The composition is different between baby teeth and permanent teeth. Because of this, the permanent teeth appear more yellow, especially when there are baby teeth right next to permanent teeth in the mouth.

Fluoride varnish creates a thin shell-like layer over the tooth’s enamel. Your child may eat or drink right away, but we recommend avoiding chewing gum and eating anything crunchy such as ice, hard candies, carrots and apples. This is so the shell-like layer does not break away, allowing maximum fluoride uptake into the tooth enamel for the next 4-6 hours. In addition, we recommend that your child avoid brushing or flossing for at least 4-6 hours after a fluoride varnish application.

Primary (baby) teeth are important for holding space for the un-erupted permanent teeth. With early loss of a primary tooth, the neighboring teeth may tip or drift into the space, leaving little or no space for the permanent tooth to erupt. A spacer is recommended to prevent this from happening and preserve the space. For single tooth spaces that have teeth on either side of the area, a band and loop will likely be recommended. The band is cemented to the tooth adjacent to the space. For a single tooth with only one tooth adjacent, a distal shoe will be recommended. A distal shoe has a small guiding plate placed in the gums to encourage proper eruption of the permanent teeth. When appropriate, the distal shoe will be removed and a band and loop will be placed. Permanent tooth eruption will be monitored and the spacer will be removed accordingly.

We recommend using an ADA approved adult toothpaste when permanent teeth begin to erupt. The grittiness or ‘abrasiveness’ of the toothpaste will aid in cleaning teeth a little better. Children’s toothpaste tends to be a gel with little grittiness. To help transition from a child’s toothpaste to an adult paste, we suggest placing a ‘smear’ of adult paste on the brush and topping it off with a smear or pea size of the child’s toothpaste.

Most over-the-counter toothpaste contains the same amount of fluoride regardless if it is children’s toothpaste or adult toothpaste. Prescription toothpaste, which does have a higher concentration of fluoride, is available when indicated by your dental professional.

A dental abscess is a localized infection associated with a tooth. A tooth may abscess when it has untreated dental decay, did not respond well to dental treatment or has had trauma.

The material selected to restore a tooth is dependent on several factors, including: if it is a permanent tooth or a baby tooth, where the tooth is located and/or how large the cavity is. Amalgam is typically the restoration of choice on teeth with large decay or when the strongest material is needed so the tooth can withstand strong biting and grinding forces.

When a baby tooth has had trauma it interrupts the blood supply into the pulp chamber. The tooth may become discolored over time because of the interruption of blood flow. Think of it as if the tooth has been ‘bruised’. When a baby tooth has had any form of trauma it is important to monitor for changes (i.e. pain while eating/drinking or biting, or a “pimple” forming on the gums just under the lip).

When the cavity (decay) is large, and bacteria has reached the nerve (pulp) of the tooth, it needs a pulpotomy. The portion of the pulp tissue that has been exposed to bacteria will be removed (baby root canal) and replaced with a special medicine. Then a silver crown will be placed to seal the tooth from getting any further decay.

There are a few reasons to refer a younger child to an orthodontist early. If a child has an orthodontic issue that requires early intervention, such as an anterior crossbite or severe crowding, he/she would benefit from an orthodontic consult. Another great reason to have a child undergo early orthodontics is to take advantage of growth. It is common to do orthodontic treatment in multiple phases. Early treatment provides significant benefits and may prevent certain conditions from worsening. Treating children during their growth stages can simplify treatment especially since the face and jaw bones have not fully developed. It is recommended to have an orthodontic evaluation around the age of 7. This early evaluation can help determine when to begin necessary treatment to achieve optimal results in the most time-efficient way possible.

No one knows exactly why children develop the tendency to grind; however, grinding is very common and often nothing to worry about. There are a few possible factors that cause a child to develop this habit. Most commonly, children who may experience pressure (from tooth eruption/exfoliation or even a simple earache) may also grind to relieve the pain and pressure. Teeth may not be aligned properly causing a child to grind. It may also be due to stress or tension.

It depends on which tooth is missing. Sometimes the space can be closed (either naturally or with orthodontics) or, sometimes having a false tooth fill the space may be the best option (this may be achieved by either a bridge or an implant). Your dentist will discuss your specific situation with you at your visit!

These are called mamelons. They are part of the enamel of the tooth and aid the teeth with eruption through the bone and tissue. Mamelons wear down and become flat over time.

Enamel discoloration can be caused by multiple factors and is dependent upon which permanent teeth are developing at the time of insult. Some factors may include trauma to the baby tooth, certain medical conditions especially those associated with high fevers, and even an excessive intake of fluoride during the years of tooth development. Another type of enamel discoloration, called enamel decalcification, is caused by poor oral hygiene and dietary habits. This results in a ‘white spot’ on the tooth.

There are two types of delivery methods for fluoride. Systemic (meaning ingested into the body) is important during tooth development. Another method, topical, is when it is applied directly to the teeth. Both are extremely important for preventing tooth decay. During tooth development, fluoride forms with other elements to form a compound that is more resistant to erosion. Topically, fluoride is an antimicrobial and helps protect against tooth decay by decreasing enamel ‘breakdown’ and aiding in the enamel remineralization, or ‘strengthening’ process.

The first baby tooth may appear around the age of 6 months with the last tooth erupting around the age 2 ½. There are a total of 20 baby teeth. The first permanent (adult) tooth should appear around the age of 6-7. There are a total of 32 adult teeth. The last teeth to erupt are the 3rd molars (wisdom teeth). Eruption of the wisdom teeth, if there is room in the mouth, typically occurs around the age of 17-20.

When a large portion of the tooth is lost due to decay or a fracture, it is often recommended to place a stainless steel (silver) crown. When a large portion of the natural tooth structure is missing (whether due to a large cavity or an existing filling), there is typically not enough ‘sound’ enamel to place a filling; therefore, the crown will provide strength back to the tooth so that the tooth can sustain normal biting forces.

Any time a tooth becomes infected, your child may need an antibiotic to help fight the infection. Sometimes you can see the infection/abscess as a bump or a pimple on the gumline, and sometimes the infection can only be detected by an x-ray and examination by your dental provider. The source of the infection, which is the tooth, must be addressed.

When a tooth has been restored and treatment has ‘failed’ it is due to multiple factors. It is common for a previously restored tooth to fail when bacteria reaches the nerve of the tooth and causes the tooth to abscess, or become infected. This can be caused by lack of proper oral hygiene habits and poor dietary habits. Taking into consideration the ‘tooth’ history is important as well. If a tooth has had large decay and/or trauma, prognosis can be compromised.

Length of time between appointments, oral hygiene habits and dietary habits can all be factors when decay is diagnosed from one appointment to another. It is also important to understand that not all decay can be detected clinically, and radiographs are necessary to detect decay between the teeth.

‘Ankylosed’ means the tooth is ‘fused’ to the bone. With trauma being the most common, there can be multiple, or even unknown, causes. It is very common for ‘baby molars’ to be diagnosed as ankylosed. The appearance of an ankylosed tooth is that it is submerged. When this occurs, it is often recommended that the tooth be extracted because the roots of the ankylosed tooth may not dissolve properly and block the eruption of the permanent tooth.

Ectopically erupting is when a tooth erupts out of the normal eruption ‘path’ or out of normal position. It is often that the ectopically erupting permanent tooth will try to erupt against the root of the baby tooth, causing early root resorption and possibly early loss of the baby tooth.

Treatment plans may change based on time between appointments, whether or not radiographs were taken at the initial appointment and at the time of restorative treatment. The dentist may only be able to diagnose a tooth’s condition while actively working on the tooth, and at that time, evaluating the best treatment option.