1. At what age should my child receive their first dental visit?

The first dental visit should be by one-year of age. A formal visit with a cleaning and fluoride treatment as well as possible X-rays may begin around the age of 2 1/2 to 3 years.

2. Should I give my child fluoride drops or tablet?

Please check with Dr. Caldwell regarding the circumstances in which he prescribes supplemental fluoride. Fluoride levels in the various neighborhoods vary greatly.

3. We do not drink tap water. Should my child receive fluoride drops or tablets?

If you are cook with tap water and make juices with it, your child probably will not need them. Again, check with Dr. Caldwell regarding the amount of fluoride your child should consume.

4. My child is 1 year old and has no teeth - should I be concerned?

Most 1-year-olds have eight to 10 teeth. However, some children experience delayed tooth eruption. You should not be concerned about this.

5. My child's permanent lower front tooth is erupting behind his baby teeth; how concerned should I be?

If the permanent tooth is nearly erupted and the baby tooth is not loose, make an appointment to be seen. If the baby tooth is fairly loose give it a week or two to come out on its own. If the tooth still does not come out or if your child has pain and difficultly eating, make an appointment to be seen. Do not be concerned about the placement of the permanent tooth, as with time the tongue will push the permanent tooth up into position.

6. My child sucks his/her thumb or finger. What side effects can happen to the mouth?

Thumb or finger sucking can cause an openbite, crossbite or backward positioning of the lower front teeth. The severity of these conditions depends on the frequency, intensity and length of time your child continues the habit. Generally, children stop sucking their thumb or finger by the age of four of five, when they become socially conscious. If your child continues this habit beyond the age of five to six years of age, when the first permanent tooth develop, an exam is necessary to help them stop. If the habit is corrected before the permanent teeth erupt, it is likely that the openbite will correct itself. Once the permanent teeth have erupted, orthodontics is often necessary to correct the crossbite.

7. When should I take my child off the bottle?

When you child can hold a cup, they should be taken off the bottle. This generally happens around the first birthday. If a child is placed to sleep with a bottle, decay may occur. Even children who suck on the sippy cup all day at will, run the risk of decay. Juices and milk have sugar in them that cause this decay. It is not so much what your child drinks, but the amount and the way that it is consumed. Constant bathing of the teeth in these drinks is what causes the decay. If you put your child to sleep with a bottle, the best way to stop this habit is by diluting the milk or juice with water over a period of two to three weeks until the bottle is mostly water. The cold turkey method is also an option, although this may cost the parents a few nights of sleep, but it works.

8. What are indications that my child is teething? What can I do to make him/her more comfortable?

Signs of teething include restlessness, irritability, and loss of appetite. They may include a low grade fever due to the irritability or slight bouts of diarrhea due to the increased saliva. We recommend liquid Tylenol and do not recommend the use of topical gels such as Orajel or Numbs-it. The best solutions to soothe teething is to have the child chew on a frozen rubber teething ring or on a popsicle. Eruption of the first permanent molars (around the age of six) can often cause ear pain as well. However, always be sure to check with your pediatrician to rule out an ear infection.

9. Why is it important to fix primary teeth - they're only going to be replaced with permanent teeth?

Primary (baby) teeth are significant for esthetic (self-image) purposes, and for eating as well as proper speaking. Not only do permanent teeth help mold the jaws as they develop, they also act as placeholders; reserving the space for permanent teeth eruption, so a malocclusion or bad bit does not develop. The last baby tooth falls out around the age of 12. If not treated, a decayed baby tooth can affect the health of the permanent tooth, and most importantly, extensive decay can cause life-threatening infections.

10. My child is three and brushes his own teeth, why do I need to do it?

Young children are not capable of properly brushing their teeth. They lack the manual dexterity. That's why Dr. Caldwell recommends that parents brush their children's teeth for the first five years of their life. Do not use toothpaste until the child is capable of spitting (three to four years of age). Toothpaste should be treated as a medication, and a pea-sized drop should be administered by the parent for the young child. Flossing should be performed prior to brushing and waxed or non-waxed floss may be used. Most children need supervision when brushing until the age of ten.

11. What are sealants and when are they recommended?

A sealant is a white plastic like coating that is placed on the chewing surface of the molars to protect them from decay. Dr. Caldwell recommends sealants for decay-free permanent molars.

12. Why do my child's permanent teeth appear slightly darker or more yellow than their baby teeth?

The permanent tooth has a larger blood supply which is closer to the surface of the tooth. This makes it appear darker. As the permanent tooth matures, the tooth shade will tend to lighten.

13. I hear my child grinding his teeth at night. Is this normal and how concerned should I be?

Many children will grind their teeth. You may hear them while they are sleeping. It is common for children to grind while either primary or permanent teeth are erupting. Grinding does not become a concern unless there is "wear" on the teeth. If the tooth is sensitive and is worn down close to or exposing the nerve, then treatment may be necessary.