When should my child first visit the dentist?
      The American Academy of Pediatric Dentistry recommends the first dental visit by a child's first birthday. Early visits will help your Pediatric Dentist recognize potential problems early, and review preventive dental care before problems exist.
      In our office, we strive to make your child's first visit to the dentist enjoyable and positive. Your child should be informed of the visit and told that the dentist and their staff will explain all procedures and answer any questions. The less fuss and anxiety concerning the visit, the better. I like the procedure "tell-show-do". We explain what we will do in an age appropriate manner, we show what we will do, by touching our mirror and other 'tools' on your child’s hand, then we use the mirror, tooth counter, etc. in your child’s mouth. We examine most young children sitting on their parents lap or sitting 'knee to knee' with your child looking at you.
      Please refrain from using phrases like: "We’re going to the dentist tomorrow and it won’t hurt." You would not say "We’re going to the park tomorrow and it won’t hurt." Your child will only hear ‘hurt’ and not the rest of your sentence. It is better to tell your child what they will feel, not what they won’t feel. For example, "the dentist may use an electric toothbrush that will tickle your teeth." Also, refrain from using words around your child that might cause unnecessary fear, such as needle, pull, drill. We make it a practice of using words which convey the same message but are pleasant and non-frightening to your child.
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Why are the primary teeth (baby teeth) important?
      It is very important to maintain the health of the primary teeth. Neglected cavities can and frequently do lead to problems which affect developing permanent teeth. Primary teeth or baby teeth are important for:

1. proper chewing and eating,
2. providing space for the permanent teeth and guiding them into the correct position, and
3. permitting normal development of the jaw bones and muscles.

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How many baby teeth are there, and when do they fall out?
      There are 20 baby (deciduous/primary) teeth, which all fall out. The first teeth to fall out are usually the lower front teeth, usually between ages 4 and 8. After the eight front teeth fall out, (4 top and 4 bottom) no teeth will fall out for approximately 2 years. Between ages 8 and 14 the last 12 baby teeth in the back will fall out.
Dental Chart

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When can my child have fluoride toothpaste?
      If you have EBMUD water coming to your home, and you do not have a charcoal filter, your child (under 4 years old) is getting adequate fluoride (if they are drinking two glasses of water each day). If your child is drinking tap water each day and swallowing toothpaste with fluoride, their permanent teeth can receive too much fluoride and develop white or brown streaks. Your child does not need fluoride toothpaste until 4 years old UNLESS, your dentist has identified risk factors which could make your child more susceptible to getting dental decay or if your child already has had cavities or fillings before age 4. After 4 years of age the permanent front teeth are formed and are no longer at risk of developing streaks from too much fluoride. Also, by 4 most children are able to spit without swallowing. Some children who are drinking fluoridated water, using fluoride toothpaste and still getting cavities, may need extra or supplemental fluoride. Consult your dentist to see if your child is in this category.
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At what age can my child brush their own teeth?
      A child has the dexterity to brush all their own teeth when they can tie their own shoe laces and use a knife and fork efficiently when eating. If your child cannot do those tasks they may be able to brush some of their teeth on their own, but not all of them. Most children (even older ones) usually miss brushing the outside of the upper molars and the inside of the lower molars. I also find many children concentrate either on their front teeth and forget the back or concentrate on the back and forget the front. The skill of flossing without using a floss holder usually comes in the teen years. Even children who have the dexterity to brush need adult supervision to make sure they are doing a thorough job.
      Many parents find their children do not cooperate for brushing, so they give in and let the child brush because they don’t want their child to have a "bad experience" with brushing. Parents need to remember there are many things in a child's upbringing they will not want to do, e.g.. sit in the car seat, change a diaper, etc. If you brush your child's teeth even if they do not like it, they will learn that a healthy mouth is important and they will eventually cooperate. Be patient, like almost everything with children they will "see the light one day".
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How do I take care of my child's teeth?
      Plaque is a sticky film in which bacteria breed: it grows on teeth. The bacteria take about 24 hours to mature to the point where they can make acid. The acid causes cavities and makes the gums bleed. Children’s teeth should be cleaned before they erupt into the mouth! How? By using a wet wash cloth or gauze to clean the gums in the evening before bed. When the teeth emerge they are coming in to a clean mouth and it will be easier to keep them clean. When your child has between 4 - 8 teeth you can switch to a soft toothbrush or a rubber finger brush. It is also important at this time for your child’s primary care giver, mom, dad or nanny to have a healthy mouth, free of active tooth decay or gum disease. When you share spoons, straws, drinks, etc. with your infant/toddler, bacteria from adult mouths can “inoculate” the infants mouth, causing dental disease. In other words, bacteria from your mouth can start growing in your baby’s mouth causing cavities and gum disease in your child! This is one reason why some children have dental decay earlier then others.
      Children who have the dexterity to brush on their own should be encouraged to brush in the morning (as soon as they wake up) before breakfast. At night an adult should brush and floss the child’s teeth. Your dentist can observe your child brushing and evaluate when they are ready to brush and floss on their own.
      Proper brushing removes plaque from the inner, outer and chewing surfaces. When teaching children to brush, place the toothbrush at a 45 degree angle; start along the gum line with a soft bristle brush in a gentle circular motion. Brush the inner surfaces of the bottom teeth first. Finish the inner surfaces of the bottom teeth, then the outer and chewing surfaces. Repeat the same method on the top teeth. Finish by brushing the tongue and cheeks. Flossing removes plaque between the teeth where a toothbrush can’t reach. Flossing should begin when any two teeth touch. Even in infants! You should floss the child's teeth until they can do it on their own. Using a flossing tool makes it easy for adult hands to reach tight spaces in children's small mouths. Slide the floss gently between the teeth using a back and forth motion to guide the floss under the gums. Gently scrape the floss against the side of each tooth. Repeat this procedure on each tooth. Don’t forget the backs of the last four teeth!
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Baby Bottle tooth decay (Early Childhood Caries)
      One serious form of decay among young children is baby bottle tooth decay. This condition is caused by frequent and long exposures of an infant’s teeth to liquids that contain sugar. Among these liquids are milk (including breast milk), formula, fruit juice and other sweetened drinks.
      Putting a baby to bed for a nap or at night with a bottle other than water can cause serious and rapid tooth decay. Sweet liquid pools around the child’s teeth giving plaque bacteria an opportunity to produce acids that attack tooth enamel. If you must give the baby a bottle as a comforter at bedtime, it should contain only water. If your child won’t fall asleep without the bottle and its usual beverage, gradually dilute the night time bottles’ contents with water over a few weeks. (add 1 ounce of water every few days)
      After each feeding, wipe the baby’s gums and teeth with a damp washcloth or gauze pad to remove plaque. The easiest way to do this is to sit down on a soft chair, on the bed, or floor and place your child in your lap so you can easily see your child’s mouth.
Early Childhood Caries Treatment Photos

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