What is a pediatric dentist?
Just as pediatricians are the experts on children’s health, growth, and development; pediatric dentists are the experts on children’s oral health, growth and development. In other words, they are the “pediatricians” of the oral cavity. A pediatric dentist has an extra two years of specialized training AFTER dental school which is dedicated to the oral health of children from infancy through teenage years. The vast majority of dental schools only devote a couple weeks of training in the treatment of children, so this extra two years is extremely valuable. All children, whether very young, pre-teen, or adolescent have varying dental needs and require different approaches in dealing with behavior, guiding their growth and development, and helping to avoid future dental problems. With this additional education, pediatric dentists have the training which allows them to offer the most up-to-date and thorough treatment for a wide variety of pediatric dental problems.
How old should my child be to come to the dentist?
According to the American Dental Association (ADA) and American Academy of Pediatric Dentistry (AAPD), your child should visit a pediatric dentist by his/her first birthday, or around six months after the eruption of the first tooth. Beginning dental care at an early age allows guidance for caring for your child’s oral health, as well as for opportunities to address preventive measures that are important for healthy teeth and a pleasing smile. Bringing children for visits beginning at a young age also assists in establishing a positive relationship between them and the dentist. Although many children are nervous or fearful at early visits, they will tend to mature, and develop more confidence and trust at subsequent visits.
Why are baby teeth important?
Maintaining the health of primary teeth (baby teeth) is much more important than many people think. Cavities that remain untreated can cause pain and infection, which, in turn, can lead to problems affecting the permanent teeth that are forming below the baby teeth. Primary teeth are also important for proper chewing and eating, holding space for permanent teeth and helping to “guide” them into a proper position, and permitting normal development of jaw bones and muscles.
Why does my child need dental x-rays?
Radiographs (commonly called x-rays) are a necessary part of the diagnostic process for all patients, including children. Without them, certain cavities and other problems will be missed. They also assist in evaluating developing teeth, complications from an injury, or planning for orthodontic treatment. If dental problems are found and treated early, the treatment will usually be less invasive, more comfortable, and generally more affordable.

Usually, we will recommend bitewing radiographs once per year beginning when a child will tolerate them, and a panoramic radiograph every 3-5 years beginning at age seven. In children considered “high risk” for tooth decay, radiographs may be recommended every six months.

With modern technology, and proper safeguards, the amount of radiation received from dental x-rays is extremely small. In fact, routine dental radiographs contribute less radiation than many activities such as sun exposure or riding in an airplane. Receiving dental radiographs presents a far smaller risk than problems that can arise as a result of undetected and untreated dental problems. As an additional level of protection, lead body aprons and shields will protect your child from any scattered radiation. Our office uses digital radiography which allows for even less radiation than conventional dental x-rays, and localizes the x-ray beam only on the area of interest (the oral cavity).

What are my options for sedation?
Small procedures in cooperative or slightly nervous children can often be performed with local anesthesia (numbing) with or without nitrous oxide. Nitrous oxide (a.k.a. “laughing gas”) is a very common form of sedation we routinely use in our office. This is given through a small breathing mask placed over the child’s nose while they watch a movie on a ceiling-mounted TV. At the end of the procedure, your child will breathe 100% oxygen for a few minutes which flushes the gas out of their system and allows them to feel normal when they leave. The AAPD recognizes this technique as a very safe, effective way to help a child relax during treatment.

Slightly more involved procedures in certain children will require the use of an oral medication along with nitrous oxide to help relax your child and help them be more cooperative for the procedure. These procedures are scheduled at specific times, require your child to be fasting the morning of the appointment, and be free of respiratory problems for two weeks leading up to the visit. When possible, we also ask that two adults be present so one can sit in the back seat with your child on the drive home.

Some children require an extensive amount of dental work. In these situations, it is often not possible for a child to cooperate for multiple or lengthy appointments to allow the treatment to be done properly. In cases like this, we may recommend your child be treated in office with a nurse anesthetist using deep sedation, or in an operating room (surgical center or hospital) under general anesthesia. Dr. Folkman will be happy to discuss any and all of these options with you should the need arise.

Can I be with my child during appointments?
Of course you can. We will never restrict you from coming back for routine visits. However, just like adults, children vary as individuals. Many children behave better with parents waiting in the reception area. However, some children will have a better experience if their parents are with them throughout their visit. One exception is during deep sedation appointments. Similar to a hospital that does not allow family into the operating room during surgery, only having the child in the back while deeply sedated allows us to fully concentrate on them and provide the safest care possible. Feel free to discuss with Dr. Folkman any concerns you may have and options that are available.
What can I do about my child's toothache?
Clean (brush and rinse) around the sore tooth thoroughly. Rinse the mouth with salt water or use dental floss to dislodge impacted food. DO NOT ever place aspirin on the gums or aching tooth, and do not give aspirin to your child. If the face is swollen, or the pain is spontaneous and interferes with sleep, contact our office as soon as possible.
My child knocked out his/her permanent tooth – what should I do?
Find the tooth. Only handle the tooth by the crown (part that normally shows in the mouth), not by the root. You may rinse the tooth if it is dirty, but DO NOT wipe or handle the tooth unnecessarily. Inspect the tooth for fractures – if none are visible, try to reinsert it into the socket. Have the child hold it in place by biting on gauze. If you cannot reinsert the tooth, transport the tooth in a cup of milk. If milk is not available, place it in a cup of the child’s saliva. DO NOT store the tooth in water. Call the office immediately. The most critical factor is time when it comes to saving a tooth that is out of the mouth.
My child fractured (broke) his/her tooth - what should I do?
Rinse the debris from injured area with warm water. Place a cold compress over the face in the area of injury. Locate and save any broken tooth fragments in milk. Contact our office as soon as possible.