Pediatric Dentists: Your Child’s Oral Care Specialist

Often called the pediatricians of dentistry, pediatric dentists specialize in providing the comprehensive preventive and therapeutic oral health care needs of children (infants through teenagers), including those with special needs (chronically ill, disabled or mentally challenged).

Pediatric dentists are also good choices for the dental care of adults with special needs. Common conditions that require special needs dental care include Down syndrome, cerebral palsy, seizure disorders, HIV infection, vision/hearing impairments, cleft lip, cleft palate, and other craniofacial conditions, and learning and developmental disabilities.

Pediatric Dental Care

Among the care provided by pediatric dentists is regular oral health exams (including caries risk assessment for infant and mother); preventive dental care (such as brushing and diet/nutrition recommendations); regular cleaning and fluoride treatments; and use of sealants to prevent cavities.A pediatric dentist also may:

Provide mouth guards (to prevent sports injuries)
Provide or recommend special preventive care to safeguard against problems, such as teething and gum disease
Offer habit counseling (e.g., thumb sucking, pacifier use)
Offer assessment and treatment for teeth straightening and improper bite in the young child (orthodontics)
Repair tooth cavities and/or defects
Diagnose oral conditions associated with diseases such as diabetes, congenital heart defects, asthma and attention-deficit/hyperactivity disorder
Diagnose and treat dental developmental difficulties (e.g., root canals on adult teeth that have not fully formed)
Provide management of gum diseases and conditions, such as pediatric periodontal disease, ulcers and tongue-tie (when the membrane that attaches the tongue to the floor of the mouth is shorter than normal. If tongue-tie interferes with breastfeeding, a pediatric dentist can clip the membrane to release the tongue)
Care for dental injuries (e.g., fractured or knocked-out teeth)

Pediatric Dentists vs. General Dentists

Many children are treated by a general dentist, who already has a well-established relationship with the entire family. However, while not necessarily providing better care than general family dentists, pediatric dentists can offer the specialized focus on your child that general dentists may not be prepared or inclined to offer. Unlike a general dentist, a pediatric dentist has two to three years of additional training after completing a four-year dental school curriculum. This program of study and hands-on experience emphasizes child psychology, growth and development. Pediatric dentists know how to examine and treat children — not always the most patient or cooperative of subjects — in ways that make them comfortable and safe. They use specially designed equipment in offices arranged, decorated and sized with children in mind.

Choosing a pediatric dentist as your child’s specialist helps ensure you are getting the latest and best treatments, care and resources to prevent, detect and treat all of your child’s dental/oral health needs throughout the various stages of development.For instance, during infancy, your pediatric dentist may focus on prevention and education. During adolescence — when appearance and self-image often take center stage — the emphasis may shift to restoring/correcting teeth and teaching preventive dental health care, which includes information on sealants, oral piercing, tobacco/drug use, and cosmetic and/or restorative options such as tooth bleaching, veneers for teeth and crowns.Pediatric dentists practice in private offices, dental schools and medical centers. Your pediatric dentist can work with pediatricians, other physicians and other dental specialists to ensure that your child is best served through a comprehensive team approach. If you’re having trouble deciding on the type of dentist for your child, ask your child’s pediatrician or your general dentist for recommendations.

Pediatric Dentists and Sedation Dentistry

Pediatric dentists are qualified to administer sedation to their patients. These sedation dentistry techniques include:

Oral medication: The pediatric dentist selects a medication and dose that will relax your child but not render him/her unconscious. He/she is still responsive to touch and direction. This option may be recommended for children who are anxious, restless or very young.

Local anesthetics: A topical anesthetic — similar to teething gel — can be applied with a cotton swab to prevent pain on the mouth’s surface. A local anesthetic, such as Lidocaine, may be injected in a specific area of a child’s mouth to prevent discomfort during treatment. Local anesthetics cause temporary numbness that may last past the visit.

Nitrous oxide (“laughing gas”): Perhaps the safest sedative in dentistry, nitrous oxide can reduce anxiety and gagging in children, making long appointments easier. The child remains conscious during treatment; post-treatment recovery is fast and complete.

General anesthesia: Most often recommended for children who cannot tolerate extensive dental treatment, general anesthesia puts patients to sleep, making them completely unconscious and unable to respond to touch or voices. General anesthesia may be the preferred treatment for a child with a mental/physical disability for whom a hospital setting provides the safest option.Discuss all aspects of the benefits and risks of sedation with your child’s pediatric dentist. For example, general anesthesia needs to be provided by qualified health professionals, including pediatric dentists with advanced education in anesthesiology, dental/medical anesthesiologists, oral surgeons and certified registered nurse anesthetists. Whether it takes place in a pediatric dental office or a hospital, treatment must feature special monitoring and emergency equipment, and trained support staff.

Frequency of Visits

The first dental visit should occur approximately six months after your child’s first tooth erupts and no later than age one. Children should visit the dentist every six months. Some dentists may recommend scheduling visits every three months in order to build up a comfort level or to treat developing concerns.

What to Expect During the First Visit

At the initial visit, you will be presented with a caries risk assessment, information about early childhood caries, and current facts about finger and pacifier habits. After examining your child’s mouth and discussing any dental issues with you, the dentist may present information about:

A program of preventive home care, including information on brushing, diet and fluoride use
Information about preventing mouth and teeth injuries
Information on growth and development

Selecting a Pediatric Dentist

Factors to consider when choosing a pediatric dentist include: Is the dentist a member of the American Academy of Pediatric Dentistry? Does the pediatric dentist keep current through continuing education classes and/or attendance at conferences, seminars, etc.?Does the pediatric dentist’s professional/personal manner put you and your child at ease?Is the staff friendly, knowledgeable and quick in addressing your child’s needs and your concerns?

Is the dental office child-centric? (Do they offer child-sized furniture and instruments, decorations, handouts, entertainment/distraction options for children of different ages, etc?) What is the practice’s policy on parents staying with their children during treatment? (Some pediatric dental offices require parents to accompany their children in order to educate parents and help reassure nervous children. Other offices encourage children to return for treatment on their own in order for the pediatric dental team to focus exclusively on the child and begin building a sense of trust right away.) What policy makes you and your child most comfortable?Does the practice accept your dental insurance? Were you properly informed about your child’s tooth development and given prevention and at-home dental care education?Were your questions and concerns (and those of your child) treated with respect and sensitivity and answered in an age-appropriate, reassuring manner?