602 Center St. Suite 203 Mount Airy, MD 21771 | Ph: 301-829-6588


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PEDIATRIC DENTISTRY

Happy Child - Pediatric Dentist in Mount Airy, MD

New patients must be accompanied by a parent or guardian.

First Visit:

What is a Pediatric Dentist?

The pediatric dentist has received an extra two to three years of specialized training after dental school, and is dedicated to the oral health of children from infancy through the teenage years. The very young, school-aged, and teenagers all need different approaches in dealing with their behavior, guiding their dental growth and development, and helping them avoid future dental problems. The pediatric dentist is best qualified to meet these needs.

First Visit

New Patient Health History (Pediatric Dental Patients Only)

As recommended by the American Academy of Pediatric Dentistry and the American Academy of Pediatrics, we advise parents to schedule their child’s first dental visit at about one year of age or when the first teeth erupt into the mouth! This is now the new standard for giving your child a chance to be cavity free. It is very important to make the first visit as positive and enjoyable for the child as possible. We want your child to enjoy getting to know our doctors and staff and be comfortable at all times. A pleasant, comfortable first visit builds trust and helps put the child at ease during future dental visits. Let the child know that the doctors and staff will explain everything in detail and will answer any questions he/she has. Children should be encouraged to discuss any fears or anxiety they feel.

Parents should not make a big deal out of the visit and refrain from using any words that could cause unnecessary fear, such as "needle" or "drill." We are experienced in dealing with children with anxiety and can explain treatment procedures in a positive and pleasant manner to avoid any anxious or negative feelings toward dentistry.

We will record the child’s dental and medical history, complete a comprehensive examination and discuss any findings with you. We will also review the importance of maintaining a good dental health program with you and your child to ensure a healthy and beautiful smile for life!

We anticipate age appropriate behavior. For instance, your two year old child does not like to sit still for even a minute. They may be unhappy or even cry when you hold them for longer than they want to be held. Children will usually work their way through it with our compassionate encouragement. Thank you for your cooperation.

What to Expect

As soon as you enter our office, you will notice that dentistry for children has changed in many ways. Start your visit by registering at the pediatric dental front desk. You are on your way to a great first experience. Our open reception area is a welcoming room filled with activities, videos and electronic games to engage and relax your child. Our world class pediatric dental and orthodontic office is designed uniquely for children and their parents. From the very first dental visit at their first birthday, we treat every child in our practice as if they are our own. You’ll definitely see “big kids” in our office too, because most of our patients stay with us through college age!

First Visit Suggestions:

We would like to make a few suggestions to prepare your child for the initial visit:

  • First, present the visit as an exciting experience (for yourself) and for your child.
  • Second, tell the child that the hygienist "will count", "brush", and "take pictures of their teeth." By explaining the exam and the cleaning in these terms, your child will better understand the situation.
  • Try to be relaxed and at ease. Your child will sense any anxiety on your part.
  • It is our job to make this the best positive experience possible. Avoid negative phrases such as "hurt", "drill", "pull", and "shot". This initial examination involves nothing uncomfortable and should be perceived by the child as non-threatening.
  • Assure your child that the doctor will be gentle and friendly. Please do not tell your child that “the dentist will not hurt”, as this probably would not otherwise have been a concern.
  • We ask parents to assume the role of a silent observer. Your presence is greatly enhanced if you play a passive role. If more than one person is speaking to the child they may become confused. Cooperation and trust must be established directly between the doctor and your child and not through you.
  • For the safety and privacy of all patients, other children who are not being treated should remain in the reception area with a supervising adult.
  • Cell phone use is distracting to your child and others. Please refrain from using your cell phone in the office.
  • Food and drinks are sources of contamination and compromise our standards of infection control. Therefore, please do not bring food or drinks into the office.
  • Try not to schedule appointments at nap-time. Just as you and I dislike being disturbed from our rest, so do the little ones. Bring them in the early morning before naptime.
  • If you know your child is not feeling well and has an elevated temperature, bringing them here is not good judgment for two reasons (1) Your child will be miserable and not have a very good experience and (2) Your child will probably infect the other children in the practice.

What About Parents Present in the Dental Treatment Areas?

Our practice philosophy is child-centered. We want you to be with your child during their visits with us. In fact, we insist on your presence because we want you to be by their side while they and you learn how to care for their smile. We welcome you in the dental treatment rooms and we encourage your participation throughout your child’s care. Let us know how we’re doing, so we can give you and your child the care you expect and deserve.

Scheduling Appointments

We would like to see all school-age patients after school: however, this is not possible. We are aware of school policies which make it more difficult for children to be out of school for any reason. However, MEDICAL and DENTAL appointments are EXCUSED ABSENCES with a doctor’s school pass and signature stating the child was in the office. We will be happy to provide that for you at your request. Missing school can be kept to a minimum when regular dental care is continued.

