But they’re baby teeth. Do we really need to treat them?
Answer: Of course we do!

At our office, we don’t like to call them baby teeth. We call them primary teeth because that’s what they are.

Primary teeth stay in the mouth up until around 12 years of age!

Every study conducted into child development shows that children with a healthy dentition have more confidence, excel more in school, suffer less from sicknesses, and have an overall better quality of life.

Besides assisting in eating, primary teeth allow for the proper development of speech as well as giving children a happy and healthy smile. All of these vital developmental processes are essential to healthy development and cannot be done without healthy teeth!!!

Furthermore, decayed and missing teeth can severely effect the development of the middle and lower facial bone structures. This can cause an improper bite, or a malocclusion, in the permanent teeth, or abnormalities in the eruption of the permanent teeth. This can create a situation that only years, and thousands of dollars, of orthodontics can fix.

We want to work with you now to keep your child’s primary teeth healthy and set the stage for the healthy development of their permanent teeth. It all starts right now by supporting their “baby teeth.”


My child doesn’t spit yet, is it safe to be using fluoride toothpaste?

Answer: I get this question at least 10 times per week.

In 2013, the American Academy of Pediatric Dentistry (AAPD) changed its recommendations for initiating Fluoride containing toothpastes from 18 months to 6 months of age. In other words, begin using Fluoride toothpaste once the first primary teeth erupt.

My stance on the Fluoride issue is very simple; a child’s hygiene practices should match his or her diet.

Once a child has teeth then they are vulnerable to acid attack by bacteria. Just by existing, teeth are a breeding ground.

Simply put, if your child is eating a diet heavy in carbohydrates or sugars, infant toothpastes are not strong enough to remove plaque and prevent cavities.

Fluoride toothpastes have what are called abrasives in them. These are microparticles that act almost like sandpaper to remove food from the tooth surface. The Fluoride component is both antibacterial and re-mineralizes the tooth structure that has been damaged by the acid produced by bacteria.

We do recommend using only a small amount of children’s Fluoride toothpaste called a smear, about the size of a rice kernel, when you do brush until your child is able to swish and spit.

If you are uncomfortable using Fluoride toothpastes, we recommend using a toothpaste that contains Xylitol. Xylitol is a sugar but it is a type of sugar that bacteria in our mouths cannot process. This type of toothpaste is surprisingly antibacterial and does not contain Fluoride.

However, only Fluoride will help to re-mineralize damaged tooth structure.


Why does he/she need a space maintainer?

Answer: Very simply, to maintain space the permanent teeth need to grow in normally!

When a primary tooth has to be extracted or is lost for any reason before it is ready to exfoliate naturally, the permanent replacement may not be ready to erupt yet.

If this is the case, primary or permanent teeth adjacent to the space will start to move to close the space.

If this happens, the permanent tooth may not have enough space to erupt naturally and may either erupt out towards the cheek or in towards the tongue or palate.

Sometimes blocked out teeth may not erupt at all and become impacted. If this happens, orthodontics may be necessary to move the adjacent teeth back to their positions and the impacted tooth may need to be located surgically and traction forces are required to pull the tooth properly into the mouth.

All of this excessive treatment is very easily avoided simply with the use of a space maintainer. Once the permanent tooth properly begins to erupt, the space maintainer is very simply removed and that is that.


Is the sedation necessary? What is the process of doing the treatment?

Answer: Let me first say as a word of caution.

Giving a child a sedative is a serious matter and should never be taken lightly or be given by someone who does not understand fully how the medications work, how they effect a child’s body (children’s bodies work much differently than adults), and most importantly, how to properly manage complications.

In the United States, general or family dentists see 2/3 of all children.

In the state of Texas, no special training is required past dental school to get a dental license, and, unfortunately, it doesn’t take much to get a sedation license.

A majority of the time spent in Pediatric specialty training is focused on understanding the physiology of children’s bodies at different developmental stages, understanding the sedative medications, and understanding how to manage complications.

I’m only saying this for our parents to make sure that if your child is going to be given sedative medications by a dentist that you make sure they are qualified to give them.

From our perspective, dental treatment needs to satisfy two principles.

It needs to be safe first and foremost, and it needs to be effective in removing infection and restoring sound tooth structure.

Sometimes, in order to accomplish this with children, sedatives can be a very effective treatment option.

Oral sedatives are given for children who have difficulty sitting still for longer treatment appointments, anxious children, and children with special needs. It can be very effective in allowing children to be calm and still so that effective dental therapy can be done with minimal stress to the child.

