Pediatric Dentistry in Indianapolis, IN

There is no such thing as the best toothpaste. We recommend only products that have been ADA (American Dental Association) accepted or approved. The selection is usually made on a case-by-case basis, but the main consideration when selecting toothpaste is your child's age. This is due to the risk of fluorosis in younger children who swallow toothpaste during regular brushing. A child may face the condition called enamel fluorosis if he or she gets too much fluoride during the years of tooth development. Too much fluoride can result in defects in tooth enamel.

By swallowing too much fluoride for the child's size and weight during the years of tooth development, a child can develop enamel fluorosis. This can happen in several different ways. First, a child may take more of a fluoride supplement than the amount prescribed. Second, the child may take a fluoride supplement when there is already an optimal amount of fluoride in the drinking water. Third, some children simply like the taste of fluoridated toothpaste. They may use too much toothpaste and then swallow it instead of spitting it out.

When a baby tooth changes color, it can mean many things. Baby teeth can and do normally change in color, particularly close to the time that they become loose; however, this change is minimal and should not be confused with a carious lesion (cavity). The best way to determine if your child has a stain or a true cavity is to take him or her to a pediatric dentist. Caries is an infectious disease; it progresses if left untreated and is usually associated with pain (especially when the cavities are large). Teeth with cavities typically assume a darker (brown) discoloration, and depending on the extent, may exhibit loss of tooth structure. Teeth that have been previously "bumped" may also change in color. Traumatized baby teeth can assume a yellow or a dark discoloration, which may or may not be associated with pain. Other less common causes of changes in color may be: fluorosis, food staining (particularly tea or colas), systemic disease (hepatitis), etc.

One of our most common consults occurs when children around the age of seven begin to lose their lower front teeth. Many of our parents become overly worried about this phenomenon. It is very normal for permanent lower incisors (front teeth) to erupt behind their predecessors (baby teeth); however, if a baby tooth is not loose by the time half of the permanent incisor has erupted, it may be necessary to pull it.

Crooked or crowded teeth are very common in the growing patient. Even patients who get braces may develop a minor degree of crooked (crowded) teeth, particularly in the front teeth of the jaws, as they grow old. The first step in determining the need for treatment is what we call an orthodontic consult. During this appointment, we may obtain special records and special x-rays of your child's jaw. This information will allow us to make a decision based on predicted growth patterns that your child may show later. In orthodontic terms, we refer to this as Early Treatment. Early Treatment refers to any orthodontic (braces) or orthopedic appliances (like headgear) treatment that begins when the child is in primary dentition or in early mixed dentition (when the first permanent teeth begin to erupt). Early Treatment has been proven to be effective despite objections by some people in the orthodontic community. The American Academy of Pediatric Dentistry (AAPD) recognizes that early diagnosis and successful treatment of developing malocclusions can have both short-term and long-term benefits, while achieving the goal of occlusal harmony, function, and facial aesthetics.

A conscious oral sedation is a procedure in which a child is given an oral medication that causes a depressed level of consciousness. The American Academy of Pediatric Dentistry (AAPD) has clearly defined the indications for this procedure, and they are as follows:

A) Preschool children who cannot understand or cooperate for definitive treatment.

B) Patients requiring dental care who cannot cooperate due to a lack of psychological or emotional maturity.

C) Patients requiring dental treatment who cannot cooperate due to a cognitive, physical or medical disability.

D) Patients who require dental care but are fearful, anxious, and cannot cooperate for treatment.

As with any procedure in which a child's conscious state is altered, there are some risks involved. The main risks (serious complications) associated with conscious sedation include, but are not limited to: aspiration, respiratory arrest, cardiac arrest, and death. Because your child will be partially awake, local dental anesthesia (a lidocaine shot) is still needed; and this may limit the extent of work that we can provide. Sedation dentistry is also an option in cases of accidents or trauma; but in these situations, the decision to administer the medication must take into consideration the risk of aspiration (breathing vomit into the lungs) and any head trauma that may have occurred. If your child is a candidate for a conscious sedation, please make sure you follow the instructions provided by your pediatric dentist.

This is the one of the most commonly asked questions that we get from our patients' parents. We try to minimize the discomfort of the injection by placing a gel that works as a local anesthetic and numbs the tissue where the injection will be administered. Profound local anesthesia is usually obtained 5 – 10 minutes after the injection, depending on the area of the mouth where the anesthetic was placed. We always check to confirm that the area is numb before we begin to work. In cases of localized infection or trauma (like broken teeth), it is very difficult to obtain profound anesthesia. However, we do have other means of supplementing the anesthetic (like conjoined use of nitrous-oxide gas, medications, or conscious sedation). Younger children, particularly preschoolers, may interpret the feeling of numbness as pain, and therefore cry. Please follow the post-operative instructions that we give you in order to minimize complications such as lip biting.