At Portland Children's Dentistry, Dr. Patricia Peirano Franklin and Dr. David Raphael provide exceptional, comprehensive dental care to our patients from infancy through adolescence. Our priority is to create a friendly and comfortable environment where our young patients have a positive dental experience. We make dentistry fun while teaching children and families the importance of good oral health.
When should I schedule my child's first visit to the dentist?
We recommend that you make an appointment to see the dentist as soon as your child gets his first tooth. The American Academy of Pediatric Dentistry recommends that a child be seen within the first 6 months after his/her first tooth erupts or by 1 year old, whichever is first.
How is a pediatric dentist different from other dentists?
All dental specialists (pediatric dentists, orthodontists, oral surgeons, and others) begin by completing dental school, then continue their education with several years of additional, specialized training. During training in the field of pediatric dentistry, Dr. David and Dr. Patty gained extensive knowledge and experience in treating infants, children, adolescents, and children with special needs.
How can I prepare my child for his first dental appointment?
A positive first visit to the dentist starts at home. You can introduce your child to our office and staff by exploring our website. We have recommended several children's books that demonstrate what happens when they first come to our office.
Tell your child how important it is to keep their teeth and gums healthy and that the doctors will help maintain their mouth health as well.
Children will pick up on anxiety of parents and siblings, so avoid making comments about negative experiences that you may have had. Make the visit to the dentist an event that is something to get excited about. Remember, Dr. David, Dr. Patty, and the staff at Portland Children's Dentistry are trained to make sure that your child has a fun, positive experience.
We generally recommend scheduling check-ups every six months. But we may recommend more frequent visits for young patients with greater dental needs; like teenagers with braces who have difficulty keeping their teeth clean, some children with special needs, and children with a very high rate of cavities.
Baby teeth aren't permanent; why do they need special care?
Yes, baby (primary) teeth might not last as long as permanent teeth, but they are just as important. They play a special role in your child's development.
Baby teeth help develop speech, chewing function, and help to hold the space for the developing adult teeth. If a child loses a baby tooth too early, this may lead to crowding and bite issues in the future.
If we do not treat decay on baby teeth, the decay will progress and can cause pain and infection that can have serious consequences to your child's health.
Parents can begin brushing their child's teeth as soon as they begin erupting, typically around 6 months of age. For the first front teeth you can use a washcloth and wipe them after feedings. As more teeth erupt make sure to use a toothbrush with soft bristles and a small head. There are two primary purposes to brushing at this young age. The first is to remove the plaque (or bacteria) and sugars that cause cavities. The second, and just as important, reason is to start establishing good habits.
At this young age, children are not very efficient at spitting, so it is important to use an appropriate amount of toothpaste. Rather than the traditional "pea sized" amount of toothpaste, the new recommendation is to use no more than a smear or grain of rice-sized amount of fluoridated toothpaste. When a child reaches 3+ years, he or she is probably better at spitting. At this stage the child can use a small pea sized amount of toothpaste twice a day.
As children get older, the teeth tend to move together, particularly in the back of the mouth. When teeth begin to touch, this creates spaces where the toothbrush cannot reach. Flossing once a day is the best way to remove the bacteria that can cause cavities between the teeth.
Children typically need help from their parents until they are old enough to have the dexterity and discipline to do it themselves. This usually happens around 7-8 years of age, but, as some parents know all too well, even teenagers may need a little encouragement when it comes to good oral hygiene habits.
Teething generally begins at about 6 months of age, starting with the 2 lower front teeth. It can be accompanied with excessive drooling, biting, chewing, and fussiness. Despite common belief, high fevers are NOT associated with teething. If your child is experiencing high fever, contact his or her pediatrician.
In total, there are 20 baby teeth which erupt by the time the child is 3 years old.
There is wide range in when the first tooth will erupt. So don't worry if your 12 month old has yet to sprout a tooth! If you have concerns, make an appointment and we can take a look.
A few tips for the teething infant or toddler:
Teething rings or toys (often these are gel filled and can be placed in the freezer)
Frozen food (frozen bagels, bananas, apple slices)
Children's Tylenol or ibuprofen (make sure to stay with in recommended doses)
We all have good and bad bacteria in our mouth. The cavity causing bacteria eats sugars that are left on our teeth from our food and drinks and turns them into acid. This acid is deposited on the teeth which dissolves the outer layer of the tooth (enamel), creating the holes in the teeth which we call cavities.
Good habits start at home. Brushing twice a day for two minutes (with an adult's help until the child is able to do a good job on his or her own) is the best place to start. This will clean the chewing and flat surfaces of the teeth, but will not clean between the teeth. When the spacing between the teeth has closed, floss should be introduced into the daily routine to reach spots between the teeth that brushing can't.
