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Children’s baby teeth generally start to fall out when the adult teeth underneath them are ready to arrive. Visits from the Tooth Fairy begin around the age of six, and continue until the last baby molar is gone.

But sometimes, we can’t wait for nature to take its course, and children need a dentist’s assistance to remove a primary tooth before it falls out on its own. Here are some common situations where extracting a baby tooth is best for a child’s present—and future—dental health.

• Serious Decay

Dentists make every effort to save teeth, and this includes baby teeth. A filling or even the baby tooth version of a root canal can be used to save little teeth when a cavity appears.

But severe decay could mean that there’s not enough healthy tooth structure left to fill. Or that bacteria have caused infection inside the tooth. Left untreated, infections can spread to other tissues in the body and can become quite serious. When a primary tooth is seriously decayed or infected, an extraction is often the healthiest choice.

• Trauma

Sometimes a baby tooth will recover on its own if it’s been jarred by an impact. Sometimes an injured tooth can be repaired with treatment. If there’s serious damage, though, a baby tooth is at risk for abscess and infection, and, sometimes, can cause harm to the adult tooth beneath it. In cases like these, an extraction is the safest option.

When an injury causes a broken or dislodged tooth, call Drs. Paul Pasternack, Chara Pasternack, and Christine Biondi immediately. Whether the tooth can be saved or should be extracted depends on how serious the injury is and how soon you can get your child to the dentist’s office or the emergency room.

Whenever a child loses a primary tooth early, a pediatric dentist will be on the lookout for potential orthodontic problems. Remaining baby teeth tend to shift to fill any empty spot. Without the proper space to come in, the adult tooth can erupt out of place or at an awkward angle. Drs. Paul Pasternack, Chara Pasternack, and Christine Biondi  might recommend a space maintainer to keep baby teeth aligned properly and to make sure the right spot stays open for the permanent tooth when it’s ready to erupt.

We’ve talked about primary teeth which are lost early, but it’s also problematic . . .

• When a Baby Tooth Doesn’t Fall Out

Usually, a wiggly baby tooth is a clue that the adult tooth underneath has started pushing its way up and out. The baby tooth’s root is gradually absorbed as the adult tooth moves into place. Without an intact root to hold it in place, the baby tooth grows looser and looser until it falls out. Now the permanent tooth has the perfect open space ready for its arrival.

But when baby teeth don’t fall out on their own, this can be another source of orthodontic difficulties.

Stubborn baby teeth can mean adult teeth erupt behind them, creating a double row of teeth (colorfully known as “shark teeth”) and risking crowding and misalignment. Or a baby tooth can block an adult tooth from erupting at all. When that baby tooth just isn’t budging, an extraction will create space for the permanent tooth to erupt.

If an extraction is scheduled, consult with Drs. Paul Pasternack, Chara Pasternack, and Christine Biondi about these important topics in advance:

• Preparing for the Procedure

A pediatric dentist is an expert not just in caring for little teeth, but in caring for little patients as well. Because extractions can be scary for children, talk to our Vorhees dental team to learn how to prepare your child for the procedure in an informative, comforting, and age-appropriate way.

• Sedation Options

A local anesthetic could be all that’s necessary for a simple extraction. If sedation is recommended for an extraction, or if you feel sedation is better for your child’s needs, discuss nitrous oxide, oral medication, and other options with your dentist.

• Aftercare

Whether it’s how to protect the area around the extraction, which foods and drinks are best over the days following, or how to treat pain and swelling, you’ll be given clear instructions by your pediatric dental team to help your child recover comfortably and quickly.

Little teeth can take different paths on their way to the Tooth Fairy. Your pediatric dentist is an expert both in treating children’s dental needs and in making sure their oral development is on schedule. If your dentist has recommended an extraction, it’s because this is the very best way to protect your child’s immediate oral health while ensuring a healthy future adult smile.

Drs. Paul Pasternack, Chara Pasternack, and Christine Biondi and our team know that as a parent, you want your child to be as healthy as possible. By now, you probably know that your son or daughter’s oral health plays a huge role in overall health.

When there are so many toothpaste ads and different styles of brush to choose from, it can be difficult to know which will serve your child the best. We recommend you break down the decision process to make it simpler.

First, your child’s age and stage of development are vital to consider. Until about the age or 12, your youngster may not be prepared to brush or floss adequately alone, due to dexterity issues. If that’s the case, it can be easier to use a battery-powered toothbrush to improve the quality of brushing.

Next is to select the right size of toothbrush head to fit your child’s mouth. As a general rule, the head of the toothbrush should be a little larger than the upper portion of the child’s thumb.

Flossers are great for children and easy to use. They have handles and a horseshoe shape on one end with floss in between. Your child can choose a color he or she likes as well as the handle size, shape, etc.

Not only are there many brands of toothpaste to choose from, there are also many different ingredients that offer varying benefits. Kids are at high risk for developing cavities so you want to make sure the following ingredients are in your child’s toothpaste if you wish to avoid problems later on.

Sodium fluoride is the standard ingredient for cavity prevention, while stannous fluoride is anti-bacterial and anti-cavity. Anti-sensitivity toothpastes often contain potassium nitrate, and triclosan can be found in one particular brand for anti-bacterial action.

Fluoride should not be ingested, so if your child can’t spit yet, use a toothpaste that contains xylitol. This is a natural sweetener and should be the first ingredient listed on the tube.

Now comes the fun part: choosing a flavor! Your little one may sample different flavors and select the one he or she likes the best. A youngster is more likely to adopt good brushing habits if the flavor is appealing.

