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Pediatric Dental Care and Dental Anxiety

January 27, 2018

dental patient covering mouthMy son had always been okay at the dentist until our last appointment. I’m not quite sure what happened. The only thing different is he was told he had a cavity and would need a filling. He went nuts and started bawling. He’s never even had a cavity before so I don’t know what he’s afraid of. There hasn’t been any experience for him to build on. What do I do to help him? He’s terrified now.



Can Breastfed Babies Skip the One Year Dental Check-Up?

September 13, 2017

I keep getting conflicting information about dental care with children. Though, I shouldn’t ‘be too surprised. I’ve only been a mom for 11 months, but so far every piece of advice or book I’ve read on child rearing has contradicted another piece of advice or book. I can read two different articles and the same action I take will either help my son grow up to be an independent genius or scar him for life. So, now I have to decide about his first dental appointment. He’s been exclusively breast fed and we’re about to start introducing table food to him. I’ve heard two things. 1. Breastfeeding is safer for teeth than formula feeding, therefore they don’t need the one-year-old check-up. 2. Every child, no matter how they’re fed, needs to have the one-year-old check-up to screen for abnormal tooth development. So, what’s your opinion?

Carlyn M.

Dear Carlyn,

Oklahoma City Pediatric Dentist

You’re right about all the conflicting in formation out there. The one thing you’ll learn throughout your lifetime as a mother is that every child is different. No child fits the norms. Because so much of the information contradicts itself, most of the time you’ll be left with following your mother’s intuition.

One thing that is true is the breastfeeding and bottle feeding have very different effects on teeth. First is the physical differences. While formula tends to pool by children’s teeth, breast milk is sent to the back of the mouth away from their teeth. Secondly, their “ingredients” for lack of a better word are different. We know that breastmilk has properties we haven’t been able to copy in formula. There is mounting evidence that the contents in breastfeeding protect children from cavities.

It would imply that breastfed children do not need to see a pediatric dentist as often. However, as you’ve learned, every child is different.

Reasons for Breastfed Children to See a Pediatric Dentist

  • Bacteria Parents with gum disease have higher levels of bacteria. That bacteria is shared through kissing and the sharing of food. As you’re about to introduce table food, that is something to consider.
  • Cavities There is always a potential for cavities. Some breastfed babies fall asleep while nursing. Generally, the fact that the milk is sent to the back of their mouth engages their swallowing reflex so no milk pools. However, sometimes the milk flows a bit after the baby stops sucking and can pool at their teeth. There isn’t evidence it does or does not cause cavities yet, but the potential is there, especially if they’re pre-disposed to decay. Which leads me to my next point.
  • Genetic Make-up Every family is different. Two people can have the same oral hygiene routine and skill. One will be cavity free, the other will end up with a mouth full of fillings and crowns simply because of their DNA.
  • Abnormal Development Your son’s teeth starting developing in the womb. Going right along with genetic issues is the possibility of abnormal development. Whenever you have an abnormality in the development of children’s teeth, it is always easier to treat the earlier it is discovered.

Your Child’s First Pediatric Dental Visit

The first visit isn’t as focused on cavities, though of course that is checked. The dentist will also check their development to make sure no intervention needs to take place. Mostly, though, it’s designed to give your son a positive experience at the dentist and show him how fun it can be.

All too often, parents wait until their son or daughter has a dental emergency pop up before bringing them in. From that moment on, they’ll associate the dentist with pain. Not to mention the more distressing procedures could likely have been avoided altogether if they’d brought them in regularly.

Insurance almost always covers the child’s first visit in full, so it won’t cost you anything but a bit of time.

I hope this helps.
This blog is brought to you by Dr. Don Swearingen.

When Is My Son Allowed to Leave a Pediatric Dentist?

July 14, 2017

My son does great at the dentist. Nothing bothers him. He does shots for cavities like he’s reading a book, but he’s only 9. When are we allowed to switch him from a pediatric dentist to a regular one? It would be so much easier on our family schedule if we could all go to the same clinic.

Amanda – A.K.A. tired mommy


It sounds like your son is a rock star at the dentist’s office. Nothing phases him. This is great. It means he’s had positive experiences that have given him confidence. Many kids require some kind of sedation. Here’s the thing, your child NEVER has to go to a pediatric dentist’s office. He’s more than welcome to see a general dentist, even from the first appointment.

There is a condition with that. You want to take him to a general dentist who enjoys treating children. Some do and some don’t. If they don’t, that won’t be a good fit for your son. So, how can you tell? First, is ask what age they’re comfortable treating children. If they say 9 or 10, then they’re not really that great with kids. If they say around 2 or 3, then you can feel fairly confident they know their way around the mini-human set.

