situation worth a call: if a permanent tooth is coming in behind a baby tooth that has not loosened, sometimes called shark teeth. It is common, it usually resolves once the baby tooth comes out, and we will tell you whether to wait it out or help it along.

We take them only when there is a reason: checking between teeth that touch each other where decay hides, confirming that permanent teeth are developing and positioned correctly, or investigating pain or an injury. Digital sensors use a small fraction of the radiation that old film required, and we use a lead apron and a thyroid collar every time. We will always explain why we want an image before we take one, and you are free to say no.

Yes, for any contact or ball sport. Basketball, soccer, and baseball send more children to us with broken front teeth than the sports parents worry about. A custom mouthguard made from a scan of your child's teeth stays put, lets them breathe and talk, and gets worn, which is the part that counts. Boil-and-bite guards are better than nothing, but they are bulky and kids take them out. We remake custom guards as your child grows.