Don’t hesitate to speak with Drs. Paul Pasternack, Chara Pasternack, and Christine Biondi if you need to make an appointment at our Vorhees office, or if you have any questions about toothpastes or toothbrushes.

Sometimes the reason for a poor night’s sleep is obvious. Maybe your child watched a scary movie. Or loaded up on sugar before bed. Or can’t get to sleep after a night of computer screens or video games. Not much we can do about these problems.

Sometimes, though, the cause of your child’s sleep difficulties is dental in origin, and that is something Drs. Paul Pasternack, Chara Pasternack, and Christine Biondi can help with.

Teeth grinding, or bruxism, is a very common childhood dental problem. While children with this condition sleep, their jaws clench and their teeth grind against each other throughout the night. When to suspect children might suffer from bruxism? When they experience:

• Frequent headaches or facial pain
• Waking with a sore jaw, or popping or clicking jaw sounds through the day
• Teeth which are chipped, cracked, flattened, worn down, or sensitive
• Waking up tired, because grinding affects the quality of sleep
• Siblings who complain about nocturnal grinding noises, which affect the quality of their

Pain and fatigue are unpleasant enough, but there are additional serious consequences for those who suffer from bruxism. Our jaws are extremely powerful, and clenching and grinding can put hundreds of pounds on pressure on teeth and jaws over a few hours of sleep.

These forces can lead to damaged teeth and dental work, and problems with the temporomandibular joint, or TMJ, the complex hinge that allows our jaws to move up and down, back and forth, and side to side.

Clearly, prevention is clearly a much better option for a healthy smile. And one of the simplest and most effective treatments for preventing the damage caused by bruxism is a night guard.

Night guards fit over the affected teeth to prevent them from touching directly, saving tooth and enamel from injury and wear. Not only do night guards prevent contact, they spread the biting forces of the jaw over the surface of the guard to greatly reduce their impact. And because they also stop the jaw muscles from clenching tightly, there’s no excess stress placed on the temporomandibular joint.

For all these reasons, a night guard is pretty much a slam dunk for adults who grind their teeth. But for children, it’s not necessarily an automatic decision. Why?

• If tooth grinding is mild and appears to be limited to baby teeth, children often outgrow the condition. Your dentist can let you know if you need to do more than monitor the situation.
• Sometimes it seems like your child’s smile changes from day to day. Between losing baby teeth and erupting adult teeth, this beautiful smile is a work in progress. A fitted night guard might not be a perfect fit while your child’s teeth are still coming in and shifting position.
• Finally, jaw and facial pain can also be caused by problems with your child’s bite or misaligned teeth, and that might mean that an orthodontic consultation is in order.

But if you suspect your child is suffering the effects of night time grinding and clenching, give our Vorhees office a call. A thorough examination will provide you with the best diagnosis and solutions for helping your child retain a healthy smile and regain a healthy night’s sleep.

And if a night guard is recommended, a dental professional is the best person to see for the most effective night guard.

While over-the-counter products are available, a custom night guard is designed to fit your child’s individual teeth and mouth perfectly. Impressions or 3D scans are taken in the office, and a guard is fabricated with the precise shape, strength, and thickness needed to protect young teeth. And, as a bonus, custom night guards offer the most comfortable fit for the most comfortable night’s sleep.

Scary movies, a late night sugar rush, mesmerizing video screens—not much we can do about those! But if your child is suffering lost sleep and painful mornings because of tooth grinding, give us a call. A night guard just might be the key to sweet dreams.

Toothaches in children can be tricky ordeals that cause distress for both the child and the parent. You may feel helpless and frustrated because you cannot pinpoint the location of the pain. It is so hard to see your little one experience discomfort and feel like there is nothing you can do about it. But there are ways you can help. Try these tips the next time your child has a toothache.

Zero in on the Painful Area

The first thing you need to do is find out where the pain is coming from. If your child is old enough, ask him or her to point to the painful area. In younger children, look for swelling and redness on the gums and cheek, dental caries (discolorations on the tooth), or broken teeth. Try to get as close to the location of the pain as possible so you can determine an effective course of action to relieve it.

Try to Find the Cause

Not all toothaches are actually toothaches. A child can bite his or her tongue or cheek, have sore gums, or develop ulcers in the mouth. Teeth that are coming in can also be quite painful. If a tooth is discolored, broken, loose, or has spots that are either darker or lighter than the rest of the tooth, those could be causes of pain.

Five-Step Approach to Dental Pain Relief

1. Floss. Help your child floss to remove any food particles that may be wedged between the teeth and could be causing pain.
2. Rinse with warm salt water. Use a warm salt-water solution and have your child rinse well by swishing or holding the salt water over the painful area.
3. Use a cold compress. This can relieve pain and swelling. If there is no swelling, you can try it anyway to subdue the pain. Try it on for about 15 minutes, then off for 20.
4. Give the child ibuprofen or acetaminophen. Use the appropriate dosage for your child’s age and administer it regularly as directed.
5. See Drs. Paul Pasternack, Chara Pasternack, and Christine Biondi. If you determine that the tooth or gum is damaged, or if the pain simply cannot be relieved, call our Vorhees office.

If your child is experiencing throbbing pain, fatigue, or fever, you should call your pediatrician as soon as possible. If your child is experiencing mouth pain accompanied by trouble breathing or swallowing, it can indicate a more serious situation and you should take your son or daughter to the emergency room.

Most mouth pain in children can be remedied with the simple steps here. The important thing is that you remain calm, no matter what. You child is taking cues from you and if you panic, he or she will panic.