If ever an issue came up that required some specialized training, he (or she) can easily refer you to a pediatric specialist.

This blog is brought to you by Dr. Don Swearingen.

Can I Sue For Custody If My Son Needed a Pulpotomy?

May 13, 2017

I just found out my son needed a pulpotomy. I’m seriously mad. This sounds serious. I’m sure it means my ex-wife’s been neglecting him and I wasn’t even notified he needed surgery. Is there a way I can sue for custody because of this? What do I need to tell the attorney?

Mark L. – Chicago


It sounds like you’re worried about your son. It’s easy to take our fear out on other people. I know it would be easy to believe this is your ex-wife’s fault, but it’s very possible it’s not. There are people who don’t take care of their teeth and hardly need any work and there are people who take impeccable care of their teeth and have all sorts of problems. Dental hygiene is only part of the equation. Genetics has a lot to do with it too.

You should be aware that a pulpotomy isn’t a serious procedure. It’s a kid version of a root canal treatment. It’s very safe and was likely not at all scary for your son. With a good pediatric dentist, your son likely didn’t look at it as any different than any other fun visit to the dentist.

Before you complicate yours and your son’s life (as well as your ex’s) make sure you have all the facts. Talk to your son’s pediatric dentist. Or maybe even talk to your ex-wife. You have a child together so communication is going to be important throughout his lifetime.

This blog is brought to you by Dr. Don Swearingen.

Sealant Rip-off From Dentist

March 13, 2017

I’m a little frustrated with our pediatric dentist. First, they insisted we get my son sealants. I actually didn’t mind that too much because I see the benefit of sealants. However, they refused to place them unless I also pay for nitrous oxide. I felt that wasn’t necessary, but sucked it up and paid the added expense.  We go back six months later for his next check-up and one of the sealants is missing. It fell off. Now they’re insisting I have it re-done at MY expense, with nitrous oxide again. Should I? I feel I’m being gouged.

Tara B. – Michigan


The dentist-patient relationship is an important one that requires trust, especially when you’re dealing with a pediatric dentist.  Our children are so important. We have enough to worry about with their safety, we should be able to put our guard down when interacting with their healthcare providers. It sounds to me like you feel you can’t trust your pediatric dentist. That may be a sign to get another one.

There isn’t a medical reason to use nitrous oxide when placing dental sealants. It’s a simple, painless procedure which shouldn’t require any type of sedation or numbing.  If your son is anxious at the dentist and has trouble calming down because of fear, that would be a reason for the nitrous. I don’t know your son, but you do.  I’ll let you decide if the nitrous was necessary in that case.

As to the sealant falling off, this bothers me also. Sealants should last for around ten years.  If they fall off that quickly it either means it wasn’t placed properly or your son eats a lot of hard or chewy/sticky food.  Obviously, that type of diet can destroy his teeth, so if that’s the case you’ll  want to re-evaluate. If you can’t see a reason his diet could have damaged the sealant, I’d ask them to replace the sealant at their expense.

If you’re uncomfortable with this pediatric clinic you can try another one or see if your dentist enjoys treating children. It’s not a necessity that children see a pediatric specialist unless a complicated issue comes up.  For basic services, a family dentist who loves children is just as adequate.

This blog is brought to you by Dr. Don Swearingen.

My Toddler is Grinding Her Teeth

January 11, 2017

My three-year-old daughter fell asleep in my lap. I heard this horrible noise and looked down. She was grinding her teeth. What do I do? She doesn’t have a dentist yet, because she’s only three.

Franny L. – Ohio


It is normal for toddlers to go through this. It most often occurs between sleep cycles, which is why you likely didn’t notice it until now. We don’t really know the cause, though there are countless theories. Some of those theories include stress, sleep apnea, allergies, medications, and teething. We don’t know that any of these are the cause, so don’t put any stress on yourself trying to figure it out.

Most children grow out of it and no further action needs to be taken. Keep an eye out for it causing her any pain.  If she grabs or complains about her jaw you might have her pediatric dentist look at her.

I realize you said she doesn’t have a dentist yet, but it is time. Not because of the grinding. She needs to have a check-up. It’s extremely important that she have positive experiences with the dentist at a young age. If you wait much longer, she more likely to develop a cavity. We don’t want that to be the first real experience she has.

This blog is brought to you by Dr. Don Swearingen.

Why Are My Son’s Fillings Falling Out?

