If you want raise children with healthy teeth, it is important to have a firm understanding of the basics. Drs. Holly, Iwase, and Shah encourage parents to learn all they can about pediatric dentistry and its role in children’s health.

What is a pediatric dentist?

Pediatric dentists begin as general dentists and then continue their studies for another two to three years. They dedicate their learning to specialized training in the oral health of infants, children, and teens. Each age group requires a different approach due to behavior, growth and development, and the risk of dental problems at that age group.

Why are the primary teeth important?

While primary teeth may not seem as important as permanent teeth because they will eventually fall out, they are vital to your child’s present and future health. Primary teeth serve as the child’s first tools in chewing and speaking, guide the permanent teeth into place, and promote the proper development of the jaw bones and muscles.

Eruption of Your Child’s Teeth

A child’s teeth begin to form while they are in the womb and can erupt as early as four months of age. The first teeth to erupt are typically the lower central incisors. These are followed by the upper central incisors. Pacing and order may vary, but most children have all twenty primary teeth by age three.

Primary teeth begin to fall out and be replaced with permanent teeth around age six. The molars and lower incisors are usually first. By age 21, a person should have 28 to 32 teeth, depending on their wisdom teeth.

A dental emergency can occur at any time and should be treated calmly. Please follow these guidelines when dealing with a dental emergency:


  • Toothache: Clean the affected area with warm water or dental floss to dislodge any food particles. Contact your dentist if the pain persists. Do not place heat or aspirin on the tooth. You can use cold compresses to reduce swelling.
  • Cut or Bitten Tongue, Cheek, or Lip: Apply ice to the injured area to reduce swelling. Apply firm, gentle pressure with gauze or a cloth to any bleeding. If the bleeding cannot be stopped, call a dentist or doctor.
  • Knocked-Out Permanent Tooth: Find the tooth if you can and handle it only by the crown, never the root. Rinse it with water but no soap, and do not scrub it. If the tooth is undamaged, insert it back into the socket have place gauze over it for your child to bite down on. You can also transport the tooth in a cup of saliva or milk. If your child is old enough not to swallow the tooth, they can hold it in their mouth against their cheek. Visit the dentist immediately.
  • Knocked-Out Baby Tooth: In most cases, treatment is not necessary. However, you should consult your dentist about receiving a space maintainer.
  • Chipped or Fractured Permanent Tooth: Contact the dentist right away to save the tooth and prevent infection. Rinse the area with water and use a cold compress to reduce swelling. Save any broken tooth fragments if possible and bring them to the dentist.
  • Chipped or Fractured Baby Tooth: Consult a pediatric dentist.
  • Severe Blow to the Head: Immediately bring your child to the nearest emergency room.
  • Possible Broken or Fractured Jaw: Immobilize the jaw and take your child to the emergency room.

Digital Radiographs (X-rays)

Digital X-rays are an important diagnostic tool for detecting harmful dental conditions. They can detect cavities, survey teeth below the gum line, diagnoses bone conditions, evaluate injuries and aid in planning orthodontic treatment. X-rays allow our dentists to detect issues that cannot be seen by the naked eye, allowing us to begin treatment while problems are still in the early stages.

We recommend dental X-rays every six months to a year, especially for children who are at a high risk of tooth decay. Digital X-rays significantly reduce exposure to radiation and our dentists offer lead aprons, shields and safeguards to further protect your child.

What is the best toothpaste for my child?

Toothpaste is vital to excellent oral health. However, toothpastes that contain harsh abrasives can damage your child’s smile. We recommend selecting a toothpaste approved by the American Dental Association. Ensure that your child spits out any remaining toothpaste to avoid ingesting too much fluoride. Young children should receive only a pea-sized amount or smear of toothpaste.

Does your child grind their teeth at night?

This condition is known as bruxism and is usually characterized by the sound grinding or wear and tear on the teeth. Stress from school or home life can cause a child to begin grinding their teeth. Pressure in the ears is another factor.

Most children do not require treatment for bruxism because they outgrow it between ages 9 and 12 but excessive wear may require a night guard to cushion the teeth and jaws. Speak with your pediatrician or dentist if you have concerns about bruxism.

Thumb Sucking

Thumb sucking is common among infants and young children as a means of security and comfort. It can also induce sleep. Most children outgrow thumb sucking on their own between two and four.

If thumb sucking persists after the eruption of adult teeth, it may disrupt tooth alignment and proper development. Aggressive thumb sucking can pull the teeth forward. Pacifiers can be equally problematic but are easier to control. If you have concerns about your child’s thumb sucking habit, you can try to correct it by:

  • Addressing any causes of anxiety
  • Providing comfort
  • Rewarding your child when they refrain from sucking
  • Visiting the dentist and having them explain to your child that thumb sucking can be harmful
  • Bandaging the thumb or placing a sock on the hand at night
  • Asking your dentist about a mouth appliance

What is pulp therapy?

Pulp therapy maintains a tooth whose inner pulp has been damaged by infection or injury, preserving the tooth from extraction. Pulp therapy is performed as pulpotomy or pulpectomy.

A pulpotomy removes diseased pulp from the crown of the tooth and an anti-bacterial agent is placed in the area. A stainless-steel crown may be placed over the treated tooth.

A pulpectomy removes all of the pulp pulp, even from the root canals. The canals are then cleaned and disinfected. If the tooth is primary, it may be filled with resorbable material. A restoration is then placed to protect and strengthen the tooth.

What is the best time for orthodontic treatment?

Most children should see a dentist by age seven for evaluation. However, some cases of bad bites can be detected by age two or three. Your child may need early orthodontics to prevent a more serious issue later on.

  • Early Treatment: Children age two to six may receive treatment for underdeveloped dental arches, premature loss of baby teeth and harmful habits like thumb sucking. Treatment at this stage may prevent the need for future orthodontic care.
  • Mixed Dentition: Children ages six to twelve receive treatment for improper jaw relationships and dental realignment issues. At this point, your child’s soft and hard tissue is responsive to orthopedic force.
  • Adolescent Dentition: By this stage, a dentist or orthodontist can address the permanent teeth and the final bite.

Adult Teeth Coming in Behind Baby Teeth

This situation is common among children and usually occurs when a lower baby tooth does not fall out as the permanent tooth erupts. Baby teeth usually fall out within two months if wiggled by the child. If the tooth does not fall out, contact our pediatric dentists to have the tooth removed and ensure the primary tooth erupts properly.

You may have more questions about your child’s oral health than what we have addressed. If so, feel free to contact Children’s Dentistry of North Dallas at 214-378-8868 to learn more about pediatric dentistry in Dallas, Texas.