The office attempts to schedule appointments at your convenience and when time is available. Preschool children should be seen in the morning because they are fresher and we can work more slowly with them for their comfort. School children with a lot of work to be done should be seen in the morning for the same reason. Since appointed times are reserved exclusively for each patient we ask that you please notify our office 24 hours in advance of your scheduled appointment time if you are unable to keep your appointment. Another patient, who needs our care, could be scheduled if we have sufficient time to notify them. We realize that unexpected things can happen, but we ask for your assistance in this regard.

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Financial and Insurance

Payment Options Include the Following:

  • Cash
  • Checks
  • Visa, MasterCard, Discover, American Express
  • Online Bill Payment through PayPal
  • Online Payment

Insurance

The Pediatric Dental office is currently participating with the following PPO insurance companies:

  • Aetna
  • Assurant
  • Blue Cross Blue Shield
  • CareFirst
  • CIGNA (DPPO)
  • Coventry Healthcare
  • Delta Dental (Premier)
  • Denex Dental
  • Dental Health Centers
  • United Healthcare
  • Lincoln
  • Wellpoint (Dental Blue Plan)

  • All other open plan dental insurances are accepted on an out-of-network basis. If you choose to schedule with an out-of-network provider, you are responsible for all fees not covered by your insurance

    If we have received all of your insurance information on the day of the appointment, we will be happy to file your claim for you. Because the insurance contract is between you, your employer and insurance company, we can only estimate your coverage in good faith but cannot guarantee coverage due to the complexities of insurance contracts. We file all insurance promptly, so your insurance company will receive each claim within days of the treatment. Your insurance processes the claim and sends you notice of the result (estimation of benefits, or “EOB”). Insurance will typically process claims within 30 days. You will be responsible for any deductibles, co-payments, or balances not covered by insurance. You are responsible for any balance on your account after 45 days, whether insurance has paid or not. We will be glad to send a refund to you if your insurance pays us. Although rare, some insurance carriers will not reimburse our office directly. In such instances, you will be responsible for the full cost of each visit at the time services are provided, and your insurance company will send you the reimbursement check directly.

    Insurance is a contract between you, your employer and the insurance company. We are not a party to that contract. We cannot be responsible for keeping up with the ever changing policies of each individual insurance plan. Depending on your individual plan, all services may not be covered.

    Please understand that we file dental claims as a courtesy to our patients. Claims are filed promptly to expedite communication with your insurance company. It is important for you to keep us informed of any insurance changes such as policy name, group and id number, or a change of employment. We are not, however, responsible for how your insurance company processes the claims or for what benefits are ultimately paid on a claim. Our office bases treatment on your child's needs, not what your insurance will pay. Insurance payments are determined by the benefit package that your employer purchased. We have no way of knowing if, or what, your insurance company will pay until the actual claim is submitted. Therefore, all account balances which have not been paid are the responsibility of the parent/guardian.

    Separated or Divorced Parents

    For separated or divorced parents, the parent who brings the child to the office is legally responsible for payment of fees charged for that child’s care. If another agrees to payment responsibility, that person must provide a notarized acknowledgment in writing of their desire to pay for care. It is the responsibility of the person bringing the child to the office to obtain a written agreement and to inform the other person of care being provided. Your understanding and cooperation with this matter is greatly appreciated. You are helping to keep our overhead expenses, in the form of direct and labor costs, down. In addition, you are helping keep your fees as low as possible. If you have any questions please feel free to ask our business office staff. Please do not hesitate to ask questions about our financial policy. We want you to be comfortable in dealing with these matters. If you have any questions regarding your insurance, we ask that you contact your company regarding the specifics and details of your plan.

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    Dental Topics and FAQ's

    Why are the Primary 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. Primary teeth also affect the development of speech and add to an attractive appearance. While the front 4 teeth last until 6-7 years of age, the back teeth (cuspids and molars) aren’t replaced until age 10-13.

    Eruption of Your Child's Teeth

    Children’s teeth begin forming before birth. Around 6 months, the first primary (or baby) teeth to erupt through the gums are the lower central incisors, followed closely by the upper central incisors. Although all 20 primary teeth usually appear by age 3, the pace and order of their eruption varies.

    Permanent teeth begin appearing around age 6, starting with the first molars and lower central incisors. This process continues until approximately age 21.

    Adults have 28 permanent teeth, or up to 32 including the third molars (or wisdom teeth).Please click on the timeline below to see the teeth erupt and to learn more.


    How Safe are Dental X-Rays

    Dental Radiographs (X-Rays) - Pediatric Dentist in Mount Airy, MD

    Radiographs (X-Rays) are a vital and necessary part of your child’s dental diagnostic process. Without them, certain dental conditions can and will be missed.

    Radiographs detect much more than cavities. For example, radiographs may be needed to survey erupting teeth, diagnose bone diseases, evaluate the results of an injury, or plan orthodontic treatment. Radiographs allow dentists to diagnose and treat health conditions that cannot be detected during a clinical examination. If dental problems are found and treated early, dental care is more comfortable for your child and more affordable for you.