December 21, 2016

At my son’s last check-up we were told he had two cavities. We went ahead and got them filled. Both of them have since fallen out. Is this normal? We’re going back to have them replaced, but I’m wondering if I should look for a different pediatric dentist. There aren’t too many of them who do white fillings and that is important to me.

Danielle C. – Idaho


White fillings are a completely different than amalgam (silver) fillings in how they are placed. While I understand why you want only white fillings and I would probably push for the same with my children, you’ll need to understand that they are much harder to place on children.

If any moisture gets under the filling during placement, it breaks the seal. Dentists usually use isolation dams and rolls of gauze to help keep the area dry. You can imagine that is not a favorite of wiggly children.

Pediatric dentists usually have two options in those cases. They either have to find a way to distract the children during the procedure, something most pediatric dentists are quite adept at. Or, they can use sedation dentistry. Either is acceptable and perfectly safe.

Talk to your dentist and ask why he thinks the fillings have failed and how he wants to prevent it from happening again. If you’re satisfied with his answer and are willing to try again, great. If not, you’re within your rights to ask for a refund and find another dentist.

This blog is brought to you by Dr. Don Swearingen.


Do You Have to Stop Going to a Pediatric Dentist When You Reach Adulthood?

October 21, 2016

I have a weird question. My daughter turns 18 in a few weeks. She was totally fine with becoming an adult, going to college, the whole new life idea…until today. Today she had a meltdown. Today she doesn’t want to go to college. She doesn’t want to get a job. You’d never believe what set it off. It was her last check-up with her pediatric dentist. She LOVES her dentist. Ever since she was two years old, she’s gone to the same office. Today, the dentist mentioned it would be her last visit and even had a gift for her. Corina burst into tears and hasn’t been the same since. I know it’s dumb, but I wondered if she really has to switch dentists now when she turns 18?

Deanna S. – New Jersey.


Growing up is hard. Change is hard. Combine the two and it’s super hard. Each pediatric dentist has their own policy when it comes to treating adults. I bet if you called her dentist and explained your daughter’s reaction they’d let her come until she’s ready for the change.

The only time that might become a real issue is if something happens where your daughter needs something like a crown or develops gum disease. While her dentist could treat those conditions and has been trained to do so, strictly pediatric dentists don’t get a lot of practice in those areas. They don’t generally come up with children.

Barring anything like that, I see no reason why she couldn’t continue with her beloved dentist for a little while longer. Of course, like I said earlier, call and explain, because every practice has their own policies on such things.

This blog is brought to you by Dr. Don Swearingen.

Why Does My Pediatric Dentist Insist on X-Rays Every Visit?

August 20, 2016

I am diligent to take my children to visit the dentist every six months, even though we don’t have a lot of money. One thing that troubles me is the fact that they insist on x-rays every single visit. My insurance only covers it once a year. If it was necessary, I would think that they’d cover it twice. Is it that important or can I skip the next ones?

Mallory F. – New Hampshire


I wouldn’t say that x-rays every six months are necessary, with the exception of a high risk patient.  If you have a child that has a greater than normal chance of developing a cavity, based on genetics or habits, it would be appropriate to do x-rays at every six months. Other than that, every year would be more the norm.

I’d talk to your pediatric dentist about your concern.  It may be he’s noticed something about your children’s teeth that make him extra cautious. Barring that, I’d just tell him you’d prefer to only do the x-rays once a year.

It’s always difficult making ends meet, especially when you have children, so any way you can save some money and still carry out your child’s best interest, is helpful.

This blog is brought to you by Dr. Don Swearingen.

Does A Toddler Need to See A Dentist for Teeth Grinding?

July 11, 2016

My three year old has started grinding his teeth. Do I need to take him to see a dentist?

Brooke L. – New Jersey


It is not uncommon for children your son’s age to grind their teeth, though we aren’t really sure of the reasons behind it yet. Most children outgrow it and it shouldn’t be a problem.  You should watch for signs that he’s having jawpain.  Children that age don’t always articulate they’re in pain, but you may see him rubbing his jaw.

Even if he wasn’t grinding his teeth, at three years old, it is time for him to visit with a dentist that treats children. He needs to have a check up.  It’s especially important that children see a dentist for the first time before there are any real dental issues.  You want their first experience to be a positive one.

Usually the first appointment is no big deal. They get a fun cleaning and the dentist ahs a look around to make sure everything is developing properly. Dentists who regularly work with kiddos make it lots of fun.

This blog is brought to you by Dr. Don Swearingen.

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