+ What is different about a Pediatric Dentist compared to a Family Dentist?

Many general dentists or "family dentists" treat children. However, pediatric dentists have a special understanding of child development and behavior management that most general providers don’t. They have completed two to three years of additional specialized dental training focused entirely on the specific management of growing mouths and busy little bodies and minds. Their added schooling also makes them more prepared to treat patients with more complex medical, developmental, and dental needs. Their role in dentistry is similar to that of a pediatrician in the medical world.

+ When should my child start seeing the dentist?

Just as babies visit their pediatricians for preventative visits called "well-baby checks," so should they visit the dentist as soon as teeth first begin to appear. Children should have their first dental visit by their first birthday or within 6 months of the first tooth erupting. You may be thinking to yourself, "Why do they have to come that early? My kid doesn’t have any problems with his/her teeth. And they’re not going to cooperate for the dentist so why bother?" That is precisely why they need to come early.

The American Academy of Pediatrics (medical organization) and the American Academy of Pediatric Dentistry (dental organization) have made this age recommendation because the amount of tooth decay in young toddlers is on the rise.

Toddlers are especially susceptible to tooth decay, precisely because they are so difficult to brush and floss and because they typically snack throughout the day to keep their boundless energy supplied. Good hygiene habits and diet are especially important for preventing decay in toddlers because their pre-cooperative age makes it very difficult (even for pediatric specialists) to perform dental treatment. If decay is detected early, there are a number of things a pediatric dentist can do to help help your child. But if cavities have become very large or widespread, toddlers often require dental treatment under general anesthesia in a hospital setting because they are incapable of tolerating extensive dental treatment.

See the article by the New York Times about the rise in dental decay in toddlers for more information:


+ How often should my child get dental checkups?

This will be determined by your child’s dentist. Most kids are seen every three to six months. Those with a higher risk of cavities, a history of extensive previous dental decay, consistently poor dental hygiene, orthodontic appliances (such as braces), anxieties, special needs or certain medical conditions are seen on a more frequent basis.

+ How do I brush my toddler’s teeth? He/she won’t "let" me!

Most toddlers won’t "let" you do anything they find mildly uncomfortable or unfamiliar. Regardless of any protest, however, smart parents persist when they know their child needs something to keep them safe or healthy: If they cry when they have a poopy diaper, we still change it anyway. If they want to run into the street, we scoop them up out of harm’s way and we endure the temper tantrum to follow. We do it because we know what is best for them and we know that such vigilance on our part will not traumatize them.

The same philosophy should exist for dental hygiene. Bacteria is trying to invade your child’s teeth. So even if they HATE it, brush their teeth. If they protest (and sometimes even scream and physically resist you), it’s called "aversive behavior." Essentially they are saying, "Mommy/ Daddy! I don’t like this! If I make your life really difficult right now will you stop?" If the answer is "Yes, I’ll stop. I’m too dang tired and it’s not worth the battle," your child has learned a new trick and will keep doing it to get you to stop. If the answer is consistently "No. I know this is good for you and will keep your teeth from getting sick," the protests will become fewer and farther between.

+ What is a cavity? And how do cavities happen?

"Tooth decay is the single most common chronic childhood disease—5 times more common than asthma, 4 times more common than early- childhood obesity, and 20 times more common than diabetes." –American Academy of Pediatric Dentistry

We all know that cavities are a bad thing, but most people don’t exactly know what they are. We all know that sugar is bad for our teeth, but most people don’t really know why.

Cavities are holes that can form in our teeth. We have bacteria in our mouths that eat whenever we do. We nickname them "sugar bugs" in our office because they digest sugars. What most people don’t know is that there are sugars in almost all foods–particularly carbohydrates. So when your child is eating crackers, cereal, bread, granola bars… whatever the carb may be, they are feeding the bacteria in their mouth. This is even the case for foods that are super-healthy, organic, non-GMO, cruelty-free, fair trade, etc. It doesn’t matter to the "sugar bugs." If it’s a carbohydrate, those germs will digest it! For about 20-30 minutes after that sugar source enters the mouth, the bacteria produces acid.

