I AM Modern Magazine for Moms

RE: Real Estate Professional
written by valerie_woo , August 17, 2008

Dear Mike,

Because I do not know the extent of the decay or how your son cooperated at his visit, it is difficult for me to tell you which option to choose. There are certain situations (if the decay is small and your son can cooperate) that sedation and novacaine is not necessary. Nonetheless, nitrous oxide is a very safe agent and as long as your son can breath through his nose it is a safe option. You can always try the nitrous oxide alone first to see how well he does. If it does not go well and your dentist cannot complete the procedure then you may want to consider the next option. Consider getting a second opinion to review your options and to see if others exist. Ultimately, you need to feel comfortable with the treatment. Dr. Woo

Real Estate Professional
written by Mike , August 14, 2008

Hello Dr. Woo,
I have a 3 year old son who recently went for his first dental checkup. The dentist found two cavities on the backside of his two front teeth. Obviously they need to be filled but she gave us two options of treatment. 1) Nitrous oxide sedation or 2) nitrous oxide sedation in combo with a conscious sedative. I am weary of any type of sedative/general anesthesia especially in children of such young age. If you have/had a child faced with these options which would you choose and why? Thank you so much for your time on this matter. Mike.

RE: Loose Teeth
written by valerie_woo , August 02, 2008

Dear Banu,

This is a very common dental question. Some children have enough space for the permanent teeth to come in very straight while others do not and they come in crooked. Some baby teeth can just fall out on their own because the permanent tooth underneath can resorb the entire baby tooth's root. However, if there is not enough room for the permanent tooth to come in, often times the permanent tooth comes in BEHIND the baby tooth and the baby tooth will stop getting loose. It's best to encourage your child to continue wiggling the baby tooth and to eat apples so the tooth will come out on it's own. However, if you or your child don't think nature will takes it's course because the permanent tooth has come in too much (you see over 50% of the permanent tooth erupted) and the baby tooth just won't budge, then it's best to see your local pediatric dentist to examine and he/she may need to help your child wiggle the tooth.

Loose Teeth
written by Banu , July 23, 2008

Dr. Woo,
My son has loose baby teeth, I mean really loose. He looks like a pirate with teeth point this way and that. He will not let me pull them out. I see his permanent teeth, they are coming in. What is the protocol? Do you pull or let nature do it?

RE: 18 mos old - Taking care of your toddler's teeth
written by valerie_woo , June 18, 2008

Dear KRM,

Q: Should we be focusing and/or paying special attention to any particular area (i.e. bottom teeth, molars, etc)? What is your recommendation for taking care of their new teeth?

A: Taking care of your toddler's teeth can sometimes be a challenge because your toddler wants to be independent! An 18 month old can have up to 16 out of the 20 baby teeth (sometimes all 20 of them if they are very early teethers) and it is important to brush each tooth as each tooth is prone to dental decay. Here are a few suggestions that may help. Realize that you will have good days and not so good days. Don't get discouraged! Being consistent, setting a routine, and making it fun will always help!

1. If your toddler wants to do it by themselves - let them! Especially in the morning when you are brushing your teeth because they are at an age where they love to copy their parents. It is important to try to get at least one good brushing before bedtime. Your child can have their turn and then mommy or daddy get a turn.
2. Sing songs - make it fun! I sing a song about brushing to the tune of Row Row Row your boat and the Wheels On the Bus. It's fun to get creative.
3. Try brushing your toddler's teeth from behind them with their head tilted up (chin up and looking up at the sky) so that you end up brushing their teeth the way you brush your own teeth and you are able to keep your child's head steady.
4. OR - have your child lay on the bed with their head on your lap. When they are in the upside down position you can really see and brush all of their teeth. Sometimes your child may wiggle around, so if you have another person to help - they can help hold the hands/legs while you focus on brushing the teeth. Getting your child to feel comfortable in this position will help them feel comfortable when they visit their pediatric dentist.
5. Try changing the flavor of non-fluoridated toothpaste and their toothbrush to make it more interesting. If your toddler doesn't like the toothbrush - try wetting a washcloth and wipe the plaque off the teeth. There is also a product called spiffies that you can purchase from Whole Foods or http://www.spiffies.com/. Spiffies are tooth wipes with xylitol that also help wipe off the plaque.
6. Flossing - there are some toddlers that do need to floss if there is not space between the teeth. If your child's teeth are close together there is a risk of getting in between cavities. Flossing will help prevent this. Kids flossers can also help.
7. Visit your pediatric dentist. Your child should visit a pediatric dentist when the first tooth comes in, usually between six and twelve months of age. Early examination and preventive care will protect your child’s smile now and in the future. It helps establish a dental home for your child and educates the caregivers regarding how to care for the teeth, brushing techniques, oral habits, diet/nutrition, and dental trauma.

18 mos old
written by KRM , June 18, 2008

Dr. Woo, it is so hard to get into the mouth of a little 18 month old toddler! I brush once/day with the baby toothpaste (safe to swallow) but again, sometimes I cannot get to every tooth - especially the top ones. Should we be focusing and/or paying special attention to any particular area (i.e. bottom teeth, molars, etc)? What is your recommendation for taking care of their new teeth?

RE: Ectodermal Dysplasia
written by valerie_woo , June 08, 2008

Dear Cristal,

Yes I am very familiar and knowlegeable with ectodermal dysplasia and would work closely with your orthodontist regarding treatment. You can contact me directly at 703.729.7005 to discuss how to approach her preventatitve treatment (with or without sedation) or any other specific questions you may have.

ED
written by cristal smith , June 01, 2008

Hello there Dr Woo:
My daughter was recently diagnosed with ectodermal dysplasia and it is time for her to go back to the dentist - however with this diagnosis I would really like someone who is familiar and knowledgeable with all that goes with it - is this something that you have experience with? I have the Orthodontist already in mind but first she needs to go to the dentist again - thanks so much! Oh and she is way sensitive about her teeth - to just get cleaned and coated last time we had to have her put to sleep -

thanks
cristal