    The American Academy of Pediatric Dentistry recommends radiographs and examinations every six months for children with a high risk of tooth decay. On average, most pediatric dentists request radiographs approximately once a year. Approximately every 3 years, it is a good idea to obtain a complete set of radiographs, either a panoramic and bitewings or periapicals and bitewings.

    Our pediatric dentists are particularly careful to minimize the exposure of their patients to radiation. With contemporary safeguards, the amount of radiation received in a dental X-ray examination is extremely small. Since we use only digital radiography which reduces radiation levels the risk is negligible. In fact, the dental radiographs represent a far smaller risk than an undetected and untreated dental problem. Lead body aprons and shields will protect your child. Today’s equipment filters out unnecessary x-rays and restricts the x-ray beam to the area of interest. High-speed film and proper shielding assure that your child receives a minimal amount of radiation exposure.

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    What's the Best Toothpaste for My Child?

    Toothbrush - Pediatric Dentist in Mount Airy, MDTooth brushing is one of the most important tasks for good oral health. Many toothpastes, and/or tooth polishes, however, can damage young smiles. They contain harsh abrasives, which can wear away young tooth enamel. When looking for a toothpaste for your child, make sure to pick one that is recommended by the American Dental Association as shown on the box and tube. These toothpastes have undergone testing to insure they are safe to use.

    Remember, children should spit out toothpaste after brushing to avoid getting too much fluoride. If too much fluoride is ingested, a condition known as fluorosis can occur. If your child is too young or unable to spit out toothpaste, consider providing them with fluoride free toothpaste, using no toothpaste, or using only a "pea size" amount of toothpaste.


    Does Your Child Grind His Teeth at Night? (Bruxism)

    Parents are often concerned about the nocturnal grinding of teeth (bruxism). Often, the first indication is the noise created by the child grinding on their teeth during sleep. Or, the parent may notice wear (teeth getting shorter) to the dentition. One theory as to the cause involves a psychological component. Stress due to a new environment, divorce, changes at school; etc. can influence a child to grind their teeth. Another theory relates to pressure in the inner ear at night. If there are pressure changes (like in an airplane during take-off and landing, when people are chewing gum, etc. to equalize pressure) the child will grind by moving his jaw to relieve this pressure.

    The majority of cases of pediatric bruxism do not require any treatment. If excessive wear of the teeth (attrition) is present, then a mouth guard (night guard) may be indicated. The negatives to a mouth guard are the possibility of choking if the appliance becomes dislodged during sleep and it may interfere with growth of the jaws. The positive is obvious by preventing wear to the primary dentition.

    The good news is most children outgrow bruxism. The grinding decreases between the ages 6-9 and children tend to stop grinding between ages 9-12. If you suspect bruxism, discuss this with your pediatrician or pediatric dentist.

    Can Thumb Sucking be Harmful for My Child’s Teeth?

    Thumb Sucking - Pediatric Dentist in Mount Airy, MDSucking is a natural reflex and infants and young children may use thumbs, fingers, pacifiers and other objects on which to suck. It may make them feel secure and happy, or provide a sense of security at difficult periods. Since thumb sucking is relaxing, it may induce sleep.

    Thumb sucking that persists beyond the eruption of the permanent teeth can cause problems with the proper growth of the mouth and tooth alignment. How intensely a child sucks on fingers or thumbs will determine whether or not dental problems may result. Children who rest their thumbs passively in their mouths are less likely to have difficulty than those who vigorously suck their thumbs.

    Children should cease thumb sucking by the time their permanent front teeth are ready to erupt. Usually, children stop between the ages of two and four. Peer pressure causes many school-aged children to stop. Pacifiers are no substitute for thumb sucking. They can affect the teeth essentially the same way as sucking fingers and thumbs. However, use of the pacifier can be controlled and modified more easily than the thumb or finger habit. If you have concerns about thumb sucking or use of a pacifier, consult your pediatric dentist.

    A few suggestions to help your child get through thumb sucking:

    • Instead of scolding children for thumb sucking, praise them when they are not.
    • Children often suck their thumbs when feeling insecure. Focus on correcting the cause of anxiety, instead of the thumb sucking.
    • Children who are sucking for comfort will feel less of a need when their parents provide comfort.
    • Reward children when they refrain from sucking during difficult periods, such as when being separated from their parents.
    • Your pediatric dentist can encourage children to stop sucking and explain what could happen if they continue.
    • If these approaches don’t work, remind the children of their habit by bandaging the thumb or putting a sock on the hand at night. Your pediatric dentist may recommend the use of a mouth appliance.

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    What is Pulp Therapy?

    The pulp of a tooth is the inner, central core of the tooth. The pulp contains nerves, blood vessels, connective tissue and reparative cells. The purpose of pulp therapy in Pediatric Dentistry is to maintain the vitality of the affected tooth (so the tooth is not lost).

    Dental caries (cavities) and traumatic injury are the main reasons for a tooth to require pulp therapy. Pulp therapy is often referred to as a "nerve treatment", "children's root canal", "pulpectomy" or "pulpotomy". The two common forms of pulp therapy in children's teeth are the pulpotomy and pulpectomy.