When your child arrives in our office on the day of his/her sedation visit, they MUST be empty stomach for six hours. They are allowed to have small sips of water but nothing else unless their medical conditions warrants. For children with special health considerations such as ADHD, Type I Diabetes, or Seizure Disorders to name a few, taking prescribed medications may be necessary. Please discuss your child’s condition with us at a treatment planning appointment so that we may properly assess the condition and determine if special dietary or prescriptions are necessary on the day of the sedation/treatment visit.

First, vital signs will be taken along with weight and an airway exam. The medication will then be given to the child to drink. Once swallowed, your child will be able to sit with you in the waiting room or staging area until it begins to take effect.

We ask that during this time, the child not be permitted to run or horseplay. If they do, the medication can affect their coordination and they can fall and hurt themselves. It’s best to let them sit in a chair and play video games or watch a movie.

Once sedated, your child will be walked back into a treatment chair where proper monitors will be attached and Nitrous Oxide (laughing gas) will be administered. Topical anesthetic will then be placed and local anesthetics given. The treatment will then begin.

At the end of the treatment, the Nitrous Oxide will be turned off and 100% Oxygen will be given for 5-10 minutes. Vital signs will again be taken and post operative instructions discussed, after which, your child will be brought to you and you will be free to go.

We will also give you a post-op form to explain these before you come. They are under the Patient Forms in the menu and we can give it to you at the office.


What do we need to do when we leave after treatment and when can they eat?

Answer: After every treatment visit, we give thorough dismissal instructions for home care.

For sedation appointments, we ask that children do not engage in any physical activity for the rest of the day.

This means swimming and other sporting activities should be cancelled.

Our numbing medication lasts roughly 2-3 hours.

To prevent your child from biting their lips, tongue, and/or cheek, we ask that children remain on a liquid diet until the numbness goes away. This includes any drinks other than milk, smoothies, soup, applesauce, yogurt, and jello to name a few.

Once the numbness wears off, children are free to eat anything.

For extractions, we recommend soft foods for one or two days as hard foods, such as chips or ice, can be irritating to the gums.

Although we never expect serious post-operative discomfort, it is always a possibility. Usually all that is needed is regular over the counter anti-inflammatory medications such as Ibuprofen or Tylenol.


Can you do everything in one appointment?

Answer: It depends but often it takes more than one visit for the safety and comfort of your child.

There are several reasons but it usually depends on the age of the child and the severity of the cavities.

The more numb someone is after treatment, the greater the likelihood they will hurt themselves by biting on their lips, tongue, and/or cheek.

We usually like to treat half the mouth at once so that children can have one side unaffected for eating.

Furthermore, for small children, it doesn’t take much to reach the maximum dosage of local anesthetics we can give.

There is a risk that by giving too much numbing medication, it can start to cause complications, some potentially serious, to other parts of the body. Moreover, we are never sure how someone will react to having dental treatment. What I mean is how sensitive their teeth will be after receiving a filling, crown, or root canal.

It is always better to have one side free of treatment in case children are sensitive so that they can chew food without being in discomfort.


Can I be with my child during treatment?

Answer: We ask that parents allow us to treat their children without them present if at all possible for the comfort of the child.

Understand that we are not trying to keep your child away from you.

There are a couple of reasons for this.

Most importantly, our goal is to do safe and effective dental work.

For this to happen, trust is a key component to the dentist-patient relationship. By allowing us to work with your child without you present, you are sending a message to your child that you trust us, thereby allowing your child to trust us.

Secondly, having parents in the room usually creates more anxiety for the child. As comfortable as we try to make having a filling, crown, root canal, or extraction, there are always going to be feelings and sensations that are new, and, at times, difficult for a child to experience.

Any dentist who tells you that they can make the experience totally pain free is lying and we do not lie to you or your children (as you can see).

When parents are in the room telling their children “it will be okay,” while they are trying to help, they are usually mistakenly creating more anxiety for their child.

To a distressed child, knowing that their parents are watching them but not helping them get out of the situation usually causes the stress to significantly worsen. So much so that usually the appointment has to be stopped and sometimes rescheduled.

Unfortunately, cavities happen throughout life and we must learn that going to the dentist, while usually not the most pleasant experience in the world, is necessary.

Again, we are not trying to keep your children away from you.

You are free to open the door at any time to check on them.

If your child is significantly distressed, we will come get you to try to calm him/her down.

However, we have been practicing pediatric dentistry in Houston for over 35 years now and we are especially gifted at using certain language and certain behavior management techniques to create a safe and educational environment for your child during their treatment visit.

Your children and grandchildren are safe in our hands.


What should I use to clean my baby’s teeth?

A toothbrush will remove plaque bacteria that can lead to decay. Any soft-bristled toothbrush with a small head, preferably one designed specifically for infants, should be used at least once a day at bedtime.
More: Dental Care For Your Baby


When should I take my child to the dentist for the first check-up?

