I'm a Paediatric Dentist AMA

[Toothwiggler]

I'm a dentist working in the specialty of Little People.
Ask me anything.

Your username has changed op

My ds has an extra lower incisor and the orthodontist feels he will need that plus a further 4 teeth (total of 5) removed as his mouth is likely to be overcrowded.
Once the teeth to be removed have been identified she was talking about this being done at the dentist.
My ds struggles at the dentist anyway. I think it will be a truely awful thing for him to go through. Is a GA recommended if the child is going to struggle with so many extractions at the same time?

My 2 year old still screams the house down every time we brush his teeth. He won't scream forever, right?

Ah, good times.
No he won't but you're doing the right thing: keep going! Be consistent. There are few solid hard rules in our family but tooth brushing is one of them.
Some tips (you may have tried)
Brush at the same time as you, dad, older siblings.
Change the toothpaste in case it's a flavour issue
Let them have a turn, it must be so frustrating for their emerging independence for us to be so uncompromising so we do Mum's turn, then X's turn (or the other way round if you prefer).

what is enamel hypoplasia and what causes it? Dd's orthodontist mentioned it and dentist confirmed it but it's never really been explained to us. She's 12 now. Previous dentist told her the decay must be caused by drinking fizzy juice and accused her of lying when she said she didn't like it. New dentist assumed we already knew but still didn't really explain when I asked, just confirmed dd has it.

Like a pp my DS has hypoplasia (still has his milk teeth). Are his adult teeth likely to be affected too?

It depends on the cause. There are environmental causes of some types of hypoplasia (something happens during tooth development that disturbs enamel formation) and some are caused by genetics. The environmental ones are usually confined to the teeth developing during the disturbance event, and genetic causes can affect primary and permanent teeth.

I have a 4 year old with asd. It's took alot of time and work to find a way to get teeth brushed. He has to do it himself. Uses one of the cheap battery operated brushes. We brush our teeth as a family and he gets a sticker for doing it. He doesn't brush them properly though it really won't let anyone near and I would rather then get a sort of brush rather than no brush. Is there anything else I can do to help. Minimising sugar and acids I do my best but he's also has a very restricted diet which causes issues too.

What's your view on 'extended' / natural term breastfeeding, especially feeding through the night? Do you have any research to back up your opinion?
I have fucking awful teeth and desperate to avoid the same fate for my son, but have heard conflicting things about feeding overnight.

This is really good question. I hope you don't mind but I want to answer it tomorrow when I'm less tired because it deserves a considered answer with links to evidence

I think my 2 year old has a small amount of tartar on the back of her bottom teeth - hard to tell as she won't let me look properly.

I'm focusing more on this area with brushing but anything else I should do? She's booked into dentist in sept - are they likely to try and remove? She won't be willing and I don't want to create a fear of dentists!

Are some children more prone to tooth decay that others? I’m always astonished that my children have perfect teeth according to the dentist when they do eat quite a lot of sugar. I do supervise brushing (in the evening), they donthemselves in the morning when some children seem to eat no sugar at all and yet have decayed teeth.

One of my neighbours has a girl who is 4. This girl has very rotten, as in black and partially missing teeth on the top row. Will the rot spread to her adult teeth or will they come out unscathed.*

The decay doesn't spread but an infection can affect the underlying developing adult tooth and cause defects in the enamel.

*Difficult one bit why did my private dentist miss so much in the kids mouths and seem to always recommend treatments he could charge a fortune for but haven’t been needed and the NHS seem to be sorting.

It’s a rhetorical question, his sister and dad have both been struck off so guessing runs in the family.*

No comment

Do you like being a dentist? Dd was going to go for this but chemistry A level too difficult so rethinking.

Love it!

*Today 22:41 StrugglingMumma

Your username has changed op*

Ah shit! Thanks for the heads up!!

How rare is it to see children with no decay? Our dentist seemed genuinely (and pleasantly) surprised at my DS' teeth

Ill be very interested to hear your reply re. breast feeding. I fed DS1 until he just turned one and DS till he just turned two. It was both children’s decision however my dentist would criticise me every time i went there. He has never seen my children’s teeth but would tell me i have undoubtedly set them up for tooth decay by breast feeding them beyond 6 months.

My just 2 year old DD won't brush her teeth anymore. I took her to the shops let her pick out a tooth brush (done this many times!) But works for a day or two then the novelty wheres off. I try to get her to brush her teeth with us but no isn't intrested. I took her to our dentist a few weeks ago and the dentist said as long as she gets the tooth paste in her mouth she isn't concerned. Not that she lets the dentist look at her teeth! Is this correct? I can get her to put the tooth paste in her mouth. I worry because her cousin at age 4 has just had to have 3 teeth removed.

My son had a dummy until his 4th birthday, dentist said it’s not a worry until they are five, my son is now 4.4 and his two front teeth, one kind of sticks out more than the other and he has a big gap between them. I had a huge gap between my teeth all of my life until I got a kind of filling between them, will my son always have a gap? His is sweet but I hated mine so much when I was older.

How long after all of the baby teeth have come through are toddlers likely to have any pain or discomfort? My dentist said the roots continue to grow for a while which could cause teething signs to continue but I wondered how long this is likely to go on for (he checked DC’s teeth and had no concerns).

Some babies or toddlers don’t seem to find teething painful but others really do. Any ideas why and what do you think is the best way to the worst of the pain? How long do you think the pain from a tooth coming through lasts - is it before eruption, during and a bit afterwards?

Dd has lost ALL her baby teeth before 10 years and has a 9mm (I think) overbite.

She's a scardy cat so is avoiding having braces fitted. My question is does it really matter when the braces go on bearing in mind the years of a retainer? Will waiting make a difference or should I push her towards braces ASAP? Thinking along growth patterns not aesthetically. I'm terrified how they think they'll remove the necessary teeth on such a wuss

My daughter is also a terrible teeth grinder, it sounds like she's going to break them in the night. I can't bear it! She's 8 so some adult teeth
I'm also a teeth grinder as Is my dad, is it genetic and can anything be done?

Op are you there,? Im interested in the response to the breastfeeding question as it is also something i am concerned about.

Thanks Toothwiggler, my DD is only just three, so I think she is probably too young at the moment for treatments, as it would probably require a general!

One other Q, if you don't mind? How much of childhood decay do you think relates to diet, and how much to deficiencies in brushing? I remember being appalled that young children had to have extractions due to decay, and wondered what on earth the parents were doing and why they weren't brushing, insisting on a healthy diet, etc. Then I had one of my own, and realised that the buggers just don't let you brush properly! It's only in the last few months I have been able to achieve anything like reasonable brushing. Prior to that we had a lot of battles with tongue thrusting the brush away, sucking off and swallowing of toothbrush, etc. I counted myself lucky if I managed to make brief contact with 80% of the tooth surfaces, but actual effective brushing? No chance for probably the first two years after eruption of the first tooth. This must be a factor, no?

Another one asking for your thoughts on dummy usage. My little boy is 3 and obsessed with his dummy. He only gets it for sleeping. His top front teeth stick out, which I guess is dummy related but don't know. Will they correct themselves when we finally get the blessed dummy off him??

Why do you not recommend a rechargeable toothbrush in under 6s? (My 4 yr old has a Braun kids one!)

Do gaps in front teeth caused by a lip tie usually close together a bit when adult teeth come in?