pediatric
Molar Sealants
Permanent molars usually have very deep pits, grooves, and fissures on the biting surface. These holes can be very difficult to keep clean so they are the most common place to get cavities.
In the 1970′s dentists started cleaning out these pits and fissures then squirting runny plastic into the cleaned out grooves to keep bacteria from growing there. This procedure is called a dental pit and fissure sealant.
First Dental Visit
Many parents are rightfully confused about when is the right time to start their children’s dental visits. Some Pediatricians say the first dentist visit should be about age two or three.
Many general dentists have difficulty managing young children so they ask parents to bring them in after age three.
The American Academy of Pediatric Dentists recommends that the first dental visit be soon after the first tooth erupts or by age one.
Cavity Infections
Some people tell me that “weak teeth” run in the family. I respond that everyone in the family most likely have an aggressive type of plaque on their teeth. Because cavities are caused by bacteria, they are the result of infection.
Infection with a specific type of bacteria is more likely to lead to a cavity than other types of bacteria. One of the most aggressive bacteria is called Streptococcus mutans. It is related to Strep throat bacteria but grows especially well on teeth.
First Dental Visit
The American Academy of Pediatric Dentists recommends the first dental visit to be whenever the first tooth erupts or by the child’s first birthday.
I agree that this works for first children but I think than once parents have been through the practice of taking their infant off the bottle by age one, brushing and flossing daily, watching sweets, and using fluoride suplements appropriately, the following kids can wait until two or even three for their first dental appointment.
Sleep Dentistry or Deep Sedation
Some children are unable to hold still for dental care even with conscious sedation. For children with many cavities that will take a long time to fill or children too young to understand the need to sit still, we are able to have them go to sleep for their dental fillings.
Today I had a four year old boy from Molalla and a three year old girl from Gladstone needing deep sedation. Deep sedation is not quite general anesthesia like for medical operations but keeps patients just barely asleep.
Toothpaste
Enough parents ask about toothpaste for their kids that it is worth revisiting. See this page for more information on children’s toothpaste. Most of these questions are concerning fluoride in toothpaste. See the article on Fluoride for more information.
Common questions about children and kid’s toothpaste:
- At what age should I start brushing?
As soon as they have teeth use a soft toothbrush with infant toothpaste or a cloth to wipe them clean.
Shark Teeth
A surprising number of children develop a double row of teeth, especially on the lower front teeth. A six year old girl from Gresham saw me last week in my Portland office with just this condition.
Her mother was concerned that the permanent lower incisors would stay inside the lower primary (baby) incisors and look abnormal. She called them “shark teeth”.
Although this usually happens with lower incisors, it can also occur with upper incisors or primary molars.