    A pulpotomy removes the diseased pulp tissue within the crown portion of the tooth. Next, an agent is placed to prevent bacterial growth and to calm the remaining nerve tissue. This is followed by a final restoration (usually a stainless steel crown).

    A pulpectomy is required when the entire pulp is involved (into the root canal(s) of the tooth). During this treatment, the diseased pulp tissue is completely removed from both the crown and root. The canals are cleansed, disinfected and, in the case of primary teeth, filled with a resorbable material. Then, a final restoration is placed. A permanent tooth would be filled with a non-resorbing material.

    What is the Best Time for Orthodontic Treatment?

    Orthodontic Treatment - Pediatric Dentist in Mount Airy, MDDeveloping malocclusions, or bad bites, can be recognized as early as 2-3 years of age. Often, early steps can be taken to reduce the need for major orthodontic treatment at a later age.

    Stage I - Early Treatment: This period of treatment encompasses ages 2 to 6 years. At this young age, we are concerned with underdeveloped dental arches, the premature loss of primary teeth, and harmful habits such as finger or thumb sucking. Treatment initiated in this stage of development is often very successful and many times, though not always, can eliminate the need for future orthodontic/orthopedic treatment.

    Stage II - Mixed Dentition: This period covers the ages of 6 to 12 years, with the eruption of the permanent incisor (front) teeth and 6 year molars. Treatment concerns deal with jaw malrelationships and dental realignment problems. This is an excellent stage to start treatment, when indicated, as your child's hard and soft tissues are usually very responsive to orthodontic or orthopedic forces.

    Stage III - Adolescent Dentition: This stage deals with the permanent teeth and the development of the final bite relationship.

    Why Does My Child Have Adult Teeth Coming in Behind Baby Teeth?

    Baby Teeth - Pediatric Dentist in Mount Airy, MDThis is a very common occurrence with children, usually the result of a lower, primary (baby) tooth not falling out when the permanent tooth is coming in. In most cases if the child starts wiggling the baby tooth, it will usually fall out on its own within two months. If it doesn't, then contact your pediatric dentist, where they can easily remove the tooth. The permanent tooth should then slide into the proper place.

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    Early Infant Oral Care

    Perinatal & Infant Oral Health

    Perinatal & Infant Oral Health - Pediatric Dentist in Mount Airy, MDThe American Academy of Pediatric Dentistry (AAPD) recommends that all pregnant women receive oral healthcare and counseling during pregnancy. Research has shown evidence that periodontal disease can increase the risk of preterm birth and low birth weight. Talk to your doctor or dentist about ways you can prevent periodontal disease during pregnancy.

    Additionally, mothers with poor oral health may be at a greater risk of passing the bacteria which causes cavities to their young children. Mother's should follow these simple steps to decrease the risk of spreading cavity-causing bacteria:

    • Visit your dentist regularly.
    • Brush and floss on a daily basis to reduce bacterial plaque.
    • Proper diet, with the reduction of beverages and foods high in sugar & starch.
    • Use a fluoridated toothpaste recommended by the ADA and rinse every night with an alocohol-free, over-the-counter mouth rinse with .05 % sodium fluoride in order to reduce plaque levels.
    • Don't share utensils, cups or food which can cause the transmission of cavity-causing bacteria to your children.
    • Use of xylitol chewing gum (4 pieces per day by the mother) can decrease a child's caries rate.

    Your Child's First Dental Visit-Establishing a "Dental Home"

    The American Academy of Pediatrics (AAP), the American Dental Association (ADA), and the American Academy of Pediatric Dentistry (AAPD) all recommend establishing a "Dental Home" for your child by one year of age. Children who have a dental home are more likely to receive appropriate preventive and routine oral health care.

    The Dental Home is intended to provide a place other than the Emergency Room for parents.

    You can make the first visit to the dentist enjoyable and positive. If old enough, 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 to-do concerning the visit, the better.

    It is best if you refrain from using words around your child that might cause unnecessary fear, such as needle, pull, drill or hurt. Pediatric dental offices make a practice of using words that convey the same message, but are pleasant and non-frightening to the child.

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    When Will My Baby Start Getting Teeth?

    Teething, the process of baby (primary) teeth coming through the gums into the mouth, is variable among individual babies. Some babies get their teeth early and some get them late. In general, the first baby teeth to appear are usually the lower front (anterior) teeth and they usually begin erupting between the age of 6-8 months.
    See "Eruption of Your Child's Teeth" for more details.

    Baby Bottle Tooth Decay (Early Childhood Caries)

    Baby Bottle Tooth Decay - Pediatric Dentist in Mount Airy, MDOne serious form of decay among young children is baby bottle tooth decay, also referred to by dentists as early childhood caries (ECC). ECC can be 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 bottle's contents with water over a period of two to three weeks.

    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, place the child’s head in your lap or lay the child on a dressing table or the floor. Whatever position you use, be sure you can see into the child’s mouth easily.