When the acid produced by the bacteria comes in contact with the enamel of the teeth, the acid leaches minerals out of the teeth, making them softer. The thicker the bacteria, the more acid is being produced and the longer that acid stays in contact with the surface of the tooth. Our saliva helps to put those minerals back into the teeth after the acidic environment neutralizes 20-30 minutes later. But if the bacteria has already formed a thick layer called "plaque," the saliva cannot reach the acid stuck to the teeth. So that spot never gets a chance to neutralize and the minerals continue to flow out of the enamel. To make things worse, when kids snack frequently, the saliva remains acidic, causing those soft spots to eventually cave in. The soft spot has now become a cavity. Now that little caved-in spot can collect more bacteria because floss and toothbrushes can’t reach into the hole, and the process continues. More and more of the tooth starts to decay and the hole gets bigger and bigger.

+ Should I switch to an electric toothbrush for my child?

Numerous studies show that electric toothbrushes are more effective than manual toothbrushes. However, young children still need very close supervision and assistance when brushing their teeth, regardless of what type of toothbrush is used. Kids that cannot yet tie their own shoes or write in cursive are physically incapable of removing the microorganisms hiding in their little mouths. They just don’t possess the necessary manual dexterity to position the brush properly in many areas of their mouths. The electric toothbrush helps (somewhat) in that regard. But here are the most common pitfalls:

  1. Make sure you are still brushing along the "gumline," or the place where the gums and the teeth meet. Kids generally don’t like the way the electric toothbrush feels in this tender area at first. It tickles! It may even cause a little soreness when you first start using it. Try holding it in a small region while counting so your child knows they get a break. Start with 5 seconds, then 10 seconds, then 20 seconds, etc. and gradually increase the length of time until the sensation is not so overwhelming.
  2. Use an electric toothbrush that recharges. Electric toothbrushes are only as effective as their battery. Store-bought, battery operated toothbrushes die very slowly over time. As the battery power wanes, so does the number of "brush strokes" the toothbrush is able to deliver in the same amount of time.
  3. Go slow! The electric toothbrush needs to linger in a given area to remove the plaque. Don’t frantically swish the brush back and forth as you would a manual toothbrush. Hold it in a given area for several seconds before moving on.

+ What is fluoride and why is it recommended?

Fluoride in a mineral that can integrate into the enamel of the teeth and forms a stronger barrier that is less susceptible to the acid attack created by bacteria when we eat. (See the FAQ about how cavities form.) It was first discovered to prevent cavities in a community that had naturally occurring fluoride in its groundwater. Dental patients had less cavities in that region than was noted in surrounding areas. Fluoride has been studied since the early 1900’s and its effects have been proven time and time again to prevent tooth decay when dosed properly.

+ Do we have fluoride in our drinking water in Sonoma County?
In most communities, fluoride supplementation is provided through the municipal water supply. That is not the case in Sonoma, Lake, and Mendocino counties (with the exception of Healdsburg.)

Fluoride supplementation through prescription is recommended for children who reside in those counties. You can request a prescription from your child’s dentist or pediatrician or substitute all drinking water with bottled fluoridated water, which can be found at stores like Babies "R" Us, Target or Amazon.

+ My baby does not spit out the toothpaste when I brush. Should I use training toothpaste or is fluoride toothpaste okay for babies?

"Training toothpaste" used to be recommended for children under the age of two. That is outdated advice, but stores still tend to stock it on their shelves. Children should begin having their teeth brushed with the proper amount of fluoridated toothpaste as soon as their first teeth show up. For children 2 and under, "just a smear" (or the size of a grain of rice) two times a day is appropriate and the amount of fluoride ingested is negligible. For kids 3 and up, the same holds true for a portion about the size as a small pea two times a day.

+ Is fluoride safe for my child?

