The most important gift we can give a child is positive early experiences at the dental office.

The skills that we teach and the preventive care we provide can make a foundation for a lifetime of healthy and comfortable smiles.

Please do not go overboard in telling a young child about going to the dentist. Tell them that they are going to have their teeth counted and have pictures taken of them. Try not to share your own concerns about going to the dentist when talking to your children about the dentist's office. Going to the dentist should be treated like an outing to the market, no big deal. Do not worry about giving them exact details about their first appointment; a simple, open ended explanation will keep them from getting scared and fixated on something you may say.

Above all, please do not wait to bring a child to the dentist until something starts hurting. This is the worst way to begin a child's first dental visit because they will now associate the dental office with pain.

When should a child start seeing the dentist?

We have found that between two and three is the best age to have a child start seeing the dentist. If there is an older sibling it is a great idea to have the younger one sit in the operatory and observe their appointment; many times they can't wait to hop in the chair so they can have all the attention. Having a child see a parent having their teeth cleaned is also a great way to introduce them to the dental office.

We take dentistry at the child's pace. Healthy attitudes about dentistry come from the first appointments, so sometimes we take things more slowly with children, even if it means a few more visits. The first visit is short and simple- we count their teeth and get them comfortable to sitting in the dental chair. We may clean their teeth and take x-rays or we might decide to do these things at the next visit if it seems like the child would be overwhelmed. The key to treating children is gaining their trust, and every time they leave our office happy we have gained more of their trust in us to not hurt or frighten them.

Baby teeth are just going to fall out anyway so why worry about them?

Baby teeth have several functions and are meant to stay in place until the permanent teeth come in. Growing children need a good variety of healthy foods and require functional teeth to chew. The most important job the baby teeth do is to maintain space for the permanent teeth to come in. When baby teeth are lost prematurely, the remaining teeth shift into the open spaces and will prevent the permanent teeth from erupting. This causes major problems with their bite as they mature and requires lengthy treatments with braces and often surgery to correct. For this reason it is critical that the baby teeth remain in place until the permanent ones are ready to grow in, which takes place from the age of six to around twelve. Take a look at the eruption charts below and you can see how the baby teeth hold space for the permanent ones as they are developing. If a baby tooth has been lost or needs to be removed and it will be more than a year before the permanent tooth comes in, a space maintainer is placed to keep the other teeth from moving. Space maintainers are made from stainless steel and are permanently cemented to the teeth. They are removed when we see the adult tooth coming in.

What about Flouride?

Fluoride is a mineral that occurs naturally in all water sources, even the oceans. The fluoride ion comes from the element fluorine. Fluorine, the 17th most abundant element in the earth's crust, is never encountered in its free state in nature. It exists only in combination with other elements as a fluoride compound.

Fluoride is effective in preventing and reversing the early signs of dental caries (tooth decay). Research has shown that there are several ways through which fluoride achieves its decay-preventive effects. It makes the tooth structure stronger, so teeth are more resistant to acid attacks. Acid is formed when the bacteria in plaque break down sugars and carbohydrates from the diet. Repeated acid attacks break down the tooth, which causes cavities. Fluoride also acts to repair, or remineralize, areas in which acid attacks have already begun. The remineralization effect of fluoride is important because it reverses the early decay process as well as creating a tooth surface that is more resistant to decay.

Fluoride is obtained in two forms: topical and systemic. Topical fluorides strengthen teeth already present in the mouth making them more decay-resistant. Topical fluorides include toothpastes, mouthrinses and professionally applied fluoride therapies.

Systemic fluorides are those that are ingested into the body and become incorporated into forming tooth structures. Systemic fluorides can also give topical protection because fluoride is present in saliva, which continually bathes the teeth. Systemic fluorides include water fluoridation or dietary fluoride supplements in the form of tablets, drops or lozenges. Systemic fluoride is prescribed by the pediatrician when a child is around 6 months of age so that in can be incorporated into the developing teeth. Some water companies have been adding fluoride to the water supply to ensure that all children are getting an adequate amount. Here in Santa Clara County it can be confusing to determine whether or not your water is fluoridated. According the the Santa Clara County Water District, the following areas are receiving fluoridated water:

• The Evergreen area of San Jose served by San Jose Municipal Water System
• Parts of Mountain View north of El Camino Real
• Alviso, Los Altos, Los Altos Hills, and Palo Alto and parts of Milpitas, Mountain View, north San Jose, Santa Clara and Sunnyvale

Many people do not drink much tap water these days so where you live and what type of water your children are drinking need to be considered when it comes to giving them fluoride. Flouride has a long, proven track record and has been very effective at reducing decay in countries all over the world as long as it is administered in the proper amounts. Excessive fluoride can actually weaken the teeth so it is important that we are aware of what is going into our children's food and drink. We recommend that all of our patients 16 and younger receive a fluoride treatment at their hygiene and exam visits, as well as for patients of any age who are at high risk for tooth decay (dry mouth, multiple restorations, inability to brush well).

When is a good time to start orthodontics (braces)?

The orthodontist wants to evaluate a child for braces when they are in the mixed dentition stage (half baby teeth, half adult teeth), around age seven to nine. At this stage in development the orthodontist can determine if early intervention is needed to correct a bite which is not developing in an ideal manner. In general, we like to see baby teeth with lots of space around them because the adult teeth are much bigger and need the space. Young children whose teeth are crowded or crooked will most likely need braces.

Sometimes a child needs to be seen by a specialist- the Pediatric Dentist...

A Pediatric Dentist is a dentist who specializes in treating children. We enjoy seeing children in our practice and do everything we can to provide for their needs here in our office, but there are situations where a referral to a Pediatric Dentist is necessary. Young children who need major dental work, developmentally disabled children, and uncooperative children need to be treated by the specialist and possibly sedated to receive the care they need. Many parents are fearful of sedating their child for dental work, but not treating their dental disease is doing them more harm. We will not restrain a child or force treatment on them, so if they are unable to cooperate it is time to see the specialist. Prevention is the best medicine for teeth, and it all starts with establishing good dental habits with your child at an early age.

Here is a link to the patient education section of our website which you may find helpful. There is a lot of information there for you to browse through and to answer any questions you may have, and was designed by a dental education company whose tools are used in our office to help our patients understand their treatment options. Some of the information there may be a bit outdated because the dental field is always evolving, but the general concepts of dentistry are nicely described and illustrated.

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