    Sippy Cups - Pediatric Dentist in Mount Airy, MDSippy Cups

    Sippy cups should be used as a training tool from the bottle to a cup and should be discontinued by the first birthday. If your child uses a sippy cup throughout the day, fill the sippy cup with water only (except at mealtimes). By filling the sippy cup with liquids that contain sugar (including milk, fruit juice, sports drinks, etc.) and allowing a child to drink from it throughout the day, it soaks the child's teeth in cavity causing bacteria.


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    Prevention

    Let's Make Brushing Fun!!

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    Care of Your Child's Teeth & Gums

    Brushing Tips:

    • Starting at birth, clean your child's gums with a soft cloth and water.
    • As soon as your child's teeth erupt, brush them with a soft-bristled toothbrush.
    • If they are under the age of 2, use a small "smear of toothpaste.
    • If they're 2-5 years old, use a "pea-size" amount of toothpaste.
    • Be sure and use an ADA-accepted fluoride toothpaste and make sure your child does not swallow it.
    • When brushing, the parent should brush the child's teeth under they are old enough to do a good job on their own.

    Flossing Tips:

    • Flossing removes plaque between teeth and under the gumline where a toothbrush can't reach.
    • Flossing should begin when any two teeth touch.
    • Be sure and floss your child's teeth daily until he or she can do it alone.

    Make sure your kids brush for 2 minutes 2 times a day

    Good Diet = Healthy Teeth

    Good Diet - Pediatric Dentist in Mount Airy, MDHealthy eating habits lead to healthy teeth. Like the rest of the body, the teeth, bones and the soft tissues of the mouth need a well-balanced diet. Children should eat a variety of foods from the five major food groups. Most snacks that children eat can lead to cavity formation. The more frequently a child snacks, the greater the chance for tooth decay. How long food remains in the mouth also plays a role. For example, hard candy and breath mints stay in the mouth a long time, which cause longer acid attacks on tooth enamel. If your child must snack, choose nutritious foods such as vegetables, low-fat yogurt, and low-fat cheese, which are healthier and better for children's teeth.

    How Do I Prevent Cavities?

    Good oral hygiene removes bacteria and the leftover food particles that combine to create cavities. For infants, use a wet gauze or clean washcloth to wipe the plaque from teeth and gums. Avoid putting your child to bed with a bottle filled with anything other than water. See "Baby Bottle Tooth Decay" for more information.

    For older children, brush their teeth at least twice a day. Also, watch the number of snacks containing sugar that you give your children.

    The American Academy of Pediatric Dentistry recommends visits every six months to the pediatric dentist, beginning at your child's first birthday. Routine visits will start your child on a lifetime of good dental health.

    Your pediatric dentist may also recommend protective sealants or home fluoride treatments for your child. Sealants can be applied to your child's molars to prevent decay on hard to clean surfaces.

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    Seal Out Decay

    AA sealant is a protective coating that is applied to the chewing surfaces (grooves) of the back teeth (premolars and molars), where four out of five cavities in children are found. This sealant acts as a barrier to food, plaque and acid, thus protecting the decay-prone areas of the teeth.

    Sealant-Before - Pediatric Dentist in Mount Airy, MDBefore Sealant Applied

    Sealant-After - Pediatric Dentist in Mount Airy, MDAfter Sealant Applied

    Fluoride

    Fluoride is an element, which has been shown to be beneficial to teeth. However, too little or too much fluoride can be detrimental to the teeth. Little or no fluoride will not strengthen the teeth to help them resist cavities. Excessive fluoride ingestion by preschool-aged children can lead to dental fluorosis, which is a chalky white to even brown discoloration of the permanent teeth. Many children often get more fluoride than their parents realize. Being aware of a child’s potential sources of fluoride can help parents prevent the possibility of dental fluorosis.

    Some of these sources are:

    • Too much fluoridated toothpaste at an early age.
    • The inappropriate use of fluoride supplements.
    • Hidden sources of fluoride in the child's diet.

    Two and three year olds may not be able to expectorate (spit out) fluoride-containing toothpaste when brushing. As a result, these youngsters may ingest an excessive amount of fluoride during tooth brushing. Toothpaste ingestion during this critical period of permanent tooth development is the greatest risk factor in the development of fluorosis.

    Excessive and inappropriate intake of fluoride supplements may also contribute to fluorosis. Fluoride drops and tablets, as well as fluoride fortified vitamins should not be given to infants younger than six months of age. After that time, fluoride supplements should only be given to children after all of the sources of ingested fluoride have been accounted for and upon the recommendation of your pediatrician or pediatric dentist.

    Certain foods contain high levels of fluoride, especially powdered concentrate infant formula, soy-based infant formula, infant dry cereals, creamed spinach, and infant chicken products. Please read the label or contact the manufacturer. Some beverages also contain high levels of fluoride, especially decaffeinated teas, white grape juices, and juice drinks manufactured in fluoridated cities.