Nutrition is another important part of avoiding cavities. Avoid sugary foods and drinks, limit the frequency of snacking, and maintain a healthy diet.
Finally, make regular appointments so that we can check the health of your child's teeth and provide professional cleanings.
What is baby bottle tooth decay and how can I prevent it?
Baby bottle tooth decay is a pattern of cavities associated with prolonged nursing or bottle feeding. It happens when a child goes to sleep with a bottle or breast feeds off and on throughout the night. During sleep, the flow of saliva is reduced and the natural self-cleansing action of the mouth is diminished.
If possible, avoid nursing your child to sleep or putting anything other than water in their bedtime bottle. Encourage your child to drink from a cup as they approach their first birthday. He or she should be weaned from the bottle at 12-14 months of age.
While gum disease is most commonly thought of as an adult concern, gingivitis (the first stage of periodontal disease) is nearly a universal problem among children and adolescents.
Chronic gingivitis can cause gum tissue to swell, turn red, and bleed easily. Gingivitis is preventable and treatable with a regular routine of brushing, flossing, and professional dental care. If left untreated, it can eventually advance to more serious forms of periodontal disease.
More aggressive forms of periodontal disease are occasionally seen in otherwise healthy teenagers and young adults. This generally happens around puberty and can cause severe bone loss and even premature loss of permanent teeth.
Certain conditions can make children more susceptible: Down syndrome, or any medical condition causing immunosuppression.
Fluoride is a mineral that occurs naturally in many foods and water sources. It is also added to some community tap water, toothpastes and mouth rinses because it helps make the enamel more resistant to tooth decay.
The Portland City water does not contain fluoride. If you are not sure if your tap water has fluoride, contact your local or state health department or water supplier.
We understand and respect that fluoride is not for everyone. Let us know if you have any questions or want to talk about this topic!
Sealants cover the pits and grooves in teeth that are difficult to brush and therefore susceptible to decay. Bacteria and sugary foods can hide in the deep grooves of the back teeth (think of what your molars look like after eating Oreos!) making a perfect environment for growing cavities. We recommend sealants as a safe, simple way to help your child avoid cavities, especially for molars, which are hardest to reach.
My child plays sports; how can I protect his teeth?
A properly fitted mouth guard is an important piece of athletic gear that can help protect your child's smile. It will stay in place while your child is wearing it, making it easy for them to talk and breathe. It should be used during any activity that could result in a blow to the face or mouth.
Ask us about custom and store-bought mouth protectors.
What should I do if my child sucks his thumb or uses a pacifier?
A pacifier or thumb sucking habit is normal for infants and young children. The majority of children will outgrow this habit by four years of age without any consequences to the adult teeth. Children who do not outgrow this, can see lasting effects on their bite, as the bones of the jaw will shape themselves around the pacifier or thumb.
Dr. Patty and Dr. David will talk with you about strategies to help your child move past his or her habit. We will assess your child's bite and discuss any effects of the habit that we see.
Concern over grinding teeth is frequently what prompts a first visit to the pediatric dentist. "It sounds like my child is chewing rocks in his sleep!" and "My child has worn down his baby teeth almost to gumline!" are common sentiments of worried parents. In fact, grinding (or "bruxism") is fairly common among young children, and generally not a cause for concern.
Most children who are night time grinders do not experience any negative consequences from the habit. The majority of cases do not require any treatment and most children will outgrow bruxism without any intervention by the time their adult teeth are in. If a child continues to grind his or her teeth once the adult teeth are in, a mouthguard may be indicated.
It is always a good idea to start thinking about whether or not orthodontics are beneficial earlier rather than later. In some cases, a malocclusion (or misalignment of the upper and lower jaws) can be recognized as early as 2-3 years of age. While orthodontic intervention at this age is rarely indicated, having an expectation of your child's growth and development will be helpful in anticipating future needs.
There are different approaches to orthodontic treatment. These approaches target different issues at the various stages of development. Depending on your child's needs, he or she may benefit from an intervention at any stage.
Early treatment generally involves only baby teeth. At this age, we are concerned with appropriate development of the upper and lower jaw, harmful habits such as thumb or pacifier sucking, and premature loss of baby teeth.
Treatment during the stage where a child has a mixture of baby and adult teeth (or the "mixed dentition") occurs generally from ages 6-12 years. This is frequently a good time to consider braces or a retainer, as the child's growth can be modified and guided to achieve an optimal outcome. Young people are very responsive to orthodontics at this stage.
The complete adult dentition is usually present at about 12 years of age. At this stage the goal of orthodontics is generally to straighten the teeth and develop the final bite relationship.
Dr. Patty and Dr. David will recommend a visit to the orthodontist as needed based on your child's needs. We work closely with the best orthodontists in Portland to make sure that our patients receive the best treatment available.