William Greenhill, DDS, of Union Pediatric Dentistry answers questions for
National Pediatric Dentistry Month
CF: What makes a pediatric dentist different from other dentists?
WG: A pediatric dentist is someone who has gone to an additional two to three years of school. So we get a lot of training in behavior management, and a lot of training in growth and development. Also, we’re real comfortable working in the hospital and working with medically compromised patients and the dental part of their overall health. If you think of it like a pediatrician, it’s the same kind of thing. We’re the dental version of that.
CF: What’s new in the world of pediatric dentistry?
WG: In 2012, the American Academy of Pediatric Dentistry (AAPD) will pair up with the Ad Council to launch a program to teach the importance of oral health in children. While we’ve seen decay in kids go down — especially in school-aged kids — there’s actually one group in which we’ve seen the decay rate go up, the 2- to 5-year-old group. A study done in 2007 by the U.S. Centers for Disease Control and Prevention, showed that almost 30 percent of kids in that age group experience decay.
One thing we try to get across to parents is when to go to the dentist for the first time, which is when the first tooth erupts or by the first birthday. You want to establish good habits early on. We can talk about what you can do and not do, like going to bed with a bottle of juice.
CF: How do children’s dental needs change as they grow older?
WG: Children want to become independent of Mom and Dad. A good guideline is that if they are able to tie their shoes, if they can write cursive, or if they are able to cut up food pretty easily, they can probably brush their teeth adequately. Also, as permanent teeth come in, usually around age 6, there can be issues. The chewing part of the back molars probably makes up 12.5 percent of the surface area of the tooth, but between the ages of 5 and 17, it accounts for around 50 – 70 percent of cavities that happen. One thing we like to do is put sealants on the teeth. If we can prevent the cavity from the beginning, that’s great. But it’s not a substitute for brushing and a good diet.
CF: Do you have advice for parents on how they can get their kids into good daily habits for their oral care?
WG: Start right from the beginning. There are infant cloths now, so even if your child doesn’t have teeth, you can wipe the gum pads down. And as teeth start coming in, you can wipe off the teeth. And there are age-appropriate toothbrushes as the back teeth come in. A conversation you want to have with your dentist is about fluoride toothpaste and when to start using that. Everyone has this mindset that you don’t start using fluoride toothpaste until after age 2, but our guidelines have changed a little, and some high-risk kids need to be on fluoride toothpaste earlier. That’s another reason why you want to see kids by age 1, so you can have that conversation. And that’s also why we want to have conversations with parents — if parents have untreated decay in their mouths, they may actually make their child more prone to decay by passing along that bacteria through sharing utensils or just giving a kiss.
CF: What are some common dental emergencies and how are they handled?
WG: The most common thing I see is broken teeth. If a tooth is knocked out, you want to try to put the tooth back in place. The prognosis is better the quicker that tooth gets put back in the mouth. Then go to the dentist. We will put a splint on the tooth, kind of like stabilizing a fracture. If you can’t get the tooth back in, for whatever reason, then you want to get to the dentist as soon as possible and you want to keep the tooth moist. The best thing is to keep it in Hank’s Balance Salt Solution, but who has that? If you don’t, use milk.
Locate a pediatric dentist at the web site of the American Academy of Pediatric Dentistry: aapd.org.