    Parents can take the following steps to decrease the risk of fluorosis in their children's teeth:

    • Use baby tooth cleanser on the toothbrush of the very young child.
    • Place only a pea sized drop of children's toothpaste on the brush when brushing.
    • Account for all of the sources of ingested fluoride before requesting fluoride supplements from your child's physician or pediatric dentist.
    • Avoid giving any fluoride-containing supplements to infants until they are at least 6 months old.
    • Obtain fluoride level test results for your drinking water before giving fluoride supplements to your child (check with local water utilities).

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    Mouth Guards

     Mouth Guards - Pediatric Dentist in Mount Airy, MDWhen a child begins to participate in recreational activities and organized sports, injuries can occur. A properly fitted mouth guard, or mouth protector, is an important piece of athletic gear that can help protect your child's smile, and should be used during any activity that could result in a blow to the face or mouth.

    Mouth guards help prevent broken teeth, and injuries to the lips, tongue, face or jaw. A properly fitted mouth guard will stay in place while your child is wearing it, making it easy for them to talk and breathe. Ask your pediatric dentist about custom and store-bought mouth protectors.


    Xylitol - Reducing Cavities

    The American Academy of Pediatric Dentistry (AAPD) recognizes the benefits of xylitol on the oral health of infants, children, adolescents, and persons with special health care needs.

    The use of XYLITOL GUM by mothers (2-3 times per day) starting 3 months after delivery and until the child was 2 years old, has proven to reduce cavities up to 70% by the time the child was 5 years old.

    Studies using xylitol as either a sugar substitute or a small dietary addition have demonstrated a dramatic reduction in new tooth decay, along with some reversal of existing dental caries. Xylitol provides additional protection that enhances all existing prevention methods. This xylitol effect is long-lasting and possibly permanent. Low decay rates persist even years after the trials have been completed.

    Xylitol is widely distributed throughout nature in small amounts. Some of the best sources are fruits, berries, mushrooms, lettuce, hardwoods, and corn cobs. One cup of raspberries contains less than one gram of xylitol.

    Studies suggest xylitol intake that consistently produces positive results ranged from 4-20 grams per day, divided into 3-7 consumption periods. Higher results did not result in greater reduction and may lead to diminishing results. Similarly, consumption frequency of less than 3 times per day showed no effect.

    To find gum or other products containing xylitol, try visiting your local health food store or search the Internet to find products containing 100% xylitol.

    Beware of Sports Drinks

    Sports Drinks - Pediatric Dentist in Mount Airy, MDDue to the high sugar content and acids in sports drinks, they have erosive potential and the ability to dissolve even fluoride-rich enamel, which can lead to cavities.

    To minimize dental problems, children should avoid sports drinks and hydrate with water before, during and after sports. Be sure to talk to your pediatric dentist before using sports drinks.

    If sports drinks are consumed:

    • reduce the frequency and contact time
    • swallow immediately and do not swish them around the mouth
    • neutralize the effect of sports drinks by alternating sips of water with the drink
    • rinse mouthguards only in water
    • seek out dentally friendly sports drinks

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    Sedation/Treatment Options

    Sedation Instructions

    Nitrous Oxide

    Some children are given nitrous oxide/oxygen, or what you may know as laughing gas, to relax them for their dental treatment. Nitrous oxide/oxygen is a blend of two gases, oxygen and nitrous oxide. Nitrous oxide/oxygen is given through a small breathing mask which is placed over the child’s nose, allowing them to relax, but without putting them to sleep. The American Academy of Pediatric Dentistry, recognizes this technique as a very safe, effective technique to use for treating children’s dental needs. The gas is mild, easily taken, then with normal breathing, it is quickly eliminated from the body. It is non-addictive. While inhaling nitrous oxide/oxygen, your child remains fully conscious and keeps all natural reflexes.

    Prior to your appointment:

    • Please inform us of any change to your child’s health and/or medical condition.
    • Tell us about any respiratory condition that makes breathing through the nose difficult for your child. It may limit the effectiveness of the nitrous oxide/oxygen.
    • Let us know if your child is taking any medication on the day of the appointment.

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    Conscious Sedation

    Conscious Sedation is recommended for apprehensive children, very young children, and children with special needs. It is used to calm your child and to reduce the anxiety or discomfort associated with dental treatments. Your child may be quite drowsy, and may even fall asleep, but they will not become unconscious.

    There are a variety of different medications, which can be used for conscious sedation. The doctor will prescribe the medication best suited for your child’s overall health and dental treatment recommendations. We will be happy to answer any questions you might have concerning the specific drugs we plan to give to your child.

    Prior to your appointment:

    • Please notify us of any change in your child’s health and/or medical condition. Do not bring your child for treatment with a fever, ear infection or cold. Should your child become ill, contact us to see if it is necessary to postpone the appointment.
    • You must tell the doctor of any drugs that your child is currently taking and any drug reactions and/or change in medical history.
    • Please dress your child in loose fitting, comfortable clothing.
    • Please make sure that your child goes to the bathroom immediately prior to arriving at the office.
    • Your child should not have solid food for at least 6 hours prior to their sedation appointment and only clear liquids for up to 4 hours before the appointment.
    • The child's parent or legal guardian must remain at the office during the complete procedure.
    • Please watch your child closely while the medication is taking effect. Hold them in your lap or keep close to you. Do not let them "run around."
    • Your child will act drowsy and may become slightly excited at first.