In order to prevent dental problems, your child should see a pediatric dentist when the first tooth appears, or no later than his/her first birthday.


What is the difference between a pediatric dentist and a family dentist?

Pediatric dentists are the pediatricians of dentistry. A pediatric dentist has two to three years specialty training following dental school and limits his/her practice to treating children only. Pediatric dentists are primary and specialty oral care providers for infants and children through adolescence, including those with special health needs.
More: The Pediatric Dentist


Are baby teeth really that important to my child?

Primary, or “baby,” teeth are important for many reasons. Not only do they help children speak clearly and chew naturally, they also aid in forming a path that permanent teeth can follow when they are ready to erupt.
More: The Pediatric Dentist


What should I do if my child has a toothache?

First, rinse the irritated area with warm salt water and place a cold compress on the face if it is swollen. Give the child acetaminophen for any pain, rather than placing aspirin on the teeth or gums. Finally, call Dr. Urbach as soon as possible to schedule an appointment.
More: Emergency Dental Care


Are thumb sucking and pacifier habits harmful for a child’s teeth?

Thumb and pacifier sucking habits will generally only become a problem if they go on for a very long period of time. Most children stop these habits on their own, but if they are still sucking their thumbs or fingers past the age of three, a mouth appliance may be recommended by your pediatric dentist.
More: Thumb, Finger and Pacifier Habits


How can I prevent decay caused by nursing?

Avoid nursing children to sleep or putting anything other than water in their bed-time bottle. Also, learn the proper way to brush and floss your child’s teeth. Take your child to a pediatric dentist regularly to have his/her teeth and gums checked. The first dental visit should be scheduled by your child’s first birthday.
More: Dental Care For Your Baby


How often does my child need to see the pediatric dentist?

A check-up every six months is recommended in order prevent cavities and other dental problems. However, your pediatric dentist can tell you when and how often your child should visit based on their personal oral health.
More: Regular Dental Visits


Toothpaste: when should we begin using it and how much should we use?

The sooner the better! Starting at birth, clean your child’s gums with a soft infant toothbrush or cloth and water. As soon as the teeth begin to appear, start brushing twice daily using fluoridated toothpaste and a soft, age-appropriate sized toothbrush. Use a “smear” of toothpaste to brush the teeth of a child less than 2 years of age. For the 2-5 year old, dispense a “pea-size” amount of toothpaste and perform or assist your child’s tooth-brushing  Remember that young children do not have the ability to brush their teeth effectively.  Children should spit out and not swallow excess toothpaste after brushing.
More:Enamel Fluorosis


How do I make my child’s diet safe for his teeth?

Make sure your child has a balanced diet, including one serving each of: fruits and vegetables, breads and cereals, milk and dairy products, and meat fish and eggs. Limiting the servings of sugars and starches will also aid in protecting your child’s teeth from decay. You can also ask your pediatric dentist to help you select foods that protect your children’s teeth.
More: Diet and Dental Health


How do dental sealants work?

Sealants work by filling in the crevasses on the chewing surfaces of the teeth. This shuts out food particles that could get caught in the teeth, causing cavities. The application is fast and comfortable and can effectively protect teeth for many years.
More: Sealants


How do I know if my child is getting enough fluoride?

Have your pediatric dentist evaluate the fluoride level of your child’s primary source of drinking water. If your child is not getting enough fluoride internally through water (especially if the fluoride level is deficient or if your child drinks bottled water without fluoride), then your pediatric dentist may prescribe fluoride supplements.
More: Enamel Fluorosis


What can I do to protect my child’s teeth during sporting events?

Soft plastic mouthguards can be used to protect a child’s teeth, lips, cheeks and gums from sport related injuries. A custom-fitted mouthguard developed by a pediatric dentist will protect your child from injuries to the teeth, face and even provide protection from severe injuries to the head.
More: Mouth Protectors


What should I do if my child falls and knocks out a permanent tooth?

The most important thing to do is to remain calm. Then find the tooth. Hold it by the crown rather than the root and try to reinsert it in the socket. If that is not possible, put the tooth in a glass of milk and take your child and the glass immediately to the pediatric dentist.
More: Emergency Dental Care


How safe are dental X-rays?

There is very little risk in dental X-rays. Pediatric dentists are especially careful to limit the amount of radiation to which children are exposed. Lead aprons and high-speed film are used to ensure safety and minimize the amount of radiation.
More: X-Ray Use and Safety


How can parents help prevent tooth decay

Parents should take their children to the dentist regularly, beginning with the eruption of the first tooth. Then, the dentist can recommend a specific program of brushing, flossing, and other treatments for parents to supervise and teach to their children. These home treatments, when added to regular dental visits and a balanced diet, will help give your child a lifetime of healthy habits.
More: Preventive Dentistry

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