The safety and efficacy of fluoride for cavity prevention has been echoed for decades by medical and dental professionals and public health officials. Here are a few of the many recommendations to the public:

American Dental Association

Word Health Organization

United States Surgeon General

American Academy of Pediatric Dentistry

American Academy of Pediatrics

For a comprehensive overview of the science behind fluoride and to examine the studies that rule out systemic health concerns, please view the following website:

Fluoride Science

+ Are dental x-rays safe and how often should my child get them?

X-rays (radiographs) are an important tool used to diagnose many dental problems. Many types of cavities or dental conditions are undetectable without them. Once the teeth are touching, there is no instrument a dentist can use in between the teeth that can reliably detect decay. The proper diagnosis of most cavities in those areas is usually unattainable without the images a dental x-ray can provide. It would be akin to a cardiologist attempting to diagnose a heart condition without an EKG.

So how much radiation is in a dental x-ray and is it safe to use regularly? First of all… Yes–It’s safe. And when used properly, the benefits exceed the risks significantly. We use digital equipment, which minimizes the dose of radiation used for all of our x-rays. The amount of radiation used in one dental x-ray ("bitewing" x-ray, which detects cavities that may be starting in between the teeth) is the same amount of radiation we get from one day of walking around on a planet that is warmed by the sun.

The number and type of x-rays your child will undergo at a dental appointment will depend on their individual needs. His/her dentist will prescribe an appropriate number of images, based on the recommendations of the American Academy of Pediatric Dentistry (AAPD) and the American Dental Association (ADA.)

For more information, refer to the website offered by the ADA: http://www.ada.org/en/member-c...

Dental Decay

Extra baby tooth blocking the development of permanent front teeth

+ When should my child see an orthodontist?

Your child’s dentist will be assessing the growth and development of the jaws and teeth at each checkup appointment. Some children will be referred for an orthodontic consultation as young as seven years old. Children that are having particular types of orthodontic issues (particularly with disturbances in jaw growth) are often best intercepted at a young age while they are still actively growing. Early evaluation provides both timely detection of problems and greater opportunity for more effective treatment. Prudent intervention guides growth and development, preventing serious problems later. When orthodontic intervention is not necessary, an orthodontist can carefully monitor growth and development and begin treatment when it is ideal.

Our doctors have extensive experience with many of the orthodontists in the area and will offer you a list of orthodontists who they trust to take the best care of our patients.

Before and After Orthodontics (Early intervention or “Phase I” orthodontics)

Severe crowding ortho

Anterior open bite

+ What is a sealant?

Sealants are protective coatings placed on the outside of a molar tooth to protect the deep grooves and pits that are naturally present on the chewing surface of those teeth. They have been shown to reduce the risk of dental decay on permanent molars by up to 80%. You will still need to floss and properly brush to further prevent decay, but the "groovy" surface where we chew is often formed with tiny imperfections that collect bacteria no matter how hard we brush and floss. Dental sealants are designed to fill in those tiny grooves and imperfections.

+ More Info

Here are some interesting facts that you may not know about teeth. For more information, click below to see the American Academy of Pediatric Dentistry’s website.

American academy


  • Dental decay is an infectious disease. Babies acquire their oral bacteria from their parents or primary caregivers even before the first tooth emerges.
  • Bacteria attached to the teeth in dental plaque produces acids when exposed to carbohydrates. Chronic repetitive exposure to acids results in demineralization of tooth enamel.
  • It takes only 24 hours for bacterial colonies to reform on teeth in the form of plaque.
  • Demineralized tooth enamel can be re-mineralized. When demineralization occurs more often than remineralization, a cavity will develop.
  • Daily fluoride supplements given during tooth formation (until 12 years old) has been proven safe and reduces dental decay by approximately 50% in permanent teeth.
  • Several orthodontic malocclusions can be detected in children as early as 2 years of age.
  • Sugar is hidden in many different foods. Find out how some of your favorite snacks stack up by clicking here.

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