    After the sedation appointment:

    • Your child will be drowsy and will need to be monitored very closely. Keep your child away from areas of potential harm.
    • If your child wants to sleep, place them on their side with their chin up. Wake your child every hour and encourage them to have something to drink in order to prevent dehydration. At first it is best to give your child sips of clear liquids to prevent nausea. The first meal should be light and easily digestible.
    • If your child vomits, help them bend over and turn their head to the side to insure that they do not inhale the vomit.
    • Because we use local anesthetic to numb your child’s mouth during the procedure, your child may have the tendency to bite or chew their lips, cheeks, and/or tongue and/or rub and scratch their face after treatment. Please observe your child carefully to prevent any injury to these areas.
    • Please call our office for any questions or concerns that you might have.

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    Outpatient General Anesthesia

    Outpatient General Anesthesia is recommended for apprehensive children, very young children, and children with special needs that would not work well under conscious sedation or I.V. sedation. General anesthesia renders your child completely asleep. This would be the same as if he/she was having their tonsils removed, ear tubes, or hernia repaired. This is performed in a hospital or outpatient setting only. While the assumed risks are greater than that of other treatment options, if this is suggested for your child, the benefits of treatment this way have been deemed to outweigh the risks. Most pediatric medical literature places the risk of a serious reaction in the range of 1 in 25,000 to 1 in 200,000, far better than the assumed risk of even driving a car daily. The inherent risks if this is not chosen are multiple appointments, potential for physical restraint to complete treatment and possible emotional and/or physical injury to your child in order to complete their dental treatment. The risks of NO treatment include tooth pain, infection, swelling, the spread of new decay, damage to their developing adult teeth and possible life threatening hospitalization from a dental infection.

    Prior to your appointment:

    • Please notify us of any change in your child’s health. Do not bring your child for treatment with a fever, ear infection or cold. Should your child become ill, contact us to see if it is necessary to postpone the appointment.
    • You must tell the doctor of any drugs that your child is currently taking and any drug reactions and/or change in medical history.
    • Please dress your child in loose fitting, comfortable clothing.
    • Your child should not have milk or solid food after midnight prior to the scheduled procedure and clear liquids ONLY (water, apple juice, Gatorade) for up to 6 hours prior to the appointment.
    • The child’s parent or legal guardian must remain at the hospital or surgical site waiting room during the complete procedure.

    After the appointment:

    • Your child will be drowsy and will need to be monitored very closely. Keep your child away from areas of potential harm.
    • If your child wants to sleep, place them on their side with their chin up. Wake your child every hour and encourage them to have something to drink in order to prevent dehydration. At first it is best to give your child sips of clear liquids to prevent nausea. The first meal should be light and easily digestible.
    • If your child vomits, help them bend over and turn their head to the side to insure that they do not inhale the vomit.
    • Prior to leaving the hospital/outpatient center, you will be given a detailed list of "Post-Op Instructions" and an emergency contact number if needed.

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    Post Op Care

    Patients with Local Anesthesia for Fillings:

    YOUR CHILD WILL BE NUMB FOR SEVERAL HOURS IN THE AREA OF THE LIPS, CHEEKS, TONGUE AND THE OUTSIDE SKIN NEAR THE TREATED AREA

    • After the appointment, give age-weight appropriate Acetaminophen (TYLENOL), Ibuprofen (Advil or Motrin) to help the anesthesia “wear-off” easier. You may give it every 4-6 hours as needed. Take prescription medications as directed.
    • Your child may eat and drink immediately after the appointment, but give your child liquids or soft food. Make good choices: give them nothing they have to chew excessively while they are numb.
    • Take it easy for the rest of the day. DO NOT PLAN TO RETURN TO ACTIVITIES OR SCHOOL THIS DAY, ESPECIALLY IF YOUR CHILD HAS HAD ORAL SEDATION E.G. VALIUM, VERSED – AND LOCAL ANESTHESIA.
    • Do not allow your child to chew, bite, suck, pick or scratch the numb area. This can cause a very SORE AND SWOLLEN area that will get better in 5 to 10 days. Call our office if this happens. Over the counter liquid Benadryl-Maalox 50-50 mix (swish and spit) works as a magic mouth rinse to help the pain after a lip or cheek-bite injury.
    • Your child may brush as normal if they have had a dental filling or crown.

    Please do not hesitate to call the office if there are any questions.

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    Care of the Mouth After Trauma

    • Please keep the traumatized area as-clean-as possible. A soft wash cloth often works well during healing to aid the process.
    • Watch for darkening of traumatized teeth. This could be an indication of a dying nerve (pulp).
    • If the swelling should re-occur, our office needs to see the patient as-soon-as possible. Ice should be administered during the first 24 hours to keep the swelling to a minimum.
    • Watch for infection (gum boils) in the area of trauma. If infection is noticed - call the office so the patient can be seen as-soon-as possible.
    • Maintain a soft diet for two to three days, or until the child feels comfortable eating normally again.
    • Avoid sweets or foods that are extremely hot or cold.
    • If antibiotics or pain medicines are prescribed, be sure to follow the prescription as directed.

    Please do not hesitate to call the office if there are any questions.

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    Care of the Mouth After Extractions

    • Bite on the gauze for 15-30 minutes to help control bleeding. We tell the kids that “it looks a little red” where the tooth used to be and the gauze soaks it right up.
    • Soft/liquid diet for the first 1-2 days and nothing hard or crunchy like Doritos, Pretzels or Pizza Crust. Cool or cold foods: shakes, crushed ice may feel best for the first 6-12 hrs.
    • Don’t use straws, or rinse forcefully or blow the nose for about 24 hours.
    • A towel on your child’s pillow will help, because saliva may be “pink” for 24-48 hrs.
    • Don’t brush teeth in an extraction area for 24 hours after surgery.
    • Keep fingers and tongue away from the extraction area.

    Please do not hesitate to call the office if there are any questions.

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    Care of Sealants

    By forming a thin covering over the pits and fissures, sealants keep out plaque and food, thus decreasing the risk of decay. Since, the covering is only over the biting surface of the tooth, areas on the side and between teeth cannot be coated with the sealant. Good oral hygiene and nutrition are still very important in preventing decay next to these sealants or in areas unable to be covered.

    Your child should refrain from eating ice or hard candy, which tend to fracture the sealant. Regular dental appointments are recommended in order for your child's dentist to be certain the sealants remain in place.

    The American Dental Association recognizes that sealants can play an important role in the prevention of tooth decay. When properly applied and maintained, they can successfully protect the chewing surfaces of your child's teeth. A total prevention program includes regular visits to the dentist, the use of fluoride, daily brushing and flossing, and limiting the number of times sugar-rich foods are eaten. If these measures are followed and sealants are used on the child's teeth, the risk of decay can be reduced or may even be eliminated!

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    Oral Discomfort After a Cleaning

    A thorough cleaning unavoidably produces some bleeding and swelling and may cause some tenderness or discomfort. This is not due to a "rough cleaning" but, to tender and inflamed gums from insufficient oral hygiene. We recommend the following for 2-3 days after cleaning was performed:

    1. A warm salt water rinse 2-3 times per day. (1 teaspoon of salt in 1 cup of warm water)
    2. For discomfort use Children's Tylenol, Advil or Motrin as directed by the age of the child.

    Please do not hesitate to contact the office if the discomfort persists for more than 7 days or if there are any questions.

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    Adolescent Dentistry

    Tongue Piercing - Is it Really Cool?

    Teens - Pediatric Dentist in Mount Airy, MD

    You might not be surprised anymore to see people with pierced tongues, lips or cheeks, but you might be surprised to know just how dangerous these piercings can be.

    There are many risks involved with oral piercings, including chipped or cracked teeth, blood clots, blood poisoning, heart infections, brain abscess, nerve disorders (trigeminal neuralgia), receding gums or scar tissue. Your mouth contains millions of bacteria, and infection is a common complication of oral piercing. Your tongue could swell large enough to close off your airway!

    Common symptoms after piercing include pain, swelling, infection, an increased flow of saliva and injuries to gum tissue. Difficult-to-control bleeding or nerve damage can result if a blood vessel or nerve bundle is in the path of the needle.

    So follow the advice of the American Dental Association and give your mouth a break - skip the mouth jewelry.

    Tobacco - Bad News in Any Form

    Tobacco in any form can jeopardize your child's health and cause incurable damage. Teach your child about the dangers of tobacco.

    Smokeless tobacco, also called spit, chew or snuff, is often used by teens who believe that it is a safe alternative to smoking cigarettes. This is an unfortunate misconception. Studies show that spit tobacco may be more addictive than smoking cigarettes and may be more difficult to quit. Teens who use it may be interested to know that one can of snuff per day delivers as much nicotine as 60 cigarettes. In as little as three to four months, smokeless tobacco use can cause periodontal disease and produce pre-cancerous lesions called leukoplakias.

    If your child is a tobacco user you should watch for the following that could be early signs of oral cancer:

    • A sore that won't heal.
    • White or red leathery patches on the lips, and on or under the tongue.
    • Pain, tenderness or numbness anywhere in the mouth or lips.
    • Difficulty chewing, swallowing, speaking or moving the jaw or tongue; or a change in the way the teeth fit together.

    Because the early signs of oral cancer usually are not painful, people often ignore them. If it's not caught in the early stages, oral cancer can require extensive, sometimes disfiguring, surgery. Even worse, it can kill.

    Help your child avoid tobacco in any form. By doing so, they will avoid bringing cancer-causing chemicals in direct contact with their tongue, gums and cheek.

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